ArticleJournal of the American Geriatrics Society2024
Postoperative use of sleep aids and delirium in older adults after major surgery: A retrospective cohort study.
Article in Journal of the American Geriatrics Society, 2024. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 4 papers.
What it found
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Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
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Who cites it
4 citing papers in PubMed.
- Recent Evidence on Factors and Potential Interventions Affecting Patient Sleep in Inpatient and Hospital Settings.Current psychiatry reports · 2026Review
- The Real-World Safety Profile of Temazepam: A 20-Year Pharmacovigilance Analysis Based on the Large-Scale FAERS Database.CNS neuroscience & therapeutics · 2026Article
- Perioperative transcutaneous auricular vagus nerve stimulation and EEG biomarkers of sleep improvement after gynecologic laparoscopy: protocol for a randomized controlled trial.Frontiers in medicine · 2026Article
- Effect of stellate ganglion block on delirium after major surgery in elderly patients: protocol for a randomised controlled study.BMJ open · 2025Article
Corrections and comments
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Authors and funding
4 authors.
Funding
Abstract
backgroundSleep aids are commonly prescribed to treat sleep disturbance, a modifiable risk factor for postoperative delirium in older patients. The use of melatonin receptor agonists in the postoperative period has been increasing. The comparative safety of melatonin receptor agonists, zolpidem, and temazepam remains uncertain.
methodsThis retrospective study included 22,083 patients ≥65 years old who initiated melatonin receptor agonists, zolpidem, or temazepam after major surgery in the Premier Healthcare Database 2009-2018. We performed propensity score-based overlap weighting and estimated the risk ratio (RR) and risk difference (RD) of postoperative delirium as the primary outcome and a composite of delirium or new antipsychotic initiation, pneumonia, and in-hospital mortality as secondary outcomes.
resultsThe mean age of the study population was 78 (SD, 7) years and 50% were female. There was no significant difference in the risk of postoperative delirium among patients treated with melatonin receptor agonists (3.4%, reference group), zolpidem (2.9%; RR [95% CI], 0.9 [0.7-1.2]; RD [95% CI] per 100 persons, -0.3 [-1.1 to 0.6]), and temazepam (3.1%; 0.9 [0.7-1.1]; RD [95% CI] per 100 persons, -0.5 [-1.2 to 0.3]). The risks of delirium or new antipsychotic initiation, pneumonia, and in-hospital mortality were also similar among all groups.
conclusionsMelatonin receptor agonists were not associated with a lower risk of postoperative delirium and other adverse outcomes compared with zolpidem and temazepam in older adults after major surgery.
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