It is very common to feel more sleepy and fatigued after having breast surgery. The combination of the physical trauma of surgery, anesthetic drugs, pain medications, and the body’s natural healing process means that excessive sleeping and fatigue are normal postoperative symptoms. However, while a certain degree of increased sleepiness is expected, excessive sleepiness that persists could potentially indicate complications.
Is feeling sleepy and tired normal after breast surgery?
Yes, increased sleepiness and fatigue after breast surgery is normal. Here are some key reasons why:
The physical trauma of surgery
Breast surgery, whether a mastectomy, breast reduction, breast lift, or breast augmentation, involves cutting, reshaping and manipulating living breast tissue. This causes trauma to the tissue, nerves and local blood vessels. The body responds by increasing inflammatory chemicals and kicking the immune system into overdrive to heal the wounds. This natural healing process places extra demands on the body that can leave patients feeling drained of energy and needing extra sleep.
The effects of anesthesia
Most breast surgery is performed under general anesthesia – which means you are fully asleep. Anesthetic drugs can make people feel exhausted, groggy and sleepy for a few days after as the drugs gradually leave the system. The length of surgery can also contribute – longer surgeries mean more anesthetic exposure.
Pain medications
Prescription opioid medications are commonly used to manage pain after breast surgery. Common side effects of these painkillers include drowsiness, cognitive impairment, fatigue and sleepiness. As the surgical pain subsides over the first week after surgery, patients can gradually reduce pain medications and feel more alert.
Interrupted and inadequate sleep
It can be difficult to get a proper night’s sleep after breast surgery. Wound discomfort, restrictive dressings, drains and a limited ability to find a comfortable sleeping position can all cut down adequate sleep. Poor sleep directly contributes to increased fatigue. As pain and wound healing progresses, sleep quality typically improves.
Low mood
Some women experience depression, flat mood and low motivation due to adjusting to changes to their body and breast appearance after surgery. A depressed mood state and associated alterations in neurotransmitters and hormones levels can also increase feelings of exhaustion.
Low iron levels
Blood loss during surgery, even if relatively minimal, can lower iron levels and contribute to postoperative fatigue and lack of energy. Iron supplementation may be recommended after surgery to help optimize red blood cell health.
How long will fatigue and sleepiness last?
While every patient’s experience is unique, usually the worst fatigue is experienced in the first 1-2 weeks after breast surgery. However, it can take anywhere from 2 to 6 weeks before energy levels and sleep needs return to normal pre-surgery patterns.
Factors that influence recovery speed include:
- Extent of surgery – more complex procedures mean longer recovery times
- Individual pain tolerance and pain management effectiveness
- Rate of wound healing
- Development of complications e.g. infections
- Pre-existing medical conditions e.g. anemia, diabetes, depression
- Availability of support for assistance with daily tasks
- Ability to eat a healthy diet
- Getting adequate sleep
With time, rest and following post-operative care instructions, the fatigue and sleepiness should gradually resolve.
Tips to manage fatigue after breast surgery
Here are some tips to help cope with excessive tiredness during recovery:
- Take scheduled naps – short 1 hour naps can help restore energy levels without interfering with nighttime sleep.
- Go to bed early – adjust bedtime earlier to ensure you’re getting enough sleep time.
- Ask for help – Don’t push yourself to do household chores. Ask family and friends for help.
- Stay hydrated – Dehydration exacerbates fatigue. Drink plenty of fluids.
- Eat nutrient rich foods – Choose fruits, vegetables, whole grains, beans, nuts, eggs, lean proteins to aid healing.
- Get light exercise – Short gentle walks help increase energy levels once your doctor approves.
- Listen to your body – Rest when tired. Don’t overexert yourself in the early recovery period.
- Take iron supplements if recommended by your doctor to help manage postoperative anemia.
Stay in close contact with your surgeon and report any concerns about persistent fatigue interfering with your ability to recover. Ongoing severe tiredness may require evaluation for complications or other factors impairing healing.
When to seek medical help for excessive sleepiness
While fatigue is normal, contact your doctor if you experience:
- Sleeping most of the day and night for days on end
- Difficulty staying awake for necessary activities like eating
- Fatigue interfering with physical therapy and recovery
- Fatigue not improving after several weeks
- Excessive sleepiness when reducing pain medication doses
- Falling asleep involuntarily
This degree of excessive and prolonged sleepiness may indicate:
- Depression or anxiety requiring counseling
- Sleep disordered breathing e.g. sleep apnea
- Anemia – low red blood cell counts
- Post-operative complications e.g. infections
- Adverse reactions or dependency on pain medications
- Underlying medical conditions e.g. thyroid disorders
If fatigue seems excessive or persists beyond one month after breast surgery, ask your doctor to evaluate for possible causes. Blood tests, sleep studies and treatment of correctable underlying factors may be warranted to get your energy back on track.
How to support someone recovering from breast surgery
For family and friends supporting a loved one after breast surgery, here are some tips that can help:
- Help with chores – Cooking, cleaning and shopping will be difficult. Offer to assist or arrange additional help.
- Provide transport – Driving can be challenging after surgery. Offer rides to medical appointments.
- Encourage rest – Don’t pressure them to overdo things. Suggest regular naps.
- Monitor energy – Note any comments about excessive fatigue and alert the care team.
- Offer company – Being present while they rest can provide comfort.
- Manage visitors – Limit visitors to reduce demands on their energy.
- Provide healthy meals – Help prepare nutritious foods or deliver meals.
- Listen attentively – Be open to any concerns they express about recovery.
- Create a calm environment – Reduce noise and distractions to aid rest and sleep.
Support and understanding from loved ones can help smooth the recovery process after breast surgery.
When to expect return to normal energy levels
Expect a gradual return to normal energy levels after:
- 1 week – Should need less sleep. Taking occasional naps.
- 2 weeks – Increase in periods of wakefulness. Less fatigue.
- 3-4 weeks – Sleeping longer at night. Most pain resolved.
- 6 weeks – Sleeping pre-surgery hours. Minimal fatigue.
However, every patient will experience their own unique recovery timeline. Be patient, listen to your body, and don’t hesitate to consult your surgeon if fatigue persists longer than expected.
Conclusion
Increased sleep needs and fatigue are very common during the recovery period after breast surgery. Allowing the body adequate rest facilitates healing. While some degree of sleepiness is normal, excessive prolonged sleepiness or fatigue can indicate complications or underlying medical conditions that require evaluation. With patience and proper post-operative self-care most women can expect a gradual return to their normal energy levels within 6 weeks.