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Cerebellar malfunction and postoperative sleep disturbances after general anesthesia: a narrative review

  • Sleep Breathing Physiology and Disorders • Review
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Abstract

The cerebellum is widely regarded as a brain region involved in motor processing, non-motor processing, and even sleep-wake cycles. Cerebellar dysfunction may cause changes in the sleep-wake cycle, leading to sleep disturbances. At present, there is limited research on its effect on postoperative sleep after general anesthesia, despite the suspicion of its implication in postoperative sleep disturbances. With this review, we aim to provide a clear and comprehensive review of the cerebellar activity during the normal sleep-wake cycle, the correlation between cerebellar dysfunction and postoperative sleep disturbances, and the effects of general anesthesia on cerebellar dysfunction. Future large-scale multicenter trials are needed to objectively support the present results, identify the initial cerebellar dysfunction to prevent postoperative sleep disturbances, and develop new therapeutic measures targeting sleep disturbances with possible far-reaching implications for neurodegenerative diseases in general.

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Data Availability

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Abbreviations

ML:

molecular layer

GCL:

granule cell layer

NREM:

non–rapid eye movement

REM:

rapid eye movement

MPB:

medial parabrachial nucleus

SWS:

slow-wave sleep

NMDA:

N-methyl-D-aspartate

AD:

Alzheimer’s disease

LC:

the locus coeruleus trajectory

PAG:

periaqueductal gray

PVN:

the parahypothalamic nucleus

OSA:

obstructive sleep apnea

GABA:

gamma-aminobutyric acid

COX:

cyclooxygenase

SP:

senile plaque

PGE2:

prostaglandin E2

p38 MAPK:

P38 mitogen-activated protein kinase

SCN:

suprachiasmatic nucleus

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Acknowledgements

The authors would like to thank Raymond C. Koehler, MD, Ph.D., from the Department of Anesthesiology and Critical Care Medicine, Johns Hopkins University, Baltimore, MD, USA, and Dr. Weifeng Song, MD, Ph.D., from the Department of Anesthesiology and Perioperative Medicine, School of Medicine, the University of Alabama at Birmingham, Birmingham, Alabama, USA, for their discussion and advice on this study.

Funding

The present study was funded by the Joint plan of key R&D plan of Liaoning Provincial Science and Technology Department (2020JH2/10300123), 345 Talent project, and the Support Plan for Innovative Talents in Liaoning Higher Education Institution (grant no. 201834).

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Authors and Affiliations

  1. Department of Anesthesiology, Beijing Friendship Hospital of Capital Medical University, Beijing, China

    Bijia Song

  2. Department of Anesthesiology, Shengjing Hospital of China Medical University, Tiexi District, Huaxiang Road, Shenyang, Liaoning, China

    Bijia Song & Junchao Zhu

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  1. Bijia Song
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Bijia Song helped to contribute to drafting or revising the article. Junchao Zhu helped to revise the article, give final approval of the version to be published, and agreed to be accountable for all aspects of the work.

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Correspondence to Junchao Zhu.

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Song, B., Zhu, J. Cerebellar malfunction and postoperative sleep disturbances after general anesthesia: a narrative review. Sleep Breath 26, 31–36 (2022). https://doi.org/10.1007/s11325-021-02361-9

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