Written by: Reneé Prince
Reviewed by: Dr. Sherrie Neustein
Updated March 18, 2021
Adequate sleep is crucial to maintaining mental, physical, and emotional health. Pain, medication, insomnia, and other sleep disturbances associated with surgery all too frequently get in the way of the sleep needed to support recovery (1) after surgery. You need sleep to heal, and after surgery, you might require extra help to receive the seven to nine hours you need. Sleep-supportive lifestyle changes and close consultation with your medical providers can put you on the path to better sleep after an operation.
How Can Sleep Help Me Manage Post-Op Pain?
In general, if you struggle with sleep before surgery, you may experience more pain (2) after your operation, which can make your sleep struggles worse. Poor sleep quality prior to surgery can also lead to an increased recovery time (3) after surgery.
Research suggests that sleep and pain both affect each other, which can create a negative spiral. As poor sleep enhances pain, that pain decreases a person's pain tolerance. Together, increased pain and decreased pain tolerance further disrupt sleep (4). At the same time, sleepiness, which often results from a lack of sleep, can reduce the effectiveness of pain medication (5), making it more difficult to manage pain and stop the cycle.
Poor sleep or a lack of sleep due to pain before surgery can affect your pain levels and recovery time after surgery. To make your recovery easier, focus on good sleep habits in the weeks before surgery, such as:
- Keeping a regular bedtime
- Waking up at the same time every day
- Stopping caffeine consumption in the early afternoon
- Shutting off electronics two hours before bed
- Avoiding heavy, high-fat meals close to bedtime
Also, talk to your physician, who may prescribe pain medication or suggest over-the-counter solutions to help you rest easier as you prepare for surgery.
Post-op pain is a natural part of the surgery recovery process, so your goal should be to manage and minimize it. Talk to your physician about pain medications that will not interfere with your sleep. Unfortunately, opioids can often disrupt your sleep (6). However, acetaminophen and ibuprofen (7) are less disruptive, making it easier to get back to a normal sleep schedule after surgery.
Medication isn’t the only way to manage post-op pain. In some cases, extra pillows, a heating pad, or ice packs can temporarily relieve symptoms enough for better sleep. Mind-body therapies (8) such as imagery, hypnosis, and relaxation techniques can relieve post-operative pain when used prior to surgery (9). Using a guided meditation app on your phone or simply learning deep breathing exercises before surgery could help you manage post-op pain more successfully.
How Do I Reduce the Effects of Anesthesia on Sleep?
Anesthesia changes (10) the structure of your sleep cycle, leading to sleep disruption. Consequently, anesthesia can also affect your metabolism, blood pressure, energy levels, and cardiovascular health. Older adults are also more likely to experience delirium (11) after general anesthesia, especially if they have pre-surgery sleep problems.
You may look like you’re asleep when under anesthesia, but these medications actually disrupt the sleep cycle (12). They alter the entrance into and timing of sleep phases, preventing the body from reaching the deepest sleep levels.
Some types of anesthesia affect the sleep cycle more than others. For example, in some cases, regional anesthesia has less of an effect on post-op sleep than general anesthesia. The types of painkillers used after the surgery affect sleep, too.
However, an anesthesiologist will determine the best medication for you based on your medical history and the type of surgery. You may ask your anesthesiologist about what medication they will use and the potential side effects on your sleep. They may not change the medication, but together, you can determine what you can do to minimize negative effects and figure out your post-op treatment plan.
How Can I Minimize the Impact of Medications?
Most people take several medications after surgery, such as pain medications, muscle relaxers, and blood pressure medication. For example, muscle relaxers may be used before surgery in conjunction with anesthesia, while blood pressure medication is given after surgery.
Muscle relaxers can increase the chances of sleep apnea, potentially causing snoring or frequent waking. Blood pressure medications, depending on the type, can either make you drowsy or cause insomnia. Some medications may make it difficult to stay awake during the day, while others cause insomnia. It all depends on the type of surgery, the medications, and how they interact with your unique biochemistry.
Talk to your physician if any medications are interfering with your overall well-being, including sleep. Opioids, also known as narcotic pain medications, cause more sleep disturbances than acetaminophen and ibuprofen. You may be able to switch to a medication with fewer sleep side effects so that you can rest better.
How Can I Relieve Insomnia by Identifying and Managing Post-Op Stress?
A good first step in relieving insomnia is identifying the cause of the problem. For some people, it’s pain. For others, it’s medication. Your sleep disturbances may also come from the stress of recovery. It could be as simple as an environmental issue, like bright lights or being in a hospital room next to a noisy street. Stress may also come from sources unrelated to surgery. Family or financial concerns may weigh heavily on your mind in addition to the physical demands of surgery.
Meditation can be helpful in managing stress that leads to insomnia. Deep breathing exercises and guided meditation help you focus on where you are in the moment, which reduces the stress caused by everything outside of recovery. Meditation won’t make your problems go away, but it can help you relax.
Well-intentioned visits from family and friends could be causing undue stress, too. Advocate for yourself or have someone you trust advocate for you if you’re incapacitated. Make your needs known so that you can rest. You may need extra help at home taking care of housework, cooking, and children. Tap into your social support system to make sure you get the sleep you need.
How Can I Improve Environmental Factors That Affect Sleep?
Environmental factors can cause major sleep disturbances, especially while in the hospital. Unfamiliar sounds, smells, and bright lights might make it difficult to rest. Bring earplugs and a sleep mask in your hospital bag. The room temperature may also interfere with sound sleep. Ask for extra blankets or lower the room temperature if you’re too hot. You may rest better sleeping in a chair or with extra pillows in the bed.
Take the time to create a relaxing, dark, cool sleep environment at home, too. You may still need earplugs and a sleep mask for a while. Do whatever you can to make sleep a priority in the hospital and at home.
A Final Note
Adequate sleep after surgery promotes healing and recovery. Make sleep a priority before going into surgery. Stay in close contact with your physician and support system after surgery so you can make adjustments to your treatment plan if needed. Better sleep can help you heal faster and face the challenges of any complications that may arise.
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