Table 1.

Effect of Common ICU Medications on Sleep

Drug Use/Medications	Mechanism of Action	Effect on Sleep
Sedation
Benzodiazepines	GABA receptor agonist	↑TST, ↓N3, ↓ REM
Dexmedetomidine	α2-agonist	↑N3, ↓SL, ↓REM
Propofol	GABA receptor agonist	↑TST, ↓SL, ↓W
Analgesia
Opioids	CNS opioid receptor agonist	↓TST, ↓N3, ↓REM, ↑W
Antipsychotic
Haloperidol	Dopamine-receptor antagonist	↑TST, ↑N3, ↑SE, ↓SL, ↓W
Olanzapine	5HT2-, D2-receptor antagonist	↑TST, ↑N3, ↑SE, ↓SL, ↓W
Cardiovascular
β-blockers	CNS β-receptor antagonist	↑W, ↓REM, nightmares
Dopamine	D2-, β1-, α1-receptor agonist	↓N3, ↓REM
Norepinephrine/Epinephrine	α- and β-receptor agonist	↓N3, ↓REM
Phenylephrine	α1-receptor agonist	↓N3, ↓REM
Other
Corticosteroids	Decreases melatonin levels	↑W, ↓N3, ↓REM

Abbreviations: CNS, central nervous system; GABA, gamma-aminobutyric acid; N3, deep or slow wave sleep stage; REM, rapid eye movement sleep; SE, sleep efficiency; SL, sleep latency; TST, total sleep time; W, wakefulness after sleep onset