Preoperative sleep quality and anxiety as predictors of postoperative pain and recovery in Gynecologic oncology surgery: A prospective observational study

Akdemir C., Turan S. A., Balcı M. F., Özen S., Şeker N., BAYRAMOĞLU Z., ...Daha Fazla

Journal of Psychosomatic Research, cilt.201, 2026 (SCI-Expanded, SSCI, Scopus) identifier identifier identifier

  • Yayın Türü: Makale / Tam Makale
  • Cilt numarası: 201
  • Basım Tarihi: 2026
  • Doi Numarası: 10.1016/j.jpsychores.2025.112496
  • Dergi Adı: Journal of Psychosomatic Research
  • Derginin Tarandığı İndeksler: Science Citation Index Expanded (SCI-EXPANDED), Social Sciences Citation Index (SSCI), Scopus, BIOSIS, CINAHL, EMBASE, Gender Studies Database, MLA - Modern Language Association Database, Psycinfo
  • Anahtar Kelimeler: Preoperative anxiety, Sleep quality, Postoperative pain, Gynecologic oncology, Patient outcomes, Digital health behavior
  • Dokuz Eylül Üniversitesi Adresli: Evet

Özet

Purpose This study evaluated associations between preoperative sleep quality, anxiety, and short-term postoperative outcomes in patients undergoing gynecologic oncology surgery. Methods This prospective observational study included 72 women undergoing open gynecologic cancer surgery. Preoperative sleep quality and anxiety were assessed 24–48 h before surgery using the Pittsburgh Sleep Quality Index (PSQI) and the Beck Anxiety Inventory (BAI). Postoperative pain was measured using the Numerical Rating Scale (NRS) at 0, 4, 8, 12, and 24 h. Complications, rescue analgesia use, and length of stay were recorded. Results Poor sleep quality (%31.9) and clinically significant anxiety (%19.4) were both associated with higher mean postoperative pain scores (PSQI ≥5: 6.3 ± 1.2 vs 5.1 ± 1.3, p = 0.002; BAI ≥16: 6.5 ± 1.1 vs 5.2 ± 1.4, p = 0.001). In adjusted analyses, higher PSQI (β = 0.112, 95 % CI 0.039–0.185, p = 0.003) and higher BAI scores (β = 0.044, 95 % CI 0.023–0.065, p < 0.001) remained significantly associated with increased mean pain. Poor sleep quality was also linked to longer hospitalization (4 vs 3 days, p < 0.001) and higher complication rates (%52.2 vs %12.2, p < 0.001). Elevated anxiety was similarly associated with higher complication rates (%57.1 vs %17.2, p = 0.004) and more frequent rescue analgesia use (%64.3 vs %29.3, p = 0.014). Conclusion Preoperative sleep disturbances and anxiety are significantly associated with worse postoperative pain, higher complication rates, and prolonged recovery; routine screening and targeted interventions may therefore improve surgical outcomes. Trial registration The study was retrospectively registered at ClinicalTrials.gov (Identifier: NCT07036549 ) on June 24, 2025.