Common sleeping pills may offer major benefit in opioid reduction

Taking melatonin or Ambien (zolpidem) before surgery may be associated with less pain and a smoother recovery afterward, according to new research.

Research presented at the ANESTHESIOLOGY 2026 annual meeting in San Diego on Oct. 18 found that improving sleep before surgery with one of these two sleeping pills could relieve anxiety while reducing postsurgical pain and opioid use.

Researchers analyzed 16 studies of patients who underwent abdominal, gynecological, orthopedic, urological, dental and other surgical procedures between 2000 and 2025.

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That represents more than 1,100 patients, according to a release from the American Society of Anesthesiologists.

Melatonin may be a better option than traditional sedatives for older adults who may be more likely to experience confusion after surgery, researchers said. (iStock)

Melatonin was usually taken the night before surgery and/or 20 to 90 minutes before anesthesia, in doses ranging from 1 mg to 20 mg.

Ambien, regularly dosed at 10 mg, was taken at bedtime either the night before surgery or over several nights up to two days before surgery.

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Although both are used as sleep aids, melatonin and Ambien work differently.

Melatonin is a natural hormone that helps regulate the sleep-wake cycle, according to the National Institutes of Health. Ambien, or zolpidem, acts on GABA-A receptors in the central nervous system to produce a sedative effect, FDA prescribing information states.

Sleep aids and surgery

Across studies, melatonin was associated with less anxiety, pain, and inflammation, in addition to a more than 30% reduction in opioid use in some abdominal surgery patients.

The analysis suggests that melatonin may offer advantages over traditional sedatives for older adults, who may be more prone to confusion after surgery. Studies using activity monitors also found that patients taking melatonin had improved recovery and sleep patterns.

Melatonin is a natural hormone that helps regulate the sleep-wake cycle, according to the National Institutes of Health. (iStock)

Ambien reportedly helped patients with pre-existing sleep problems sleep better before surgery and was also associated with less pain afterward.

Colorectal surgery patients taking Ambien needed fewer opioid medications during and in the 24 hours after surgery. They also had lower levels of inflammation.

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Those who underwent hip replacement surgery reportedly experienced less anxiety and depression and were more satisfied with the healing process.

Because this was a scoping study summarizing existing research rather than directly testing a treatment, the researchers could not make clinical recommendations or fully assess risk of bias. They noted that more research is needed.

Ambien reportedly helped patients with pre-existing sleep problems sleep better before surgery, and results revealed an association with reduced pain after surgery. (iStock)

Why sleep might affect pain

Dr. Sebastian Amaya, lead author of the study and senior resident in anesthesiology at Yale School of Medicine, said he was not surprised that improved sleep was associated with positive outcomes.

He noted that sleep is “extremely important” for maintaining overall health and controlling the immune system, cognitive functions and emotional well-being.

In the studies reviewed, melatonin and Ambien use was associated with less pain and less opioid use, the doctor reiterated.

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“Pain is ultimately an experience,” Amaya said, noting that a person’s environment and other individual factors can influence pain levels.

Sleep also plays an important role in brain function, including the processes involved in how pain is experienced, he added.

According to the researcher, several studies have shown that patients experienced decreased pain levels and decreased opioid consumption in the immediate postoperative period. (iStock)

“Many of the hormones involved in pain are also involved in sleep,” he said. “If you have insomnia, if you have other chronic sleep problems, all of these different biological pathways can be disrupted, which could lead to increased pain after surgery.”

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“So by having someone with optimized sleep preoperatively, we reduce the risk of increased pain after surgery.”

Opioids are commonly prescribed to manage pain after surgery, and research has linked greater postsurgical exposure to opioids to an increased risk of persistent use. Although the possibility that better sleep could reduce opioid use after surgery is promising, Amaya cautioned that the results are not conclusive.

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“Many of these studies showed that patients had decreased pain levels and decreased opioid consumption in the immediate postoperative period,” he said. “Unfortunately, they were not followed up over the next few days. That would be another study that would have to be done.”

Sleep experts recommend talking with a primary care provider about sleep solutions before surgery. (iStock)

Amaya said the goal is to get patients out of the hospital as quickly as possible while keeping pain under control. Improving sleep before surgery can be “low-hanging fruit,” especially since modern lifestyle factors such as blue light and noise can interfere with sleep quality.

“There are probably a lot of people who have poor quality sleep, and that can play a role when they have surgery and have post-operative issues, like a lot of pain,” he said. “Maybe their sleep could have been optimized with better sleep hygiene, or maybe they could have talked to their primary care doctor about it.”

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Dr. Wendy Troxel, a Utah-based licensed clinical psychologist and senior behavioral scientist at RAND who was not involved in the study, said the findings “make sense” from a sleep perspective.

“We know how important sleep is for healing and recovery, and it’s completely normal to feel anxious and sleep poorly before a major medical procedure,” she told Fox News Digital. “For some patients, a short-term sleeping pill at the time of surgery may help.”

Anxiety before the procedure and poor sleep quality are normal, an expert said.

Troxel suggested the problem would be that sleeping pills are generally not recommended as a long-term solution for insomnia.

“I’m a little surprised that melatonin showed benefit, because the overall evidence suggests that it has limited effects as a sleep aid for most people,” she noted. “It may be that placebo, or life expectancy effects, may also contribute, especially in such a stressful context.”

“We know how important sleep is for healing and recovery, and it is completely normal to feel anxious and sleep poorly before a major medical procedure.”

Despite the limitations, Troxel concluded that the results are “interesting and could have a positive impact on patient care during surgical procedures.”

For patients anticipating an upcoming surgery, Troxel noted that anxiety before surgery and inconsistent sleep are “normal” and there may be short-term solutions.

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“Anyone considering taking melatonin or a prescription sleep aid should check with their surgical and anesthesia team to see what is right for them,” she advised.

Fox News Digital has reached out to the makers of Ambien and melatonin for comment.