Hidden Gem Of Drugs That Interfere With Sleep
Everyone Must Know About Drugs Many factors influence sleep quality, but one that is not always considered is the medications that are taken. For this reason, Carlos Teixeira, vice president of the European Society of Sleep Technicians, reviews for CuídatePlus the effects of various drug families, on the occasion of his speech at the last Congress of the Spanish Sleep Society (SES), held in Vitoria.
Before going into the subject, the expert reviews the macrostructure of sleep, which is divided into two major phases: non-REM sleep (which, in turn, has three other phases) and REM sleep (in which dreams appear). . By completing these phases we complete a sleep cycle -which usually lasts between 90 and 120 minutes-, and each night we complete about four or five cycles.
In the brain, structures such as the hypothalamus, the frontal lobe, and the nuclei of the brain stem are related to sleep control. Also, there are many neurotransmitters that promote sleep or wakefulness, such as hypocretin or orexin, norepinephrine, serotonin, histamine, dopamine, acetylcholine, and GABA. That is the reason why a large number of drugs interfere with our sleep cycles.
“The prescription of antidepressants in Spain is tremendous, with an immense increase in the last ten years, surely for the life we have led, in a society in which we have to be available almost 24 hours a day,” Teixeira warns. Antidepressants are not intended directly as sleep, but they do influence sleep because they are sedative.
Why You Should Forget Everything You Learned About Drugs That Interfere With Sleep
Another great group are antiepileptics and anticonvulsants, which also have a sedative effect and increase total sleep time. Specifically, benzodiazepines – drugs with an antiepileptic, anxiolytic, hypnotic and muscle relaxant effect – promote drowsiness and decrease anxiety. Benzodiazepines are prescribed in patients with acute insomnia in order to reduce sleep latency (the time that passes from when we go to sleep until we fall asleep).
But “you have to be careful because, as they are drugs that are so depressants of the central nervous system, they can aggravate respiratory problems or even aggravate sleep apnea,” says the sleep expert. So how should they be used? “In theory, benzodiazepines should be used temporarily, the problem is that in reality it is not like that,” Teixeira regrets. “Melatonin works as a sleep regulator associated with the circadian rhythm, but it is not as potent as benzodiazepines and is much safer than this.”
Like benzodiazepines, opiates are also widely used and their central nervous system depressant effect is very powerful. Antipsychotics normally block dopamine, promoting some drowsiness. While antiparkinsonians what they do is decrease both REM sleep and deep sleep.
Another widely used group of drugs that can also cause drowsiness are the first-generation antihistamines (used to control allergy symptoms). “By passing the blood-brain barrier they are more sedating. They increase deep sleep and decrease REM. ” In contrast, second-generation antihistamines would give less drowsiness.
“Many patients on antihypertensive medication, such as beta-blockers, complain of nighttime insomnia, excessive daytime sleepiness, and increased sleep latency. In contrast, alpha agonists have a sedative effect, “says Teixeira. Antiarrhythmic drugs, which are used in patients with heart failure, also cause some insomnia and nightmares, claiming that they have dreams that seem very real to them.
As a precaution, the vice president of the European Society of Sleep Technicians considers that if the hypertensive patient reports that they have insomnia, their doctor should be vigilant and prescribe a medication that does not potentiate this sleep disorder. The time of day when the medication is consumed is also important, says the expert. “In the case of some medications for high blood pressure (HT), they should be taken in the morning precisely because of their effect on sleep.”