Abstract: Perioperative sleep disorders can present as obstructive sleep apnea, insufficient total sleep time, increased nighttime awakenings, and circadian rhythm disturbances, which have profoundly negative effects on disease prognosis. There is an urgent need for more effective preventive and therapeutic strategies. As an N-methyl-D-aspartate (NMDA) receptor antagonist, ketamine and its dextroisomer (esketamine) are widely recognized for their antidepressant, sedative, and analgesic effects. Recent studies have confirmed their regulatory effects on sleep cycles and circadian rhythms, significantly improving sleep quality. These effects may be related to their antidepressant, anti-inflammatory, analgesic properties, and regulation of circadian clock genes.