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Benadryl and REM sleep
#1
I'm sure everyone here has tried Benadry (diphenhydramine HCl) at some time or another. I just read a review claiming that Benadryl is effective as a sleep aid, but keeps you from having REM sleep. That doesn't make a lot of sense to me. Has anyone heard this?
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#2
I have not heard that specifically, but it's plausible. Many drugs affect sleep architecture. I think most side effects studied are insomnia and drowsiness. I don't think the effect on architecture, sleep levels is often studied with many drugs. I take benadryl regularly and dream.
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#3
I think there is folk-lore out there that says it DOES decrease REM sleep. You will read this on multiple web sites and in different places that don't really quote any studies.

However, there was a single study I saw done on RATS that said it didn't have much of an effect, one way or another. This rat study looked at different antihistamines, including Benadryl, chorpheniramine, etc., but only found one that was effective in increasing REM sleep and decreasing sleep latency, and that antihistamine was cyproheptidine.

For what it is worth, (to my wife it is), she takes Benadryl just about every night. She does dream and does feel rested. It may work differently in RATS and in different humans. The bottom line is each individual. If it is working for you, and you feel more rested using it, don't even worry about what others may be saying about Bendadryl.
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#4
(06-29-2012, 09:35 AM)BabyDoc Wrote: I think there is folk-lore out there that says it DOES decrease REM sleep. You will read this on multiple web sites and in different places that don't really quote any studies.
However, there was a single study I saw done on RATS that said it didn't have much of an effect, one way or another. This rat study looked at different antihistamines, including Benadryl, chorpheniramine, etc., but only found one that was effective in increasing REM sleep and decreasing sleep latency, and that antihistamine was cyproheptidine.
... If it is working for you, and you feel more rested using it, don't even worry about what others may be saying about Bendadryl.

Thanks for that information. I was looking for science and, from what you say, evidently there is little available.

It doesn't do a lot for me, but I'm trying anything I can get to stop waking up five or six times a night. Even 75 mg has only a slight effect, so I think I'm going to forget about Benadryl.

Melatonin does work for me, however. A 3 mg tablet taken at dusk makes me drowsy in about an hour. My next experiment will be with time release melatonin, because I understand its half life is only 30-50 minutes (Wikipedia). Natrol (Rite-Aid, Amazon) sells a 10 mg tab with a fast acting outer shell and a slow acting inner component. It's cheap and I'm in the U.S. so I don't need a prescription.
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#5
JJJ, I have the same problem with frequent awakening that you do. I get up at least 6 times a night. I haven't found a medication that helps. APAP hasn't helped that ,even though my AHI is 1 or less. Furthermore, I don't see any relationship between my awakenings and the few break-through events that show up on SleepyHead or Rescan. Fortunately, I generally don't have any trouble falling asleep, after awakening. While I definitely feel more rested since starting my APAP 2 months ago, it would be even better if my sleep were less interupted. Hopefully, in time it will get better.

Most sleep medications will help you to fall asleep. They just don't help to keep you asleep. Melatonin is a natural subtance released from the pineal gland in our brains. It is released like clockwork, usually at the time of the evening when we are most accustomed to falling asleep.
Some people make less of this hormone as they get older and either need a medication to stimulate its release from the brain, or take actual Melatonin. Otherwise they can't fall asleep. But Melatonin won't keep them asleep, especially if something else is awakening them. Therefore, I would doubt that a sustained released form of Melatonin will be any more affective in keeping most people asleep than a shorter acting form of it. However, should one awaken and then not be able to fall asleep, then a longer acting form might help. I have tried a sustained released Melatonin myself. It was purchased from GNC. It did not end my awakening, although I thought, perhaps, I fell back to sleep a bit faster.

I guess what we both have to figure out for ourselves is what is awakening us, if it isn't a apnea or hypopnea. In my case, I thought I was awakening to urinate from my prostate problem, which is mild to moderate at most. If I wake up and don't try to urinate, I can't fall back to sleep, even though the amount I urinate is usually a rather small volume, under 60 cc. Prostate medication helps avoid hesitency but doesn't help my waking up. Bladder emptying studies, during the day, have showed that I am emptying my bladder. So the reason for my frequent awakening to void only a small amount remains a mystery at this point. They say that nocturia, alone, could be a sign of OSA, but my OSA seems to be treated effectively, and nocturia persists. So If it doesn't get better, (maybe I need to give it a couple more months with my APAP, I may need to seek another urologic opinion. Or I may have an anxiety problem that awakens me. (At this point I am certainly anxious about my bladder.) Although I don't feel depressed, it may be that my sleep would benefit from an antidepressant. The point of all this discussion is that there can be a variety of reasons for awakening. Unless you can figure what is awakening you, it is unlikely that you can fix the problem with a single shot gun, do all, medication. That medication has yet to be invented, or I would be taking it.
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#6
I also have fragmented sleep. None of the sleep aids I've tied help with this. They do help me get to sleep, but they don't stop me from waking up long before it's time to wake up.

One thing I have noticed is that this problem has lessened with CPAP therapy. Very gradually. I still wake up at least once a night, usually three or four times. But I do find it much easier, usually, to fall back asleep.

Before CPAP therapy I would often have to get out of bed and read for awhile before I could go back to bed. That almost never happens now.

Before CPAP therapy I would almost always be lying awake when the alarm went off. Often I'd get out of bed before it went off. Now, I almost always am sleeping when the alarm goes off.
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#7
BabyDoc,

Thanks for your long and informative reply. I have the same problems as you, except I have no prostrate issues. I agree with everything you say. I have tried to find events that prompt arousals, but no patterns emerge. I do note that the fewer awakenings the better I feel the next day. I suspect that, since I wake up about once per hour, I'm not getting a full set of the four stages. That is, my understanding is that a complete cycle takes about an hour and a half. But without the equipment in a sleep lab it's hard to say which stage is getting shortchanged.

Today I bought the time release melatonin and will try it tonight. Stay tuned.
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#8
(06-28-2012, 09:14 PM)JJJ Wrote: I'm sure everyone here has tried Benadry (diphenhydramine HCl) at some time or another. I just read a review claiming that Benadryl is effective as a sleep aid, but keeps you from having REM sleep. That doesn't make a lot of sense to me. Has anyone heard this?

There is a lot of new research that says that Benadryl makes you dumber the next day, as well as being bad for sleep architecture. Doctors are recommending it less & less. I can't post links, but if you google benadryl sleep architecture, and look at the articles, you'll see.

I used it for many years at times I didn't have a prescription sleeping pill, because at least it makes the awful nights go by faster. But you pay a price.
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#9
(06-29-2012, 11:28 AM)BabyDoc Wrote: In my case, I thought I was awakening to urinate from my prostate problem, which is mild to moderate at most. If I wake up and don't try to urinate, I can't fall back to sleep, even though the amount I urinate is usually a rather small volume, under 60 cc. Prostate medication helps avoid hesitency but doesn't help my waking up. Bladder emptying studies, during the day, have showed that I am emptying my bladder. So the reason for my frequent awakening to void only a small amount remains a mystery at this point.

I have a very similar problem. It doesn't feel like I'm waking up to urinate, but when I wake up, I have to urinate, even if its a very small amount, otherwise my bladder itches & I can't get back to sleep. This doesn't happen during the day - I do have to go to the bathroom more often than most people, but it doesn't "itch" if I hold it for awhile.

It's a mystery to me too, but seems likely related to sleep-disordered breathing.
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#10
I'm currently on a rotation of 4 antihistmines: Zyrtec, Allegra, Clairitin and Benadryl. I take them just before I go to bed. I try to get a minimum effective dose with each. So the Zyrtec & Clairitin pills are broken in half and since the Allegra (generic) tablet is so nice and big (and pricey) it gets chopped into quarters.

The old machine - M Series BiPAP Auto - stopped keeping stats a couple of years ago. The new machine I got late last week - System One BiPAP Auto - so I'm going to produce some reports on antihistamine effectiveness.

I'm not a fan of the nasal steroids - tried them ~10 years ago pre-cpap era and they gave me a nose bleed issue that has never fully gone away.

If you're looking for a different antihistamine to try I suggest Astelin. Scrip only but your doc might have samples. I started on therapy back in Jan/09. Took 6 months of herculean effort and spotty compliance to figure out that my right nostril was often clogging up. Tried an antihistamine and it worked like a charm. Called my doc for an appt and told him what I did. He opened up the drawer and gave me a sample of Astelin.
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