Sleep problems are not uncommon immediately following surgery and can last for days or even weeks, but most patients get back to normal about a week after surgery.

There can be many reasons why you struggle to sleep after surgery, most common being the following:

• Pain & Pain Medication:  Post-surgical pain can make it difficult to fall asleep and reach deep sleep. Some people also experience side effect of insomnia from pain medications and steroids.
• Frequent waking: You wake up to take your medications on schedule and disrupt sleep.
• Increased stress: Surgery is emotionally and physically stressful for most patients.
• General Anesthesia: Some patients have more pronounced insomnia after surgery with general anesthesia. The reasons are still not fully known.
• Major surgery: More involved procedures require longer recovery and often result in poor sleep.
• Food: Certain foods can change your metabolism and affect sleep or cause chronic inflammation that triggers insomnia: coffee, tea (esp. black tea), chocolate, alcohol, soda, foods high in fat, sugar and sodium, white bread and sweets, fast food and ultra processed food.
• Sleep Apnea: If you have sleep apnea, it can worsen after surgery. Pain medication can further decrease airway control during sleep and increase feeling of exhaustion.
• General Insomnia Risk Factors: Older patients and women are more likely to develop insomnia, also patients who have anxiety and generally increased levels of stress. Same for those whose physical activity is not sufficient, work shifts or nights, use caffeine, alcohol, nicotine, drugs and have less than optimal sleeping environment (noise, light, mattress).

Tips for Improving Sleep

• Aim to go to bed and wake up around the same time each day, including weekends.
• Establish bedtime routine: No electronics and low lights. Take a warm bath or listen to relaxing music.
• Keep your bedroom comfortably cool and quiet. Make sure your mattress and pillows are comfortable.
• Don’t eat at the very least 2-3 hours before bedtime.
• Exercise daily if possible, preferably not too close to bedtime.
• If you are still having problems falling asleep, talk to your doctor about prescription or herbal medications that might be appropriate for you.
• Get a wedge pillow to raise your upper body to prevent heartburn during the night.
• Try therapy, like cognitive behavioral therapy, or mindfulness-based therapy.