Relationship between sleep disturbances and depressive symptoms in patients after general anesthesia: A retrospective case-control study

Abstract

BACKGROUND

Evaluating the relationship between sleep quality and depressive symptoms after laparoscopic hysterectomy under general anesthesia can help improve postoperative depressive symptoms.

AIM

To evaluate the correlation between sleep quality and depression symptoms in patients after laparoscopic hysterectomy under general anesthesia and explore factors associated with postoperative sleep disturbances and depression.

METHODS

This retrospective case-control study included 102 females who underwent laparoscopic hysterectomy under general anesthesia at our hospital between January 2022 and June 2024, excluding those with severe cardiovascular/cerebrovascular disease, liver/kidney dysfunction, or other underlying conditions. Sleep quality and depressive symptoms were evaluated preoperatively and at 1-week, 1-month, and 3-months postoperatively using the Pittsburgh Sleep Quality Index (PSQI) and the Hamilton Depression Rating Scale (HAMD). Physiological indicators (heart rate, blood pressure, and oxygen saturation) and laboratory parameters were monitored. Pearson correlation and logistic regression analyses were performed to examine the association between sleep quality and depressive symptoms.

RESULTS

Mean age of participants was (52.30 ± 8.39) years, with a body mass index of (23.56 ± 2.79) kg/m². Preoperative comorbidities included hypertension (25.49%), diabetes (14.71%), and heart disease (9.80%). Patients with poor preoperative sleep quality (higher PSQI scores) exhibited significantly more severe depressive symptoms (P < 0.05). Postoperative PSQI scores improved at 1-week, 1-month, and 3-months compared to baseline (P < 0.05). HAMD scores decreased at 1-week and 1-month postoperatively but returned to near preoperative levels at 3-months. Physiological indicators remained within normal ranges, and the postoperative complication rate was < 5%. Logistic regression showed that poor postoperative sleep quality was an independent predictor of depressive symptoms (odds ratio = 1.64, 95%CI: 1.22-2.20, P < 0.05).

CONCLUSION

Sleep quality was significantly correlated with depressive symptoms after laparoscopic hysterectomy under general anesthesia. Patients with poor postoperative sleep quality were more prone to depression. Early interventions for sleep disturbances are potentially beneficial for mitigating depression and improve mental health.

Keywords: Anesthesia; Laparoscopic hysterectomy; Quality of sleep; Depressive symptoms; Postoperative recovery

Core Tip: This study found a significant correlation between sleep quality and depressive symptoms after laparoscopic hysterectomy under general anesthesia. Patients with poor preoperative sleep quality experienced more severe depressive symptoms, and although postoperative sleep quality improved over time, depressive symptoms were still present at 3 months. Poor postoperative sleep quality was identified as an independent predictor of depression. Early interventions aimed at improving sleep quality post-surgery could help alleviate depressive symptoms, contributing to better mental health outcomes and improving overall recovery in these patients.