Sleep, an evolutionarily conserved state of decreased arousal, is fundamental for healthy cardiovascular, immune, and cognitive function (Curr Opin Neurobiol 2017;44:178-85). We are typically active during the day and sleep during the night. This is because the homeostatic sleep drive and circadian rhythm interact to regulate sleep (J Biol Rhythms 1999;14:557-68). The homeostatic sleep drive strengthens with every waking hour and may be regulated by increasing adenosine concentrations in the brain. This perhaps explains why caffeine, an adenosine receptor antagonist, promotes wakefulness. Circadian rhythms are internally driven cycles of biological processes that typically adhere to approximate 24-hour cycles. The suprachiasmatic nucleus controls the production of melatonin to regulate our sleep-wake cycle. Unfortunately, sleep and circadian disturbances are highly prevalent in the general population (Int J Epidemiol 2011;40:1431-7).
Sleep disturbance is a hallmark feature of the perioperative period (Anesthesiology 2016;125:979-91). The effect of...
