Research progress on postoperative sleep disorders in orthopedic surgery patients

doi:10.12092/j.issn.1009-2501.2026.02.016

Abstract

Abstract:

Sleep is a natural cyclical physiological phenomenon with profound implications for the human body. Adequate postoperative sleep quality not only promotes bodily repair and maintains physiological balance but also plays an irreplaceable role in improving cognitive function, regulating emotions, and expediting postoperative recovery. However, postoperative patients commonly experience a decline in sleep quality, particularly prevalent among orthopedic surgery patients. This article aims to facilitate the postoperative recovery of orthopedic surgery patients by addressing postoperative sleep quality issues. It provides a comprehensive review of the epidemiology, mechanisms, risk factors, impact on prognosis, and prevention and treatment measures of postoperative sleep disorders in orthopedic surgery patients, offering new insights and clinical practice references for preventing postoperative sleep disorders.

Key words: orthopedic surgery, postoperative management, sleep, postoperative sleep disorders, postoperative rehabilitation

CLC Number:

Wenxin ZHAO, Xingyu XIONG, Wen TAN, Yuanyuan WANG, Zhengxiu SUN, Yongao LIN, He LIU, Junli CAO. Research progress on postoperative sleep disorders in orthopedic surgery patients[J]. Chinese Journal of Clinical Pharmacology and Therapeutics, 2026, 31(2): 281-288.

Figures/Tables 2

References 47

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技术设备	经颅磁刺激（TMS）	经皮耳迷走神经刺激（taVNS）	经颅直流电刺激（tDCS）	经皮穴位电刺激（TEAS）
原理	电磁感应原理：通过外部的电磁场使大脑中能够产生与之感应的电场，改善脑血液循环，对内源性神经递质的代谢产生影响	迷走神经刺激：经孤束核传导，广泛影响大脑的各个部分，包括丘脑、小脑、眼窝前额皮质、边缘系统、下丘脑和髓质	直流电：调节神经元静息膜电位，阳极刺激导致神经元静息膜电位去极化，起兴奋作用；阴极刺激通过超极化抑制皮层兴奋性	通过电流刺激体表特定穴位，广泛激活躯体感觉与运动区
作用方式	电磁系统形成颅内电流	低强度电流	低强度（一般为1～2 mA）直流电	低强度电流
作用位置	左、右侧背外侧前额叶皮质	左、右耳甲艇部	阳极位于左侧背外侧前额叶皮层上方，阴极位于右侧眶上区域上方	涌泉穴、三阴交穴、神门穴、内关穴等
刺激模式	低频刺激（≤1 Hz）	密集波，脉冲频率4～20 Hz，强度0.8～12 mA，低于患者的最大耐受性	强度0.5～2 mA，低于患者的最大耐受性	疏密频率采用 2/100 Hz，强度 6～10 mA，低于患者的最大耐受性
时间频率	每日1次，每次20～30 min，连续2～4周不等	每日1～2次，每次30 min，每周至少5 d，共持续4周	每日1次，每次20～ 30 min	每日1次，每次30 min，持续3～5 d
作用结果	抑制患者脑干上行网状激动系统功能，使诱导慢波睡眠出现，加深睡眠深度	降低内侧前额叶皮层与其他大脑区域的功能连接，缩短入睡时间、延长睡眠时间	改变脑电图节律，增强睡眠时的慢波活动	血浆褪黑素含量增加，睡眠质量明显提升
不良反应	电磁干扰、夜间多梦等	心率减慢、耳鸣等	暂时性头痛、电极下皮肤瘙痒等	皮肤烧灼感、过敏反应等

技术设备	经颅磁刺激（TMS）	经皮耳迷走神经刺激（taVNS）	经颅直流电刺激（tDCS）	经皮穴位电刺激（TEAS）
原理	电磁感应原理：通过外部的电磁场使大脑中能够产生与之感应的电场，改善脑血液循环，对内源性神经递质的代谢产生影响	迷走神经刺激：经孤束核传导，广泛影响大脑的各个部分，包括丘脑、小脑、眼窝前额皮质、边缘系统、下丘脑和髓质	直流电：调节神经元静息膜电位，阳极刺激导致神经元静息膜电位去极化，起兴奋作用；阴极刺激通过超极化抑制皮层兴奋性	通过电流刺激体表特定穴位，广泛激活躯体感觉与运动区
作用方式	电磁系统形成颅内电流	低强度电流	低强度（一般为1～2 mA）直流电	低强度电流
作用位置	左、右侧背外侧前额叶皮质	左、右耳甲艇部	阳极位于左侧背外侧前额叶皮层上方，阴极位于右侧眶上区域上方	涌泉穴、三阴交穴、神门穴、内关穴等
刺激模式	低频刺激（≤1 Hz）	密集波，脉冲频率4～20 Hz，强度0.8～12 mA，低于患者的最大耐受性	强度0.5～2 mA，低于患者的最大耐受性	疏密频率采用 2/100 Hz，强度 6～10 mA，低于患者的最大耐受性
时间频率	每日1次，每次20～30 min，连续2～4周不等	每日1～2次，每次30 min，每周至少5 d，共持续4周	每日1次，每次20～ 30 min	每日1次，每次30 min，持续3～5 d
作用结果	抑制患者脑干上行网状激动系统功能，使诱导慢波睡眠出现，加深睡眠深度	降低内侧前额叶皮层与其他大脑区域的功能连接，缩短入睡时间、延长睡眠时间	改变脑电图节律，增强睡眠时的慢波活动	血浆褪黑素含量增加，睡眠质量明显提升
不良反应	电磁干扰、夜间多梦等	心率减慢、耳鸣等	暂时性头痛、电极下皮肤瘙痒等	皮肤烧灼感、过敏反应等

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