Perioperative administration of Dexmedetomidine may improve postoperative sleep quality in patients

Sleep disorders are conditions that impair your sleep or prevent you from getting restful sleep and, as a result, can cause daytime sleepiness and other symptoms. Sleep disturbances, including sleep deprivation, disruption, and abnormal architecture, are prevalent in postoperative patients.

A recent study in BMC Anesthesiology by Huizi Liu, and team assessed the effect of dexmedetomidine (DEX) on postoperative sleep quality using polysomnography (PSG) to identify possible interventions for postoperative sleep disturbances.

Huizi Liu, and team found that the current systematic review and meta-analysis provided support for the perioperative administration of DEX in improving postoperative sleep quality by increasing the percentage of stage N2 sleep and sleep efficiency, prolonging the duration of total sleep time (TST), and decreasing the percentage of stage N1 sleep and sleep arousals. Also DEX, used as an adjuvant for pain management, provided effective postoperative analgesia.

Researchers did an electronic search of PubMed/MEDLINE, EMBASE, Cochrane Library and Web of Science was conducted from database inception to November 20, 2022. Randomized controlled trials (RCTs) on the effect of DEX administration on postoperative sleep quality using PSG or its derivatives were included. The sleep efficiency index (SEI), arousal index (AI), percentages of stage N1, N2 and N3 of non-rapid eye movement (NREM) sleep, and rapid eye movement (REM) sleep were measured in our meta-analysis.

The key findings of the study are

• Researchers included Five studies, involving 381 participants. Administration of DEX significantly improved SEI, lowered AI, decreased the duration of stage N1 sleep and increased the duration of stage N2 sleep compared to placebo groups.

• There were no significant differences in the duration of stage N3 sleep and REM sleep.

• DEX administration lowered the postoperative Visual Analogue Scale (VAS) score and improved the Ramsay sedation score with no adverse effect on postoperative delirium (POD).

• However, high heterogeneity was observed in most of the primary and secondary outcomes.

In conclusion Huizi Liu, and team concluded that “Our study provides support for the perioperative administration of DEX to improve postoperative sleep quality. The optimal dosage and overall effect of DEX on postoperative sleep quality require further investigation using large-scale randomized controlled trials.”

Reference: Liu, H., Wei, H., Qian, S. et al. Effects of dexmedetomidine on postoperative sleep quality: a systematic review and meta-analysis of randomized controlled trials. BMC Anesthesiol 23, 88 (2023). https://doi.org/10.1186/s12871-023-02048-6.