Title:Benzodiazepines and Sleep Architecture: A Systematic Review
Volume: 22
Issue: 2
Author(s): Felipe Maraucci Ribeiro de Mendonça, Giulia Paulo Rossi Ribeiro de Mendonça, Laura Costa Souza, Lucas Pequeno Galvão, Henrique Soares Paiva, Cintia de Azevedo Marques Périco, Julio Torales, Antonio Ventriglio, João Maurício Castaldelli-Maia and Anderson Sousa Martins Silva*
Affiliation:
- Health Secretariat of São Bernardo do Campo, São Bernardo do Campo, SP, Brazil
- Medical School, Universidade Nove de Julho, Sao Paulo, SP, Brazil
Keywords:
Benzodiazepines, sleep, sleep architecture, sleep slow-wave, sleep REM, sleep stages.
Abstract:
Background: Insomnia, defined as a difficulty in initiating or maintaining sleep, is a relevant
medical issue. Benzodiazepines (BZDs) are commonly prescribed to treat insomnia. Two
phases characterize human sleep structure: sleep with Non-Rapid Eye Movement (NREM) and
sleep with Rapid Eye Movement (REM). Physiological sleep includes NREM and REM phases in
a continuous cycle known as “Sleep Architecture.”
Objective: This systematic review summarizes the studies that have investigated effects of BZDs
on Sleep Architecture.
Methods: The articles selection included human clinical trials (in English, Portuguese, or Spanish)
only, specifically focused on BZDs effects on sleep architecture. PubMed, BVS, and Google Scholar
databases were searched.
Results: Findings on BZDs effects on sleep architecture confirm an increase in stage 2 of NREM
sleep and a decrease in time of stages 3 and 4 of NREM sleep with a reduction in time of REM
sleep during the nocturnal sleep.
Conclusion: Variations in NREM and REM sleep may lead to deficits in concentration and working
memory and weight gain. The increase in stage 2 of NREM sleep may lead to a subjective improvement
of sleep quality with no awakenings. BZDz should be prescribed with zeal and professional
judgment. These patients should be closely monitored for possible long-term side effects.
