The relationship between sleep disorders and postoperative delirium in adult patients: Protocol for an updated systematic review and meta-analysis.

INTRODUCTION

Postoperative delirium (POD) is a common complication after surgery. The association between sleep disorders and the risk of POD has been widely studied. Sleep disorders have emerged as a potential risk factor for POD, but recent studies provide conflicting evidence regarding the existence and the extent of the association. The aim of this systematic review and meta-analysis will be to estimate the association between sleep disorders and the risk of POD in adult patients.

METHODS AND ANALYSIS: A systematic review will be conducted to estimate the association between sleep disorders and the risk of POD in adult patients. This systematic review protocol follows the Preferred Reporting Items for Systematic Review and Meta-Analysis Protocols (PRISMA-P) statement. Literature searches will be carried out in the PubMed, Embase, CINAHL, and PsycINFO databases from inception until August 2025 without language restrictions. Only observational studies that investigated the association between sleep disorders and POD will be included. Two independent reviewers will be responsible for the selection of studies, extraction of information and risk of bias assessment of the articles. A random effects model will be used to calculate the pooled risk estimates for the outcome. Subgroup analysis will be conducted to explore potential sources of heterogeneity. Publication bias will be estimated by funnel plots and Egger's test. Sensitivity analysis will also be performed to explore the stability of the overall effect size. Also, evidence quality will be assessed. All data will be analysed using Review Manager (V.5.3) and Stata (V.14.0) statistical software.

DISCUSSION: The proposed systematic review and meta-analysis will highlight the association of sleep disorders and the risk of POD in adult patients. The findings of this review and meta-analysis will help clinicians consider the sleep disorders to make better health decisions. Trial registration: Prospero registration number: CRD42024604118.