Sleep is an essential component of postoperative recovery. Sleep disturbance is a common postoperative complication that can interfere with recovery and contribute to additional complications. However, it may represent a modifiable risk factor that can be addressed to improve postoperative outcomes (Chouchou et al., 2020). 

There are several reasons patients experience difficulty sleeping after surgery. The hospital environment is often loud and bright, making it difficult for patients to obtain restful sleep. Additionally, postoperative pain can interfere with sleep. Less obvious contributors to sleep disturbance include the aftereffects of anesthesia, opioid use, and postoperative inflammatory responses (Wang et al., 2020). 

Rather than being merely a passive state of rest, sleep plays an active role in regulating immune function, hormonal balance, pain perception, and cognitive recovery. In the postoperative setting, when the body is already under significant physiologic stress, disrupted sleep may amplify inflammatory responses, worsen fatigue, and impair a patient’s ability to participate in early mobilization and other recovery measures. For these reasons, sleep quality should be viewed as part of the broader recovery process rather than as a secondary comfort issue. 

Improved sleep quality has been associated with several important clinical benefits. Research suggests that better sleep is associated with improved immune function, enhanced tissue repair, and decreased inflammation. Poor perioperative sleep has also been associated with worse recovery, including higher pain burden and increased risk of postoperative delirium in some populations. Measures that reduce nighttime disruption, improve pain control, and support sleep hygiene may therefore improve postoperative recovery (Chouchou et al., 2020). 

Preoperative sleep is also an important predictor of postoperative outcomes. For example, one study of patients undergoing rotator cuff repair found that patients with higher sleep quality before surgery experienced less postoperative pain, lower anxiety and depression scores, improved satisfaction with care, and better shoulder function in the early postoperative period. Although the differences between patients with higher versus lower preoperative sleep quality shrank over time, the findings highlight the importance of sleep quality in the immediate postoperative period (Mou et al., 2025). 

Several interventions may improve sleep quality after surgery. Nonpharmacologic measures such as providing eye masks or earplugs may improve sleep quality. Noise-reduction strategies and minimizing nighttime disruptions in postoperative wards may also be beneficial. These interventions are generally low-cost, low-risk, and feasible in many perioperative settings. Simple measures such as clustering overnight vital sign checks and reducing unnecessary alarms may further decrease sleep disruption in hospitalized patients. 

Physicians can also take steps to support patients’ sleep quality. Careful surgical technique and multimodal pain management strategies may reduce tissue trauma, inflammation, and postoperative pain, which may in turn improve sleep quality. Acupuncture and pharmacologic measures may also be helpful, whether by facilitating sleep onset with agents such as melatonin or by improving pain control (Wang et al., 2020). 

Overall, sleep should be considered an essential component of perioperative care rather than simply a comfort measure. Addressing sleep quality through pain control, environmental modifications, and appropriate pharmacologic support may improve postoperative recovery, reduce complications, and improve overall patient satisfaction. Greater attention to sleep may also help clinicians deliver more patient-centered perioperative care. 

References 

1. Chouchou F, Khoury S, Chauny JM, Denis R, Lavigne GJ. Postoperative sleep disturbances: A potential modifiable risk factor for postoperative complications. J Clin Med. 2020;9(6):1841. doi:10.3390/jcm9061841.  
2. Wang JP, Lu SF, Guo LN, Ren CG, Zhang ZW. Poor sleep quality as a risk factor for postoperative delirium: A systematic review and meta-analysis. Front Neurol. 2020;11:629. doi:10.3389/fneur.2020.00629.  
3. Mou L, Zhang W, Liao J, et al. Effect of preoperative sleep quality on rapid postoperative recovery from non-traumatic rotator cuff injuries. Front Med (Lausanne). 2025;12:1587685. Published 2025 Oct 10. doi:10.3389/fmed.2025.1587685.