Sleep problems are very common in the days and weeks immediately following surgery. Unfortunately, it often happens at a time when you need even more sleep to help recover from the stress of surgery.

You may be affected if you’re sleeping in the hospital or another medical facility rather than in your own home. The problem may be as simple as an uncomfortable pillow or mattress. Or it may be related to your surgery or medication.

This article discusses the reasons you might have trouble sleeping after surgery and how you can improve your sleep.

Causes

There can be many reasons why you are unable to sleep after surgery. Some of the most common include the following:

• • Frequent waking: At the hospital, you may have your vital signs, like blood pressure and temperature, taken every few hours. Also, most hospitals draw labs in the middle of the night. You may have to wake up to take your medications on schedule. You may also need to wake up to do physical therapy or speak with your doctor.

  • Poor airway control: Poor airway control often results in sleep apnea (short periods of not breathing during sleep) and snoring. If you already have these problems, they may worsen after surgery. Narcotic pain medication can decrease airway control during sleep, as can very deep sleep from exhaustion.2

  • Larger surgeries: Longer and more involved procedures often result in poorer sleep. Larger surgeries require longer hospital stays, more attentive care from the medical staff, more medication, more anesthesia, and a longer recovery.

  • Pain: It can be very hard to sleep when you are experiencing pain. Moving in your sleep can cause pain and wake you from a deep sleep. Pain can make it difficult to fall asleep, stay asleep, and reach deep sleep.

• Morphine: Morphine and morphine-based pain medications have a known ability to interfere with sleep. While pain relief can improve sleep, pain medications can often have a side effect of insomnia or “jitters.”3

• Steroids and other drugs: Steroids decrease inflammation, but they often cause difficulty sleeping. This may be remedied by taking steroid medications in the morning. There are also painkillers and other medications that can make you feel groggy when you want to feel wide awake.

• Monitoring devices: If you’re in the hospital, you may have a heart monitor probes on your chest, an oxygen saturation probe on your finger, an IV in your arm, and drainage tubes in your incision wound. These can make you feel as though you are trying to sleep while tangled in a net.

• Noise: Hospitals are noisy places. If you’re having trouble falling asleep or staying asleep, the noise may seem like a marching band walking down the hallways. Your IV pump may start beeping at random times, and you may have a roommate who snores.

• Hunger and thirst: If you’re not permitted to eat, you may find that your hunger or thirst is annoying enough to prevent sleep.

• Room temperature: While many hospitals offer temperature controls in individual patient rooms, many do not. If you prefer a cold room for sleep and your hospital room is warm, you may have difficulty sleeping.

• Light: The light in hospital hallways, the parking lots outside your window, and even night lights may make it difficult to sleep.

• Increased stress hormones: Surgery is emotionally and physically stressful. This can lead to an increase in stress hormones in the body, which in turn makes sleep more challenging.

Tips for Improving Sleep

If you’re having trouble sleeping after surgery, it’s important to try to pinpoint the issue.

If lights are keeping you awake, a sleep mask may help. If you are struggling with noise, ask the staff to decrease the noise level or consider using earplugs. If the temperature is an issue, ask about changing the thermostat before going to sleep.

You may sleep better sitting up in a comfortable chair or with extra pillows, especially if you have sleep apnea or snore. Elevating your head can often decrease these symptoms and allow for more restful sleep.

If medications are interfering with sleep, ask your healthcare provider if they can adjust the dose or switch you to another drug. If pain medications are the problem, you may benefit from switching to a non-opioid pain reliever like Tylenol (acetaminophen) or Advil (ibuprofen).

Bear in mind that over-the-counter pain relievers may not be as effective as their prescription counterparts. Weigh the benefits and potential consequences before requesting a change.

You may need to ask family members to keep visits short if they are causing you stress. (This can be a big factor in the risk of insomnia.) Most of all, don’t stay silent if you’re having trouble sleeping. The less sleep you have, the slower your recovery may be.

Using Sleeping Pills

Many medications and supplements are available to enhance sleep. It’s important to speak with your healthcare provider before starting a sleep aid. That’s because many medications given after surgery, particularly pain medications and anti-anxiety medicine, can cause sedation.

Combining sedating medications can lead to dangerous decreases in your body’s drive to breathe. Even an over-the-counter medication, such as Benadryl, can cause breathing problems when combined with pain medication.

Clearly, the biggest concern about sleeping pills is the risk of dependence. You should never use sleeping pills for more than a few weeks and only when needed. If overused, you may be unable to sleep without them—a clear sign of dependence. You might also experience a rebound effect in which the drug interferes with your sleep.

Summary

Sleep problems are common in the days and weeks after surgery. A number of factors may affect your ability to get a good night’s sleep. It may be related to your hospital environment, such as the level of noise, frequent interruptions, or uncomfortable monitoring devices. You may be dealing with issues such as poor airway control or pain that wakes you up.
Let your doctor know if you’re having any trouble sleeping. They can help you find a solution, whether it’s changing your sleeping environment or trying a different medication.