Skip to main content
SpringerLink
Log in

Association between sleep quality and general anesthesia in teenager under elective surgery: a prospective study

  • Original Article
  • Published:
Irish Journal of Medical Science (1971 -) Aims and scope Submit manuscript

Abstract

Objective

Anesthesia was reported to be associated with lowered postoperative sleep quality in adults, but its effect on teenager was less understood. This study was conducted to explore the association between postoperative sleep quality and general anesthesia in teenagers.

Methods

A prospective study was conducted. Teenagers aged from 12 to 16 years who were treated with general anesthesia and under urologic or otolaryngologic surgery were recruited. Healthy teenagers matched by sex and age (± 3 years) with the specific case were recruited as the controls. The Sleep Habits Questionnaire was applied to assess the sleep quality of the teenagers. We applied a logistic regression analysis to evaluate the association between general anesthesia in teenagers under elective surgery and poor sleep quality. Risk ratio (RR) and its corresponding 95% confidence interval (CI) were computed.

Results

A total of 212 teenagers were included comprising 106 patients with general anesthesia who underwent urologic or otolaryngologic surgery and 106 healthy controls. The male participants were accounting for 47.2% (100/212). Anesthesia duration and surgery duration in the patients were 103.7 ± 14.4 min and 162.1 ± 17.0 min, respectively. Positive associations between general anesthesia and poor sleep quality in the 1st, 3rd, and 7th postoperative days were found, and RRs and their corresponding 95%CIs were 4.87 (1.72–13.79), 3.33 (1.22–9.1), and 3.26 (1.07–9.93), respectively. However, there was a lack of statistical associations before surgery and after 14 postoperative days.

Conclusions

Teenagers who were treated with general anesthesia and under urologic or otolaryngologic surgery might have poor sleep quality within 7 postoperative days.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Log in via an institution

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Institutional subscriptions

Fig. 1
Fig. 2
Fig. 3
Fig. 4
Fig. 5
Fig. 6

Similar content being viewed by others

Data availability

The data that support the findings of this study are available from the corresponding author upon reasonable request.

References

  1. Stinson JN, Hayden JA, Ahola KS et al (2014) Sleep problems and associated factors in children with juvenile idiopathic arthritis: a systematic review[J]. Pediatr Rheumatol Online J 12:19

    Article  Google Scholar 

  2. Liu KA, Liu CC, Alex G et al (2020) Anesthetic management of children undergoing drug-induced sleep endoscopy: a retrospective review[J]. Int J Pediatr Otorhinolaryngol 139:110440

  3. Pavlova M, Kopala-Sibley DC, Nania C et al (2020) Sleep disturbance underlies the co-occurrence of trauma and pediatric chronic pain: a longitudinal examination[J]. Pain 161(4):821–830

    Article  Google Scholar 

  4. Luo M, Song B, Zhu J (2020) Sleep disturbances after general anesthesia: current perspectives [J]. Front Neurol 11:629

    Article  Google Scholar 

  5. Wenk M, Pöpping DM, Chapman G et al (2013) Long-term quality of sleep after remifentanil-based anaesthesia: a randomized controlled trial[J]. Br J Anaesth 110(2):250–257

    Article  CAS  Google Scholar 

  6. Kushikata T, Sawada M, Niwa H et al (2016) Ketamine and propofol have opposite effects on postanesthetic sleep architecture in rats: relevance to the endogenous sleep-wakefulness substances orexin and melanin-concentrating hormone[J]. J Anesth 30(3):437–443

    Article  Google Scholar 

  7. Rabbitts JA, Groenewald CB, Tai GG et al (2015) Presurgical psychosocial predictors of acute postsurgical pain and quality of life in children undergoing major surgery[J]. J Pain 16(3):226–234

    Article  Google Scholar 

  8. Selvadurai S, Maynes JT, McDonnell C et al (2018) Evaluating the effects of general anesthesia on sleep in children undergoing elective surgery: an observational case-control study[J]. Sleep 41(8)

  9. Owens JA, Spirito A, McGuinn M (2000) The Children’s Sleep Habits Questionnaire (CSHQ): psychometric properties of a survey instrument for school-aged children[J]. Sleep 23(8):1043–1051

    Article  CAS  Google Scholar 

  10. Li SH, Jin XM, Shen XM et al (2007) Development and psychometric properties of the Chinese version of Children’s Sleep Habits Questionnaire][J. Zhonghua Er Ke Za Zhi 45(3):176–180

    PubMed  Google Scholar 

  11. Tsai PS, Wang SY, Wang MY et al (2005) Psychometric evaluation of the Chinese version of the Pittsburgh Sleep Quality Index (CPSQI) in primary insomnia and control subjects[J]. Qual Life Res 14(8):1943–1952

    Article  CAS  Google Scholar 

  12. Sullivan M, Bishop SR, Pivik J (1995) The Pain Catastrophizing Scale: development and validation [J]. Psychol Assess 7(4):524–532

    Article  Google Scholar 

  13. Terkawi AS, Sullivan M, Abolkhair A et al (2017) Development and validation of Arabic version of the pain catastrophizing scale[J]. Saudi J Anaesth 11(Suppl 1):S63–S70

    Article  Google Scholar 

  14. Lam CL, Tse EY, Gandek B (2005) Is the standard SF-12 health survey valid and equivalent for a Chinese population? [J]. Qual Life Res 14(2):539–547

    Article  Google Scholar 

  15. Waxman JA, Shenouda KG, Lin HS (2020) Assessment and management of postoperative pain associated with sleep apnea surgery [J]. Otolaryngol Clin North Am 53(5):765–777

    Article  Google Scholar 

  16. Luo ZY, Li LL, Wang D et al (2019) Preoperative sleep quality affects postoperative pain and function after total joint arthroplasty: a prospective cohort study[J]. J Orthop Surg Res 14(1):378

    Article  Google Scholar 

  17. Strutz PK, Kronzer V, Tzeng W et al (2019) The relationship between obstructive sleep apnoea and postoperative delirium and pain: an observational study of a surgical cohort[J]. Anaesthesia 74(12):1542–1550

    Article  CAS  Google Scholar 

  18. Devlin JW, Skrobik Y, Gélinas C et al (2018) Clinical practice guidelines for the prevention and management of pain, agitation/sedation, delirium, immobility, and sleep disruption in adult patients in the ICU[J]. Crit Care Med 46(9):e825–e873

    Article  Google Scholar 

  19. Song B, Li Y, Teng X et al (2020) Comparison of morning and evening operation under general anesthesia on intraoperative anesthetic requirement, postoperative sleep quality, and pain: a randomized controlled trial [J]. Nat Sci Sleep 12:467–475

    Article  Google Scholar 

  20. Li S, Song B, Li Y et al (2021) Effects of intravenous anesthetics vs inhaled anesthetics on early postoperative sleep quality and complications of patients after laparoscopic surgery under general anesthesia [J]. Nat Sci Sleep 13:375–382

    Article  Google Scholar 

  21. Song B, Li Y, Teng X et al (2019) The effect of intraoperative use of dexmedetomidine during the daytime operation vs the nighttime operation on postoperative sleep quality and pain under general anesthesia [J]. Nat Sci Sleep 11:207–215

    Article  Google Scholar 

  22. Pick J, Chen Y, Moore JT et al (2011) Rapid eye movement sleep debt accrues in mice exposed to volatile anesthetics[J]. Anesthesiology 115(4):702–712

    Article  Google Scholar 

  23. Abeysuriya RG, Lockley SW, Robinson Pa et al (2018) A unified model of melatonin, 6-sulfatoxymelatonin, and sleep dynamics[J]. J Pineal Res 64(4):e12474

  24. Kapek Ł, Paprocka J, Kijonka M et al (2020) Circadian profile of salivary melatonin secretion in hypoxic ischemic encephalopathy [J]. Int J Endocrinol 2020:6209841

    Article  Google Scholar 

  25. Coppola S, Caccioppola A, Chiumello D (2020) Internal clock and the surgical ICU patient[J]. Curr Opin Anaesthesiol 33(2):177–184

    Article  Google Scholar 

  26. Madrid-Navarro CJ, Sanchez-Galvez R, Martinez-Nicolas A et al (2015) Disruption of circadian rhythms and delirium, sleep impairment and sepsis in critically ill patients. Potential therapeutic implications for increased light-dark contrast and melatonin therapy in an ICU environment [J]. Curr Pharm Des 21(24):3453–3468

  27. Song Y, Liu Y, Yuan Y et al (2021) Effects of general versus subarachnoid anaesthesia on circadian melatonin rhythm and postoperative delirium in elderly patients undergoing hip fracture surgery: a prospective cohort clinical trial[J]. EBioMedicine 70:103490

  28. Cao Z, Fang Y, Lu Y et al (2017) Melatonin alleviates cadmium-induced liver injury by inhibiting the TXNIP-NLRP3 inflammasome[J]. J Pineal Res 62(3)

  29. Muñoz-Hoyos A, Heredia F, Moreno F et al (2002) Evaluation of plasma levels of melatonin after midazolam or sodium thiopental anesthesia in children[J]. J Pineal Res 32(4):253–256

    Article  Google Scholar 

  30. Potts AL, Cheeseman JF, Warman GR (2011) Circadian rhythms and their development in children: implications for pharmacokinetics and pharmacodynamics in anesthesia[J]. Paediatr Anaesth 21(3):238–246

    Article  Google Scholar 

  31. Qiu Q, Song X, Sun C et al (2021) Effect of general anesthesia on postoperative melatonin secretion in 4-to 6-year-old children with snoring][J. Nan Fang Yi Ke Da Xue Xue Bao 41(1):128–134

    CAS  PubMed  Google Scholar 

  32. Kain ZN, Caldwell-Andrews AA, Weinberg ME et al (2005) Sevoflurane versus halothane: postoperative maladaptive behavioral changes: a randomized, controlled trial[J]. Anesthesiology 102(4):720–726

    Article  CAS  Google Scholar 

  33. Wu XH, Cui F, Zhang C et al (2016) Low-dose dexmedetomidine improves sleep quality pattern in elderly patients after noncardiac surgery in the intensive care unit: a pilot randomized controlled trial [J]. Anesthesiology 125(5):979–991

    Article  CAS  Google Scholar 

Download references

Author information

Authors and Affiliations

  1. Anesthesiology Department, The Fifth Affiliated Hospital of Wenzhou Medical University, Lishui Municipal Central Hospital, Zhejiang, 323000, Lishui City, People’s Republic of China

    Fang Zheng, Wu Wang, Kai-lai Zhu, Hai-lin Xing & Lei-ming Ding

  2. Infectious Disease, Lishui Hospital of Traditional Chinese Medicine, Zhejiang, 323000, Lishui City, People’s Republic of China

    Zhen-hui Zheng

  3. Department of Orthopaedic Surgery, The Fifth Affiliated Hospital of Wenzhou Medical University, Lishui Municipal Central Hospital, Zhejiang, 323000, Lishui, People’s Republic of China

    Hai-lin Xing

Authors
  1. Fang Zheng
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. Zhen-hui Zheng
    View author publications

    You can also search for this author in PubMed Google Scholar

  3. Wu Wang
    View author publications

    You can also search for this author in PubMed Google Scholar

  4. Kai-lai Zhu
    View author publications

    You can also search for this author in PubMed Google Scholar

  5. Hai-lin Xing
    View author publications

    You can also search for this author in PubMed Google Scholar

  6. Lei-ming Ding
    View author publications

    You can also search for this author in PubMed Google Scholar

Contributions

F.Z. and L.M.D. contributed to the study concept and design. F.Z. contributed to the literature review and manuscript writing. F.Z., Z.H.Z., W.W., and K.L.Z. contributed to the data collection and analysis. Z.H.Z. and W.W. contributed to the data collection. All the authors approved the final version of the article for submission.

Corresponding author

Correspondence to Lei-ming Ding.

Ethics declarations

Ethics approval

Ethics committee approval was obtained from the Lishui City People’s Hospital. This study was performed in line with the principles of the Declaration of Helsinki.

Consent to participate

Informed consent was obtained from all individual participants included in the study.

Conflict of interest

The authors declare no competing interests.

Additional information

Publisher's Note

Springer Nature remains neutral with regard to jurisdictional claims in published maps and institutional affiliations.

Rights and permissions

Reprints and permissions

About this article

Check for updates. Verify currency and authenticity via CrossMark

Cite this article

Zheng, F., Zheng, Zh., Wang, W. et al. Association between sleep quality and general anesthesia in teenager under elective surgery: a prospective study. Ir J Med Sci 191, 2297–2303 (2022). https://doi.org/10.1007/s11845-021-02847-1

Download citation

  • Received:

  • Accepted:

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s11845-021-02847-1

Keywords

Search

Navigation