Li Yaozu, Zuo Muyan, Wang Ruoguo, Li Yongxiang, Williams John P, An Jianxiong
Medical School, University of Chinese Academy of Sciences, Beijing, People's Republic of China.
Center for Pain & Sleep Medicine, Affiliated Hospital of Shandong Second Medical University (Weifang Medical University), Weifang, People's Republic of China.
Nat Sci Sleep. 2025 Sep 4;17:2111-2118. doi: 10.2147/NSS.S550428. eCollection 2025.
Insomnia is a common symptom of depression, and their complex, bidirectional relationship poses significant challenges for treatment. Dexmedetomidine (Dex), an α-adrenergic receptor agonist, shows unique advantages in inducing sleep closely resembling physiological sleep and is gaining interest as a potential therapy for insomnia.
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.
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.
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 (R = 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).
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.
失眠是抑郁症的常见症状，它们复杂的双向关系给治疗带来了重大挑战。右美托咪定（Dex）是一种α-肾上腺素能受体激动剂，在诱导与生理睡眠极为相似的睡眠方面具有独特优势，作为一种潜在的失眠治疗方法正受到关注。
本研究旨在通过多导睡眠图（PSG）确定抑郁症相关失眠患者诱导N2期睡眠的右美托咪定平均有效剂量，并识别影响剂量变异性的因素。
2023年4月至8月，从山东第二医科大学附属医院疼痛与睡眠医学中心招募了91例抑郁症相关失眠患者。所有患者在持续PSG监测下接受静脉输注右美托咪定（稀释至4μg/mL并以60mL/h的速度给药）。记录诱导N2期睡眠所需的右美托咪定累积剂量。收集临床数据，并进行单因素和多线性回归分析以识别影响右美托咪定剂量的因素。
最终分析纳入了82例患者。诱导N2期睡眠所需的右美托咪定平均有效剂量为49.0±16.4μg。多变量回归分析确定年龄（P<0.001）和体重（P=0.022）是右美托咪定剂量的独立预测因素，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托咪定剂量之间存在正相关（R=0.181）。在滴定过程中，患者的生命体征保持稳定，心率显著下降（68.2±10.0对57.0±13.3次/分钟，P<0.05），而平均动脉压和血氧饱和度无显著变化（P>0.05）。
右美托咪定可有效诱导抑郁症相关失眠患者进入N2期睡眠，且安全性良好，所需剂量随年龄增加而增加。
