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Volume 1 Supplement 1

Safety in Health

Post-operative sleep quality and pain in children and adolescents


Post-operative sleep is one of the major aspects for rehabilitation and recovery after a surgical intervention. Sleep problems after surgery are common and are mainly triggered by the body's stress response to the trauma of surgery. This places high demands on the pre and post-operative care of children and adolescents. Our study examines the association between sleep and pain in young patients (11-19 years) during post-operative care.

Materials and methods

240 patients, aged 11 to 19 years, were included in this analysis of prospectively collected data. Children and adolescents filled out a questionnaire designed to survey pain and pain-related problems in postoperative paediatric patients. The pain was assessed using the 6-face Faces Pain Scala revised (0-2-4-6-8-10), the sleep related aspect by dichotomous items (yes/no) or polytomous items (never to always).


Postoperative sleep was associated with pain. Patients who were tired on the first postoperative day had significant more rest pain [median (IQR): 2 (0-4) vs. 0 (0-2); p = .003] and pain during movement in bed [4 (2-6) vs. 2 (2-4); p = .006].

Problems to fall asleep the previous day because of pain were associated with patient's well-being. Patients who had problems to fall asleep felt weaker (p < .001), more depressed (p = .003) and less well (p < .001) compared to patients without pain related problem to fall asleep.

Awakening because of pain and the patient's feeling showed a similar pattern. Patients who were more likely to wake up because of pain during night felt weaker (p < .001, more depressed (p = .021) and less well (p < .001).


Postoperative pain had a significant negative impact on sleep quality and therefore on recovery after surgery. Showing the association between sleep quality and pain could be useful to offer a more individual pain therapy. Improving sleep quality by an optimized postoperative care is an important target to guarantee an optimal recovery.

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Correspondence to Julian Kammel.

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This article is published under license to BioMed Central Ltd. This is an Open Access article distributed under the terms of the Creative Commons Attribution License (, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited. The Creative Commons Public Domain Dedication waiver ( applies to the data made available in this article, unless otherwise stated.

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Kammel, J., Messerer, B., Avian, A. et al. Post-operative sleep quality and pain in children and adolescents. Saf Health 1 (Suppl 1), A4 (2015).

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