Effects of anesthesia and surgery on sleep

Profound sleep disturbance is common for at least 6 days following anesthesia and surgery. The magnitude of the disturbance appears to be more related to the magnitude of surgery, and anesthesia seems to be of less importance. In general, NREM sleep is reduced for 4 nights postoperatively and REM sleep is abolished for the first (and sometimes the second) postoperative night. There is a significant REM rebound thereafter. This may explain the increased incidence of hypoxemia during this period. Etiological factors involved in the sleep disturbance include the surgical stress response, fever, pain, opioid administration, starvation, age, psychological factors, preoperative sleep architecture, and environmental factors.

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