ObjectiveTo investigate the impact of perioperative sleep disorders on short-term postoperative outcomes in patients undergoing coronary artery bypass grafting (CABG) and to provide a basis for optimizing clinical outcomes. MethodsThis single-center, prospective cohort study enrolled 295 patients scheduled for CABG at Xijing Hospital between August 2024 and September 2025. After screening, based on preoperative sleep assessments, patients were divided into a sleep disorder group and a non-sleep disorder group. Sleep status was evaluated using the Pittsburgh sleep quality index (PSQI) and cardiopulmonary coupling (CPC) sleep monitoring. Postoperative complication rates, recovery indicators, and laboratory results were compared between the two groups. Multivariate logistic regression analysis was performed to determine the association between sleep disorders and adverse postoperative outcomes. ResultsAfter screening, 256 patients including 201 males and 55 females with a mean age of (62.4±8.3) years, met the inclusion criteria. There were 157 patients in the sleep disorder group and 99 in the non-sleep disorder group. No statistically significant differences in baseline characteristics were found between the two groups (P>0.05). Compared with the non-sleep disorder group, the sleep disorder group had significantly higher incidences of postoperative delirium, atrial fibrillation (AF), hyperalgesia, and postoperative hypertension, longer ICU stays, extended duration of mechanical ventilation, and significantly increased postoperative drainage volume, elevated postoperative cardiac injury markers, poorer recovery of left ventricular ejection fraction, and a more severe inflammatory response (P＜0.05). Multivariate logistic regression analysis identified sleep disorder as an independent risk factor for postoperative AF (OR=2.21, 95%CI 1.20-4.06, P=0.010), delirium (OR=2.18, 95%CI 1.16-4.09, P=0.015), and hyperalgesia (OR=1.78, 95%CI 1.04-3.05, P=0.036). ConclusionPerioperative sleep disorder is closely associated with adverse short-term postoperative outcomes in patients undergoing CABG, as it increases the risk of postoperative complications and delays cardiac function recovery. These findings underscore the clinical importance of perioperative sleep management.