Which sleep medication class typically reduces both REM sleep and slow-wave sleep?

Which sleep medication class typically reduces both REM sleep and slow-wave sleep?

• A. Ramelteon and Melatonin
• B. Benzodiazepines and Z-drugs
• C. SSRIs/SNRIs
• D. Melatonin

Answer: (B)

Benzodiazepines and Z-drugs work by enhancing GABAergic inhibition at the GABA-A receptor. This action quiets brain activity enough to help you fall asleep and stay asleep, but it also dampens the deepest and most restorative sleep stages. As a result, both REM sleep and slow-wave sleep are typically reduced, even though overall sleep continuity improves. In contrast, melatonin and ramelteon mainly affect when you fall asleep and your circadian timing, with little disruption to the architecture of sleep stages. SSRIs and SNRIs tend to suppress REM sleep, but their effects on slow-wave sleep are variable and less consistently reducing both deep stages as seen with benzodiazepine-type hypnotics. So the pattern of shrinking both REM and slow-wave sleep points to benzodiazepines and Z-drugs.

Benzodiazepines and Z-drugs work by enhancing GABAergic inhibition at the GABA-A receptor. This action quiets brain activity enough to help you fall asleep and stay asleep, but it also dampens the deepest and most restorative sleep stages. As a result, both REM sleep and slow-wave sleep are typically reduced, even though overall sleep continuity improves.

In contrast, melatonin and ramelteon mainly affect when you fall asleep and your circadian timing, with little disruption to the architecture of sleep stages. SSRIs and SNRIs tend to suppress REM sleep, but their effects on slow-wave sleep are variable and less consistently reducing both deep stages as seen with benzodiazepine-type hypnotics. So the pattern of shrinking both REM and slow-wave sleep points to benzodiazepines and Z-drugs.