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Hip and Knee Care

Articles on caring for your hips and knees before and after replacement surgery written by surgeon members of the American Association of Hip and Knee Surgeons

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Getting a Good Night’s Sleep after Hip or Knee Replacement Surgery

 

One of the most common complaints after total joint replacement is difficulty sleeping. The most common cause of sleep disruption is pain. It has been reported that more than half of patients wake up with pain after joint replacement.

Many factors can affect the quality of sleep after a major surgery including anesthesia-type, narcotic use and discomfort due to pain or restricted leg movements. As sleep is crucial to the recovery process, it is important to follow appropriate pain management protocols. Contemporary pain management protocols inhibit pain in more than one way. Many protocols use a variety of injections and nerve blocks for localized pain, as well as narcotics and anti-inflammatory medication for several weeks after surgery. You should carefully follow your pain management plan as outlined by your health care team to ensure an adequate recovery.

Usually around the second or third week after surgery, you will start to feel better and increase your activity levels while at the same time decrease your use of pain medication. This often coincides with having a difficult time sleeping. When this occurs, you should take your pain medication an hour before bed to achieve better comfort and help restore your sleep cycle. A few days off from strenuous activity or physical therapy will not inhibit your recovery, but can have a tremendous effect on your ability to fall asleep and stay asleep.

Overall, sleep deprivation after total joint replacement is manageable through pain management, the occasional use of sleeping pills, and activity modification. If you find these don’t work, call your surgeon who can help you manage sleep disturbances as you continue to recover after surgery.

References

  1. Rosenberg-Adamsen S, Kehlet H, Dodds C, Rosenberg J. Postoperative sleep disturbance: mechanisms and clinical implications.  Br J Anaesth.1996;76:552-559.
  2. Wylde V, Rooker J, Halliday L, et al. Acute postoperative pain at rest after hip and knee arthroplasty: severity, sensory qualities and impact on sleep. Orthopaedics & Traumatology: Surgery & Research. 2011;7:139-44.
  3. Myoji Y, Fujita K, Mawatari M et al. Changes in sleep-wake rhythms, subjective sleep quality and pain among patients undergoing total hip arthroplasty. Int J Nurs Pract. 2014 Apr 30. doi: 10.1111/ijn.12345. [Epub ahead of print]
  4. Krenk L, Jennum P, Kehlet H. Sleep disturbances after fast-track hip and knee arthroplasty. Brit Journ of Anesthesia. 2012; 109:769-75.

This article has been written and peer reviewed by the AAHKS Patient and Public Relations Committee and the AAHKS Evidence Based Medicine Committee. Links to these pages or content used from the articles must be given proper citation to the American Association of Hip and Knee Surgeons.

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