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Melatonin and Ambien before surgery may improve sleep, reduce pain and opioid use after surgery

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Melatonin and Ambien before surgery may improve sleep, reduce pain and opioid use after surgery

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Improving sleep before surgery through the use of melatonin or Ambien (zolpidem) may ease presurgical anxiety, reduce pain after surgery, decrease opioid requirements and help patients recover better, according to an analysis of 25 years of research presented at the ANESTHESIOLOGY 2026 annual meeting.

Poor sleep and anxiety are common before surgery and can contribute to heightened pain sensitivity, increased opioid use and slower recovery. In the studies, patients typically took melatonin the night before surgery and/or 20 to 90 minutes before anesthesia. Ambien was taken at bedtime, either the night before surgery or on multiple nights beginning up to two days before surgery.

The findings suggest that addressing sleep may be a modifiable part of preparing for surgery that helps support recovery.

"While we usually focus on what happens in the operating room, our review suggests we may be overlooking a critical window for improving outcomes in the nights before surgery," said Sebastian Amaya, M.D., senior author of the study and an anesthesiology resident at Yale School of Medicine in New Haven, Connecticut.

"Our paper is unique because it focused exclusively on pre-surgery-only use of melatonin or Ambien, showing that something as simple as improving sleep before a procedure can help patients have a more comfortable recovery while reducing the need for heavy painkillers and their potential risks."

The researchers analyzed 16 studies of patients undergoing abdominal, gynecologic, orthopedic, urologic, dental and other surgical procedures published between 2000 and 2025, which included a total of more than 1,100 patients.


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