REVIEW article
Front. Psychiatry
Sec. Sleep Disorders
Volume 16 - 2025 | doi: 10.3389/fpsyt.2025.1612230
This article is part of the Research TopicThe Advance on Sleep Disorder: Mechanisms and InterventionsView all 15 articles
Esketamine for Postoperative Sleep Disturbance: Clinical Evidence, Mechanisms, and Future Directions
Provisionally accepted
- 1Lanzhou University, Lanzhou, Gansu Province, China
- 2First Hospital of Lanzhou University, Lanzhou, Gansu Province, China
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Postoperative sleep disturbance (PSD) is a common complication following surgery. Numerous factors can contribute to PSD, including personal factors, intraoperative factors, postoperative complications and environmental factors. PSD can lead to a range of adverse outcomes, severely impairing patients' postoperative recovery and long-term prognosis. Esketamine, a noncompetitive N-methyl-D-aspartate (NMDA) receptor antagonist and the dextrorotatory isomer of ketamine, which has stronger receptor affinity, more significant analgesic effects and better safety than ketamine. In recent years, in addition to the proven sedative, analgesic and antidepressant properties, emerging evidence highlights that esketamine may improve PSD through a variety of mechanisms, but the existing research results are still controversial. This article reviews the latest research progress of esketamine in improving PSD, and discusses its clinical efficacy and potential mechanism of action, in order to provide theoretical basis and practical guidance for optimizing perioperative anesthesia management and promoting postoperative rehabilitation of patients.
Keywords: Postoperative sleep disturbance, sleep quality, Esketamine, Ketamine, NMDA receptor antagonist
Received: 15 Apr 2025; Accepted: 23 Oct 2025.
Copyright: © 2025 Liu, Liu, Fu, Gao and Liu. This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) or licensor are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms.
* Correspondence: Yatao Liu, liuyt@lzu.edu.cn
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