Effects of anaesthesia and surgery on sleep-wake timing and subjective sleep quality in children: an observational study.

Abstract

Surgery and anaesthesia can cause disruption of the circadian timing system and diurnal sleep-wake rhythm. However, it remains unknown how sleep-wake rhythm in children is affected by anaesthesia and surgery, and if anaesthesia without a surgical procedure disturbs sleep-wake cycles. We recruited children aged 1-11 y undergoing anaesthesia for an elective surgical procedure or magnetic resonance imaging. The Children's Chronotype Questionnaire, Children's Sleep Habits Questionnaire and a daily sleep diary from three days before until seven days after anaesthesia were used to assess sleep-wake rhythm and sleep quality. In total, 117 patients (median (IQR [range]) age 4 (2-6 [1-11]) y, 56 (47.9%) female) were included. The midpoint of sleep did not change on the night after anaesthesia when compared with three nights before (estimated median time difference 8 min, 95%CI -15-1, p = 0.12, n = 114). Median (IQR [range]) midpoint of sleep at baseline was 01.42 (01.22-02.19 [00.10-03.15]) for the surgical group and 01.22 (01.03-02.07 [00.15-04.02]) for the magnetic resonance imaging group. The midpoint of sleep did not shift on the night after anaesthesia for either group (surgical group: 01.37 (01.07-02.15 [23.00-03.12]), estimated median time difference -15 min, 95%CI -27-0, p = 0.07, n = 58; magnetic resonance imaging group: 01.30 (01.07-02.07 [23.45-05.00]), estimated median time difference 0 min, 95%CI -9-9, p = 0.90, n = 56), and there was no between-group difference (estimated median time difference: -15 min, 95%CI -30-0 min, p = 0.07). Subjective sleep quality was unaffected. We found no disruption of sleep-wake rhythm in children after anaesthesia and surgery. Further research is needed to see whether more invasive procedures and accompanying anaesthesia pose a risk of disrupting sleep-wake rhythms in children.