Sleep aids before surgery may reduce pain and opioids

A scoping review presented at the ANESTHESIOLOGY 2026 meeting in San Diego looked at 16 studies involving more than 1,100 patients who had surgery ranging from abdominal and orthopedic to dental, from 2000 to 2025. The sleep aids were linked to less pain after surgery and a smoother recovery, the researchers found.

Sleep aids reduce pain and opioids

Melatonin was usually taken the night before surgery or 20 to 90 minutes before anesthesia, at doses from 1 mg to 20 mg. Ambien (zolpidem) was given at a steady 10 mg, either at bedtime the night before surgery or over several nights up to two days before the procedure. Melatonin is a natural hormone that regulates the sleep-wake cycle. Ambien works on GABA-A receptors to produce a sedative effect.

Across the studies, melatonin was linked to lower anxiety, pain and inflammation, and some abdominal surgery patients had a more than 30% drop in opioid use. Ambien helped patients with existing sleep problems sleep better before surgery and was linked to less pain afterward. In colorectal surgery, patients who took it needed less opioid medication during and in the first 24 hours after the procedure. Melatonin could also offer advantages over traditional sedatives for older adults, who may be more prone to confusion after surgery.

The authors noted that, as a scoping review, the work cannot make clinical recommendations or fully assess bias, and more research is needed. One expert cautioned that sleep aids are not recommended as a long-term solution for insomnia. Patients considering either drug should check with their surgical and anesthesia team first.