The role of the glymphatic system in the development of chronopathological disorders in patients after surgery with prolonged anesthesia

Prolonged general anesthesia may disrupt the glymphatic system, leading to persistent postoperative sleep disorders.

• The glymphatic system is essential for clearing metabolites from the central nervous system, particularly during sleep.
• Dysfunction of this system can be caused by anesthetics, inhibiting aquaporin-4 activity and promoting oxidative stress and neuroinflammation.
• Anesthetics may adversely affect the suprachiasmatic nucleus and melatonin secretion, disrupting normal sleep patterns.
• Genetic factors, such as the APOE4 allele, may increase susceptibility to the effects of anesthesia on sleep.
• Chronotherapy, including melatonin, antioxidants, and glymphatic function modulators, could help restore normal sleep patterns.
• Personalized anesthesia protocols may be necessary to mitigate the impact on the glymphatic system and prevent sleep-related issues.

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