Understanding The Factors Blocking Your Rem Sleep

REM sleep, or rapid eye movement sleep, is a unique phase of sleep in mammals and birds, characterised by random rapid eye movement, low muscle tone, and the propensity to dream vividly. Many factors can block REM sleep, including certain drugs and medical conditions. For example, antidepressants are known to suppress REM sleep, and selective serotonin reuptake inhibitors (SSRIs) have been shown to disturb sleep. On the other hand, tricyclic antidepressants (TCAs) and serotonin antagonist and reuptake inhibitors (SARIs) have been found to improve sleep quality and continuity. Mood-altering drugs, such as cocaine, ecstasy, and LSD, also suppress REM sleep. Additionally, conditions like REM sleep-related brady-arrhythmia syndrome can disrupt this sleep phase, leading to cardiac rhythm disorders.

Antidepressants

The impact of antidepressants on sleep initiation and maintenance is more specific to the type of antidepressant. For example, SSRIs can cause insomnia and worsen sleep quality, while bupropion has been found to be surprisingly more favourable for sleep. It is activating during the day and has a neutral or positive effect on sleep architecture.

Mirtazapine and trazodone are two antidepressants that can help patients fall asleep and improve their sleep architecture. However, mirtazapine's sedative effects are greater in the lower dose range (15mg and below), which may not be sufficient to treat depression. Trazodone's sedative effects tend to wear off over time, and it carries risks such as daytime fatigue and dry mouth, which can further interfere with sleep.

Some antidepressants may also induce or exacerbate sleep disorders such as restless legs syndrome, sleep bruxism, REM sleep behaviour disorder, and sleep apnea.

Nicotine

Effects on Sleep

Withdrawal Effects

Quitting nicotine can also lead to sleep disturbances. During the initial days of withdrawal, individuals may experience a range of unpleasant symptoms, including constipation, diarrhea, headaches, anxiety, and irritability. Sleep issues are also common during this period, with about half of former smokers reporting trouble sleeping while trying to quit. The resulting sleep deficit can create a challenge for those attempting to stay away from cigarettes.

Improving Sleep While Quitting

To enhance sleep quality during nicotine withdrawal, it is recommended to incorporate physical activity during the day, reduce caffeine intake by stopping caffeinated beverages at least 8 hours before sleep, and consult a doctor about adjusting the dosage or timing of nicotine replacement therapy.

Alcohol

Additionally, alcohol influences the circadian rhythm by lowering melatonin levels and interfering with core body temperatures, impacting sleep quality. It may also worsen snoring and symptoms of obstructive sleep apnea, as it relaxes upper airway muscles, increasing airway resistance and the likelihood of airway blockage.

While alcohol can promote sleep onset, it ultimately disrupts sleep architecture and quality. Its effects on sleep stages, hormones, and the circadian rhythm contribute to a restless and fragmented night's rest. Therefore, despite its sedative properties, alcohol is not recommended as a sleep aid due to its detrimental impact on overall sleep.

Marijuana

Cannabis has several active compounds, including tetrahydrocannabinol (THC) and cannabidiol (CBD). While THC typically acts as a sedative, it can have a stimulating effect for some people, especially those who are new to using cannabis or taking higher doses. CBD appears to promote alertness at lower doses and sleepiness at higher doses.

THC is the main psychoactive cannabinoid in cannabis and is what gives the "high" associated with its use. It has been shown to have a range of therapeutic benefits, including pain relief. THC has sedative effects, and evidence indicates that it may improve breathing during sleep, making it a potential therapy for treating obstructive sleep apnea.

THC appears to play the most active role in altering sleep architecture and the time spent in specific sleep stages. Research has found that THC is most closely linked to reductions in REM sleep and increases in deep, slow-wave sleep and the lighter stages of non-REM sleep. While THC has clear sedative effects, a too-heavy concentration can lead to next-day grogginess.

CBD, on the other hand, is a non-mind-altering cannabinoid that promotes relaxation and has no psychoactive effects. It has been shown to reduce anxiety, relieve pain, and promote mental focus and clarity. CBD may also reduce symptoms of REM sleep behaviour disorder and excessive daytime sleepiness.

Cannabis with higher levels of THC typically reduces the amount of REM sleep. Reducing REM sleep means reducing dreams, and for those who experience PTSD, it could mean reducing nightmares. The theory is that if you spend less time dreaming, you'll spend more time in a "deep sleep" state, which is thought to be the most restorative and restful part of the sleep cycle.

However, REM sleep is important for healthy cognitive and immune functioning, and cannabis with higher THC levels could impair your sleep quality if taken long-term. Interrupted REM sleep may have negative effects on mood regulation and memory, and long-term cannabis use may also have unwanted effects on the brain, including difficulty with learning, memory, and focus.

Healthcare professionals generally discourage the long-term use of any sleep aid, including cannabis.

Cocaine

The impact of cocaine on sleep is not limited to the immediate effects. Chronic cocaine use can lead to long-term disruptions in sleep patterns and circadian rhythms. It can alter the brain's chemistry, making it challenging for individuals to regulate their sleep even after they stop using the drug. This is because cocaine can cause changes in gene expression, particularly in genes regulating the sleep-wake cycle.

Furthermore, cocaine use is often associated with other behaviours that can indirectly disrupt sleep. For example, cocaine users may experience rhinitis due to damage to their nasal passages, making it difficult to breathe and disrupting their sleep. The increased heart rate and blood pressure induced by cocaine can also make it challenging to fall asleep or maintain deep sleep. Additionally, the anxiety and paranoia induced by cocaine use can lead to sleep disorders and deprivation.

Overall, cocaine's impact on sleep is complex and far-reaching. It disrupts the natural balance of neurotransmitters, alters brain activity, and affects the different stages of sleep. These disruptions can have negative consequences on both physical and mental health, highlighting the importance of understanding and addressing sleep problems in individuals struggling with cocaine use.

Frequently asked questions