Objective:

To evaluate the effect of intranasal dexmedetomidine on postoperative sleep quality in adult surgical patients.

Approach:

• Study Design: Systematic review and meta-analysis of randomized controlled trials.
• Data Sources: PubMed, Cochrane Library, and Embase were searched until May 20, 2026.
• Comparative Analysis: Intranasal dexmedetomidine was compared with placebo or other controls.
• Outcome Measures: Subjective and objective sleep outcomes, sleep disturbance, and adverse events were analyzed.
• Subgroup Analyses: Performed based on route, timing, duration of administration, patient characteristics, surgical type, anesthesia type, and evaluation scales.

Key Findings:

• Intranasal dexmedetomidine improved subjective postoperative sleep scores (SMD = -1.29, 95% CI [-1.80, -0.77], p < 0.00001).
• Postoperative sleep efficiency increased significantly (SMD = 1.71, 95% CI [0.94, 2.48], p < 0.0001).
• Total sleep time increased significantly (SMD = 1.76, 95% CI [0.67, 2.84], p = 0.002).
• Sleep latency was reduced with dexmedetomidine administration (SMD = -1.07, 95% CI [-1.66, -0.49], p = 0.0003).
• The risk of sleep disturbance decreased (RR = 0.53, 95% CI [0.39, 0.73], p < 0.0001).
• Adverse events such as delirium, nausea, vomiting, and anxiety were less common in the dexmedetomidine group.

Interpretation:

Intranasal dexmedetomidine may improve short-term postoperative sleep, but evidence is limited.

Limitations:

• Heterogeneity in study designs, doses, and assessment tools.
• Limited number of high-quality trials.

Conclusion:

Intranasal dexmedetomidine may improve short-term postoperative sleep, but more high-quality trials are needed.

Sources:

• Systematic Review Registration