Disordered Sleep in Adolescents Recovering From Surgery

Marjorie Odegard¹, Jessica Barrington-Trimis², Olivia A Keane³, Shadassa Ourshalimian⁴, Eugene Kim⁵, Lorraine I Kelley-Quon⁶

Affiliations

¹ Division of Pediatric Surgery, Children's Hospital Los Angeles, Los Angeles, CA, USA; Department of Surgery, Keck School of Medicine of the University of Southern California, Los Angeles, CA, USA; Department of Surgery, Hennepin County Medical Center, Minneapolis, MN, USA.
² Department of Population and Public Health Sciences, Keck School of Medicine, University of Southern California, Los Angeles, CA, USA.
³ Division of Pediatric Surgery, Children's Hospital Los Angeles, Los Angeles, CA, USA; Department of Surgery, Keck School of Medicine of the University of Southern California, Los Angeles, CA, USA. Electronic address: okeane@chla.usc.edu.
⁴ Division of Pediatric Surgery, Children's Hospital Los Angeles, Los Angeles, CA, USA; Department of Surgery, Keck School of Medicine of the University of Southern California, Los Angeles, CA, USA.
⁵ Division of Pain Medicine, Children's Hospital Los Angeles, Los Angeles, CA, USA.
⁶ Division of Pediatric Surgery, Children's Hospital Los Angeles, Los Angeles, CA, USA; Department of Surgery, Keck School of Medicine of the University of Southern California, Los Angeles, CA, USA; Department of Population and Public Health Sciences, Keck School of Medicine, University of Southern California, Los Angeles, CA, USA.

PMID: 38670831
PMCID: PMC11401771 (available on 2025-10-01)
DOI: 10.1016/j.jpedsurg.2024.03.060

Disordered Sleep in Adolescents Recovering From Surgery

Marjorie Odegard et al. J Pediatr Surg. 2024 Oct.

. 2024 Oct;59(10):161545.

doi: 10.1016/j.jpedsurg.2024.03.060. Epub 2024 Apr 4.

Authors

Marjorie Odegard¹, Jessica Barrington-Trimis², Olivia A Keane³, Shadassa Ourshalimian⁴, Eugene Kim⁵, Lorraine I Kelley-Quon⁶

Affiliations

¹ Division of Pediatric Surgery, Children's Hospital Los Angeles, Los Angeles, CA, USA; Department of Surgery, Keck School of Medicine of the University of Southern California, Los Angeles, CA, USA; Department of Surgery, Hennepin County Medical Center, Minneapolis, MN, USA.
² Department of Population and Public Health Sciences, Keck School of Medicine, University of Southern California, Los Angeles, CA, USA.
³ Division of Pediatric Surgery, Children's Hospital Los Angeles, Los Angeles, CA, USA; Department of Surgery, Keck School of Medicine of the University of Southern California, Los Angeles, CA, USA. Electronic address: okeane@chla.usc.edu.
⁴ Division of Pediatric Surgery, Children's Hospital Los Angeles, Los Angeles, CA, USA; Department of Surgery, Keck School of Medicine of the University of Southern California, Los Angeles, CA, USA.
⁵ Division of Pain Medicine, Children's Hospital Los Angeles, Los Angeles, CA, USA.
⁶ Division of Pediatric Surgery, Children's Hospital Los Angeles, Los Angeles, CA, USA; Department of Surgery, Keck School of Medicine of the University of Southern California, Los Angeles, CA, USA; Department of Population and Public Health Sciences, Keck School of Medicine, University of Southern California, Los Angeles, CA, USA.

PMID: 38670831
PMCID: PMC11401771 (available on 2025-10-01)
DOI: 10.1016/j.jpedsurg.2024.03.060

Abstract

Background and objectives: Sleep is essential for postoperative recovery. Prescription opioid can be associated with disordered sleep. There is little research on sleep patterns among adolescents using opioids for postoperative pain. Our objective was to identify factors associated with disordered sleep among adolescents undergoing surgery.

Methods: Prospective single-center survey-based cohort study of adolescents (13-20y) undergoing eight surgeries commonly associated with an opioid prescription. Participants completed a preoperative survey measuring clinical, mental health, and sociodemographic factors, and postoperative surveys at 30- and 90-days. All surveys administered the Sleep Problems Questionnaire. Repeated measures logistic regression evaluated the impact of surgery on worsening postoperative sleep scores. Linear change model evaluated sleep score trajectories; Poisson regression identified the impact of preoperative disordered sleep on opioid use.

Results: Overall, 167 adolescents (median 15y, 64% female) were included. Twenty-seven (16.2%) reported disordered sleep preoperatively and 41 (24.6%) postoperatively. Prescription opioid use was not associated with development of disordered sleep postoperatively (OR:1.33; 95% CI:0.38-4.68). Adolescents were 2.20 (95% CI:1.42-3.40) times more likely to report disordered sleep postoperatively. Preoperative disordered sleep, time after surgery, and mental health comorbidities were associated with worsening postoperative sleep score trajectories (p < 0.01). Adolescents with preoperative disordered sleep were not more likely to use opioids (OR:2.56, 95% CI:0.76-8.63, p = 0.13) nor did they use more pills (IRR:0.84, 95% CI:0.62-1.15, p = 0.27).

Conclusions: Adolescents were more likely to report disordered sleep postoperatively. Preoperative disordered sleep and mental health comorbidities, but not prescription opioid use, were associated with worsening sleep after surgery. Future efforts to improve adolescent postoperative sleep should address baseline disordered sleep and mental health comorbidities.

Level of evidence: Level II.

Type of study: Prospective cohort study.

Keywords: Disordered sleep; Pediatric surgery; Postoperative opioids; Postoperative sleep.

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Conflict of interest statement

Conflicts of interest All authors reported no biomedical financial interests or potential conflicts of interest relevant to this article.

References

1. Su X, Wang DX. Improve postoperative sleep: what can we do? Curr Opin Anaesthesiol. 2018;31(1):83. doi:10.1097/ACO.0000000000000538 - DOI - PMC - PubMed
1. Dolan R, Huh J, Tiwari N, et al. A prospective analysis of sleep deprivation and disturbance in surgical patients. Ann Med Surg. 2016;6:1–5. doi:10.1016/J.AMSU.2015.12.046 - DOI - PMC - PubMed
1. Webster LR, Choi Y, Desai H, et al. Sleep-disordered breathing and chronic opioid therapy. Pain Med. 2008;9(4):425–432. doi:10.1111/J.1526-4637.2007.00343.X - DOI - PubMed
1. Angarita GA, Emadi N, Hodges S, et al. Sleep abnormalities associated with alcohol, cannabis, cocaine, and opiate use: a comprehensive review. Addict Sci Clin Pract. 2016;11(1). doi:10.1186/S13722-016-0056-7 - DOI - PMC - PubMed
1. Dimsdale JE, Norman D, DeJardin D, et al. The effect of opioids on sleep architecture. J Clin sleep Med. 2007;3(1):33–36. - PubMed

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Disordered Sleep in Adolescents Recovering From Surgery

Affiliations

Disordered Sleep in Adolescents Recovering From Surgery

Authors

Affiliations

Abstract

Conflict of interest statement

References

MeSH terms

Substances

Grants and funding

LinkOut - more resources

Research Materials