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The relationship between preoperative sleep disturbance and acute postoperative pain control : A systematic review and meta-analysis

Niklasson, Andrea ; Finan, Patrick H ; Smith, Michael T ; Forsberg, Alexandra LU ; Dietz, Nicholas ; Kander, Thomas LU orcid ; Werner, Mads U LU ; Irwin, Michael R ; Kosek, Eva and Bjurström, Martin F (2025) In Sleep Medicine Reviews 79.
Abstract

Poor preoperative sleep quality and impaired sleep continuity may heighten acute postoperative pain intensity and increase analgesic consumption, with negative implications for recovery, mental and physical health. The main objective of the current review was to investigate the relationship between preoperative sleep disturbance and acute postoperative pain control. Four electronic databases were systematically searched from inception to December 2023. Two reviewers screened articles, extracted data, and assessed risk of bias for each included study. The search identified 26 prospective cohort studies and 3 retrospective cohort studies (16104 participants). Of the 29 included studies, 23 focused on preoperative insomnia symptoms, and... (More)

Poor preoperative sleep quality and impaired sleep continuity may heighten acute postoperative pain intensity and increase analgesic consumption, with negative implications for recovery, mental and physical health. The main objective of the current review was to investigate the relationship between preoperative sleep disturbance and acute postoperative pain control. Four electronic databases were systematically searched from inception to December 2023. Two reviewers screened articles, extracted data, and assessed risk of bias for each included study. The search identified 26 prospective cohort studies and 3 retrospective cohort studies (16104 participants). Of the 29 included studies, 23 focused on preoperative insomnia symptoms, and three studies each focused on preoperative objective sleep continuity or sleep-disordered breathing. Meta-analysis, based on five studies with 1226 participants, showed that clinically significant preoperative insomnia symptoms were associated with moderate to severe pain intensity on the first postoperative day (odds ratio 2.69 (95 % confidence interval 2.03-3.57), p < 0.0001). Qualitative analysis showed relatively robust associations between preoperative insomnia symptoms, impaired sleep continuity and poorer acute, as well as subacute, postoperative pain control. Findings related to obstructive sleep apnea syndrome were mixed. Given that insomnia is a potentially modifiable risk factor, interventions targeting sleep prior to surgery may improve postoperative pain control.

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author
; ; ; ; ; ; ; ; and
organization
publishing date
type
Contribution to journal
publication status
published
subject
in
Sleep Medicine Reviews
volume
79
article number
102014
publisher
W.B. Saunders
external identifiers
  • scopus:85208102776
  • pmid:39504912
ISSN
1087-0792
DOI
10.1016/j.smrv.2024.102014
language
English
LU publication?
yes
additional info
Copyright © 2024 The Authors. Published by Elsevier Ltd.. All rights reserved.
id
6b1f6d43-781a-43e0-a086-8c16f3744a8b
date added to LUP
2024-11-11 08:44:21
date last changed
2025-07-09 12:35:11
@article{6b1f6d43-781a-43e0-a086-8c16f3744a8b,
  abstract     = {{<p>Poor preoperative sleep quality and impaired sleep continuity may heighten acute postoperative pain intensity and increase analgesic consumption, with negative implications for recovery, mental and physical health. The main objective of the current review was to investigate the relationship between preoperative sleep disturbance and acute postoperative pain control. Four electronic databases were systematically searched from inception to December 2023. Two reviewers screened articles, extracted data, and assessed risk of bias for each included study. The search identified 26 prospective cohort studies and 3 retrospective cohort studies (16104 participants). Of the 29 included studies, 23 focused on preoperative insomnia symptoms, and three studies each focused on preoperative objective sleep continuity or sleep-disordered breathing. Meta-analysis, based on five studies with 1226 participants, showed that clinically significant preoperative insomnia symptoms were associated with moderate to severe pain intensity on the first postoperative day (odds ratio 2.69 (95 % confidence interval 2.03-3.57), p &lt; 0.0001). Qualitative analysis showed relatively robust associations between preoperative insomnia symptoms, impaired sleep continuity and poorer acute, as well as subacute, postoperative pain control. Findings related to obstructive sleep apnea syndrome were mixed. Given that insomnia is a potentially modifiable risk factor, interventions targeting sleep prior to surgery may improve postoperative pain control.</p>}},
  author       = {{Niklasson, Andrea and Finan, Patrick H and Smith, Michael T and Forsberg, Alexandra and Dietz, Nicholas and Kander, Thomas and Werner, Mads U and Irwin, Michael R and Kosek, Eva and Bjurström, Martin F}},
  issn         = {{1087-0792}},
  language     = {{eng}},
  publisher    = {{W.B. Saunders}},
  series       = {{Sleep Medicine Reviews}},
  title        = {{The relationship between preoperative sleep disturbance and acute postoperative pain control : A systematic review and meta-analysis}},
  url          = {{http://dx.doi.org/10.1016/j.smrv.2024.102014}},
  doi          = {{10.1016/j.smrv.2024.102014}},
  volume       = {{79}},
  year         = {{2025}},
}