Effective Dexmedetomidine Dose for Stage N2 Sleep Induction and Associated Factors in Depression-Related Insomnia: A Polysomnography-Based Analysis.

IF 3.4 2区医学 Q2 CLINICAL NEUROLOGY

Nature and Science of Sleep Pub Date : 2025-09-04 eCollection Date: 2025-01-01 DOI:10.2147/NSS.S550428

Yaozu Li, Muyan Zuo, Ruoguo Wang, Yongxiang Li, John P Williams, Jianxiong An

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Abstract

Background: Insomnia is a common symptom of depression, and their complex, bidirectional relationship poses significant challenges for treatment. Dexmedetomidine (Dex), an α₂-adrenergic receptor agonist, shows unique advantages in inducing sleep closely resembling physiological sleep and is gaining interest as a potential therapy for insomnia.

Objective: This study aimed to determine the average effective Dex dose for inducing stage N2 sleep in patients with depression-related insomnia via polysomnography (PSG), and to identify factors affecting dose variability.

Methods: From April to August 2023, 91 patients with depression-related insomnia were recruited from the Center for Pain and Sleep Medicine at the Affiliated Hospital of Shandong Second Medical University. All patients received intravenous Dex infusion (diluted to 4 μg/mL and administered at 60 mL/h) under continuous PSG monitoring. The cumulative Dex dose required to induce stage N2 sleep was recorded. Clinical data were collected, and univariate and multiple linear regression analyses were performed to identify factors influencing Dex dose.

Results: A total of 82 patients were included in the final analysis. The mean effective dose of Dex required to induce stage N2 sleep was 49.0 ± 16.4 μg. Multivariate regression analysis identified age (P < 0.001) and body weight (P = 0.022) as independent predictors of Dex dose, with age exerting a stronger predictive effect. Simple linear regression further demonstrated a positive association between age and Dex dose (R² = 0.181). During titration, patients' vital signs remained stable, with heart rate significantly decreasing (68.2 ± 10.0 vs 57.0 ± 13.3 bpm, P < 0.05), whereas mean arterial pressure and oxygen saturation showed no significant changes (P > 0.05).

Conclusion: Dex could effectively induces stage N2 sleep in patients with depression-related insomnia and has a favorable safety profile, with the required dose increasing with age.

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右美托咪定对抑郁症相关性失眠的N2期睡眠诱导及相关因素的有效剂量：基于多导睡眠图的分析。

背景：失眠是抑郁症的常见症状，其复杂的双向关系为治疗带来了重大挑战。右美托咪定（Dexmedetomidine, Dex）是一种α2-肾上腺素能受体激动剂，在诱导睡眠方面具有独特的优势，与生理睡眠相似，是一种潜在的失眠治疗方法。目的：本研究旨在通过多导睡眠图（PSG）确定Dex诱导抑郁症相关性失眠患者N2期睡眠的平均有效剂量，并探讨影响剂量变异性的因素。方法：选取山东第二医科大学附属医院疼痛与睡眠医学中心于2023年4月至8月收治的91例抑郁症相关性失眠患者。所有患者均在连续PSG监测下静脉滴注Dex（稀释至4 μg/mL，以60 mL/h给药）。记录诱导N2期睡眠所需的药敏酮累积剂量。收集临床资料，进行单因素和多元线性回归分析，以确定影响右美沙芬剂量的因素。结果：共纳入82例患者。诱导N2期睡眠所需的Dex平均有效剂量为49.0±16.4 μg。多因素回归分析发现，年龄（P < 0.001）和体重（P = 0.022）是Dex剂量的独立预测因子，年龄的预测作用更强。简单线性回归进一步表明，年龄与右美沙芬剂量呈正相关（R²= 0.181）。滴定期间，患者生命体征稳定，心率明显降低（68.2±10.0 vs 57.0±13.3 bpm, P < 0.05），平均动脉压和血氧饱和度无明显变化（P < 0.05）。结论：Dex可有效诱导抑郁症相关性失眠患者N2期睡眠，且安全性较好，且需药量随年龄增长而增加。

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来源期刊

Nature and Science of Sleep Neuroscience-Behavioral Neuroscience

CiteScore

5.70

自引率

5.90%

发文量

245

审稿时长

16 weeks

期刊介绍： Nature and Science of Sleep is an international, peer-reviewed, open access journal covering all aspects of sleep science and sleep medicine, including the neurophysiology and functions of sleep, the genetics of sleep, sleep and society, biological rhythms, dreaming, sleep disorders and therapy, and strategies to optimize healthy sleep. Specific topics covered in the journal include: The functions of sleep in humans and other animals Physiological and neurophysiological changes with sleep The genetics of sleep and sleep differences The neurotransmitters, receptors and pathways involved in controlling both sleep and wakefulness Behavioral and pharmacological interventions aimed at improving sleep, and improving wakefulness Sleep changes with development and with age Sleep and reproduction (e.g., changes across the menstrual cycle, with pregnancy and menopause) The science and nature of dreams Sleep disorders Impact of sleep and sleep disorders on health, daytime function and quality of life Sleep problems secondary to clinical disorders Interaction of society with sleep (e.g., consequences of shift work, occupational health, public health) The microbiome and sleep Chronotherapy Impact of circadian rhythms on sleep, physiology, cognition and health Mechanisms controlling circadian rhythms, centrally and peripherally Impact of circadian rhythm disruptions (including night shift work, jet lag and social jet lag) on sleep, physiology, cognition and health Behavioral and pharmacological interventions aimed at reducing adverse effects of circadian-related sleep disruption Assessment of technologies and biomarkers for measuring sleep and/or circadian rhythms Epigenetic markers of sleep or circadian disruption.