Submitted by muted_Log_454 t3_yiagcm in explainlikeimfive
It’s well known that drugs such as antidepressants (particularly SSRIs) and benzodiazepines suppress REM sleep,it’s also well known that REM sleep is crucial for memory,cognition,consolidation of memory and many other important functions,my question is what are the long term outcomes of drugs that suppress REM?
Anyone else take a 15 minute nap, have dreams (so presumably experience REM sleep) and wake up feeling crazy rested?
We used to believe dreaming always happened in REM sleep, but we've later discovered that's not actually true. It can happen in the other stages as well, most often in NR3 and least often in NR1.
But it's also possible it was "hypnogogic hallucinations," which can be a dream-like state as you're falling asleep. If you've had the experience of thinking about something and suddenly jerking awake (hypnogogic jerks) and feeling like you were in a light dream, it was probably that an not a "true" dream (if the two can even be fully distinguished, I'm not up to date on the research). For me, whether by jerking awake, or rolling over, or something else, I often "wake up" from a hypnogogic hallucination and find myself feeling well-rested, regardless of how tired I was just a few minutes previous.
I had three separate nightmares, like different setting and circumstances and narratives, in like 30 minutes last night (I noticed what time I went to sleep and what time I awakened). So, yes?
To address OP's specific question about SSRIs: One of the objective findings in people with depression is decreased REM latency (so you fall into REM faster), and increased total REM sleep. There can, of course, be other sleep disturbances such as insomnia or hypersomnia. But, all things being equal, a depressed person will spend more time in REM and less time in Stages 1-3.
All that is to say, decreased REM sleep from SSRI use may actually be normalizing your sleep cycles, rather than "disrupting" them. I'm not familiar enough with the literature to say that for certain, though.
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Well I know for me it's been a blessing, before I started smoking weed I would get the worst night terrors, things got a lot better when I stopped getting dreams I could remember, or any at all.
I can relate. When I was smoking regularly I stopped dreaming altogether (or stopped remembering them), layed it off for a week and suddenly I get lucid dreams every other night.
It's really common for people who discontinue weed to get more vivid dreams, especially in the first week or two after stopping. It does level out after a while. (I've taken tolerance breaks several times and have more recently all but quit for about six months now.)
When I have to chill on the weed I get the worst dreams, it's either floating heads outside my window, spiders, or sleep walking. It'll always start the same, with me falling asleep but the dreams start with me in bed trying to fall asleep and then spooky shit happens. I'll jump out of bed, rip off the blankets looking for spiders and really piss of my girlfriend. At least she knows the difference between awake me and sleep walking me. Because only one of those throws shit around then room looking for the window screen to keep the heads out while accusing her of hiding it. May have called her a bitch.
Just be sure to keep your THC intake steady or the REM rebound will give you some crazy vivid dreams. Too real, sometimes, at least in my experience.
I'm not sure there's been any studies regarding long term use of specific drugs on memory, but there could be some out there.
The best theory put forward by researchers is that REM sleep is, indeed, required to process memory, experience, and cognition that is gained during waking hours. Even if there's been absolutely no study regarding specific drug-induced reduction of REM and how it affects individuals, I'd think it pretty clear that anything that stops/reduces REM, short or long term, is going to cause memory consequences.
Yep thats exactly my thought process. Science on drugs is often rare and not thorough enough to make definite conclusions but it's fair to say that whatever impairs REM sleep must impair memory and possibly other systems as well.
>I'm not sure there's been any studies regarding long term use of specific drugs on memory, but there could be some out there.
Doesn't seem like it's based on specific drugs though, which strengthens their point. Not a bad study, but still not as precise as desired.
Yes that is true! I did a little extra digging and found some more studies. This one, 'Pharmacological REM sleep suppression paradoxically improves rather than impairs skill memory', found that SSRIs did not, in fact, affect the creation of new memories. The study 'Sleep and cognition at baseline and the effects of REM sleep diminution after 1 week of antidepressive treatment in patients with depression' similarly found 'no negative effects of a decrease in REM sleep on memory performance in patients taking antidepressants' in their study using SSRIs and SNRIs. Both studies here may imply that new memories can be created during sleep even in the absence of REM sleep.
Kind of like alcohol, which also suppresses rem
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I take an antidepressant daily and definitely notice that it gives me more and more vivid dreams. What is really wild though is if I forget a dose I get sucked in to these crazy intense and trippy dreams, to the point where I barely feel rested/find it hard to drag myself awake. It's definitely weird!
How would this affect dreams? I dream more when I'm prescribed antidepressants but there is a considerable le reduction in the 'dreamlike quality' of my dreams, they are much more mundane
I vaguely recall readig a claim that there are 2 sorts of dreams.
Supposedly, some are boring simulations of realistic simulations. Like waiting at traffic lights or eating meals.
While others are wild combinations of crazy factors (which probably have that 'dreamlike quality' to them).
The former ones are your brain practicing old scenarios, and the latter ones are imagination and preparation for new scenarios.
You get them in roughly equal amounts of time, but you don't always remember your dreams so your personal experience may be different.
I don't know where I read this though. It might be just an idea by a blogger, or it might be an opinion of a neuroscientist. (And even if it is the opinion of a neuroscientist, it might only an opinion/hunch of theirs, and I probably haven't remembered it 100% correct.)
Profound Emotional disregulation. During REM your brain extracts the coles notes from the emotional charge/events of the day and writes it long term memory. Your buffer is only so big, if you don't empty it every night it's starts to overflow and your emotional regulation goes nuts and you along with it.
What an eye opener. Been on SSRIs for years and had no idea it had an effect on REM sleep and memory. I've also had memory issues and am pretty much always tired. I just thought it was from getting older (and I'm not in great physical health).
Alcohol surpresses REM sleep. Drinking on the daily means you go a long time without REM. You really need REM sleep, so what happens is that you start getting it when you're awake. That's where pink elephants come from. Hallucinations induced by lack of REM sleep.
I have narcolepsy and get a lot of REM sleep if I don't take my RX. While the stories are interesting, it makes me feel like I've been running all night and wake up exhausted
I think you're referring to alcohol withdrawal and/or alcohol induced psychosis. In either case it's the hippothalamus and pretty much the entire pre-frontal cortex malfunctioning from brain damage, which causes the pink elephants.
You're right that you do need REM sleep though.
Most common is antidepressants such as SSRIs like Prozac, etc. Can have REM sleep behavior disorder where you” act out”your dreams such as kicking and punching ( danger to bedmate). Definitely impairs memory and overall Unrested and daytime sleepiness.
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Michael Jackson was given Propofol to induce sleep. It was administered intravenously by his personal physican. No REM sleep occurs when Propofol is used. He was given this drug every night for several weeks as he was preparing for a world tour that would never happen. Those around him noticed his troubling decline during this time. He wasn't able to remember song lyrics or dance moves. He exhibited symptoms of dementia. For Michael Jackson the consequence of a drug that suppressed REM sleep was death.
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There was a Star Trek TNG episode (Night Terrors ) where this happened (space stuff zapped the crew) and everyone started hallucinating.
Aside from being science fiction not science fact, the scenario involved is different. SSRIs et al. dont eliminate REM sleep (which yes, is bad) but can disrupt it to varying degrees. While this can have some effects on a persons sleep schedule, how well they sleep, etc. it doesn’t cause the same symptoms as lack of REM sleep/sleep at all, as depicted in the show would have.
Ive found that zoloft as an SSRI doesnt disrupt my REM sleep near the same extent that alcohol or weed do. luckily!
I was thinking if the MAS*H episode. Hawkeye losing his arms freaked me out as a kid!
Wait, you guys actually sleep the first 1-2 weeks of cutting out weed? I literally stay up for more than 5,6…7 days straight or even longer. And I never smoke more than a couple bowls of flower a day
Damn thats crazy! Do you get any sort of hallucinations? In my life ive stayed awake no more than 36hrs tops a few times, with minor hallucinations toward the end.
But for me i dont sleep much if im taking a break, i would say 4-5hrs tops on a 'good' night. The thing that bothers me most is the sort of hot flashes/night sweats i get. Do you haveany other side effects?
It killed Michael Jackson. Daily propofol injections led to him going completely without REM sleep for two months.
Didn't he OD?
From Wikipedia:
"On June 25, 2009, American singer Michael Jackson died of acute propofol and benzodiazepine intoxication at his home on North Carolwood Drive in the Holmby Hills neighborhood of Los Angeles, California."
"On August 28, 2009, the Los Angeles County Department of Medical Examiner-Coroner concluded that Jackson's death was a homicide.[2] Jackson had been administered propofol and anti-anxiety benzodiazepines lorazepam and midazolam by his doctor.[3] Murray was convicted of involuntary manslaughter in November 2011, and was released in 2013 after serving two years of his four-year prison sentence with time off for good behavior."
"Jackson had long suffered from insomnia, and had a history of using drugs in an attempt to help him sleep.[14] Jackson's physician Conrad Murray was present to help Jackson sleep and gave him various drugs including diazepam, ativan, lorazepam and midazolam while monitoring him by his bedside.[13] After several hours and several drug injections, Jackson was still unable to fall asleep, and, according to Murray, was repeatedly asking him for "milk", a term for the powerful sedative propofol, which Jackson had used in the past as a sleep aid. At 10:40 AM, with Jackson still not asleep, Murray relented to his requests and injected him with 25 milligrams of propofol diluted with lidocaine. With Jackson finally asleep, Murray testified that he left his bedside to go to the bathroom, and after returning two minutes later, discovered that Jackson was not breathing and had a weak pulse.“
Yeah but that sounds like they overdid it on the drugs, not that lack of REM sleep did him in.
I think perhaps OP was implying that the lack of REM was likely to have played a role in what led to his death, inability to sleep seemed to be the reason he asked for the drugs in the first place 🤔 it would only worsen his mental state from there, requiring more and more to even just achieve sleep alone, which just isn't enough ☹️
that stance is, in regard to the original question, in a totally different room lmao
🤷♀️ I'm not the OP of the post or the comment thread, so I can't really help you with that.
DJ__Hanzel t1_iuiwgbg wrote
Difficult ELI5.
We don't know anywhere nearly enough about REM sleep as it is. Nor the brain very well as it is. They all would impact REM in different ways.
Sleep works kind of like this:
NR1 Sleep (non-REM 1) - Very light sleep. You will feel like you just nodded off. When you awake from it, it doesn't even feel as though you slept. Very low demand sleep. This is what you aim for in a quick nap - under 15 minutes.
NR2 Sleep (non-REM 2) - Lighter sleep that comprises most of your time slept. Feels like more than nodding off, but still not too deep in sleep to be awakened. Good for long naps - under 45 mins.
NR3 sleep (non-REM 3; also known as Delta Sleep) - Deep sleep. Difficult to be awakened at this time. Most restful portion of sleep. This is when the body and brain repair themselves.
REM sleep (Rapid Eye Movement Sleep) - This is when you dream. It is the most demanding part of sleep. Your heart rate increases and becomes variable. Your brain activity flies through the roof. This part of sleep is believed to be responsible in processing emotions and cementing memories.
*My weird little opinion on REM sleep, which is by know means factual: We need to experience things to learn. Our dreams are our way of simulating these things into a way we can experience them, process them, and cement them. Again, by no means factual.
After REM it circles back and continues in layers: NR3, NR2, NR1, repeat. (NR1, NR2, NR3, REM, NR3, NR2, NR1, NR2, etc.)
A common REM suppressor, cannabis, impacts REM cycles by shortening them. With shortened REM cycles, though, comes with more non-REM sleep (NR1/2/3) in a similiar period to someone with regular length REM cycles.
So a person who uses cannabis and sleeps the same amount of time as somebody who doesn't use cannabis would theoretically get a more restful sleep than the latter, based on cannabis' impact on REM sleep, alone (not taking into account physiological effects). But the cannabis user would have gotten less REM sleep and time to cement their memories.