Research progress in anesthetic drugs and techniques for sleep disorders_West China Medical Journal

Authors：

TONG Jing ^1,2 , PAN Xiaoli ¹ ,  LIANG Peng ^1,3

1. Department of Anesthesiology, West China Hospital, Sichuan University, Chengdu, Sichuan 610041, P. R. China;
2. Department of Anesthesia Operation, the First People’s Hospital of Shuangliu District, West China Airport Hospital Sichuan University, Chengdu, Sichuan 610200, P. R. China;
3. Day Surgery Center, General Practice Medical Center, West China Hospital, Sichuan University, Chengdu, Sichuan 610041, P. R. China;

Corresponding author：

LIANG Peng, Email: liangpengwch@scu.edu.cn

Keywords：

Anesthesia mechanism; sleep cycle; sleep disorder; chronic insomnia; stellate ganglion block

DOI：

10.7507/1002-0179.202503282

Video：

Export PDF Favorites Scan Get Citation

Abstract Full text Figures/Tables Video References Cited by

Sleep disorder is a global health concern. Given the physiological similarities between anesthesia-induced states of consciousness and natural sleep, the application of anesthetic drugs and techniques in the diagnosis and treatment of sleep disorders has become increasingly prominent. This article systematically reviews the classification of sleep disorders, elaborates on the progress of anesthetic drugs and techniques in various types of sleep disorders, aiming to provide clinicians with scientific diagnostic and therapeutic evidence.

1.	Medic G, Wille M, Hemels ME. Short- and long-term health consequences of sleep disruption. Nat Sci Sleep, 2017, 9: 151-161.
2.	Kerkhof GA. Epidemiology of sleep and sleep disorders in the Netherlands. Sleep Med, 2017, 30: 229-239.
3.	K Pavlova M, Latreille V. Sleep disorders. Am J Med, 2019, 132(3): 292-299.
4.	Brown RE, Basheer R, McKenna JT, et al. Control of sleep and wakefulness. Physiol Rev, 2012, 92(3): 1087-1187.
5.	Sateia MJ. International classification of sleep disorders-third edition: highlights and modifications. Chest, 2014, 146(5): 1387-1394.
6.	江小建, 余英, 高盈. 中青年人群失眠现状及其相关社会心理影响因素分析. 实用预防医学, 2022, 29(2): 242-245.
7.	Bao WW, Jiang S, Qu WM, et al. Understanding the neural mechanisms of general anesthesia from interaction with sleep-wake state: a decade of discovery. Pharmacol Rev, 2023, 75(3): 532-553.
8.	Miao A, Luo T, Hsieh B, et al. Brain clearance is reduced during sleep and anesthesia. Nat Neurosci, 2024, 27(6): 1046-1050.
9.	Mashour GA, Hudetz AG. Bottom-up and top-down mechanisms of general anesthetics modulate different dimensions of consciousness. Front Neural Circuits, 2017, 11: 44.
10.	Moody OA, Zhang ER, Vincent KF, et al. The neural circuits underlying general anesthesia and sleep. Anesth Analg, 2021, 132(5): 1254-1264.
11.	Luppi PH, Fort P. Neurochemistry of sleep an overview of animal experimental work. Handb Clin Neurol, 2011, 98: 173-90.
12.	Choi K, Lee YJ, Park S, et al. Efficacy of melatonin for chronic insomnia: systematic reviews and meta-analyses. Sleep Med Rev, 2022, 66: 101692.
13.	Morin CM, Benca R. Chronic insomnia. Lancet, 2012, 379(9821): 1129-1141.
14.	Riemann D, Espie CA, Altena E, et al. The European insomnia guideline: an update on the diagnosis and treatment of insomnia 2023. J Sleep Res, 2023, 32(6): e14035.
15.	Roy MS, Sarkar BK, Kundu SK. Site specific binding pattern of benzodiazepines with GABAA receptor and related impact on their activities in the human body: an in silico method based study. Heliyon, 2024, 10(13): e33929.
16.	Forman SA. γ-aminobutyric acid type a receptor subtypes and circuit connections in midazolam-induced amnesia, sedation, and hypnosis. Anesthesiology, 2022, 136(6): 880-882.
17.	Silverstein BH, Parkar A, Groenhout T, et al. Effect of prolonged sedation with dexmedetomidine, midazolam, propofol, and sevoflurane on sleep homeostasis in rats. Br J Anaesth, 2024, 132(6): 1248-1259.
18.	沈阳阳, 周俊英. 失眠药物治疗及进展. 中国临床医生杂志, 2023, 51(12): 1394-1397.
19.	Lee JY, Farrell B, Holbrook AM. Deprescribing benzodiazepine receptor agonists taken for insomnia: a review and key messages from practice guidelines. Pol Arch Intern Med, 2019, 129(1): 43-49.
20.	胡淇云, 徐森, 刘雨思, 等. 瑞马唑仑诱导睡眠平衡术在慢性失眠中的临床应用效果. 中国新药杂志, 2024, 33(12): 1256-1261.
21.	Zhang JF, Williams JP, Zhao QN, et al. Multimodal sleep, an innovation for treating chronic insomnia: case report and literature review. J Clin Sleep Med, 2021, 17(8): 1737-1742.
22.	张钊, 王英伟. 丙泊酚对大脑功能网络调节机制的研究进展. 国际麻醉学与复苏杂志, 2021, 42(10): 1120-1124.
23.	Yue XF, Wang AZ, Hou YP, et al. Effects of propofol on sleep architecture and sleep-wake systems in rats. Behav Brain Res, 2021, 411: 113380.
24.	Dai W, Xiao Y, Tu Y, et al. Propofol protects hippocampal neurons in sleep-deprived rats by inhibiting mitophagy and autophagy. Ann Transl Med, 2021, 9(18): 1427.
25.	Lu Y, Xiao Y, Tu Y, et al. Propofol-induced sleep ameliorates cognition impairment in sleep-deprived rats. Sleep Breath, 2023, 27(1): 181-190.
26.	Xu Z, Jiang X, Li W, et al. Propofol-induced sleep: efficacy and safety in patients with refractory chronic primary insomnia. Cell Biochem Biophys, 2011, 60(3): 161-166.
27.	Uzbay T, Shahzadi A. A comprehensive analysis of propofol abuse, addiction and neuropharmacological aspects: an updated review. Korean J Anesthesiol, 2025, 78(2): 91-104.
28.	Hu Y, Zhou H, Zhang H, et al. The neuroprotective effect of dexmedetomidine and its mechanism. Front Pharmacol, 2022, 13: 965661.
29.	An JX, Williams JP, Fang QW, et al. Feasibility of patient-controlled sleep with dexmedetomidine in treating chronic intractable insomnia. Nat Sci Sleep, 2020, 12: 1033-1042.
30.	安建雄, 张建峰, 赵倩男, 等. 多模式睡眠: 慢性失眠的创新疗法. 中华麻醉学杂志, 2020, 40(5): 520-523.
31.	方七五, 钱晓焱, 郑鑫, 等. 右美托咪定滴定判断不宁腿综合征的准确性. 中华麻醉学杂志, 2021, 41(7): 861-864.
32.	Wu J, Liu X, Ye C, et al. Intranasal dexmedetomidine improves postoperative sleep quality in older patients with chronic insomnia: a randomized double-blind controlled trial. Front Pharmacol, 2023, 14: 1223746.
33.	Savastano S, Baldi E, Compagnoni S, et al. Electrical storm treatment by percutaneous stellate ganglion block: the STAR study. Eur Heart J, 2024, 45(10): 823-833.
34.	Li YL. Stellate ganglia and cardiac sympathetic overactivation in heart failure. Int J Mol Sci, 2022, 23(21): 13311.
35.	秋添, 韩佳炜, 张润琛, 等. 针灸星状神经节治疗失眠的机制研究. 天津中医药, 2024, 41(1): 111-116.
36.	Dai D, Zheng B, Yu Z, et al. Right stellate ganglion block improves learning and memory dysfunction and hippocampal injury in rats with sleep deprivation. BMC Anesthesiol, 2021, 21(1): 272.
37.	顾宇, 岳馨, 韩翃, 等. 超声引导下星状神经节阻滞治疗老年失眠症的效果. 中国老年学杂志, 2024, 44(3): 594-597.
38.	于博, 白鹏. 电针头穴和体穴对慢性失眠患者睡眠的影响. 世界睡眠医学杂志, 2024, 11(11): 2446-2448, 2452.
39.	李畅, 周东升, 禹海航. 经颅交流电刺激在失眠障碍中的应用研究进展. 中华物理医学与康复杂志, 2023, 45(3): 274-277.
40.	Lin D, Huang X, Sun Y, et al. Perioperative sleep disorder: a review. Front Med (Lausanne), 2021, 8: 640416.
41.	Liu H, Wei H, Qian S, et al. Effects of dexmedetomidine on postoperative sleep quality: a systematic review and meta-analysis of randomized controlled trials. BMC Anesthesiol, 2023, 23(1): 88.
42.	Zeng W, Chen L, Liu X, et al. Intranasal dexmedetomidine for the treatment of pre-operative anxiety and insomnia: a prospective, randomized, controlled, and clinical trial. Front Psychiatry, 2022, 13: 816893.
43.	Wang Y, Jin Z, Xu W, et al. Clinical observation of dexmedetomidine nasal spray in the treatment of sleep disorders on the first night after undergoing maxillofacial surgery: a single-center double-blind randomized controlled study. J Pharm Pharm Sci, 2023, 26: 11699.
44.	Kwaśny A, Cubała WJ, Włodarczyk A, et al. Sleep alterations in treatment-resistant depression patients undergoing ketamine treatment. Pharmacol Rep, 2024, 76(6): 1325-1332.
45.	Hu CH, Chou WY. Improved Pittsburgh Sleep Quality Index scores on first postoperative night achieved by propofol anesthesia in patients undergoing ambulatory gynecologic surgery. World J Clin Cases, 2022, 10(21): 7256-7264.
46.	Huang P, Cong L, Lu Z, et al. Postoperative sleep quality of insomnia patients after TIVA anesthesia: a prospective study. J Perianesth Nurs, 2024, 39(1): 73-78.
47.	Lei M, Zhang P, Liu Y, et al. Propofol and sufentanil may affect the patients’ sleep quality independently of the surgical stress response: a prospective nonrandomized controlled trial in 1033 patients’ undergone diagnostic upper gastrointestinal endoscopy. BMC Anesthesiol, 2017, 17(1): 53.
48.	Qiu D, Wang XM, Yang JJ, et al. Effect of intraoperative esketamine infusion on postoperative sleep disturbance after gynecological laparoscopy: a randomized clinical trial. JAMA Netw Open, 2022, 5(12): e2244514.
49.	王坚, 丁国鹏, 宋丹丹. 低剂量艾司氯胺酮对腹腔镜胆囊切除术日间手术患者术后睡眠障碍的影响. 华西医学, 2025, 40(2): 198-204.
50.	Loadsman JA, Hillman DR. Anaesthesia and sleep apnoea. Br J Anaesth, 2001, 86(2): 254-266.
51.	Lackey TG, Duffy JR, Green KK. A protocol for propofol-infusion drug-induced sleep endoscopy. Otolaryngol Head Neck Surg, 2023, 168(2): 234-240.
52.	Stanley JJ. Drug-induced sleep endoscopy: techniques, interpretation and implications. Curr Opin Pulm Med, 2020, 26(6): 623-628.
53.	Manconi M, Garcia-Borreguero D, Schormair B, et al. Restless legs syndrome. Nat Rev Dis Primers, 2021, 7(1): 80.
54.	Silber MH, Becker PM, Buchfuhrer MJ, et al. The appropriate use of opioids in the treatment of refractory restless legs syndrome. Mayo Clin Proc, 2018, 93(1): 59-67.
55.	Trenkwalder C, Beneš H, Grote L, et al. Prolonged release oxycodone-naloxone for treatment of severe restless legs syndrome after failure of previous treatment: a double-blind, randomised, placebo-controlled trial with an open-label extension. Lancet Neurol, 2013, 12(12): 1141-1150.
56.	Kapur N, Friedman R. Oral ketamine: a promising treatment for restless legs syndrome. Anesth Analg, 2002, 94(6): 1558-1559.

1. Medic G, Wille M, Hemels ME. Short- and long-term health consequences of sleep disruption. Nat Sci Sleep, 2017, 9: 151-161.
2. Kerkhof GA. Epidemiology of sleep and sleep disorders in the Netherlands. Sleep Med, 2017, 30: 229-239.
3. K Pavlova M, Latreille V. Sleep disorders. Am J Med, 2019, 132(3): 292-299.
4. Brown RE, Basheer R, McKenna JT, et al. Control of sleep and wakefulness. Physiol Rev, 2012, 92(3): 1087-1187.
5. Sateia MJ. International classification of sleep disorders-third edition: highlights and modifications. Chest, 2014, 146(5): 1387-1394.
6. 江小建, 余英, 高盈. 中青年人群失眠现状及其相关社会心理影响因素分析. 实用预防医学, 2022, 29(2): 242-245.
7. Bao WW, Jiang S, Qu WM, et al. Understanding the neural mechanisms of general anesthesia from interaction with sleep-wake state: a decade of discovery. Pharmacol Rev, 2023, 75(3): 532-553.
8. Miao A, Luo T, Hsieh B, et al. Brain clearance is reduced during sleep and anesthesia. Nat Neurosci, 2024, 27(6): 1046-1050.
9. Mashour GA, Hudetz AG. Bottom-up and top-down mechanisms of general anesthetics modulate different dimensions of consciousness. Front Neural Circuits, 2017, 11: 44.
10. Moody OA, Zhang ER, Vincent KF, et al. The neural circuits underlying general anesthesia and sleep. Anesth Analg, 2021, 132(5): 1254-1264.
11. Luppi PH, Fort P. Neurochemistry of sleep an overview of animal experimental work. Handb Clin Neurol, 2011, 98: 173-90.
12. Choi K, Lee YJ, Park S, et al. Efficacy of melatonin for chronic insomnia: systematic reviews and meta-analyses. Sleep Med Rev, 2022, 66: 101692.
13. Morin CM, Benca R. Chronic insomnia. Lancet, 2012, 379(9821): 1129-1141.
14. Riemann D, Espie CA, Altena E, et al. The European insomnia guideline: an update on the diagnosis and treatment of insomnia 2023. J Sleep Res, 2023, 32(6): e14035.
15. Roy MS, Sarkar BK, Kundu SK. Site specific binding pattern of benzodiazepines with GABAA receptor and related impact on their activities in the human body: an in silico method based study. Heliyon, 2024, 10(13): e33929.
16. Forman SA. γ-aminobutyric acid type a receptor subtypes and circuit connections in midazolam-induced amnesia, sedation, and hypnosis. Anesthesiology, 2022, 136(6): 880-882.
17. Silverstein BH, Parkar A, Groenhout T, et al. Effect of prolonged sedation with dexmedetomidine, midazolam, propofol, and sevoflurane on sleep homeostasis in rats. Br J Anaesth, 2024, 132(6): 1248-1259.
18. 沈阳阳, 周俊英. 失眠药物治疗及进展. 中国临床医生杂志, 2023, 51(12): 1394-1397.
19. Lee JY, Farrell B, Holbrook AM. Deprescribing benzodiazepine receptor agonists taken for insomnia: a review and key messages from practice guidelines. Pol Arch Intern Med, 2019, 129(1): 43-49.
20. 胡淇云, 徐森, 刘雨思, 等. 瑞马唑仑诱导睡眠平衡术在慢性失眠中的临床应用效果. 中国新药杂志, 2024, 33(12): 1256-1261.
21. Zhang JF, Williams JP, Zhao QN, et al. Multimodal sleep, an innovation for treating chronic insomnia: case report and literature review. J Clin Sleep Med, 2021, 17(8): 1737-1742.
22. 张钊, 王英伟. 丙泊酚对大脑功能网络调节机制的研究进展. 国际麻醉学与复苏杂志, 2021, 42(10): 1120-1124.
23. Yue XF, Wang AZ, Hou YP, et al. Effects of propofol on sleep architecture and sleep-wake systems in rats. Behav Brain Res, 2021, 411: 113380.
24. Dai W, Xiao Y, Tu Y, et al. Propofol protects hippocampal neurons in sleep-deprived rats by inhibiting mitophagy and autophagy. Ann Transl Med, 2021, 9(18): 1427.
25. Lu Y, Xiao Y, Tu Y, et al. Propofol-induced sleep ameliorates cognition impairment in sleep-deprived rats. Sleep Breath, 2023, 27(1): 181-190.
26. Xu Z, Jiang X, Li W, et al. Propofol-induced sleep: efficacy and safety in patients with refractory chronic primary insomnia. Cell Biochem Biophys, 2011, 60(3): 161-166.
27. Uzbay T, Shahzadi A. A comprehensive analysis of propofol abuse, addiction and neuropharmacological aspects: an updated review. Korean J Anesthesiol, 2025, 78(2): 91-104.
28. Hu Y, Zhou H, Zhang H, et al. The neuroprotective effect of dexmedetomidine and its mechanism. Front Pharmacol, 2022, 13: 965661.
29. An JX, Williams JP, Fang QW, et al. Feasibility of patient-controlled sleep with dexmedetomidine in treating chronic intractable insomnia. Nat Sci Sleep, 2020, 12: 1033-1042.
30. 安建雄, 张建峰, 赵倩男, 等. 多模式睡眠: 慢性失眠的创新疗法. 中华麻醉学杂志, 2020, 40(5): 520-523.
31. 方七五, 钱晓焱, 郑鑫, 等. 右美托咪定滴定判断不宁腿综合征的准确性. 中华麻醉学杂志, 2021, 41(7): 861-864.
32. Wu J, Liu X, Ye C, et al. Intranasal dexmedetomidine improves postoperative sleep quality in older patients with chronic insomnia: a randomized double-blind controlled trial. Front Pharmacol, 2023, 14: 1223746.
33. Savastano S, Baldi E, Compagnoni S, et al. Electrical storm treatment by percutaneous stellate ganglion block: the STAR study. Eur Heart J, 2024, 45(10): 823-833.
34. Li YL. Stellate ganglia and cardiac sympathetic overactivation in heart failure. Int J Mol Sci, 2022, 23(21): 13311.
35. 秋添, 韩佳炜, 张润琛, 等. 针灸星状神经节治疗失眠的机制研究. 天津中医药, 2024, 41(1): 111-116.
36. Dai D, Zheng B, Yu Z, et al. Right stellate ganglion block improves learning and memory dysfunction and hippocampal injury in rats with sleep deprivation. BMC Anesthesiol, 2021, 21(1): 272.
37. 顾宇, 岳馨, 韩翃, 等. 超声引导下星状神经节阻滞治疗老年失眠症的效果. 中国老年学杂志, 2024, 44(3): 594-597.
38. 于博, 白鹏. 电针头穴和体穴对慢性失眠患者睡眠的影响. 世界睡眠医学杂志, 2024, 11(11): 2446-2448, 2452.
39. 李畅, 周东升, 禹海航. 经颅交流电刺激在失眠障碍中的应用研究进展. 中华物理医学与康复杂志, 2023, 45(3): 274-277.
40. Lin D, Huang X, Sun Y, et al. Perioperative sleep disorder: a review. Front Med (Lausanne), 2021, 8: 640416.
41. Liu H, Wei H, Qian S, et al. Effects of dexmedetomidine on postoperative sleep quality: a systematic review and meta-analysis of randomized controlled trials. BMC Anesthesiol, 2023, 23(1): 88.
42. Zeng W, Chen L, Liu X, et al. Intranasal dexmedetomidine for the treatment of pre-operative anxiety and insomnia: a prospective, randomized, controlled, and clinical trial. Front Psychiatry, 2022, 13: 816893.
43. Wang Y, Jin Z, Xu W, et al. Clinical observation of dexmedetomidine nasal spray in the treatment of sleep disorders on the first night after undergoing maxillofacial surgery: a single-center double-blind randomized controlled study. J Pharm Pharm Sci, 2023, 26: 11699.
44. Kwaśny A, Cubała WJ, Włodarczyk A, et al. Sleep alterations in treatment-resistant depression patients undergoing ketamine treatment. Pharmacol Rep, 2024, 76(6): 1325-1332.
45. Hu CH, Chou WY. Improved Pittsburgh Sleep Quality Index scores on first postoperative night achieved by propofol anesthesia in patients undergoing ambulatory gynecologic surgery. World J Clin Cases, 2022, 10(21): 7256-7264.
46. Huang P, Cong L, Lu Z, et al. Postoperative sleep quality of insomnia patients after TIVA anesthesia: a prospective study. J Perianesth Nurs, 2024, 39(1): 73-78.
47. Lei M, Zhang P, Liu Y, et al. Propofol and sufentanil may affect the patients’ sleep quality independently of the surgical stress response: a prospective nonrandomized controlled trial in 1033 patients’ undergone diagnostic upper gastrointestinal endoscopy. BMC Anesthesiol, 2017, 17(1): 53.
48. Qiu D, Wang XM, Yang JJ, et al. Effect of intraoperative esketamine infusion on postoperative sleep disturbance after gynecological laparoscopy: a randomized clinical trial. JAMA Netw Open, 2022, 5(12): e2244514.
49. 王坚, 丁国鹏, 宋丹丹. 低剂量艾司氯胺酮对腹腔镜胆囊切除术日间手术患者术后睡眠障碍的影响. 华西医学, 2025, 40(2): 198-204.
50. Loadsman JA, Hillman DR. Anaesthesia and sleep apnoea. Br J Anaesth, 2001, 86(2): 254-266.
51. Lackey TG, Duffy JR, Green KK. A protocol for propofol-infusion drug-induced sleep endoscopy. Otolaryngol Head Neck Surg, 2023, 168(2): 234-240.
52. Stanley JJ. Drug-induced sleep endoscopy: techniques, interpretation and implications. Curr Opin Pulm Med, 2020, 26(6): 623-628.
53. Manconi M, Garcia-Borreguero D, Schormair B, et al. Restless legs syndrome. Nat Rev Dis Primers, 2021, 7(1): 80.
54. Silber MH, Becker PM, Buchfuhrer MJ, et al. The appropriate use of opioids in the treatment of refractory restless legs syndrome. Mayo Clin Proc, 2018, 93(1): 59-67.
55. Trenkwalder C, Beneš H, Grote L, et al. Prolonged release oxycodone-naloxone for treatment of severe restless legs syndrome after failure of previous treatment: a double-blind, randomised, placebo-controlled trial with an open-label extension. Lancet Neurol, 2013, 12(12): 1141-1150.
56. Kapur N, Friedman R. Oral ketamine: a promising treatment for restless legs syndrome. Anesth Analg, 2002, 94(6): 1558-1559.

West China Medical Journal

Latest ArticlesResearch progress in anesthetic drugs and techniques for sleep disorders

Abstract Full text Figures/Tables Video References Cited by

Format

Content