Name: Melanie A.

Galedo
Section: BSN 13-A
CASE ANALYSIS

Postoperative sleep disorders and their potential impacts on surgical outcomes

Abstract
Postoperative sleep disturbance is a common occurrence with significant adverse
effects on patients including delayed recovery, impairment of cognitive function, pain
sensitivity and cardiovascular events. The development of postoperative sleep
disturbance is multifactorial and involves the surgical inflammatory response, the
severity of surgical trauma, pain, anxiety, the use of anesthetics and environmental
factors such as nocturnal noise and light levels. Many of these factors can be managed
perioperatively to minimize the deleterious impact on sleep. Pharmacological and non-
pharmacological treatment strategies for postoperative sleep disturbance include
dexmedetomidine, zolpidem, melatonin, enhanced recovery after surgery (ERAS)
protocol and controlling of environmental noise and light levels. It is likely that a
combination of pharmacological and non-pharmacological therapies will have the
greatest impact; however, further research is required before their use can be routinely
recommended.

Reference: Rampes, S. et al (2019). Postoperative sleep disorders and their potential

impacts on surgical outcomes. The Journal of Biomedical
Research, {articleBase.volume}(${articleBase.issue}),
https://doi.org/10.7555/jbr.33.20190054
Reflection

Rest unsettling influence is a typical event in post-operative patients, especially in

those admitted to the emergency unit who undergone major surgeries. Postoperative
rest aggravation happens because of various variables, such as mature age,
preoperative comorbidity, sort of sedation, seriousness of careful injury, postoperative
torment, condition worry, just as different elements prompting distress of patients. If not
oversaw, postoperative rest aggravation can prompt postponed recuperation and
expanded dreariness. While postoperative rest unsettling influence itself is very much
perceived, its antagonistic impacts on patients are definitely not. Advancement of rest
aggravations produces hurtful consequences for postoperative patients, that is,
prompting higher danger of incoherence, expanded affectability to torment, more
cardiovascular occasions, and more unfortunate recuperation.
Sleep is an important aspect that needs attention and proper intervention in order to
reduce the harmful effect that it can do to the post-operative recovery of the patient.
Because of the decreased sleep time and increase arousal or awakening it can lower
the immune system and the ability of the system to repair such damage that body
received during the major surgery. One of the major effects is pain, the relationship
between sleep and pain is reciprocal; poor sleep can lead to increased in sensitivity to
pain thus will result to higher analgesic intake. According to Rampes, S. et al (2019)
major surgical trauma is thought to be accompanied by a period of immunosuppression
which can lead to infection or surgical trauma, the quality of sleep on the first night
postoperatively can be an important determinant of duration in hospital stay a high
quality sleep was associated with a shorter hospital stay and vice vera to those who
have problem in sleeping pattern. Nonpharmacological measure is used to increased
sleeping pattern of the patient such as maintaining a quiet and dim environment and
decreasing interruptions from care activities at night, improve sleep quality and sleep
efficiency. A meta-analysis showed that the use of ear plugs and eye mask is also
helpful in promoting sleep among patients in ICU. Pharmacological measure is also
practiced in order to help improve patient who have a high difficulty in getting sleep and
showed a negative response in their health Dexmedetomidine, Melatonin, and Zolpidem
are mostly used to pharmacological measure.
Postoperative sleep disturbance is a study or a phenomenon that is well studied and
still studied by many because there are so many factors that can affect the sleeping
pattern of an individual and it can change from situation to situation. This type of study
can highly contribute to the health and wellbeing of our patients, it can contribute on
how the health care workers will handle the situation through prevention and treatment
regime as well drive awareness to the community.