The mediating role of pain in the relationship between sleep and recovery.

Abstract

Backgraund: Sleep disturbances and pain are common in the early postoperative period and can significantly impact recovery. Poor sleep quality may increase pain perception, while unmanaged pain can further disrupt sleep, creating a negative cycle that impairs healing. Understanding how these factors interact is essential to improving postoperative outcomes.

Aim: This study aims to examine the mediating role of pain in the relationship between sleep quality on the first postoperative night and the level of recovery.

Methods: This descriptive and cross-sectional study was conducted with 250 patients who underwent laparoscopic cholecystectomy in the general surgery clinic of a university hospital. Data were collected using the Patient Information Form, the Richards-Campbell Sleep Questionnaire, the Quality of Recovery-40 Questionnaire, and the Visual Analogue Scale. For statistical analysis, Pearson correlation, regression, hierarchical regression, and bootstrap mediation analysis were performed.

Results: Sleep quality was found to be a significant and positive predictor of recovery (β = 0.415, p < .001). However, when pain was included in the model, the effect of sleep quality decreased but remained significant (β = 0.130, p = .035). The results of the bootstrap mediation analysis confirmed that pain was a significant mediator in this relationship.

Conclusion: Sleep quality influences postoperative recovery both directly and indirectly through pain levels. The findings suggest that holistic approaches to sleep and pain management in postoperative care processes may optimise recovery.