Episode 75 explores why sleep becomes so difficult after total knee replacement and why nighttime often feels harder than many people expect after surgery. Michelle explains the interaction between postoperative inflammation, swelling fluctuations, nervous system alertness, pain sensitivity, positioning discomfort, medication timing, and sleep monitoring behaviors. The episode also discusses why many people feel physically exhausted yet mentally alert after surgery and why disrupted sleep can remain unpredictable long after the daytime environment quiets down.Get the Making Sense of Pain After Knee Replacement on Amazon.The Kindle version is available now. The print version drops on May 30, 2026.Total Knee Success Insidertotalkneesuccess.comMedical Disclaimer: This podcast is for educational purposes only and does not constitute medical advice. The content is not intended to replace individualized medical guidance, diagnosis, or treatment. Always consult your surgeon, physical therapist, or other qualified healthcare provider regarding your specific condition, surgical decisions, and rehabilitation plan.Amazon Affiliate Disclaimer: Some resources mentioned in this podcast may include Amazon affiliate links. If you choose to purchase through these links, the podcast may earn a small commission at no additional cost to you.Evidence-Based Content Statement: All information presented in this episode is grounded in peer-reviewed research, published clinical guidelines, and current best practices in orthopedic surgery and rehabilitation.Music Licensing Statement: Intro and outro music for the Total Knee Success Podcast is licensed for commercial use. Editing and production for this episode were completed using Descript.References:Huang Z, Ma J, Shen B, Pei F. Combination of perioperative sleep disorder and depression can predict long-term outcomes after total knee arthroplasty. Knee Surg Sports Traumatol Arthrosc. 2021;29(6):1905-1914.Krenk L, Jennum P, Kehlet H. Sleep disturbances after fast-track total hip and knee arthroplasty. Br J Anaesth. 2012;109(5):769-775.Madsen MT, Rosenberg J, Gögenur I. Actigraphy for measurement of sleep and physical activity after surgery: a systematic review. Sleep Med Rev. 2013;17(5):387-398.Wylde V, Rooker J, Halliday L, Blom A. Acute postoperative pain at rest after hip and knee arthroplasty: severity, sensory qualities and impact on sleep. Orthop Traumatol Surg Res. 2011;97(2):139-144.Finan PH, Goodin BR, Smith MT. The association of sleep and pain: an update and a path forward. J Pain. 2013;14(12):1539-1552.Haack M, Simpson N, Sethna N, Kaur S, Mullington J. Sleep deficiency and chronic pain: potential underlying mechanisms and clinical implications. Neuropsychopharmacology. 2020;45(1):205-216.Ravyts SG, Dzierzewski JM, Grah SL, et al. Sleep and pain interference in individuals with chronic pain: the role of anxiety and sleep hygiene. J Clin Sleep Med. 2018;14(9):1565-1573.Smith TO, Mansfield M, Dainty JR, et al. Does sleep quality improve following total hip or knee arthroplasty? A systematic review. Clin Rehabil. 2017;31(11):1445-1456.

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