Surgical Aftermath: Understanding Insomnia Causes and Solutions
Post-surgical insomnia is a common issue that many patients face, with symptoms such as difficulty falling asleep, frequent nighttime awakenings, and early morning awakenings with inability to return to sleep.
Causes of Post-Surgical Insomnia
The root causes of insomnia after surgery are varied. Surgical stress, postoperative pain, anxiety, and the effects of anesthesia and hospital environment factors like noise and disruption of normal routines are common culprits. Neuropathic pain related to surgical sites, especially in musculoskeletal-related surgeries like spinal procedures, can also significantly contribute to sleep disturbances. Inflammatory response after surgery and certain medications used during or after surgery, including general anesthesia, can also cause insomnia, particularly in older adults.
Symptoms of Post-Surgical Insomnia
The symptoms of post-surgical insomnia mirror those of general insomnia, leading to non-restorative sleep and daytime impairment such as fatigue, irritability, concentration difficulties, and mood disturbances.
Treatment Options for Post-Surgical Insomnia
Treatment for post-surgical insomnia focuses on managing the underlying causes. Effective pain control to reduce neuropathic or musculoskeletal pain, addressing anxiety related to the surgical experience, and maintaining good sleep hygiene are key strategies. Cognitive behavioral therapy for insomnia (CBT-I) is an evidence-based psychological treatment shown to help improve insomnia symptoms even in patients with chronic pain conditions.
Managing Insomnia While in the Hospital
While in the hospital, making the bed comfortable, blocking out noise and light, discussing pain management or temporary sleep aids with a doctor, and discussing medications that could be worsening sleep with a doctor can help improve sleep. After leaving the hospital, keeping the sleeping area dark, cool, and quiet, using blackout blinds or curtains, using pillows to prop the body in a comfortable position, allowing the person to sleep by themselves, avoiding large meals late in the evening, going to sleep and waking up at the same time every day can help reduce disruptions and improve sleep.
Persistent Insomnia
If insomnia persists, it is important to discuss this with a doctor. In some cases, insomnia can be due to an underlying condition that requires diagnosis and treatment. Most cases of insomnia after surgery resolve on their own, but if it persists beyond the first week, a person should contact a doctor. A doctor may recommend medications or lifestyle changes to treat insomnia, or refer a person to a sleep specialist if insomnia persists.
Safety Precautions
It is crucial to avoid taking sleeping aids after surgery or any other time without consulting a doctor. Some medications, including over-the-counter sleep aids and natural supplements, can interact with anesthesia or other drugs. People should not change the dosage of any medication or start taking new sleep aids without discussing it with a doctor first, as this could cause serious side effects.
A 2022 longitudinal study showed significant alterations in sleep patterns during the first 6 nights after surgery, with sleep returning to usual levels within the first week for most people. However, hospital patients may experience disruptions due to regular medical checks and specific medication or test times.
In sum, post-surgical insomnia is a common issue that can have a significant impact on a patient's recovery. Understanding the causes, recognising the symptoms, and implementing effective treatment strategies can help improve sleep quality and aid overall surgical recovery.
- Some patients may find relief from post-surgical insomnia by considering sleep supplements, but it's crucial to consult with a doctor before starting any new sleep aids to avoid potential drug interactions with anesthesia or other medications.
- In addition to physical health-and-wellness concerns, post-surgical insomnia can also have mental-health implications, as persistent sleep disturbances can lead to fatigue, irritability, and mood disturbances.
- Although surgery can lead to other medical-conditions requiring attention, such as othersurgeries, it's not uncommon for the effects of surgery to also include sleep disruptions and insomnia.
- To prevent sleep disturbances and insomnia, science emphasizes the use of evidence-based strategies like cognitive behavioral therapy for insomnia (CBT-I), good sleep hygiene, and effectively managing pain before and after surgery.
