POSTOPERATIVE SLEEP DISTURBANCE - CAUSES, FACTORS AND EFFECTS ON OUTCOME

Post-operative sleep disturbance, with suppression of rapid eye moveme nt sleep and slow wave sleep followed by a subsequent rebound, seems t o be related to the magnitude of trauma and thereby to the surgical st ress response. In this context, cortisol, autonomic stimulation, and c ertain cytokines may lead to abnormal sleep. Furthermore, the environm ent, pain and the administration of analgesics seem to be important fa ctors in the precipitation of sleep abnormalities. Post-operative slee p disturbance may contribute to the development of episodic hypoxaemia , haemodynamic instability and altered mental status, all of which hav e an influence on post-operative morbidity and mortality. Prevention o r reduction of the post-operative sleep disturbance may be achieved by minimizing surgical trauma, changing the conventional nursing procedu res, avoiding opioids and treating pain with non-opioid analgesics, al though none of these methods has been thoroughly studied. Post-operati ve sleep disturbance represents an important research field, since it may have a significant adverse impact on post-operative outcome.