Insomnia After Surgery: Causes and How to Sleep Better
Insomnia after surgery is common. Learn the causes, how long it lasts, how to sleep better in hospital and at home, and when sleep apnea is a risk
The operation went well, but the nights feel longer than you expected. You toss and turn and wake at every sound. Insomnia after surgery has several causes, mainly pain, the hospital environment, medicines (especially strong painkillers) and anxiety. In most cases sleep improves gradually over a few days to a few weeks.
Sometimes, though, poor sleep is not just a passing nuisance. It deserves attention, especially in people who snore or have sleep apnea.
Is it normal not to sleep after surgery?
Yes, trouble sleeping after an operation is very common. One scientific review found that 36% of hospitalised patients reported insomnia they did not have before admission.
Sleep in the first nights is shorter and more broken. A study that measured brain activity during sleep found the changes concentrated in the first six nights after surgery, with sleep returning to normal within the first week for many patients.
Insomnia after surgery rarely becomes a chronic problem. But if it lasts beyond the first week or slows your recovery, tell your doctor.
More than a week on and your sleep is still broken?
If poor sleep continues after surgery, or comes with loud snoring or marked daytime sleepiness, a sleep disorder may be the cause. A sleep medicine consultant can find the reason and set a clear plan.
What causes insomnia after surgery?
There is rarely a single cause. Usually several factors come together on the same night:
1- Pain
Pain is the most common cause. Pain and sleep work in both directions: pain breaks sleep, and poor sleep makes the body more sensitive to pain.
2- The hospital environment
Machine alarms and corridor noise, lights at night, too little daylight during the day, and night checks for blood pressure or medication all unsettle the body clock and interrupt sleep.
3- Anaesthesia and surgical stress
Surgery itself puts heavy stress on the body, with inflammation and hormonal changes. This shows in sleep during the first days, especially after major operations.
4- Opioid painkillers and other medicines
Among post-surgery medicines, opioid painkillers have the most pronounced effect on sleep. Others may also play a part, including some antibiotics, steroids, respiratory medicines and beta blockers.
5- Anxiety and stress
Worry about the outcome, the pain or getting back to work keeps the mind awake just when the body needs rest.
6- Sleeping position and medical equipment
You may have to sleep on your back or in an unfamiliar position, with drains, a catheter or a wound that hurts with every move.
7- Less movement and long naps
Staying in bed most of the day and dozing repeatedly reduce the body's need for sleep at night, so sleepiness comes later.
Can anesthesia cause insomnia after surgery?
Anaesthesia is part of the picture, but rarely the whole story. Some causes of insomnia after surgery do not show up in the number of hours at all. After surgery, deep sleep and dream sleep both decrease, and these are the stages the body relies on for repair and recovery. The drop is clearer after major operations.
That is why you may sleep for hours in hospital and still wake as if you had not slept. This is expected in the first days and improves as pain eases, medicines are reduced and you return home.
Why poor sleep after surgery should not be ignored
Insomnia after surgery may seem minor next to the wound and the pain, but it affects recovery itself:
Confusion and delirium after surgery in older adults, reported in between 10% and 60% of older patients depending on the study, with poor sleep among the linked factors
Greater sensitivity to pain and a greater need for painkillers
Slower recovery and return to activity
Low mood and more anxiety
Notably, in one study, sleep problems before surgery were the strongest predictor of poorly controlled pain afterwards.
Sleep apnea after surgery: the risk many people miss
This part concerns a specific group, but it is the most important in this article. Sleep apnea makes anaesthesia and the period after it more delicate, because some anaesthetic drugs and painkillers slow breathing.
The problem is that many people do not know they have it. In a study of heart surgery patients, about a quarter had sleep apnea, and 80% of them had never been diagnosed.
If you snore loudly or feel very sleepy during the day, tell your surgeon and anaesthetist before the operation, even without a diagnosis
If you use a CPAP machine, bring it to hospital and tell the medical team
Waking repeatedly with a choking feeling after surgery should be reported to the team straight away
To learn the signs of this disorder and how it is diagnosed, see our article on what sleep apnea is.
How long does insomnia after surgery last?
It usually lasts from a few days to a few weeks and improves gradually as pain eases, painkillers are reduced and you return to movement and your daily routine.
It varies with the type and size of the operation and the patient's age and health. Major operations, including heart and orthopaedic surgery, may need longer than minor procedures.
How to get over insomnia after surgery
A few simple steps may ease insomnia after surgery, both in hospital and at home:
In hospital
Use an eye mask and earplugs to cut light and noise.
Ask the team to group night checks together where possible.
Tell the nurse if pain is keeping you awake, because well-timed pain relief makes a big difference.
Back at home
Return to the bedtime and wake time you kept before the operation.
Get daylight and move as much as your doctor allows.
Keep the bedroom dark, quiet and at a comfortable temperature.
Cut down on long naps and avoid heavy meals in the evening.
Sleeping position
Follow your surgeon's advice on position, and use pillows to support the wound and ease pressure on it.
For a practical example, see our guide on how to sleep correctly after gastric sleeve surgery.
Can you take sleeping pills after surgery?
Taking any sleep aid, even an over-the-counter one, is not advised without your doctor's approval. Some sleep medicines may interact with anaesthetic drugs and painkillers, and may add to drowsiness or slow breathing.
Some sedatives may ease anxiety but do not restore the natural depth of sleep. The decision belongs to the doctor who knows your medicines and condition.
When should you tell your doctor?
Contact your doctor in these situations:
Loud snoring with pauses in breathing, or waking with a choking feeling
New confusion, especially in older adults
Insomnia that continues beyond the first week after surgery
Poor sleep that holds back recovery or physiotherapy
Signs of depression or severe anxiety
Does one of these signs apply to you?
If your sleep has not improved after surgery, or signs of sleep apnea appear, a specialist assessment can help you recover faster. Appointments run Sunday to Wednesday evenings.
Book an appointment with a sleep consultant
💬 Ask about your case on WhatsApp
Before surgery: how to protect your sleep in advance
Much of what drives insomnia after surgery can be prepared for before you go into hospital:
Tell your surgeon and anaesthetist if you snore or feel very sleepy during the day.
If you have chronic insomnia and the operation is not urgent, starting cognitive behavioural therapy for insomnia a few weeks beforehand may help.
Bring your CPAP machine if you use one.
Pack an eye mask and earplugs in your hospital bag.
Discuss with your doctor how pain will be managed at night.
Why Subat Clinics?
A sleep problem after surgery may be temporary, or it may reveal a disorder that was there before without a diagnosis. At Subat Clinics this is assessed carefully:
A consultant in sleep medicine to diagnose insomnia and sleep apnea
Home sleep studies carried out at home within Riyadh, better suited to someone recovering from surgery
Cognitive behavioural therapy sessions for insomnia with a dedicated specialist
Online consultations for those who find it hard to attend after surgery
How to prepare for your appointment
These details help the doctor pin down the causes of insomnia after surgery in your case:
The type and date of your operation
Your current medicines, especially painkillers and their timing
A sleep log for recent days: bedtime and number of awakenings
Whether you had a sleep problem or snored before the operation
Notes from your bed partner about snoring or breathing pauses
Conclusion
Insomnia after surgery is usually temporary: pain, a noisy hospital, medicines and anxiety. Sleep tends to improve within days to weeks as you recover. But poor sleep that drags on, snoring with breathing pauses, or confusion in an older person are signs that should not go unassessed.
Book your appointment
If your sleep has not improved after surgery, or you suspect sleep apnea, do not put off the assessment. Book now and start by finding the cause.
Address: Othman Ibn Affan Road, Al-Taawun District, Riyadh 12477
Phone: 0112011100
WhatsApp: 0505999713
The clinic is not an emergency facility. In an emergency call 997 or go to the nearest hospital.
Sources:
Sleep Foundation — Insomnia After Surgery: Causes and Recovery Tips
Lin et al. — Perioperative Sleep Disorder: A Review (Frontiers in Medicine)
Sipilä & Kalso — Sleep Well and Recover Faster with Less Pain (Journal of Clinical Medicine)
American Society of Anesthesiologists — Obesity, Sleep Apnea, and Anesthesia
This content is for health awareness and does not replace a personal medical consultation. Do not take any sleep medicine after surgery without your treating doctor's approval.
Medically reviewed by: Dr. Ahmed Alruhaimi, Consultant in Pulmonary Medicine and Sleep Medicine, Subat Clinics
Last reviewed: October 2026
Frequently asked questions
Does general anaesthesia cause long-term insomnia?
Poor sleep after surgery usually comes from a combination of factors rather than anaesthesia alone, and it generally improves within days to weeks.
Is it normal to sleep more than usual after surgery?
It may happen in the first days because of fatigue and some medicines. What matters is returning gradually to your usual sleep times as you recover.
Does melatonin help with sleep after surgery?
Taking it without your doctor's advice is not recommended, because it may interact with other medicines. The decision belongs to the treating doctor.
Is sleep different after a caesarean section?
Pain combines with caring for the baby and waking for feeds. Sleeping when the baby sleeps and asking family for help where possible is advisable.