30 - E. Drugs and Disorders

E. Drugs and Disorders

© SPMM Course E. Drugs and Disorders Disorder / drugs Changes Alcohol  Increase SWS (chronic use – loss of SWS)  Reduce initial REM but increase second half REM Alcohol withdrawal  Loss of SWS  Increased REM  Intense REM rebound Anxiety disorders  Increased stage 1 sleep (light sleep)  Reduced REM, normal REM latency  Reduced slow wave sleep Benzodiazepines  Decrease sleep latency  Increase sleep time  Reduce stage 1 sleep  Increase stage 2 sleep  Reduce REM and SWS  REM rebound on cessation  Prevent the transition from lighter stage 2 sleep into deep, restorative (stages 3 and 4) sleep. Cannabis  Increase SWS  Suppress REM Carbamazepine  Suppresses REM and increases REM latency  Increases SWS Dementia  Increased sleep latency & fragmentation  Reduced sleep time Depression  Loss of SWS slow wave sleep (first half)  Increased REM (leading on to Early awakening)  Reduced REM latency Lithium  Suppresses REM and increases REM latency  Increases SWS Opiates  Decrease SWS & REM  Withdrawal REM rebound Schizophrenia  Inconsistent reduction in REM latency and slow wave sleep.  N.B.: Antipsychotics have variable effects SSRIs  Alerting due to 5HT2 stimulation  May reduce REM latency  Variable effects of REM suppression Stimulants  Reduce sleep time by decreasing both REM sleep and SWS  REM rebound on cessation (except modafinil) Tricyclics  REM suppression (especially Clomipramine)  Increased SWS and stage 1 sleep Z hypnotics  Less effect on sleep architecture; Zopiclone may increase SWS