{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,7,10]],"date-time":"2026-07-10T06:16:26Z","timestamp":1783664186142,"version":"3.55.0"},"reference-count":46,"publisher":"Frontiers Media SA","license":[{"start":{"date-parts":[[2026,7,10]],"date-time":"2026-07-10T00:00:00Z","timestamp":1783641600000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":["frontiersin.org"],"crossmark-restriction":true},"short-container-title":["Front. Med."],"abstract":"\n Background<\/jats:title>\n Postoperative sleep disturbance is common in surgical patients and may slow recovery. Dexmedetomidine has a sleep like sedative effect, and intranasal administration provides a convenient and non-invasive route. The aim of our study was to evaluate the effect of intranasal dexmedetomidine on postoperative sleep quality in adult surgical patients.<\/jats:p>\n <\/jats:sec>\n \n Methods<\/jats:title>\n We performed a systematic review and meta-analysis of randomized controlled trials. PubMed, the Cochrane Library and Embase were searched to May 20, 2026. Intranasal dexmedetomidine was compared with placebo or other controls. Subjective and objective sleep outcomes, sleep disturbance and adverse events were analysed using standard meta-analytic methods. Subgroup analyses were further performed according to the route, timing, and duration of administration, as well as patient characteristics, surgical type, anesthesia type, and evaluation scales.<\/jats:p>\n <\/jats:sec>\n \n Results<\/jats:title>\n \n 15 trials were included. For subjective scores where a lower value means better sleep, intranasal dexmedetomidine improved postoperative sleep compared with controls (SMD\u202f=\u202f\u22121.29, 95% CI [\u22121.80, \u22120.77],\n I<\/jats:italic>\n 2<\/jats:sup>\n =\u202f90%,\n p<\/jats:italic>\n &lt;\u202f0.00001). Subgroup analyses suggested that the timing of administration, sex distribution, and surgical type might be important sources of heterogeneity. For scores where a higher value means better sleep, postoperative scores were also higher in the dexmedetomidine group (SMD\u202f=\u202f1.75, 95% CI [0.94, 2.57],\n I<\/jats:italic>\n 2<\/jats:sup>\n \u202f=\u202f94%,\n p<\/jats:italic>\n \u202f&lt;\u202f0.0001). Sleep efficiency (SMD\u202f=\u202f1.71, 95% CI [0.94, 2.48],\n I<\/jats:italic>\n 2<\/jats:sup>\n =\u202f93%, p\u202f&lt;\u202f0.0001) and total sleep time (SMD\u202f=\u202f1.76, 95% CI [0.67, 2.84],\n I<\/jats:italic>\n 2<\/jats:sup>\n \u202f=\u202f91%,\n p<\/jats:italic>\n \u202f=\u202f0.002) increased, sleep latency (SMD\u202f=\u202f\u22121.07, 95% CI [\u22121.66, \u22120.49],\n I<\/jats:italic>\n 2<\/jats:sup>\n \u202f=\u202f86%,\n p<\/jats:italic>\n \u202f=\u202f0.0003) reduced, while REM sleep, N1 sleep, and N3 sleep did not change. The risk of sleep disturbance decreased (RR\u202f=\u202f0.53, 95% CI [0.39, 0.73],\n I<\/jats:italic>\n 2<\/jats:sup>\n =\u202f74%,\n p<\/jats:italic>\n &lt;\u202f0.0001). Adverse events such as delirium, nausea and vomiting, and anxiety were less common in the dexmedetomidine group.\n <\/jats:p>\n <\/jats:sec>\n \n Conclusion<\/jats:title>\n Intranasal dexmedetomidine may improve short-term postoperative sleep, but evidence is limited and more high-quality trials are needed.<\/jats:p>\n <\/jats:sec>\n \n Systematic review registration<\/jats:title>\n \n PROSPERO 2025 CRD420251186146, Available from\n https:\/\/www.crd.york.ac.uk\/PROSPERO\/view\/CRD420251186146<\/jats:ext-link>\n .\n <\/jats:p>\n <\/jats:sec>","DOI":"10.3389\/fmed.2026.1890318","type":"journal-article","created":{"date-parts":[[2026,7,10]],"date-time":"2026-07-10T05:38:09Z","timestamp":1783661889000},"update-policy":"https:\/\/doi.org\/10.3389\/crossmark-policy","source":"Crossref","is-referenced-by-count":0,"title":["Effects of intranasal dexmedetomidine on postoperative sleep quality: a systematic review and meta-analysis of randomized controlled trials"],"prefix":"10.3389","volume":"13","author":[{"given":"Jiacheng","family":"Zhao","sequence":"first","affiliation":[{"name":"Department of Anesthesiology, Suzhou Ninth Hospital Affiliated to Soochow University","place":["Suzhou, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Chao","family":"Zhang","sequence":"additional","affiliation":[{"name":"Department of Anesthesiology, Suzhou Ninth Hospital Affiliated to Soochow University","place":["Suzhou, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Hui","family":"Li","sequence":"additional","affiliation":[{"name":"Department of Anesthesiology, Suzhou Ninth Hospital Affiliated to Soochow University","place":["Suzhou, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yuxin","family":"Qiu","sequence":"additional","affiliation":[{"name":"Department of Anesthesiology, The First Affiliated Hospital, Sun Yat-sen University","place":["Guangzhou, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jinbiao","family":"Li","sequence":"additional","affiliation":[{"name":"Department of Anesthesiology, Suzhou Ninth Hospital Affiliated to Soochow University","place":["Suzhou, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Hui","family":"Cao","sequence":"additional","affiliation":[{"name":"Department of Anesthesiology, Suzhou Ninth Hospital Affiliated to Soochow University","place":["Suzhou, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Xinggen","family":"Zhou","sequence":"additional","affiliation":[{"name":"Department of Anesthesiology, Suzhou Ninth Hospital Affiliated to Soochow University","place":["Suzhou, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Siyao","family":"Guan","sequence":"additional","affiliation":[{"name":"Department of Anesthesiology, Suzhou Ninth Hospital Affiliated to Soochow University","place":["Suzhou, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jie","family":"Wang","sequence":"additional","affiliation":[{"name":"Department of Anesthesiology, Suzhou Ninth Hospital Affiliated to Soochow University","place":["Suzhou, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ming","family":"Yao","sequence":"additional","affiliation":[{"name":"Department of Anesthesiology, Suzhou Ninth Hospital Affiliated to Soochow University","place":["Suzhou, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1965","published-online":{"date-parts":[[2026,7,10]]},"reference":[{"key":"ref1","doi-asserted-by":"publisher","first-page":"8","DOI":"10.3389\/fmed.2021.640416","article-title":"Perioperative sleep disorder: a review","volume":"8","author":"Lin","year":"2021","journal-title":"Front Med (Lausanne)"},{"key":"ref2","doi-asserted-by":"publisher","first-page":"271","DOI":"10.7555\/JBR.33.20190054","article-title":"Postoperative sleep disorders and their potential impacts on surgical outcomes","volume":"34","author":"Rampes","year":"2020","journal-title":"J Biomed Res"},{"key":"ref3","doi-asserted-by":"publisher","first-page":"1192","DOI":"10.21037\/gs-22-312","article-title":"Relationship of sleep disturbance and postoperative delirium: a systematic review and meta-analysis","volume":"11","author":"He","year":"2022","journal-title":"Gland Surg"},{"key":"ref4","doi-asserted-by":"publisher","first-page":"323","DOI":"10.4097\/kja.19259","article-title":"Dexmedetomidine: present and future directions","volume":"72","author":"Lee","year":"2019","journal-title":"Korean J Anesthesiol"},{"key":"ref5","doi-asserted-by":"publisher","first-page":"69","DOI":"10.1016\/j.clinph.2017.10.005","article-title":"Dexmedetomidine promotes biomimetic non-rapid eye movement stage 3 sleep in humans: a pilot study","volume":"129","author":"Akeju","year":"2018","journal-title":"Clin 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patients undergoing elective thoracoscopic lung surgery: a prospective, randomized study","volume":"16","author":"Mei","year":"2024","journal-title":"Nat Sci Sleep"},{"key":"ref12","doi-asserted-by":"publisher","first-page":"960","DOI":"10.1016\/j.bja.2017.11.100","article-title":"Pharmacokinetic and pharmacodynamic study of intranasal and intravenous dexmedetomidine","volume":"120","author":"Li","year":"2018","journal-title":"Br J Anaesth"},{"key":"ref13","doi-asserted-by":"publisher","first-page":"1613","DOI":"10.2147\/DDDT.S461122","article-title":"Preoperative anxiolytic and sedative effects of intranasal remimazolam and dexmedetomidine: a randomized controlled clinical study in children undergoing general surgeries","volume":"18","author":"Cai","year":"2024","journal-title":"Drug Des Devel Ther"},{"key":"ref14","doi-asserted-by":"publisher","first-page":"66","DOI":"10.1186\/s12871-025-02939-w","article-title":"Efficacy of intranasal dexmedetomidine-esketamine sedation for pediatric acceptance of facemask: single-center, double-blind, randomized, controlled trial","volume":"25","author":"Zhang","year":"2025","journal-title":"BMC Anesthesiol"},{"key":"ref15","doi-asserted-by":"publisher","first-page":"e0154192","DOI":"10.1371\/journal.pone.0154192","article-title":"Intranasal dexmedetomidine as a sedative premedication for patients undergoing suspension laryngoscopy: a randomized double-blind study","volume":"11","author":"Lu","year":"2016","journal-title":"PLoS One"},{"key":"ref16","doi-asserted-by":"publisher","first-page":"2045","DOI":"10.1007\/s11325-021-02342-y","article-title":"Dexmedetomidine-soaked nasal packing can reduce pain and improve sleep quality after nasal endoscopic surgery: a double-blind, randomized, controlled clinical trial","volume":"25","author":"Wang","year":"2021","journal-title":"Sleep Breath"},{"key":"ref17","doi-asserted-by":"publisher","first-page":"26","DOI":"10.3389\/jpps.2023.11699","article-title":"Clinical observation of 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range","volume":"14","author":"Wan","year":"2014","journal-title":"BMC Med Res Methodol"},{"key":"ref27","doi-asserted-by":"publisher","first-page":"1519","DOI":"10.1111\/anae.16726","article-title":"Pre-operative dexmedetomidine nasal spray and emergence agitation in adults undergoing ear, nose and throat surgery: a randomised controlled trial","volume":"80","author":"Wang","year":"2025","journal-title":"Anaesthesia"},{"key":"ref28","doi-asserted-by":"publisher","first-page":"17","DOI":"10.1186\/s13741-024-00371-1","article-title":"Effects of short-term preoperative intranasal dexmedetomidine plus conventional treatment on delirium following cardiac surgery in patients with sleep disorders","volume":"13","author":"Fang","year":"2024","journal-title":"Periop Med"},{"key":"ref29","doi-asserted-by":"publisher","first-page":"6061","DOI":"10.2147\/DDDT.S487463","article-title":"Intranasal dexmedetomidine for the Management of Preoperative Anxiety-Related Insomnia: a randomized, three-blinded, clinical trial compared with lorazepam and placebo","volume":"18","author":"Yang","year":"2024","journal-title":"Drug Des Devel Ther"},{"key":"ref30","doi-asserted-by":"publisher","first-page":"42","DOI":"10.1186\/s12871-024-02417-9","article-title":"Dexmedetomidine nasal administration improves perioperative sleep quality and neurocognitive deficits in elderly patients undergoing general anesthesia","volume":"24","author":"He","year":"2024","journal-title":"BMC Anesthesiol"},{"key":"ref31","doi-asserted-by":"publisher","first-page":"1075","DOI":"10.1213\/ANE.0000000000006464","article-title":"Effect of different administration routes of dexmedetomidine on postoperative delirium in elderly patients undergoing elective spinal surgery: a prospective randomized double-blinded controlled trial","volume":"136","author":"Niu","year":"2023","journal-title":"Anesth Analg"},{"key":"ref32","doi-asserted-by":"publisher","first-page":"14","DOI":"10.3389\/fphar.2023.1223746","article-title":"Intranasal dexmedetomidine improves postoperative sleep quality in older patients with chronic insomnia: a randomized double-blind controlled trial","volume":"14","author":"Wu","year":"2023","journal-title":"Front Pharmacol"},{"key":"ref33","doi-asserted-by":"publisher","DOI":"10.3389\/fpsyt.2022.816893","article-title":"Intranasal dexmedetomidine for the treatment of pre-operative anxiety and insomnia: a prospective, randomized, controlled, and clinical trial","volume":"13","author":"Zeng","year":"2022","journal-title":"Front Psych"},{"key":"ref34","doi-asserted-by":"publisher","DOI":"10.1186\/s12871-026-03906-9","article-title":"Perioperative dexmedetomidine nasal spray improves postoperative sleep in patients undergoing thoracoscopic lung surgery: a prospective, randomized controlled trial","volume":"26","author":"Ling","year":"2026","journal-title":"BMC Anesthesiol"},{"key":"ref35","doi-asserted-by":"publisher","first-page":"1","DOI":"10.2147\/DDDT.S582503","article-title":"A novel standardized dexmedetomidine nasal spray formulation for procedural sedation during venous port implantation: a randomized, double-blind, placebo-controlled clinical trial","volume":"20","author":"Tong","year":"2026","journal-title":"Drug Des Devel Ther"},{"key":"ref36","doi-asserted-by":"publisher","first-page":"11842","DOI":"10.1038\/s41598-026-39450-2","article-title":"Effects of different administration routes of dexmedetomidine on sleep quality in patients undergoing total knee arthroplasty","volume":"16","author":"Huang","year":"2026","journal-title":"Sci Rep"},{"key":"ref37","doi-asserted-by":"publisher","first-page":"213","DOI":"10.1186\/s12871-026-03720-3","article-title":"Intranasal low-dose dexmedetomidine alleviates propofol-associated postoperative sleep disturbance in female hysteroscopy patients: a randomized controlled trial","volume":"26","author":"Wang","year":"2026","journal-title":"BMC Anesthesiol"},{"key":"ref38","doi-asserted-by":"publisher","first-page":"10821","DOI":"10.2147\/DDDT.S559012","article-title":"Preventive effect of preoperative intranasal dexmedetomidine for postoperative delirium in elderly patients with sleep disorders undergoing major noncardiac surgery: a randomized, triple-blind, placebo-controlled trial","volume":"19","author":"Chen","year":"2025","journal-title":"Drug Des Devel Ther"},{"key":"ref39","doi-asserted-by":"publisher","DOI":"10.1002\/mco2.70213","article-title":"The nasal\u2013brain drug delivery route: mechanisms and applications to central nervous system diseases","volume":"6","author":"Qiu","year":"2025","journal-title":"MedComm (Beijing)"},{"key":"ref40","doi-asserted-by":"publisher","first-page":"775","DOI":"10.3390\/pharmaceutics17060775","article-title":"Intranasal drug delivery Technology in the Treatment of central nervous system diseases: challenges, advances, and future research directions","volume":"17","author":"Wu","year":"2025","journal-title":"Pharmaceutics"},{"key":"ref41","doi-asserted-by":"publisher","first-page":"476","DOI":"10.1097\/ALN.0000000000005314","article-title":"Effects of subanesthetic oromucosal dexmedetomidine on sleep in humans: a randomized, controlled pharmacokinetics\u2013pharmacodynamics study","volume":"142","author":"Schnider","year":"2025","journal-title":"Anesthesiology"},{"key":"ref42","doi-asserted-by":"publisher","first-page":"4495","DOI":"10.1097\/JS9.0000000000002489","article-title":"Effect of dexmedetomidine for epidural supplementation on postpartum sleep disturbance after cesarean delivery: a double-blind, randomized clinical trial","volume":"111","author":"Li","year":"2025","journal-title":"Int J Surg"},{"key":"ref43","doi-asserted-by":"publisher","first-page":"315","DOI":"10.1186\/s12871-024-02708-1","article-title":"Safety and efficacy of a novel dexmedetomidine nasal spray for pre-anesthetic sedation in children: a randomized, double-blind, placebo-controlled trial","volume":"24","author":"Gao","year":"2024","journal-title":"BMC Anesthesiol"},{"key":"ref44","doi-asserted-by":"publisher","DOI":"10.3389\/fphar.2025.1528612","article-title":"Comparison of a ready-to-use intranasal dexmedetomidine spray with traditional intranasal dexmedetomidine drops for sedation in preschool children: a prospective, randomized, controlled study","volume":"16","author":"Jin","year":"2025","journal-title":"Front Pharmacol"},{"key":"ref45","doi-asserted-by":"publisher","first-page":"1210","DOI":"10.1111\/j.1365-2044.2012.07309.x","article-title":"A randomised comparison of two intranasal dexmedetomidine doses for premedication in children","volume":"67","author":"Yuen","year":"2012","journal-title":"Anaesthesia"},{"key":"ref46","doi-asserted-by":"publisher","first-page":"834","DOI":"10.1007\/s12630-016-0617-y","article-title":"Dosing and efficacy of intranasal dexmedetomidine sedation for pediatric transthoracic echocardiography: a retrospective study","volume":"63","author":"Miller","year":"2016","journal-title":"Can J Anesth\/J Can Anesth"}],"container-title":["Frontiers in 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