REM sleep and drugs

Q: Alcohol ______________ the REM sleep? (select one)

A) increases

B) suppresses

Answer: B

There needs to be more work done on the effect of medications on the sleep pattern of ICU patients, who are simultaneously subject to multiple infusions and high-impact medications. The Rapid Eye movement (REM) phase of sleep and its effect on ventilation remain an area of interest for clinicians. 

Many commonly used drugs in ICU suppress REM sleep, including sedatives-hypnotics, barbiturates, antiepileptics, beta antagonists, monoamine oxidase inhibitors (MOIs), selective serotonin reuptake inhibitors (SSRIs),  tricyclic antidepressants, and other stimulants such as alcohol. Also important to understand that sudden withdrawal of these drugs may increase the REM phase of sleep and can have consequential effects on the patient.

#sleep-in-icu

References;

1. España RA, Scammell TE. Sleep neurobiology from a clinical perspective. Sleep 2011; 34:845.

2. Cooper AB, Thornley KS, Young GB, Slutsky AS, Stewart TE, Hanly PJ. Sleep in critically ill patients requiring mechanical ventilation. Chest. 2000 Mar;117(3):809-18. doi: 10.1378/chest.117.3.809. Erratum in: Chest 2001 Mar;119(3):993. PMID: 10713011.

3. Messineo L, Eckert DJ, Taranto-Montemurro L, Vena D, Azarbarzin A, Hess LB, Calianese N, White DP, Wellman A, Gell L, Sands SA. Ventilatory Drive Withdrawal Rather Than Reduced Genioglossus Compensation as a Mechanism of Obstructive Sleep Apnea in REM Sleep. Am J Respir Crit Care Med. 2022 Jan 15;205(2):219-232. doi: 10.1164/rccm.202101-0237OC. PMID: 34699338; PMCID: PMC8787251.