Jia XP, Lou QX, Chen XZ, Zhang YZ. Relationship between sleep disturbances and depressive symptoms in patients after general anesthesia: A retrospective case-control study. World J Psychiatry 2025; 15(8): 105770 [DOI: 10.5498/wjp.v15.i8.105770]
Corresponding Author of This Article
Yun-Zhen Zhang, MBBS, Department of Anesthesiology, Hangzhou Women’s Hospital (Hangzhou Maternity and Child Health Care Hospital, Hangzhou First People’s Hospital Qianjiang New City Campus), No. 369 Kunpeng Road, Shangcheng District, Hangzhou 310008, Zhejiang Province, China. 18069950448@163.com
Research Domain of This Article
Psychiatry
Article-Type of This Article
Retrospective Cohort Study
Open-Access Policy of This Article
This article is an open-access article which was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/
Xiu-Ping Jia, Qian-Xing Lou, Xiao-Zhen Chen, Department of Anesthesiology, Yiwu Central Hospital, Yiwu 322000, Zhejiang Province, China
Yun-Zhen Zhang, Department of Anesthesiology, Hangzhou Women’s Hospital (Hangzhou Maternity and Child Health Care Hospital, Hangzhou First People’s Hospital Qianjiang New City Campus), Hangzhou 310008, Zhejiang Province, China
Author contributions: Jia XP and Zhang YZ were guarantors and designed the study; Jia XP, Lou QX, and Zhang YZ participated in data acquisition, analysis, and interpretation, and drafted the initial manuscript; Chen XZ, Jia XP, and Lou QX critically revised the article for important intellectual content; All authors participated in this study and jointly reviewed and edited the manuscript.
Institutional review board statement: This study has been approved by the Ethics Committee of Yiwu Central Hospital, with the Approval No. K2024-IRB-059.
Informed consent statement: The study was conducted with the consent of patients and their guardians who signed informed consent forms.
Conflict-of-interest statement: All the authors report no relevant conflicts of interest for this article.
STROBE statement: The authors have read the STROBE Statement—checklist of items, and the manuscript was prepared and revised according to the STROBE Statement—checklist of items.
Data sharing statement: No data available.
Open Access: This article is an open-access article that was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution NonCommercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: https://creativecommons.org/Licenses/by-nc/4.0/
Corresponding author: Yun-Zhen Zhang, MBBS, Department of Anesthesiology, Hangzhou Women’s Hospital (Hangzhou Maternity and Child Health Care Hospital, Hangzhou First People’s Hospital Qianjiang New City Campus), No. 369 Kunpeng Road, Shangcheng District, Hangzhou 310008, Zhejiang Province, China. 18069950448@163.com
Received: April 15, 2025 Revised: May 20, 2025 Accepted: June 17, 2025 Published online: August 19, 2025 Processing time: 114 Days and 17.7 Hours
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.
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.
