SSRIs and sleep in man

Abstract

SSRIs have marked dose-dependent effects on REM sleep in healthy volunteers and depressed patients, with REM onset latency being lengthened and REM amount being reduced. After weeks of treatment REM latency remains long, but the amount of REM recovers, and shows rebound after withdrawal. These changes in amount of REM sleep may reflect receptor adaptation. Sleep continuity is worsened by SSRIs, with time awake after sleep onset and stage 1 sleep being increased early in treatment. Effects are more marked in normal volunteers than in depressed patients, probably because normal volunteers have better baseline sleep. This worsening in sleep recovers after a few days in depressed patients. In general the deterioration in sleep continuity is not paralleled by a worsening of subjective ratings of sleep, which improve during SSRI treatment of depression.