Popular sleep aids before surgery could prevent painkiller dependence later
Popular sleep aids before surgery could prevent painkiller dependence later
Taking melatonin or Ambien (zolpidem) may be associated with less pain and a smoother recovery afterward, according to new research.
Research presented at the ANESTHESIOLOGY 2026 annual meeting in San Diego on Oct. 18 found that improving sleep before surgery with one of these two sleep aids could ease anxiety while reducing post-surgical pain and opioid use.
The researchers analyzed 16 studies of patients who underwent abdominal, gynecologic, orthopedic, urologic, and other surgical procedures between 2000 and 2025.
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This amounted to more than 1,100 patients, according to a press release from the American Society of Anesthesiologists.
Melatonin was typically taken the night before surgery and/or 20 to 90 minutes before anesthesia, with dosages ranging from 1 mg to 20 mg.
Ambien, consistently dosed at 10 mg, was taken at bedtime either the night before surgery or for multiple nights up to two days before the procedure.
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Although both are used as sleep aids, melatonin and Ambien work differently.
Melatonin is a naturally occurring hormone that helps regulate the sleep-wake cycle, according to the National Institutes of Health. Ambien, or zolpidem, acts on GABA-A receptors in the to produce a sedative effect, states FDA prescribing information.
Across all studies, melatonin was associated with , pain and inflammation, in addition to a more than 30% reduction in opioid use among some abdominal surgery patients.
The analysis suggested melatonin could offer advantages over traditional sedatives for older adults, who may be more susceptible to confusion after surgery. Studies that used activity monitors also found that patients who took melatonin showed improvements in recovery and sleep patterns.
Ambien reportedly helped patients with pre-existing sleep problems sleep better before surgery and was also associated with less pain afterward.
Patients who underwent colorectal surgery and took Ambien required less opioid medication during and in the first 24 hours after the procedure. They also had lower inflammation levels.
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Those who had hip replacement reportedly experienced less anxiety and and were more satisfied with the recovery process.
Because this was a scoping review, which summarizes existing research rather than testing a treatment directly, the researchers could not make clinical recommendations or fully assess the risk of bias. They noted that more research is needed.
Dr. Sebastian Amaya, senior study author and senior anesthesiology resident at Yale School of Medicine, said he was not surprised that improving sleep was associated with positive outcomes.
He noted that sleep is "extremely important" for maintaining overall health and controlling the immune system, cognitive function and .
In the studies reviewed, use of melatonin and Ambien was associated with less pain and lower opioid use, the doctor reiterated.
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