Does trazodone affect REM sleep? (3+ benefits)

In this article, we will discuss whether trazodone affects REM sleep or not. Furthermore, we’ll explore the impact of trazodone on sleep patterns, what research suggests on this, the importance of REM sleep, the potential benefits and side effects of trazodone on REM sleep and the recommendations to maintain healthy REM sleep while taking trazodone. 

Does trazodone affect REM sleep?

Yes, trazodone, an antidepressant, is known to have an impact on REM (rapid eye movement) sleep. Trazodone is usually prescribed off-label to promote sleep quality in insomniac individuals because of its depressant effects on the central nervous system. (1)

Trazodone is typically FDA-approved for treating patients with major depressive disorders. It is classified as a serotonin modulator which exerts its effects by increasing the levels of serotonin in the brain. Serotonin is a neurotransmitter involved in mood regulation and boosting motivation in a person, thereby reducing the feeling of sadness and anxiety. It also tends to influence sleep quality among other functions. (1)

REM sleep can be referred to as the stage of the sleep cycle during which a person is experiencing vivid dreams. This happens because the brain is in a state of hyperactivity, although the body is at deep rest. This stage is thought to be important for cognitive functions like certain aspects of memory and emotional processing. It takes up about 25% of the total sleep architecture. (2)

If you’re concerned about the effects of trazodone on your sleep cycle, it’s advisable to consult your healthcare provider for further guidance.

How does trazodone affect REM sleep?

The exact mechanism by which trazodone affects REM (rapid eye movement) sleep is not fully understood. However, it is believed that the primary mechanism through which trazodone works, such as the balancing of the levels of a neurotransmitter called serotonin might have an impact on sleep quality. (2)

As trazodone is a serotonin modulator, which influences the mood and sleep-wake cycle of a person, the modulations in serotonin levels can contribute to its sedative effects and influence the overall sleep architecture, including REM sleep. The elevated levels of serotonin from trazodone reduce REM sleep and promote non-REM sleep which is also called deep sleep in a person which helps in physical restoration and recovery. (1)

Other than this, trazodone is also thought to have alpha-adrenergic blocking properties. This action may also contribute to its sedative effects as adrenergic receptors could influence the balance between REM and non-REM sleep. (4)

However, it is crucial to remember that everyone is different in terms of brain chemistry and how they respond to medications, especially antidepressants. Therefore, some individuals may experience a significant reduction in REM sleep while others may not be as affected. 

What does research suggest?

According to a research study, scientists performed a clinical trial on 8 patients with depression to determine the effect of trazodone on their sleep cycle. They started the treatment with trazodone for 5 weeks, with a week of fake treatment using a placebo before and after. (3)

The researchers concluded that 5 out of 8 people showed positive responses with improved sleep quality. Trazodone was found to suppress REM sleep significantly, promoting deep sleep and it also delayed the latency (onset) period when REM sleep started in the patient’s sleep cycle. This study indicates that antidepressants like trazodone can impact REM sleep without influencing the overall sleep continuity of a person. (3)

What are the potential benefits of trazodone on REM sleep? 

Here are some potential benefits of trazodone on REM sleep: (1,4)

Insomnia treatment: 

Trazodone is helpful in depression patients struggling with sleep-related problems. It promotes their sleeping quality by exerting sedative effects and reducing the time of REM sleep stage making it easier for people to fall in deep sleep and stay asleep. 

Reduction in nightmares or night terrors: 

The suppression in REM sleep from trazodone can be beneficial in addressing troublesome conditions like nightmares or night terrors, particularly in individuals who are dealing with post-traumatic stress disorder (PTSD). It reduces the sleep disturbances that are often associated with vivid and distressing dreams.

Improved sleep continuity: 

Trazodone is known for its ability to improve sleep continuity, which means it may help individuals stay asleep throughout the night. It contributes to a more stable and restful sleep experience by reducing REM sleep. 

Reduced REM-related disorders: 

Trazodone can be helpful with conditions such as REM sleep behaviour disorder (RBD), where people act out their dreams during REM sleep. Its REM-suppressing effects can greatly reduce the occurrence of disruptive dream-related behaviour. 

What are the potential side effects of trazodone on REM sleep?

Some potential side effects of trazodone on REM sleep are discussed below which could vary from person to person: (5)

• Reduced dreaming: By suppressing the REM stage, trazodone decreases the frequency and intensity of dreams. Some people may find this impact of sleep alteration undesirable and miss having dreams. 

• Impact on memory and learning: The REM sleeping stage is found to play a crucial role in the learning and memory consolidation of a person. Thus, reducing this stage may impact cognitive processes including learning and memory. People who rely on this optimal memory function may consider this as a potential side effect.

• REM-rebound: If you suddenly stop taking trazodone all at once or reduce its dosage to a significant level, there could be a withdrawal side effect related to the rebound of REM sleep. This may lead to increased timings of the REM stage and vivid dreams throughout the night. 

• Potential impact on emotional processing: The REM stage is also associated with how you process your emotions. People with mood concerns should talk to their doctor about how this medication can influence their emotional well-being. 

• Individual variability: The responses of individuals may significantly vary from one another in terms of trazodone. Some may experience a reduction in REM sleep while others do not sense much difference. 

How to maintain healthy REM sleep while taking trazodone?

It’s essential to maintain a healthy REM sleep while taking trazodone, but also in general. Communicate with your healthcare provider before starting the medication. Stick to the recommended dosage regimen (the typical dose of trazodone for sleep is 100mg max and 25mg minimum) and timings of taking trazodone. Do not alter the dose or change the time on your own as this will interfere with your regular sleeping pattern. (1)

Follow your regular sleeping schedule by going to bed at waking up at the same time every day. Consistency might help regulate your body’s internal clock. Ensure to create a calm atmosphere and relaxed bedtime routine that may help promote better sleep quality, like reading a book, taking a warm bath or making your room pitch dark, quiet and cold, whatever suits you most. (4)

Make sure to not intake any stimulants including caffeine and nicotine, especially in the late hours leading to bedtime as these substances may interfere with your sleep quality. Also, avoid taking heavy meals at least 2 hours before you sleep. Limit your screen time by less exposure to gadgets like TV, mobiles etc to enhance sleep quality. (2,4)

Adopt lifestyle modifications and add exercise to your daily routine like doing some running or cardio and practicing techniques to reduce or manage your stress such as yoga or meditation. All these approaches help promote overall health and better sleep. 

As a pharmacist, in my opinion, trazodone is a well-tolerated antidepressant among majority of individuals. I would suggest you stick to your prescribed dosage regimen and take the medication before bedtime if it’s intended for sedative purposes to avoid daytime drowsiness. If you experience any concerning side effects related to memory or cognition with taking trazodone inform your doctor right away. 

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