PT  - JOURNAL ARTICLE
AU  - Afkhamnejad, Elahhe
AU  - Kumar, Sandhya
TI  - The Role of Prescription Drugs in REM Sleep (P1.109)
DP  - 2018 Apr 10
TA  - Neurology
PG  - P1.109
VI  - 90
IP  - 15 Supplement
4099  - http://n.neurology.org/content/90/15_Supplement/P1.109.short
4100  - http://n.neurology.org/content/90/15_Supplement/P1.109.full
SO  - Neurology2018 Apr 10; 90
AB  - Objective: To evaluate the effect of antidepressant and antipsychotic drugs on sleep, we hypothesized that patients taking these medications alone or in combination would achieve significantly less REM stage sleep.Background: Previous research has determined that humans spend 20% of their time sleeping in the rapid-eye movement (REM) stage. Antidepressant medications have been shown to decrease time spent in REM sleep while the effects of antipsychotics have not been fully evaluated.Design/Methods: We conducted a retrospective chart review of 258 polysomnograms from patients of the Wake Forest Department of Sleep Medicine from September 2012 to July 2017. Participants were included if they were over the age of 18 and had undergone a full night polysomnogram while on an antidepressant and/or an antipsychotic. Participants diagnosed with sleep apnea were excluded. Antidepressants included citalopram, escitalopram, fluoxetine, paroxetine, duloxetine, venlafaxine, bupropion, mirtazapine, and trazadone. Antipsychotics included haloperidol, aripiprazole, lurasidone, olanzapine, risperidone, quetiapine, and ziprasidone.Patients were placed into one of four categories based on their medication: One Antidepressant (125 participants), Multiple Antidepressants (70 participants), Antidepressant and Antipsychotic (45 participants), or Antipsychotic Alone (18 participants). The average percent REM sleep for each category was compared to the 20% control value mentioned in the Background and to each other category using a t-test with unequal variances.Results: The average percent REM sleep for each category was calculated as follows: One Antidepressant:12.4%Multiple Antidepressants:12.5%Antidepressant and Antipsychotic: 8.2%Antipsychotic Alone: 8.8%All categories achieved statistically significant lower REM amounts than the control (p-value =.0001). Categories 3 and 4 achieved statistically significant lower REM amounts than categories 1 and 2 (p-value =.0002).Conclusions: Antidepressants and antipsychotics, alone and in combination, reduce REM sleep in humans with antipsychotics driving REM lower than antidepressants. These drugs may interrupt normal sleep architecture by increasing serotonin levels, which typically plummet during REM.Study Supported by: Clinical and Translational Science InstituteDisclosure: Dr. Afkhamnejad has nothing to disclose. Dr. Kumar has nothing to disclose.