Experiencing difficulty falling and staying asleep after having surgery is common. It’s often tied to factors like pain, medications, and the hospital environment. Insomnia after surgery is often short-lived, and sleep aids and optimal sleep habits can help.

Insomnia is difficulty falling, staying, or returning to sleep after waking up throughout the night.

This can be a chronic sleep disorder or a short-term sleep disturbance associated with factors like stressful events.

Insomnia after surgery is common. It’s one of the different sleep disturbances possible after a surgical procedure.

Insomnia after surgical procedures may be due to a combination of factors.

Medication side effects

General anesthesia can cause sleep disturbances like insomnia.

General anesthetic drugs induce unconsciousness by affecting areas of your brain responsible for wakefulness and sleep. This can alter your sleep cycle and create temporary sleep irregularities, even after the anesthetic leaves your system.

Anesthesia is just one medication that can lead to insomnia after surgery. Some pain management medications have the potential also to affect your sleep. Opioids, like morphine and oxycodone, have the most pronounced effects on sleep quality. These may be used in postoperative care if you have severe pain.

Acute and chronic pain

According to a 2020 research review, pain is the most common cause of sleep disturbances after surgery.

Depending on the surgery, a certain level of postoperative inflammation and discomfort can be expected. Pain after surgery can make it challenging to get restorative slumber. For some people, inflammatory processes after surgery can also cause neuroinflammation, heightening the body’s sensitivity to pain.

The more complex and involved your procedure is, the more influential pain during recovery can be on your sleep.

Stress and anxiety

Preoperative anxiety is associated with adverse postsurgery experiences, including insomnia. While the exact reasons aren’t clear, anxiety symptoms like hyperarousal, rumination, and increased pain sensitivity may be involved. Anxiety itself is known to disturb sleep cycles.

Similarly, feeling overwhelmed and stressed from surgery can affect your sleep. Your body’s stress response, also known as the “fight, flight, or freeze” response, involves the release of hormones and inflammatory substances that may discourage deep sleep.

The hospital environment

Hospitals are busy and new territory for many people. There’s always a light on somewhere, doctors and nurses regularly check in, and sometimes, nighttime treatments are necessary.

Depending on your surgery, you may be hooked up to multiple types of monitoring equipment. These devices are outfitted with alarms to alert hospital staff of any changes in your vitals. Postsurgical dressings, drains, and catheters can be uncomfortable or make it difficult to move freely.

You may even share your room with another person who requires ongoing care throughout the day and night. Simply put, the hospital environment can make it difficult to sleep continually, if at all.

Even after your hospital stay, especially if it lasted a few days, your body may take some time to adapt to your usual nighttime routine.

Insomnia after surgery generally lasts for a shorter period compared to insomnia from nonsurgical causes. How long you experience insomnia, however, will depend on individual factors like your overall health, the type of surgery you underwent, and if you have a history of sleep disturbances.

A 2022 longitudinal study found surgery-related sleep disturbances typically occurred during the first 6 nights after the intervention and usually resolved within the first week.

A research review from 2021 suggests some people may experience insomnia after surgery for months or up to 1 year, depending on the type of surgery involved.

Sleeping pills should only be used after surgery if a doctor gives you the green light. Using any medication without consulting a treating physician could cause potentially serious medication interactions or side effects.

Under certain circumstances, a doctor may prescribe a sleep aid alongside behavioral strategies (like cognitive behavioral therapy for insomnia) to help improve sleep quality, reduce pain, and decrease opioid use.

However, it also depends on your other medications and overall health needs.

Managing postsurgical insomnia can start the first night of recovery. If you have overnights in the hospital, packing sleep supports like ear plugs and an eye mask might help with disruptive lights and sounds.

Consider bringing your pillow and a set of comfortable PJs if the hospital allows it. You can also get something for emotional comfort, like a stuffed animal or anything that makes you feel cozy.

While you might not be able to change much about how often hospital staff visit or what monitoring equipment is used, you can discuss your pain management options with a doctor if you’re concerned they’ll affect your sleep. You can also ask for additional comfort items, like blankets or a rolled towel to place between your knees.

Once you’re home from surgery, more sleep variables are within your control. While pain management may still be a challenge, factors like your environment and stress level can be managed.

To boost your chance for the best quality sleep possible, consider:

  • keeping your room cool, dark, and quiet
  • continuing to use sleep aids like eye masks and earplugs
  • avoiding large meals before bed
  • using blue light-blocking glasses while watching electronics
  • engaging in a relaxation routine before bed
  • keeping a consistent sleep-wake schedule
  • incorporating stress management techniques throughout the day

Insomnia after surgery usually resolves on its own, but signs that insomnia may require medical attention include:

  • having symptoms past the first week of recovery
  • feeling daytime fatigue that affects activities or function
  • experiencing challenges in concentration or memory
  • having symptoms of depression or anxiety
  • noticing new physical challenges like high blood pressure

If you’re not sleeping well, speaking with a healthcare professional can help rule out other underlying causes. It could also help identify medications, pain levels, or other factors contributing to sleep disturbances.

Insomnia after surgery is common. Postsurgical pain, medications, new anxiety, and the hospital environment can all negatively impact your ability to sleep.

While most cases of insomnia after a surgical procedure resolve on their own within a week, it’s possible to experience it long-term. A healthcare professional can help determine the underlying cause and the next steps.