Journal of Dental Anesthesia and Pain Medicine

The Korean Dental Society of Anesthsiology (대한치과마취과학회)
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Influence of general anesthesia on the postoperative sleep cycle in patients undergoing surgery and dental treatment: a scoping review on the incidence of postoperative sleep disturbance

  • Terumi Ayuse (Nagasaki University Hospital, Department of Special Care Dentistry) ;
  • Shinji Kurata (Nagasaki University Graduate School of Biomedical Science, Department of Clinical Physiology) ;
  • Gaku Mishima (Nagasaki University Hospital, Department of Dental Anesthesia) ;
  • Mizuki Tachi (Nagasaki University Hospital, Department of Dental Anesthesia) ;
  • Erika Suzue (Nagasaki University Hospital, Department of Dental Anesthesia) ;
  • Kensuke Kiriishi (Nagasaki University Hospital, Department of Special Care Dentistry) ;
  • Yu Ozaki-Honda (Nagasaki University Hospital, Department of Special Care Dentistry) ;
  • Takao Ayuse (Nagasaki University Hospital, Department of Special Care Dentistry)
  • Received : 2023.02.25
  • Accepted : 2023.03.13
  • Published : 2023.04.01
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Abstract

General anesthesia may influence the postoperative sleep cycle; however, no clinical studies have fully evaluated whether anesthesia causes sleep disturbances during the postoperative period. In this scoping review, we explored the changes in postoperative sleep cycles during surgical procedures or dental treatment under general anesthesia. We compared and evaluated the influence of general anesthesia on sleep cycles and sleep disturbances during the postoperative period in adult and pediatric patients undergoing surgery and/or dental treatment. Literature was retrieved by searching eight public databases. Randomized clinical trials, observational studies, observational case-control studies, and cohort studies were included. Primary outcomes included the incidence of sleep, circadian cycle alterations, and/or sleep disturbances. The search strategy yielded six studies after duplicates were removed. Finally, six clinical trials with 1,044 patients were included. In conclusion, general anesthesia may cause sleep disturbances based on alterations in sleep or the circadian cycle in the postoperative period in patients scheduled for elective surgery.

Keywords

Acknowledgement

The authors would like to thank all the staff at the Department of Dental Anesthesiology and Special Care Dentistry, Nagasaki University Hospital for their support.

References

  1. Knill RL, Moote CA, Skinner MI, Rose EA. Anesthesia with abdominal surgery leads to intense REM sleep during the first postoperative week. Anesthesiology 1990; 73: 52-61. https://doi.org/10.1097/00000542-199007000-00009
  2. Rosenberg J, Wildschiodtz G, Pedersen MH, von Jessen F, Kehlet H. Late postoperative nocturnal episodic hypoxaemia and associated sleep pattern. Br J Anaesth 1994; 72: 145-50. https://doi.org/10.1093/bja/72.2.145
  3. Song B, Zhu J. A narrative review of the impact of cerebellar dysfunction and sleep disturbances after general anesthesia in patients with Alzheimer's disease. Ann Palliat Med 2021; 10: 6919-25. https://doi.org/10.21037/apm-20-2597
  4. Song B, Zhu J. Cerebellar malfunction and postoperative sleep disturbances after general anesthesia: a narrative review. Sleep Breath 2022; 26: 31-6. https://doi.org/10.1007/s11325-021-02361-9
  5. Moody OA, Zhang ER, Vincent KF, Kato R, Melonakos ED, Nehs CJ, et al. The neural circuits underlying general anesthesia and sleep. Anesth Analg 2021; 132: 1254-64. https://doi.org/10.1213/ANE.0000000000005361
  6. Ayuse T, Kurata S, Sanuki T, Mishima G, Kiriishi K, Kawai M, et al. Effects of general anesthesia on postoperative sleep cycles in dentally disabled patients. Spec Care Dentist 2019; 39: 3-9. https://doi.org/10.1111/scd.12335
  7. Wang Y, Liu J, Jin Z, Li W, Wei L, Yang D, et al. Effects of multiple exposures to general anesthesia on the sleep quality of children after plastic surgery in Beijing, China: a cohort study. Sleep Biol Rhythms 2022; 20: 509-19. https://doi.org/10.1007/s41105-022-00397-2
  8. Matton S, Romeo GP. Behavioral regression in 2 patients with autism spectrum disorder and attention-deficit/ hyperactivity disorder after oral surgery performed with a general anesthetic. J Am Dent Assoc 2017; 148: 519-24. https://doi.org/10.1016/j.adaj.2017.05.006
  9. Gogenur I, Wildschiotz G, Rosenberg J. Circadian distribution of sleep phases after major abdominal surgery. Br J Anaesth 2008; 100: 45-9. https://doi.org/10.1093/bja/aem340
  10. Glickman G. Circadian rhythms and sleep in children with autism. Neurosci Biobehav Rev 2010; 34: 755-68. https://doi.org/10.1016/j.neubiorev.2009.11.017
  11. Mannion A, Leader G. Sleep problems in autism spectrum disorder: a literature review. Rev J Autism Dev Disord 2014; 1: 101-9. https://doi.org/10.1007/s40489-013-0009-y
  12. Carmassi C, Palagini L, Caruso D, Masci I, Nobili L, Vita A, et al. Systematic review of sleep disturbances and circadian sleep desynchronization in autism spectrum disorder: toward an integrative model of a self-reinforcing loop. Front Psychiatry 2019; 10: 366.
  13. Gunes S, Ekinci O, Feyzioglu A, Ekinci N, Kalinli M. Sleep problems in children with autism spectrum disorder: clinical correlates and the impact of attention deficit hyperactivity disorder. Neuropsychiatr Dis Treat 2019; 15: 763-71. https://doi.org/10.2147/NDT.S195738
  14. Tricco AC, Lillie E, Zarin W, O'Brien KK, Colquhoun H, Levac D, et al. PRISMA extension for scoping reviews (PRISMA-ScR): checklist and explanation. Ann Intern Med 2018; 169: 467-73. https://doi.org/10.7326/M18-0850
  15. Song Y, Liu Y, Yuan Y, Jia X, Zhang W, Wang G, et al. 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. EBioMedicine 2021; 70: 103490.
  16. van Zuylen ML, Meewisse AJG, Ten Hoope W, Eshuis WJ, Hollmann MW, Preckel B, et al. Effects of surgery and general anaesthesia on sleep-wake timing: CLOCKS observational study. Anaesthesia 2022; 77: 73-81. https://doi.org/10.1111/anae.15564
  17. Selvadurai S, Maynes JT, McDonnell C, Cushing SL, Propst EJ, Lorenzo A, et al. Evaluating the effects of general anesthesia on sleep in children undergoing elective surgery: an observational case-control study. Sleep 2018; 41: 1-10. https://doi.org/10.1016/j.sleep.2017.09.031
  18. Tran J, Chen JW, Trapp L, McCormack L. An investigation of the long and short term behavioral effects of general anesthesia on pediatric dental patients with autism. Front Oral Health 2021; 2: 679946.
  19. Rosenberg J. Sleep disturbances after non-cardiac surgery. Sleep Med Rev 2001; 5: 129-37. https://doi.org/10.1053/smrv.2000.0121
  20. Rosenberg-Adamsen S, Kehlet H, Dodds C, Rosenberg J. Postoperative sleep disturbances: mechanisms and clinical implications. Br J Anaesth 1996; 76: 552-9. https://doi.org/10.1093/bja/76.4.552
  21. Gogenur I. Postoperative circadian disturbances. Dan Med Bull 2010; 57: B4205.
  22. Cronin AJ, Keifer JC, Davies MF, King TS, Bixler EO. Postoperative sleep disturbance: influences of opioids and pain in humans. Sleep 2001; 24: 39-44. https://doi.org/10.1093/sleep/24.1.39
  23. Nixon GM, Kermack AS, McGregor CD, Davis GM, Manoukian JJ, Brown KA, et al. Sleep and breathing on the first night after adenotonsillectomy for obstructive sleep apnea. Pediatr Pulmonol 2005; 39: 332-8. https://doi.org/10.1002/ppul.20195
  24. Rabelo FA, Braga A, Kupper DS, De Oliveira JA, Lopes FM, de Lima Mattos PL, et al. Propofol-induced sleep: polysomnographic evaluation of patients with obstructive sleep apnea and controls. Otolaryngol Head Neck Surg 2010; 142: 218-24. https://doi.org/10.1016/j.otohns.2009.11.002
  25. Tung A, Bergmann BM, Herrera S, Cao D, Mendelson WB. Recovery from sleep deprivation occurs during propofol anesthesia. Anesthesiology 2004; 100: 1419-26. https://doi.org/10.1097/00000542-200406000-00014
  26. Cronin A, Keifer JC, Baghdoyan HA, Lydic R. Opioid inhibition of rapid eye movement sleep by a specific mu receptor agonist. Br J Anaesth 1995; 74: 188-92. https://doi.org/10.1093/bja/74.2.188
  27. Wang D, Teichtahl H. Opioids, sleep architecture and sleep-disordered breathing. Sleep Med Rev 2007; 11: 35-46. https://doi.org/10.1016/j.smrv.2006.03.006
  28. Poulsen RC, Warman GR, Sleigh J, Ludin NM, Cheeseman JF. How does general anaesthesia affect the circadian clock? Sleep Med Rev 2018; 37: 35-44. https://doi.org/10.1016/j.smrv.2016.12.002
  29. Goldman SE, Alder ML, Burgess HJ, Corbett BA, Hundley R, Wofford D, et al. Characterizing sleep in adolescents and adults with autism spectrum disorders. J Autism Dev Disord 2017; 47: 1682-95. https://doi.org/10.1007/s10803-017-3089-1
  30. Ohayon MM, Carskadon MA, Guilleminault C, Vitiello MV. Meta-analysis of quantitative sleep parameters from childhood to old age in healthy individuals: developing normative sleep values across the human lifespan. Sleep 2004; 27: 1255-73. https://doi.org/10.1093/sleep/27.7.1255
  31. Dette F, Cassel W, Urban F, Zoremba M, Koehler U, Wulf H, et al. Occurrence of rapid eye movement sleep deprivation after surgery under regional anesthesia. Anesth Analg 2013; 116: 939-43. https://doi.org/10.1213/ANE.0b013e3182860e58
  32. Kendall T, Megnin-Viggars O, Gould N, Taylor C, Burt LR, Baird G, et al. Management of autism in children and young people: summary of NICE and SCIE guidance. BMJ 2013; 347: f4865.
  33. Baker EK, Richdale AL. Sleep patterns in adults with a diagnosis of high-functioning autism spectrum disorder. Sleep 2015; 38: 1765-74. https://doi.org/10.5665/sleep.5160
  34. Narasingharao K, Pradhan B, Navaneetham J. Sleep disorder, gastrointestinal problems and behaviour problems seen in autism spectrum disorder children and yoga as therapy: a descriptive review. J Clin Diagn Res 2016; 10: VE01-3. https://doi.org/10.7860/JCDR/2016/24175.8922
  35. McLay L, France K, Blampied N, van Deurs J, Hunter J, Knight J, et al. Function-based behavioral interventions for sleep problems in children and adolescents with autism: summary of 41 clinical cases. J Autism Dev Disord 2021; 51: 418-32. https://doi.org/10.1007/s10803-020-04548-7
  36. McLay L, Hansen SG, Carnett A, France KG, Blampied NM. Attributions, causal beliefs, and help-seeking behavior of parents of children with autism spectrum disorder and sleep problems. Autism 2020; 24: 1829-40.  https://doi.org/10.1177/1362361320924216
  37. Posar A, Visconti P, Blunda V, Pizza F, Plazzi G. Autism spectrum disorder and narcolepsy: a possible connection that deserves to be investigated. Front Psychiatry 2020; 11: 265.
  38. Ayuse T, Ozaki-Honda Y, Kurata S, Mishima G, Kiriishi K, Magata N, et al. Study on the preventive effect of ramelteon on the onset of sleep disorder after general anesthesia in patients with autism spectrum disorder: a study protocol. Medicine (Baltimore) 2020; 99: e22826.
  39. Kawai M, Kurata S, Sanuki T, Mishima G, Kiriishi K, Watanabe T, et al. The effect of midazolam administration for the prevention of emergence agitation in pediatric patients with extreme fear and non-cooperation undergoing dental treatment under sevoflurane anesthesia, a double-blind, randomized study. Drug Des Devel Ther 2019; 13: 1729-37. https://doi.org/10.2147/DDDT.S198123
  40. Tsukinaga A, Mihara T, Takeshima T, Tomita M, Goto T, Yamanaka T. Effect of melatonin and melatonin agonists on postoperative sleep quality in adult patients: a protocol for systematic review and meta-analysis with trial sequential analysis. BMJ Open 2021; 11: e047858.