Episode 76 explores what fragmented sleep can start changing after total knee replacement and why disrupted nights often affect far more than nighttime alone. Michelle explains how interrupted sleep can influence pain sensitivity, energy, focus, patience, and perceived effort during the day. The episode also discusses why progress can feel inconsistent when sleep is unreliable and why day-to-day variability can be normal in the early post-op period.Get the Making Sense of Pain After Knee Replacement on Amazon.Kindle version is available. 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: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. doi:10.1016/j.jpain.2013.08.007.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. doi:10.1038/s41386-019-0439-z.Krenk L, Jennum P, Kehlet H. Sleep disturbances after fast-track hip and knee arthroplasty. Br J Anaesth. 2012;109(5):769-775. doi:10.1093/bja/aes239.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. doi:10.1177/0269215517690842.Mehta N, Sancheti P, Sanghavi S, et al. Sleep quality improves after total knee arthroplasty: addressing early disturbance and risk factors. J ISAKOS. 2025;10(1):100373. doi:10.1016/j.jisako.2024.100373.Ferrero A, Patrucco F, Marcolin MG, Anzillotti G. Objective sleep disturbance after total hip and knee arthroplasty: a systematic review of wearable-derived metrics and targeted interventions. Arthroplast Today. 2026;39:102013. doi:10.1016/j.artd.2026.102013.Zhu Z, Zhu Z, Peng C, et al. Perioperative sleep disturbances in total knee arthroplasty: incidence, mechanisms, and management strategies. J Orthop Surg Res. 2025;20:964. doi:10.1186/s13018-025-06416-5.Smith TJ, Wilson MA, Karl JP, et al. Impact of sleep restriction on local immune response and skin barrier restoration with and without “multinutrient” nutrition intervention. J Appl Physiol (1985). 2018;124(1):190-200. doi:10.1152/japplphysiol.00547.2017.

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