Effects of surgery and general anaesthesia on sleep–wake timing: CLOCKS observational study

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Effects of surgery and general anaesthesia on sleep–wake timing: CLOCKS observational study. / van Zuylen, M. L.; Meewisse, A. J. G.; ten Hoope, W. et al.

In: Anaesthesia, Vol. 77, No. 1, 01.2022, p. 73-81.

Research output: Contribution to journal › Article › Academic › peer-review

BibTeX

@article{d2aab3d257b044babf10bf92499f4d05,

title = "Effects of surgery and general anaesthesia on sleep–wake timing: CLOCKS observational study",

abstract = "Surgery and general anaesthesia have the potential to disturb the body{\textquoteright}s circadian timing system, which may affect postoperative outcomes. Animal studies suggest that anaesthesia could induce diurnal phase shifts, but clinical research is scarce. We hypothesised that surgery and general anaesthesia would result in peri-operative changes in diurnal sleep–wake patterns in patients. In this single-centre prospective cohort study, we recruited patients aged ≥18 years scheduled for elective surgery receiving ≥30 min of general anaesthesia. The Munich Chronotype Questionnaire and Pittsburgh Sleep Quality Index were used to determine baseline chronotype, sleep characteristics and sleep quality. Peri-operative sleeping patterns were logged. Ninety-four patients with a mean (SD) age of 52 (17) years were included; 56 (60%) were female. The midpoint of sleep (SD) three nights before surgery was 03.33 (55 min) and showed a phase advance of 40 minutes to 02.53 (67 min) the night after surgery (p < 0.001). This correlated with the midpoint of sleep three nights before surgery and was not associated with age, sex, duration of general anaesthesia or intra-operative dexamethasone use. Peri-operatively, patients had lower subjective sleep quality and worse sleep efficiency. Disruption started from one night before surgery and did not normalise until 6 days after surgery. We conclude that there is a peri-operative phase advance in midpoint of sleep, confirming our hypothesis that surgery and general anaesthesia disturb the circadian timing system. Patients had decreased subjective sleep quality, worse sleep efficiency and increased daytime fatigue.",

keywords = "anaesthesia, circadian rhythm, circadian timing system, sleep–wake timing, surgery",

author = "{van Zuylen}, {M. L.} and Meewisse, {A. J. G.} and {ten Hoope}, W. and Eshuis, {W. J.} and Hollmann, {M. W.} and B. Preckel and Siegelaar, {S. E.} and Stenvers, {D. J.} and J. Hermanides",

note = "Funding Information: The study was registered on The Netherlands Trial Register (NL8709). MH served as executive section editor of pharmacology for Anesthesia and Analgesia, section editor of anaesthesiology for the Journal of Clinical Medicine and received speaker?s fees from CSL Behring and Eurocept BV. No external funding or other competing interests declared. Publisher Copyright: {\textcopyright} 2021 The Authors. Anaesthesia published by John Wiley & Sons Ltd on behalf of Association of Anaesthetists.",

year = "2022",

month = jan,

doi = "10.1111/anae.15564",

language = "English",

volume = "77",

pages = "73--81",

journal = "Anaesthesia",

issn = "0003-2409",

publisher = "Wiley-Blackwell",

number = "1",

}

RIS

TY - JOUR

T1 - Effects of surgery and general anaesthesia on sleep–wake timing: CLOCKS observational study

AU - van Zuylen, M. L.

AU - Meewisse, A. J. G.

AU - ten Hoope, W.

AU - Eshuis, W. J.

AU - Hollmann, M. W.

AU - Preckel, B.

AU - Siegelaar, S. E.

AU - Stenvers, D. J.

AU - Hermanides, J.

N1 - Funding Information: The study was registered on The Netherlands Trial Register (NL8709). MH served as executive section editor of pharmacology for Anesthesia and Analgesia, section editor of anaesthesiology for the Journal of Clinical Medicine and received speaker?s fees from CSL Behring and Eurocept BV. No external funding or other competing interests declared. Publisher Copyright: © 2021 The Authors. Anaesthesia published by John Wiley & Sons Ltd on behalf of Association of Anaesthetists.

PY - 2022/1

Y1 - 2022/1

N2 - Surgery and general anaesthesia have the potential to disturb the body’s circadian timing system, which may affect postoperative outcomes. Animal studies suggest that anaesthesia could induce diurnal phase shifts, but clinical research is scarce. We hypothesised that surgery and general anaesthesia would result in peri-operative changes in diurnal sleep–wake patterns in patients. In this single-centre prospective cohort study, we recruited patients aged ≥18 years scheduled for elective surgery receiving ≥30 min of general anaesthesia. The Munich Chronotype Questionnaire and Pittsburgh Sleep Quality Index were used to determine baseline chronotype, sleep characteristics and sleep quality. Peri-operative sleeping patterns were logged. Ninety-four patients with a mean (SD) age of 52 (17) years were included; 56 (60%) were female. The midpoint of sleep (SD) three nights before surgery was 03.33 (55 min) and showed a phase advance of 40 minutes to 02.53 (67 min) the night after surgery (p < 0.001). This correlated with the midpoint of sleep three nights before surgery and was not associated with age, sex, duration of general anaesthesia or intra-operative dexamethasone use. Peri-operatively, patients had lower subjective sleep quality and worse sleep efficiency. Disruption started from one night before surgery and did not normalise until 6 days after surgery. We conclude that there is a peri-operative phase advance in midpoint of sleep, confirming our hypothesis that surgery and general anaesthesia disturb the circadian timing system. Patients had decreased subjective sleep quality, worse sleep efficiency and increased daytime fatigue.

AB - Surgery and general anaesthesia have the potential to disturb the body’s circadian timing system, which may affect postoperative outcomes. Animal studies suggest that anaesthesia could induce diurnal phase shifts, but clinical research is scarce. We hypothesised that surgery and general anaesthesia would result in peri-operative changes in diurnal sleep–wake patterns in patients. In this single-centre prospective cohort study, we recruited patients aged ≥18 years scheduled for elective surgery receiving ≥30 min of general anaesthesia. The Munich Chronotype Questionnaire and Pittsburgh Sleep Quality Index were used to determine baseline chronotype, sleep characteristics and sleep quality. Peri-operative sleeping patterns were logged. Ninety-four patients with a mean (SD) age of 52 (17) years were included; 56 (60%) were female. The midpoint of sleep (SD) three nights before surgery was 03.33 (55 min) and showed a phase advance of 40 minutes to 02.53 (67 min) the night after surgery (p < 0.001). This correlated with the midpoint of sleep three nights before surgery and was not associated with age, sex, duration of general anaesthesia or intra-operative dexamethasone use. Peri-operatively, patients had lower subjective sleep quality and worse sleep efficiency. Disruption started from one night before surgery and did not normalise until 6 days after surgery. We conclude that there is a peri-operative phase advance in midpoint of sleep, confirming our hypothesis that surgery and general anaesthesia disturb the circadian timing system. Patients had decreased subjective sleep quality, worse sleep efficiency and increased daytime fatigue.

KW - anaesthesia

KW - circadian rhythm

KW - circadian timing system

KW - sleep–wake timing

KW - surgery

UR - http://www.scopus.com/inward/record.url?scp=85113151786&partnerID=8YFLogxK

U2 - 10.1111/anae.15564

DO - 10.1111/anae.15564

M3 - Article

C2 - 34418064

VL - 77

SP - 73

EP - 81

JO - Anaesthesia

JF - Anaesthesia

SN - 0003-2409

IS - 1

ER -

ID: 19433515

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