Sleep Aids Before Surgery Tied to Less Pain and Fewer Opioids

A review of 25 years of research, presented at ANESTHESIOLOGY 2026, indicates that using melatonin or zolpidem (Ambien) to improve sleep before surgery may reduce anxiety, postoperative pain, and opioid requirements. The analysis examined 16 studies involving more than 1,100 patients who had abdominal, gynecologic, orthopedic, urologic, dental, or other procedures, with melatonin doses from 1 to 20 mg and zolpidem at 10 mg. The authors say that addressing sleep in the nights before an operation could be a changeable factor that supports recovery.

The review, presented at ANESTHESIOLOGY 2026, examined 16 studies from 2000–2025 with over 1,100 patients having abdominal, gynecologic, orthopedic, urologic, dental, or other surgery. Melatonin was tested at 1–20 mg, often the night before and/or 20–90 minutes before anesthesia; zolpidem was 10 mg at bedtime, sometimes for up to two preoperative nights.

Some abdominal surgery patients cut opioid use by over 30%. Wrist monitors suggested melatonin supported normal sleep and daytime activity during recovery. Colorectal patients required fewer opioids during and 24 hours after surgery and had lower inflammatory markers. Hip replacement patients reported less anxiety, depression, and greater satisfaction. Melatonin may help anxious, respiratory-risk, or older patients; zolpidem may suit those with insomnia.