Objective To compare the effect of general anesthesia (GA) and combined spinal and epidural anesthesia (CSEA) on postoperative sleep quality in patients undergoing transurethral resection of prostate (TURP). Methods A total of 80 patients who underwent TURP in Chaohu Hospital Affiliated to Anhui Medical University were selected. According to the method of anesthesia, the patients were divided into two groups (n=40): GA group and CSEA group. Patients in the GA group underwent GA, while the CSEA group received CSEA. All patients received the same postoperative pain management. The patient conditions were evaluated on the day of surgery and on postoperative day 1. The sleep diaries were used to assess subjective sleep quality, including the number of awakening, sleep time, and sleep satisfaction. Furthermore, objective sleep quality was assessed by wearable smart wristbands recording total sleep time (TST), rapid eye movement (REM) time, light sleep time and deep sleep time. Postoperative pain was assessed by the Visual Analog Scale (VAS) score. Patient sedation was assessed using the Ramsay score. Results Compared with the CSEA group, the GA group showed increases in the number of awakening (P<0.05), and decreases in sleep satisfaction score (P<0.05), sleep time (P<0.05), TST and REM time and deep sleep time (P<0.05). On postoperative day 1, compared with the GA group, patients in the CSEA group showed reduced awakening times (P<0.05), extended sleep time (P<0.05), and increased sleep satisfaction scores (P<0.05), as well as prolonged REM and deep sleep time (P<0.05) and shortened light sleep time (P<0.05); there was no statistical difference in TST between the two groups (P>0.05). There were no statistical differences on VAS score and Ramsay score between the two groups on the day of surgery and on postoperative day 1 (P>0.05). Conclusions TURP patients receiving GA have more severe postoperative sleep disturbances, compared with CSEA.