{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,28]],"date-time":"2026-08-28T09:19:49Z","timestamp":1787908789728,"version":"build-2784847793"},"reference-count":40,"publisher":"Wiley","issue":"1","license":[{"start":{"date-parts":[[2024,11,17]],"date-time":"2024-11-17T00:00:00Z","timestamp":1731801600000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"},{"start":{"date-parts":[[2024,11,17]],"date-time":"2024-11-17T00:00:00Z","timestamp":1731801600000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/doi.wiley.com\/10.1002\/tdm_license_1.1"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Acta Anaesthesiol Scand"],"published-print":{"date-parts":[[2025,1]]},"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Introduction<\/jats:title>\n                    <jats:p>The circadian timing system regulates diurnal sleep\u2013wake rhythm. Previously, we showed that, in patients undergoing elective surgery, sleep\u2013wake timing is altered and post\u2010operative sleep quality is reduced. However, how the timing of the surgical procedure affects the disturbance and what other factors affect this disturbance remain unknown.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>Single\u2010centre prospective observational study investigating the influence of surgery timing on post\u2010operative sleep in adult patients (\u226518\u2009years) undergoing elective surgery. Sleep\u2013wake timing was measured from three nights before until seven nights after surgery with a daily sleeping log. Primary outcome was post\u2010operative midpoint of sleep shift between patients undergoing morning and afternoon surgeries. Secondary outcomes included factors affecting sleep timing disturbance and changes in subjective sleep quality.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      We included 259 patients: 144 patients underwent morning procedures (08:00\u2009h\u201312:00\u2009h) and 115 underwent afternoon procedures (12:00\u2009h\u201317:00\u2009h). Both groups had significant phase advance of midpoint of sleep on the night after surgery when compared with three nights before surgery (mean\u2009\u2212\u200900:41\u2009h, 95% CI \u221200:27\u2009h to \u221200:54\u2009h,\n                      <jats:italic>p<\/jats:italic>\n                      \u2009&lt;\u2009.001, for morning surgery and mean\u2009\u2212\u200900:28\u2009h, 95% CI \u221200:09\u2009h to \u221200:46\u2009h,\n                      <jats:italic>p<\/jats:italic>\n                      \u2009=\u2009.003, for afternoon surgery). However, there was no between\u2010group difference (mean\u2009\u2212\u200900:13\u2009h, 95% CI \u221200:35\u2009h\u201300:09\u2009h,\n                      <jats:italic>p<\/jats:italic>\n                      \u2009=\u2009.25). Reduction of sleep quality was also similar. Phase advance was larger for patients with an evening chronotype or with lower pre\u2010operative sleep quality. Decline of sleep quality after surgery was larger for patients with an evening chronotype, longer procedures or better pre\u2010operative sleep quality.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>Our results suggest that the timing of surgery between 08:00\u2009h and 17:00\u2009h does not modulate the effect of anaesthesia and surgery on phase of the sleep\u2013wake rhythm in patients undergoing elective surgery with a low pre\u2010operative risk of delirium.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Editorial Comment<\/jats:title>\n                    <jats:p>Timing of surgery may impact post\u2010operative sleep. However, in this prospective cohort study of elective surgical patients, sleep\u2013wake timing and post\u2010operative sleep quality did not differ between those undergoing morning versus afternoon surgery.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1111\/aas.14543","type":"journal-article","created":{"date-parts":[[2024,11,17]],"date-time":"2024-11-17T22:19:45Z","timestamp":1731881985000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":1,"title":["Effects of morning versus afternoon surgery on peri\u2010operative disturbance of sleep\u2013wake timing: An observational study"],"prefix":"10.1111","volume":"69","author":[{"ORCID":"https:\/\/orcid.org\/0009-0004-4268-4401","authenticated-orcid":false,"given":"Arjen J. 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