Study: Poor sleep before surgery boosts risk of postoperative delirium

Editor's Note

Poor sleep quality in the month leading up to surgery could increase the risk of postoperative delirium, according to research presented at the Anesthesiology 2024 annual meeting, hosted by the American Society of Anesthesiologists (ASA). An October 15 report in NewsWise has the details.

According to the article, postoperative delirium affects up to 15% of surgical patients and is particularly prevalent in high-risk groups, such as older adults and those undergoing hip fracture surgeries. Although insomnia is a known risk factor, this  is reportedly the first study to directly assess preoperative sleep quality as a predictive factor. 

Researchers reportedly focused on 150 patients aged 18 and over who were undergoing general anesthesia for non-cardiac surgeries, mostly abdominal and gynecologic procedures lasting over two hours. Using the Pittsburgh Sleep Quality Index (PSQI), patients assessed their sleep in categories such as duration, disturbance, efficiency, and use of sleep medications.  

Results showed that 44 patients reported poor sleep, with 11 (25%) of these individuals developing postoperative delirium. In contrast, among the 106 patients who reported good sleep quality, 19 (17.9%) experienced delirium. The study found a 39.66% higher incidence of delirium among patients who had poor sleep compared to those with better sleep quality.

Researchers suggested that healthcare providers encourage preoperative sleep preparation to help mitigate delirium risks. Practical recommendations to improve sleep quality include:

• Maintaining a consistent sleep schedule
• Establishing a calming pre-sleep routine, such as reading or taking a warm bath
• Keeping the sleep environment cool, dark, and quiet
• Avoiding screens at least an hour before bed
• Staying active during the day but avoiding exercise close to bedtime
• Practicing stress-reduction techniques (mindfulness, deep breathing)