Does Cymbalta suppress REM sleep? (7+ consequences)

This article will discuss the impact of Cymbalta (duloxetine) on REM sleep. It will explain the mechanisms by which Cymbalta affects REM sleep, examine relevant research findings on its influence, and mention the potential consequences of suppressed REM sleep.

Furthermore, the article will discuss the factors that may increase Cymbalta’s suppression of REM sleep. Finally, it will provide suggestions on what to do if Cymbalta is suppressing REM sleep and causing side effects.

Does Cymbalta suppress REM sleep?

Yes, Cymbalta, which is the brand name for duloxetine, can suppress REM sleep. Research has indicated that duloxetine can decrease REM sleep, which is the stage of sleep associated with vivid dreams and essential for emotional and cognitive processing. 

Suppressed REM sleep can have a significant impact on both physical and mental health, leading to a range of problems and consequences that can negatively affect overall well-being and therapy with duloxetine.

It is important for individuals experiencing issues with REM sleep to seek medical attention to address any underlying causes or contributing factors.

How can Cymbalta suppress REM sleep?

While the exact mechanism is not fully understood, it is believed that the balance between the serotoninergic, noradrenergic, and cholinergic systems plays a significant role in the regulation of REM sleep [1].

Since Cymbalta is a serotonin-norepinephrine reuptake inhibitor, it increases the levels of these neurotransmitters in the brain. This elevation in serotonin and norepinephrine can lead to a decrease in the activation of cholinergic neurons, which are known to be involved in promoting REM sleep [1].

To illustrate, in comparison to monoaminergic neurons, such as noradrenergic and serotonergic ones, the cholinergic system may become relatively under-active. This imbalance in neurotransmitter activity may contribute to the suppression of REM sleep [1].

Furthermore, researchers state that antidepressants that increase the availability of both serotonin and norepinephrine, like Cymbalta, have a greater impact on REM sleep suppression compared to drugs that primarily increase just one neurotransmitter.

However, further research is needed to fully understand the precise mechanisms by which Cymbalta affects REM sleep [1].

What does research suggest?

In a study investigating the impact of duloxetine on sleep characteristics, it was found that the average time taken by patients to reach REM sleep (REM latency) increased from 58.5 minutes at baseline to 193.6 minutes while on duloxetine [2].

This indicates a significant 231% delay in the occurrence of REM sleep due to duloxetine. Furthermore, the study found that REM sleep lasted an average of 94.8 minutes before patients were administered duloxetine, compared to only 51.5 minutes after administration [2].

This resulted in a notable 46% decrease in REM duration. Therefore, it can be concluded that duloxetine has the potential to suppress REM sleep [2].

Another investigation studied sleep parameters in patients taking a placebo, 60 mg of duloxetine, and 80 mg of duloxetine. Both doses of duloxetine resulted in suppression of REM sleep and prolonged REM latency [1].

However, the 60 mg dose causes more significant suppression of REM sleep compared to the higher dose [1].

What risks are associated with suppressed REM sleep?

Some of the risks associated with Cymbalta-induced suppressed REM sleep include:

  • REM sleep plays a role in cognitive function. Thus, its suppression may lead to a memory decline and difficulty learning.
  • Suppressed REM sleep can worsen depression and anxiety, which may decrease Cymbalta’s effectiveness in managing these conditions.
  • Cymbalta-induced suppressed REM sleep can increase pain sensitivity, which can also negatively impact the effectiveness of the medication in treating neuropathic pain [3].
  • Sufficient REM sleep is important for maintaining a healthy immune system. Cymbalta-related suppressed REM sleep may compromise one’s immunity.
  • Long-term suppression of REM sleep can increase the risk of hallucinations.
  • Studies suggest that persistent insufficient REM sleep increases the risk of weight gain, which is already a side effect of Cymbalta [4].
  • The suppression of REM sleep can cause nightmares.
  • Cymbalta-induced REM sleep suppression can negatively impact the overall quality of sleep and lead to insomnia, which is a side effect of Cymbalta as well. This may result in other side effects like daytime sleepiness and tiredness.

What factors influence Cymbalta’s impact on REM sleep?

Several factors may suppress REM sleep while taking Cymbalta:

Medication factors

Firstly, taking high doses of the drug or abruptly increasing the dosage without proper dose escalation can increase the risk of experiencing suppressed REM sleep as a side effect.

Additionally, excessive alcohol consumption while on Cymbalta can heighten Cymbalta-induced REM sleep suppression. Patients who concurrently take medications that decrease REM sleep, such as other antidepressants, MAO inhibitors, antihistamines, and stimulants, are more likely to encounter this side effect.

Lifestyle factors

Irregular sleeping patterns and poor sleep hygiene can also disrupt sleep characteristics and lead to a decrease in REM sleep while using Cymbalta. Furthermore, uncomfortable and noisy sleeping environments may heighten REM sleep latency.

Health condition

It is worth noting that stress, depression, and anxiety can contribute to a decrease in REM sleep. Moreover, conditions like sleep apnea and restless leg syndrome can disrupt the sleep cycle, potentially augmenting the occurrence of Cymbalta-related REM suppression.

Finally, certain diseases, such as Parkinson’s disease, Alzheimer’s disease, and narcolepsy, can also impact REM sleep while taking Cymbalta.

What to do if Cymbalta suppresses REM sleep?

If Cymbalta is suppressing REM sleep and causing side effects such as increased REM sleep latency or suppressed REM sleep, there are several management strategies you can consider to optimize your sleep and minimize these effects.

The first and most important step is to discuss your concerns with your doctor. Based on your condition, risk factors, and medical history, they may adjust your Cymbalta dosage or prescribe alternative medications if necessary.

If high doses or sudden increases in Cymbalta dosage are contributing to the suppression of REM sleep, your doctor may reduce your dosage and assess your response.

It is advisable to limit your alcohol intake and improve your sleep hygiene. Moreover, you should inform your doctor about all the other drugs you’re taking. They may review your medications and optimize your treatment plan to minimize this side effect.

Finally, your doctor may recommend certain medications that can treat the suppression of REM sleep caused by Cymbalta. These include specific antidepressants, such as bupropion or mirtazapine, and benzodiazepines.


Based on my research, I found that Cymbalta suppresses REM sleep. I believe this is important because REM sleep suppression may lead to multiple problems like impaired cognition, worsening of depression or anxiety, increased pain sensitivity, decreased immunity, and a higher risk of hallucinations and weight gain.

In my perspective, some individual factors and co-existing conditions can influence the impact of Cymbalta on REM sleep. If you are experiencing issues with your REM sleep while taking Cymbalta, I recommend communicating your concerns with your healthcare provider.

They can review your treatment plan, consider dosage adjustments or alternative medications, and provide recommendations to improve your sleep hygiene and overall sleep quality.

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Kluge M, Schüssler P, Steiger A. Duloxetine increases stage 3 sleep and suppresses rapid eye movement (REM) sleep in patients with major depression. Eur Neuropsychopharmacol. 2007 Jul;17(8):527-31. doi: 10.1016/j.euroneuro.2007.01.006. Epub 2007 Mar 6. PMID: 17337164.


Hakki Onen S, Alloui A, Jourdan D, Eschalier A, Dubray C. Effects of rapid eye movement (REM) sleep deprivation on pain sensitivity in the rat. Brain Res. 2001 May 11;900(2):261-7. doi: 10.1016/s0006-8993(01)02320-4. PMID: 11334806.


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