Pharmacological Interventions and Their Effects on Total Sleep, Slow Wave Sleep, and REM Sleep: A Scoping Review of Current Evidence
James Bates, Tyler Krall, James Kelbert, Christopher Lau, Joshua Tobin, Joyce Lee-IannottiBackground
Sleep plays a critical role in physical and cognitive health, with slow wave sleep serving as a particularly important restorative stage. Total sleep time and rapid eye movement sleep also contribute to overall sleep health and are frequently affected by pharmacological interventions targeting sleep architecture.
Objective
To map and summarize the existing evidence regarding the effects of pharmacological interventions primarily on slow wave sleep, with total sleep time and rapid eye movement sleep examined as secondary outcomes to provide broader context for changes in sleep architecture.
Eligibility Criteria
English-language studies evaluating pharmacologic agents and their quantified effects on sleep architecture in human or animal models were eligible for inclusion.
Sources of Evidence
A systematic search of the Ovid Medline database was performed to identify studies published between January 1, 1990, and July 1, 2024.
Charting Methods
Relevant studies were screened, and data were extracted regarding medication class, mechanism of action, and reported effects on total sleep time, slow wave sleep time, and rapid eye movement sleep time.
Results
The search identified 324 relevant articles, of which 71 met inclusion criteria and were included in the final review. The findings delineate four primary categories of medications that influence total sleep time, slow wave sleep, and rapid eye movement sleep: antipsychotics, neurotransmitter modulators, hormone-based treatments, and dopaminergic agents. Evidence suggests that several pharmacological agents influence sleep architecture, with some medications demonstrating the ability to increase total sleep time, enhance slow wave sleep, or modulate rapid eye movement sleep.
Conclusions
This scoping review highlights pharmacologic agents that may influence key components of sleep architecture and suggests potential therapeutic avenues for improving sleep quality. However, additional large-scale and long-term studies are needed to further evaluate the safety, efficacy, and selective modulation of sleep stages. These findings contribute to the development of targeted pharmacotherapies aimed at optimizing sleep and addressing related medical conditions.