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Association between preoperative sleep quality and postoperative nausea and vomiting in patients undergoing
Turgay Atay1, Mehmet Akif Yazar2,3, Mustafa Aydemir2
1Department of Anesthesiology and Reanimation, University of Health Sciences Konya City Hospital, Konya, Türkiye. drturgayatay@gmail.com.
Background:
Postoperative nausea and vomiting (PONV) remains a common and distressing complication after surgery. Although established risk factors are well defined, the role of preoperative sleep quality has not been fully elucidated. This study aimed to evaluate the association between preoperative sleep quality and PONV in patients undergoing laparoscopic cholecystectomy.
Methods:
This single-center prospective observational study included 145 patients undergoing elective laparoscopic cholecystectomy. Preoperative sleep quality was assessed using the Pittsburgh Sleep Quality Index (PSQI) one day before surgery. PONV risk was evaluated using the Apfel score. The incidence of PONV within the first 24 h postoperatively was recorded, and nausea severity was assessed using a numeric rating scale (NRS). Multivariable logistic regression analysis was performed to identify independent predictors of PONV.
Results:
Overall, PONV occurred in 119 of 145 patients (82.1%, 95% CI 75.0-87.5). Vomiting occurred in 48 patients (33.1%). Patients who developed PONV had significantly higher PSQI scores than those who did not (median 6 vs. 3, p < 0.001). A PSQI score ≥ 5 was more frequent among patients with PONV (70.6% vs. 26.9%, p < 0.001). PSQI scores were moderately correlated with postoperative nausea severity (ρ = 0.626, p < 0.001). In multivariable analysis, PSQI score remained independently associated with PONV (OR 1.33, 95% CI 1.12-1.58, p = 0.001), whereas the Apfel score was not statistically significant.
Conclusions:
Preoperative sleep quality was independently associated with both the occurrence and severity of PONV. These findings suggest that sleep quality may represent a relevant factor associated with early postoperative outcomes. However, further studies with broader adjustment for potential confounders, external validation, and formal evaluation of predictive performance are needed before PSQI can be incorporated into routine PONV risk assessment.
Trial Registration:
Not applicable. As an observational study, trial registration was not required.
