Slow-wave sleep and the possibilities of modern insomnia therapy

Close metadata

Recommended articles:

Monotonous sound stimuli embedded with either binaural or monaural beats have the same effect on sleep latency: study on a large subject group. S.S. Korsakov Journal of Neurology and Psychiatry. 2023;(4):109-113

Treatment of mental disorders caused or triggered by somatic and neurological diseases with the use of the multimodal antidepressant trazodone. S.S. Korsakov Journal of Neurology and Psychiatry. 2023;(4-2):81-89

Insomnia in the context of affective disorders. S.S. Korsakov Journal of Neurology and Psychiatry. 2023;(5-2):43-48

Management of patients with insomnia and polymorbidity: expert consensus. S.S. Korsakov Journal of Neurology and Psychiatry. 2023;(5-2):49-57

Comparative study of the clinical efficacy and safety of the fixed dose combination Levroso Long with Melaxen and Diphenhydramine in patients with insomnia. S.S. Korsakov Journal of Neurology and Psychiatry. 2023;(5-2):76-81

The impact of antiepileptic therapy on sleep disorders in women with epilepsy. S.S. Korsakov Journal of Neurology and Psychiatry. 2023;(5-2):105-109

Psychopathological syndromes with sleep disorders in patients with type 2 diabetes mellitus. S.S. Korsakov Journal of Neurology and Psychiatry. 2023;(6):30-35

Prevalence and risk factors of delirium in COVID-19. S.S. Korsakov Journal of Neurology and Psychiatry. 2023;(7):86-92

Alternative methods of therapy for comorbid sleep disorders as a method of choice in adult patients with epilepsy. S.S. Korsakov Journal of Neurology and Psychiatry. 2023;(8):42-48

Effective therapy of insomnia, especially chronic insomnia, is one of the most pressing neuropsychiatric problems. Unfortunately, at present in the Russian Federation, as in most other countries of the world, there are no officially approved drugs for long-term treatment of insomnia. In this regard, the use of medical sedation agents that do not have restrictions on the duration of use is of considerable interest. This review considers drugs of various psychopharmacological classes, one way or another used in practice for the correction of sleep disorders, especially in patients with underlying comorbid pathology.

Keywords:

slow wave sleep

insomnia

procognitive activity

Trazodone

Authors:

V.E. Medvedev

Patrice Lumumba Peoples Friendship University of Russia

ORCID: 0000-0001-8653-596X

N.V. Titova

Federal Center of Brain and Neurotechnologies;
Pirogov Russian National Research Medical University

ORCID: 0000-0002-7044-3013

I.V. Milyukhina

N. Bechtereva Institute of the Human Brain

ORCID: 0000-0002-6433-542X

F.Sh. Shagiakhmetov

National Scientific Center for Narcology — Branch «Serbsky National Medical Research Center of Psychiatry and Narcology»

ORCID: 0000-0002-3130-3149

R.R. Borukaev

LLC «Angelini Pharma Rus»

ORCID: 0000-0001-6080-7293

I.V. Kolyvanova

LLC «Angelini Pharma Rus»

ORCID: 0000-0003-0785-7288

Received:

17.07.2023

Accepted:

26.07.2023

List of references:

Everitt H, Baldwin DS, Stuart B, et al. Antidepressants for insomnia in adults. Cochrane Database Syst Rev. 2018;5(5):CD010753. https://doi.org/10.1002/14651858.CD010753.pub2
Kaur H, Spurling BC, Bollu PC. Chronic Insomnia. [Updated 2023 Feb 12]. In: StatPearls [Internet]. Treasure Island (FL): StatPearls Publishing; 2023 Jan. https://www.ncbi.nlm.nih.gov/books/NBK526136/
Buysse DJ. Insomnia. JAMA. 2013;309(7):706-716. https://doi.org/10.1001/jama.2013.193
Vande-Griend JP, Anderson SL. Histamine-1 receptor antagonism for treatment of insomnia. J Am Pharm Assoc (2003). 2012;52(6):e210-9. https://doi.org/10.1331/JAPhA.2012.12051
Pelayo R, Bertisch SM, Morin CM, et al. Should Trazodone Be First-Line Therapy for Insomnia? A Clinical Suitability Appraisal. Journal of Clinical Medicine. 2023;12(8):2933. https://doi.org/10.3390/jcm12082933
Fagiolini A, Comandini A, Catena Dell’Osso M, Kasper S. Rediscovering trazodone for the treatment of major depressive disorder. CNS Drugs. 2012;26(12):1033-1049. https://doi.org/10.1007/s40263-012-0010-5
Schwartz TL, Goradia V. Managing insomnia: an overview of insomnia and pharmacologic treatment strategies in use and on the horizon. Drugs Context. 2013;2013:212257. https://doi.org/10.7573/dic.212257
Jaffer KY, Chang T, Vanle B, et al. Trazodone for Insomnia: A Systematic Review. Innov Clin Neurosci. 2017;14(7-8):24-34.
Carskadon M, Dement W. Normal human sleep: An overview. In: Kryger MH, Roth T, Dement WC, editors. Principles and Practice of Sleep Medicine. 4th ed. Philadelphia: Elsevier Saunders; 2005.
Walsh JK. Enhancement of slow wave sleep: implications for insomnia. J Clin Sleep Med. 2009;5(2 suppl):27-32.
Tononi G, Cirelli C. Sleep and synaptic homeostasis: a hypothesis. Brain Res Bull. 2003;62:143-150.
Walker M. The role of slow wave sleep in memory processing. J Clin Sleep Med. 2009;5(suppl):20-26.
Xie L, Kang H, Xu Q, et al. Sleep drives metabolite clearance from the adult brain. Science. 2013;342(6156):373-377. https://doi.org/10.1126/science.1241224
Hablitz LM, Vinitsky HS, Sun Q, et al. Increased glymphatic influx is correlated with high EEG delta power and low heart rate in mice under anesthesia. Sci Adv. 2019;5(2):eaav5447. Published 2019 Feb 27. https://doi.org/10.1126/sciadv.aav5447
Reddy OC, van der Werf YD. The Sleeping Brain: Harnessing the Power of the Glymphatic System through Lifestyle Choices. Brain Sci. 2020;10(11):868. Published 2020 Nov 17. https://doi.org/10.3390/brainsci10110868
Bacyinski A, Xu M, Wang W, Hu J. The Paravascular Pathway for Brain Waste Clearance: Current Understanding, Significance and Controversy. Front Neuroanat. 2017;11:101. Published 2017 Nov 7. https://doi.org/10.3389/fnana.2017.00101
Colten HR, Altevogt BM, eds. Sleep Disorders and Sleep Deprivation: An Unmet Public Health Problem. Washington (DC): National Academies Press (US); 2006. 2, Sleep Physiology. Institute of Medicine (US) Committee on Sleep Medicine and Research. https://www.ncbi.nlm.nih.gov/books/NBK19956/
de Mendonça FMR, de Mendonça GPRR, Souza LC, et al. Benzodiazepines and Sleep Architecture: A Systematic Review. CNS Neurol Disord Drug Targets. 2023;22(2):172-179. https://doi.org/10.2174/1871527320666210618103344
Atkin T, Comai S, Gobbi G. Drugs for Insomnia beyond Benzodiazepines: Pharmacology, Clinical Applications, and Discovery. Pharmacol Rev. 2018;70(2):197-245. https://doi.org/10.1124/pr.117.014381
Shagiakhmetov FSh. Atypical antipsychotics: more similarities or differences? Theoretical background (part 1). STPN. 2014;1:14-22. (In Russ.). https://cyberleninka.ru/article/n/atipichnye-antipsihotiki-bolshe-shodstv-ili-razlichiy-teoreticheskie-predposylki-chast-1
Shagiakhmetov FSh. Atypical antipsychotics: more similarities or differences? Theoretical Background (part 2). STPN. 2014;2:4-9. (In Russ.). https://cyberleninka.ru/article/n/atipichnye-antipsihotiki-bolshe-shodstv-ili-razlichiy-teoreticheskie-predposylki-chast-2
Hecht Orzack M, Cole JO, Friedman L, Bird M, McEachern J. Weight changes in antidepressants: a comparison of amitriptyline and trazodone. Neuropsychobiology. 1986;15(suppl 1):28-30. https://doi.org/10.1159/000118237
Bjorvatn B, Ursin R. Changes in sleep and wakefulness following 5-HT1A ligands given systemically and locally in different brain regions. Rev Neurosci. 1998;9(4):265-273. https://doi.org/10.1515/revneuro.1998.9.4.265
Petrova NN, Shagiakhmetov FSh, Borukaev RR. Trazodone: facets of clinical efficacy. Psychiatry and Psychopharmacotherapy. 2021;23(3):40-46. (In Russ.).
Kleinlogel H. Effects of the selective alpha 1-adrenoceptor blocker prazosin on EEG sleep and waking stages in the rat. Neuropsychobiology. 1989;21(2):100-103. https://doi.org/10.1159/000118560
Fulda S, Kloiber S, Dose T, et al. Mirtazapine provokes periodic leg movements during sleep in young healthy men. Sleep. 2013;36(5):661-669. https://doi.org/10.5665/sleep.2622
Haldar P, Haldar P. Mirtazapine Aggravates Restless Leg Syndrome:A Case Report. Indian J Psychiatry. 2022;64(suppl 3):586-587. https://doi.org/10.4103/0019-5545.341707
Makiguchi A, Nishida M. Mirtazapine-Induced Restless Legs Syndrome Treated With Pramipexole. American Psychiatric Association Publishing. Published Online: 26 Feb 2015. https://doi.org/10.1176/appi.neuropsych.13120357
Monti JM, Monti D. The involvement of dopamine in the modulation of sleep and waking. Sleep Med Rev. 2007;11:113-133. https://doi.org/10.1016/j.smrv.2006.08.003
Qu WM, Xu XH, Yan MM, et al. Essential role of dopamine D2 receptor in the maintenance of wakefulness, but not in homeostatic regulation of sleep, in mice. J Neurosci. 2019;30:4382-4389. https://doi.org/10.1523/JNEUROSCI.4936-09.2010
Gedge L, Lazowski L, Murray D, et al. Effects of quetiapine on sleep architecture in patients with unipolar or bipolar depression. Neuropsychiatr Dis Treat. 2010;6:501-508. https://doi.org/10.2147/ndt.s12433
Sharpley AL, Vassallo CM, Cowen PJ. Olanzapine increases slow-wave sleep: evidence for blockade of central 5-HT(2C) receptors in vivo. Biol Psychiatry. 2000;47(5):468-470. https://doi.org/10.1016/s0006-3223(99)00273-5
Cohrs S, Meier A, Neumann AC. et al. Improved sleep continuity and increased slow wave sleep and REM latency during ziprasidone treatment: a randomized, controlled, crossover trial of 12 healthy male subjects. J Clin Psychiatry. 2005;66(8):989-996. https://doi.org/10.4088/jcp.v66n0805
Kuehn BM. FDA Warns Antipsychotic Drugs May Be Risky for Elderly. JAMA. 2005;293(20):2462. https://doi.org/10.1001/jama.293.20.2462
Yan J. FDA Extends Black-Box Warning to All Antipsychotics. American Psychiatric Association Publishing/CLINICAL & RESEARCH NEWS Published Online: 18 Jul 2008. https://doi.org/10.1176/pn.43.14.0001
Knol W, van Marum RJ, Jansen PA, et al. Antipsychotic drug use and risk of pneumonia in elderly people. J Am Geriatr Soc. 2008;56:661-666.
Pratt N, Roughead EE, Ramsay E, et al. Risk of hospitalization for hip fracture and pneumonia associated with antipsychotic prescribing in the elderly: a self-controlled case-series analysis in an Australian health care claims database. Drug Saf. 2011;34:567-575.
Trifiro G, Spina E, Gambassi G. Use of antipsychotics in elderly patients with dementia: do atypical conventional agents have a similar safety profile? Pharmacol Res. 2009;59:1-12.
Herzig SJ, LaSalvia MT, Naidus E, et al. Antipsychotics and the Risk of Aspiration Pneumonia in Individuals Hospitalized for Nonpsychiatric Conditions: A Cohort Study. J Am Geriatr Soc. 2017;65(12):2580-2586. https://doi.org/10.1111/jgs.15066
Ostroumova OD, Goloborodova IV, Isaev RI, Pereverzev AP. Antipsychotics: features of undesirable adverse reactions in elderly and senile patients. Zhurnal Nevrologii i Psikhiatrii im. S.S. Korsakova. 2019;119(2):105-117. (In Russ.). https://doi.org/10.17116/jnevro2019119021105
Kheirbek RE, Fokar A, Little JT, et al. Association Between Antipsychotics and All-Cause Mortality Among Community-Dwelling Older Adults. J Gerontol A Biol Sci Med Sci. 2019;74(12):1916-1921. https://doi.org/10.1093/gerona/glz045
Paus S, Brecht HM, Köster J, et al. Sleep attacks, daytime sleepiness, and dopamine agonists in Parkinson’s disease. Mov Disord. 2003;18(6):659-667. https://doi.org/10.1002/mds.10417
Monti JM, Jantos H. The roles of dopamine and serotonin, and of their receptors, in regulating sleep and waking. Prog Brain Res. 2008;172:625-46. https://doi.org/10.1016/S0079-6123(08)00929-1
Lagos P, Scorza C, Monti JM, et al. Effects of the D3 preferring dopamine agonist pramipexole on sleep and waking, locomotor activity and striatal dopamine release in rats. Eur Neuropsychopharmacol. 1998;8(2):113-120. https://doi.org/10.1016/s0924-977x(97)00054-0
Nodel’ MR. Effects of the dopamine agonist mirapex (pramipexole) therapy on sleep disorders in Parkinson’s disease. Zhurnal Nevrologii i Psikhiatrii im. S.S. Korsakova. 2010;110(3):42-47. (In Russ.).
Inoue Y, Hirata K, Kuroda K, et al. Efficacy and safety of pramipexole in Japanese patients with primary restless legs syndrome: A polysomnographic randomized, double-blind, placebo-controlled study. Sleep Med. 2010;11(1):11-16. https://doi.org/10.1016/j.sleep.2009.03.009
Jama L, Hirvonen K, Partinen M, et al. A dose-ranging study of pramipexole for the symptomatic treatment of restless legs syndrome: polysomnographic evaluation of periodic leg movements and sleep disturbance. Sleep Med. 2009;10(6):630-636. https://doi.org/10.1016/j.sleep.2008.05.014
Jiménez-Jiménez FJ, Alonso-Navarro H, García-Martín E, Agúndez JAG. Current Treatment Options for REM Sleep Behaviour Disorder. J Pers Med. 2021;11(11):1204. https://doi.org/10.3390/jpm11111204
Tundo A, Betro’ S, de Filippis R, et al. Pramipexole Augmentation for Treatment-Resistant Unipolar and Bipolar Depression in the Real World: A Systematic Review and Meta-Analysis. Life. 2023;13(4):1043. https://doi.org/10.3390/life13041043
Tundo A, Betro’ S, Iommi M, de Filippis R. Efficacy and safety of 24-week pramipexole augmentation in patients with treatment resistant depression. A retrospective cohort study. Prog Neuropsychopharmacol Biol Psychiatry. 2022;112:110425. https://doi.org/10.1016/j.pnpbp.2021.110425
Tundo A, de Filippis R, De Crescenzo F. Pramipexole in the treatment of unipolar and bipolar depression. A systematic review and meta-analysis. Acta Psychiatrica Scandinavica. 2019;140(2):116-125. https://doi.org/10.1111/acps.13055
Bazil CW, Dave J, Cole J, Stalvey J, Drake E. Pregabalin increases slow-wave sleep and may improve attention in patients with partial epilepsy and insomnia. Epilepsy Behav. 2012;23(4):422-425. https://doi.org/10.1016/j.yebeh.2012.02.005
Lo HS, Yang CM, Lo HG, et al. Treatment effects of gabapentin for primary insomnia. Clin Neuropharmacol. 2010;33(2):84-90. https://doi.org/10.1097/WNF.0b013e3181cda242
Foldvary-Schaefer N, De Leon Sanchez I, Karafa M, et al. Gabapentin increases slow-wave sleep in normal adults. Epilepsia. 2002;43(12):1493-1497. https://doi.org/10.1046/j.1528-1157.2002.21002.x
Hindmarch I, Dawson J, and Stanley N. A double-blind study in healthy volunteers to assess the effects on sleep of pregabalin compared with alprazolam and placebo. Sleep. 2005;28(2):187-193. https://doi.org/10.1093/sleep/28.2.187
Garcia-Borreguero D, Patrick J, DuBrava S, et al. Pregabalin versus pramipexole: effects on sleep disturbance in restless legs syndrome. Sleep. 2014;37(4):635-643. https://doi.org/10.5665/sleep.3558
Kim ES, Deeks ED. Gabapentin Enacarbil: A Review in Restless Legs Syndrome. Drugs. 2016;76(8):879-887. https://doi.org/10.1007/s40265-016-0584-1
Weresch J, Kirkwood J, Korownyk CS. Gabapentin for alcohol use disorder. Can Fam Physician. 2021;67(4):269. https://doi.org/10.46747/cfp.6704269
Mason BJ, Quello S, Goodell V, et al. Gabapentin treatment for alcohol dependence: a randomized clinical trial. JAMA Intern Med. 2014;174(1):70-77. https://doi.org/10.1001/jamainternmed.2013.11950
Karam-Hage M, Brower KJ. Gabapentin treatment for insomnia associated with alcohol dependence. Am J Psychiatry. 2000;157(1):151.
Brower KJ, Myra Kim H, Strobbe S, et al. A randomized double-blind pilot trial of gabapentin versus placebo to treat alcohol dependence and comorbid insomnia. Alcohol Clin Exp Res. 2008;32(8):1429-1438. https://doi.org/10.1111/j.1530-0277.2008.00706.x
Zheng Y, Lv T, Wu J, Lyu Y. Trazodone changed the polysomnographic sleep architecture in insomnia disorder: a systematic review and meta-analysis. Sci Rep. 2022;12(1):14453. https://doi.org/10.1038/s41598-022-18776-7
Stahl SM. Stahl’s essential psychopharmacology: Neuroscientific basis and practical applications (4th ed.). Cambridge University Press. 2013.
Varga AW, Ducca EL, Kishi A, et al. Effects of aging on slow-wave sleep dynamics and human spatial navigational memory consolidation. Neurobiol Aging. 2016;42:142-149.
Shamim SA, Warriach ZI, Tariq MA, et al. Insomnia: Risk Factor for Neurodegenerative Diseases. Cureus. 2019;11(10):e6004. https://doi.org/10.7759/cureus.6004
Wang J, Chen X, Liao J, et al. The influence of non-breathing-related sleep fragmentation on cognitive function in patients with cerebral small vessel disease. Neuropsychiatr Dis Treat. 2019;15:1009-1014. https://doi.org/10.2147/NDT.S193869
Wang J, Liu S, Zhao C, et al. Effects of Trazodone on Sleep Quality and Cognitive Function in Arteriosclerotic Cerebral Small Vessel Disease Comorbid With Chronic Insomnia. Front Psychiatry. 2020;11:620.
La AL, Walsh CM, Neylan TC, et al. Long-Term Trazodone Use and Cognition: A Potential Therapeutic Role for Slow-Wave Sleep Enhancers. J Alzheimers Dis. 2019;67(3):911-921.
Smales ET, Edwards BA, Deyoung PN, et al. Trazodone Effects on Obstructive Sleep Apnea and Non-REM Arousal Threshold. Ann Am Thorac Soc. 2015;12(5):758-764. https://doi.org/10.1513/AnnalsATS.201408-399OC
Shams-Alizadeh N, Maroufi A, Asadi Z, et al. Trazodone as an Alternative Treatment for Neuroleptic-Associated Akathisia: A Placebo-Controlled, Double-Blind, Clinical Trial. J Clin Psychopharmacol. 2020;40(6):611-614. https://doi.org/10.1097/JCP.0000000000001286
Ribosa-Nogué R, Pagonabarraga J, Kulisevsky J. Efficacy of trazodone in antipsychotic-induced akathisia resistant to conventional treatment. Parkinsonism Relat Disord. 2012;18(7):902-903. https://doi.org/10.1016/j.parkreldis.2012.04.001
Stryjer R, Rosenzcwaig S, Bar F, et al. Trazodone for the treatment of neuroleptic-induced acute akathisia: a placebo-controlled, double-blind, crossover study. Clin Neuropharmacol. 2010;33(5):219-222. https://doi.org/10.1097/WNF.0b013e3181ee7f63

Close metadata