Changes in sleep patterns of patients undergoing general anesthesia for maxillofacial plastic surgery: a prospective cohort study

To evaluate changes in the sleep patterns of patients undergoing general anesthesia for maxillofacial plastic surgery. A total of 200 consecutive craniofacial plastic surgery patients were enrolled in this study. Sixteen patients who did not stay in the craniofacial ward on the night before surgery were excluded, providing a final total of 184 patients. PSQI was used to evaluate sleep quality 1 month before surgery (baseline) and on the night before surgery. According to the baseline sleep quality score, patients were assigned to the sleep disorder group (SD group, n = 51, 27.7%; PSQI score > 5) or non-sleep disorder group (NSD group, n = 133, 72.3%; PSQI score ≤ 5). The PSQI score on the night before the operation was compared with the baseline score. Amongst the total sample size, the incidence of disturbed sleep on the night before surgery was significantly higher than baseline (PSQI score > 5: 89,48.4% vs.51,27.7%, respectively, P = 0.037). In the NSD group, the PSQI score the night before surgery was significantly increased compared with the baseline score (5.6 ± 3.2 vs. 2.4 ± 1.4, respectively, P < 0.0001). The PSQI score on the night before surgery was significantly lower in the NSD group than in the SD group (5.6 ± 3.2 vs. 7.4 ± 4.1, respectively, P = 0.009). On the night before surgery, the time to fall asleep was significantly prolonged. The sleep duration, the total time in bed, and the sleep efficiency were significantly reduced compared with the baseline in the NSD group. On the night before surgery, the sleep duration and the total time in bed were also reduced in the SD group, however, with no significant change in PSQI score. Patients without sleep disorders were more likely to have sleep disorders before surgery. So, this study concluded that a goal of perioperative management should be to actively address the sleep problems before surgery.