Sleep and Anesthesia

Abstract

Since both anesthesia and sleep depress consciousness, bidirectional relationship between them has been further studied. Earlier findings have shown that they share electroencephalographic features and brain regions that are activated in both state of unconsciousness. Despite these similarities, medication-induced sedation provokes different outcome from natural sleep. Enlisting commonly used analgesic drugs, such as benzodiazepines, intravenous agents, benzodiazepine antagonists, opioids, and other adjuvants, the study is comprised of assorted case studies that are clinically applicable or comparable. Acknowledging potential of analgesic drugs on sleep disorders including sleep deprivation, narcolepsy, circadian rhythm disorder, periodic limb movement disorder, and obstructive sleep apnea, the study underscores the clinical importance of studying both fields, sleep and anesthesia. In conclusion, the aim of this review is explaining the consequences of analgesic agents or sedatives on sleep and sleep disorders.

Premedication effect of melatonin on propofol induction dose for anesthesia, anxiety, orientation and sedation after abdominal surgery: a double-blinded randomized trial

“…Melatonin interacts with multiple receptors, including opioidergic, benzodiazepinergic, muscarinic, nicotinic, serotonergic, α1- and α2-adrenergic, and melatonergic receptors found in the spinal cord in the central nervous system 38. Premedication reduces the need for anesthetic induction agents during surgery 79. Melatonin, an effective hypnotic drug, is revealed to have the effect on both the onset and maintenance of sleep,10 while it is known as a natural hypnotic agent whose actions are activated by MT1 and MT2 receptors and a yet-unclarified physiologic mechanism underlying the analgesic actions of melatonin 79…”

“…Premedication reduces the need for anesthetic induction agents during surgery 79. Melatonin, an effective hypnotic drug, is revealed to have the effect on both the onset and maintenance of sleep,10 while it is known as a natural hypnotic agent whose actions are activated by MT1 and MT2 receptors and a yet-unclarified physiologic mechanism underlying the analgesic actions of melatonin 79…”

Sleep as a Therapeutic Target in the Aging Brain

“…Like sleep, general anesthesia and sedation are associated with altered levels of arousal. Although sleep differs from these states in its reversibility and self-regulation [16], sleep and anesthesia can share electroencephalographic features and in the brain regions activated or inhibited in either state [17]. Slow delta (0.5-4 Hz) activity is a feature both of deep N3 sleep as well as general anesthesia [18].…”

The effects of the general anaesthetic propofol on Drosophila larvae

“…While general anaesthesia is similar to sleep in many ways, it is clearly a different form of sedation. Unlike sleep, consciousness, pain response, and motor functions are mostly lost during general anaesthesia (Song et al, 2018). Furthermore, electroencephalogram (EEG) data can reveal differences in brain activity between sleep and general anaesthesia.…”

“…Finally, at the most profound state of general anaesthesia, the EEG is isoelectric (figure 1.3) (Brown et al, 2010). Emergence from general anaesthesia is also characterised by delayed recovery of alertness, unlike the quick recovery after waking up from sleep (Song et al, 2018). These differences indicate there are other targets for general anaesthetics besides GABAergic sleep circuits.…”