{
  "abstract": "Background:: Postoperative sleep disturbance (PSD) after major abdominal surgery in older adults is common and impairs recovery. Dexmedetomidine is a selective α2-adrenergic agonist with sedative, analgesic, and anti-inflammatory properties that promotes natural sleep. We hypothesized that intraoperative dexmedetomidine would reduce PSD in this population.\n\nMethods:: In this randomized, double-blind, placebo-controlled trial, 210 older adults undergoing major abdominal surgery were randomly assigned (1:1:1) to receive intraoperative normal saline, dexmedetomidine 0.3 μg/kg/h, or 0.6 μg/kg/h. The primary outcome was PSD on the first postoperative night (Athens Insomnia Scale score ≥ 6). Secondary outcomes included PSD on until nights 30; pain at 24 and 48 h; delirium and depressive symptoms within 7 days; and recovery quality on postoperative days 1‒3. Sleep patterns on nights 1 and 2 were assessed using wrist actigraphy. This trial was registered on the Chinese Clinical Trial Registry (Identifier: ChiCTR2300073163; principal investigator: Ke Peng; dated July 23, 2023; https://www.chictr.org.cn/showproj.html?proj=199410).\n\nResults:: 203 patients (median age 71 years; 67.5% male) completed this trial. Compared with normal saline (n = 67), both low-dose (n = 68) and high-dose dexmedetomidine (n = 68) significantly reduced first-night PSD (20.6% vs 65.7%; relative risk 0.31, 95% CI 0.19–0.50; NNT 2.2; P < 0.001; and 11.8% vs 65.7%; relative risk 0.18, 95% CI 0.09–0.34; NNT 1.8; P < 0.001, respectively). The two doses did not differ. Dexmedetomidine was associated with lower sleep disturbance on night 2 and higher recovery quality, without between-group differences in hypotension, bradycardia, delirium, or 30-day mortality. Exploratory actigraphy analysis (n = 20 per group) showed longer total sleep time and lower wake-time percentage associated with dexmedetomidine.\n\nConclusions:: Intraoperative dexmedetomidine infusion reduced the relative risk of first-night PSD by 70–80% among older adults undergoing major abdominal surgery. These findings require confirmation in multicenter trials.",
  "abstract_shown": true,
  "affiliations": [
    "Department of Anesthesiology, First Affiliated Hospital of Soochow University, Suzhou, China",
    "Institute of Anesthesiology, Soochow University, Suzhou, China",
    "Jintan Traditional Chinese Medicine Hospital, Changzhou, China",
    "Department of Anesthesiology and Pain Medicine, University of California Davis Health, Sacramento, CA USA",
    "Anesthesia and Critical Care, National Hospital for Neurology and Neurosurgery, University College London Hospitals NHS Trust, London, UK"
  ],
  "article_type": "research article",
  "arxiv": null,
  "author_total": 10,
  "authors": [
    {
      "affs": [
        0,
        1
      ],
      "name": "Hui-ping Peng"
    },
    {
      "affs": [
        0,
        1
      ],
      "name": "Jing-hui Hu",
      "orcid": "0009-0000-9352-7714"
    },
    {
      "affs": [
        0,
        1,
        2
      ],
      "name": "Li-ping Fan"
    },
    {
      "affs": [
        0,
        1
      ],
      "name": "Xiu Yang"
    },
    {
      "affs": [
        0,
        1
      ],
      "name": "Hua-yue Liu",
      "orcid": "0000-0002-1504-1310"
    },
    {
      "affs": [
        0,
        1
      ],
      "name": "Xi-sheng Shan",
      "orcid": "0000-0003-4779-1906"
    },
    {
      "affs": [
        3
      ],
      "name": "Hong Liu",
      "orcid": "0000-0003-3611-7131"
    },
    {
      "affs": [
        4
      ],
      "name": "Nazneen Sudhan"
    },
    {
      "affs": [
        0,
        1
      ],
      "name": "Fu-hai Ji",
      "orcid": "0000-0001-6649-665X"
    },
    {
      "affs": [
        0,
        1
      ],
      "name": "Ke Peng",
      "orcid": "0000-0003-2879-1759"
    }
  ],
  "bibtex": "https://research.draconitic.com/paper/adysyn7a4yqh2.bib",
  "cited_by": 1,
  "doi": "10.1038/s43856-026-01769-2",
  "fulltext_url": "https://pmc.ncbi.nlm.nih.gov/articles/PMC13710947/",
  "id": "adysyn7a4yqh2",
  "issns": [
    "2730-664X"
  ],
  "landing_url": "https://doi.org/10.1038/s43856-026-01769-2",
  "language": "en",
  "licence": "CC-BY-NC-ND-4.0",
  "licence_label": "CC BY-NC-ND 4.0",
  "licence_source": "article",
  "licence_url": "https://creativecommons.org/licenses/by-nc-nd/4.0/",
  "metadata_licence": null,
  "native_subjects": [
    [
      "heading",
      "Article"
    ],
    [
      "openalex",
      "2703|Anesthesia and Sedative Agents"
    ]
  ],
  "openalex": "W7167226528",
  "pdf_url": "https://www.nature.com/articles/s43856-026-01769-2_reference.pdf",
  "pmcid": "PMC13710947",
  "pmid": "42399418",
  "published": "2026-07-03",
  "publisher": "Nature Publishing Group",
  "ris": "https://research.draconitic.com/paper/adysyn7a4yqh2.ris",
  "sources": [
    {
      "first_seen": "2026-10-31T12:21:48Z",
      "native_id": "PMC13710947",
      "source": "pmc",
      "url": "https://doi.org/10.1038/s43856-026-01769-2"
    }
  ],
  "subjects": [
    {
      "field": "medicine",
      "origin": "openalex:2703|Anesthesia and Sedative Agents",
      "subfield": "surgery"
    }
  ],
  "title": "Intraoperative dexmedetomidine reduces postoperative sleep disturbance in older adults undergoing major abdominal surgery: a single-center, randomized, double-blind, placebo-controlled trial",
  "title_text": "Intraoperative dexmedetomidine reduces postoperative sleep disturbance in older adults undergoing major abdominal surgery: a single-center, randomized, double-blind, placebo-controlled trial",
  "type": "peer-reviewed",
  "updated_at": "2026-10-31T12:21:48Z",
  "url": "https://research.draconitic.com/paper/adysyn7a4yqh2",
  "venue": "Communications Medicine",
  "versions": []
}