How to increase Rapid Eye Movement (REM) and deep sleep stages?

From the Guidelines

To get more REM and deep sleep, establish a consistent sleep schedule and create a relaxing bedtime routine, as these habits have been shown to improve sleep quality and duration, according to recent studies 1.

Key Recommendations

• Establish a consistent sleep schedule by going to bed and waking up at the same time every day, even on weekends.
• Create a relaxing bedtime routine that includes activities like reading, taking a warm bath, or practicing meditation 30-60 minutes before sleep.
• Optimize your sleep environment by keeping your bedroom cool (65-68°F), dark, and quiet.
• Limit exposure to blue light from electronic devices at least 1-2 hours before bedtime, or use blue light blocking glasses if necessary.
• Avoid caffeine after midday and limit alcohol consumption, as both can disrupt sleep architecture.
• Regular exercise, particularly in the morning or afternoon, can promote deeper sleep, but avoid vigorous activity within 2-3 hours of bedtime.
• Consider natural supplements like magnesium (200-400mg), melatonin (0.5-5mg taken 30-60 minutes before bed), or valerian root if needed.

Rationale

These recommendations work because they align with your body's natural circadian rhythm and create optimal conditions for your brain to cycle properly through sleep stages, allowing sufficient time in both REM and deep sleep phases which are essential for memory consolidation, cognitive function, and physical restoration. A recent study published in the Journal of Clinical Sleep Medicine found that melatonin supplementation can improve REM sleep behavior disorder symptoms 1. Another study published in Sleep Medicine Reviews found that regular exercise can promote deeper sleep, but the timing of exercise is important to avoid disrupting sleep architecture 1.

Additional Considerations

• Consult with a healthcare professional before starting any new supplements or medications.
• Be patient and consistent when implementing these recommendations, as it may take some time to notice improvements in sleep quality.
• Consider keeping a sleep diary to track progress and identify areas for further improvement.

From the FDA Drug Label

The effect of eszopiclone on reducing sleep latency and improving sleep maintenance was established in studies with 2100 subjects (ages 18 to 86) with chronic and transient insomnia in six placebo-controlled trials of up to 6 months’ duration. Effects on Sleep Stages In studies that measured the percentage of sleep time spent in each sleep stage, zolpidem tartrate has generally been shown to preserve sleep stages. Sleep time spent in stages 3 and 4 (deep sleep) was found comparable to placebo with only inconsistent, minor changes in REM (paradoxical) sleep at the recommended dose.

The FDA drug label does not provide direct information on how to get more REM and deep sleep. While eszopiclone and zolpidem have been shown to improve sleep maintenance and reduce sleep latency, the labels do not specifically address increasing REM and deep sleep stages. Key points to consider:

• Eszopiclone and zolpidem are used to treat insomnia, but their effects on specific sleep stages are not fully described in the labels.
• Preserving sleep stages is mentioned for zolpidem, but this does not directly answer the question of increasing REM and deep sleep.
• No specific guidance is provided on how to increase REM and deep sleep using these medications 2 3.

From the Research

Strategies to Improve REM and Deep Sleep

To improve REM and deep sleep, several strategies can be employed, including:

• Establishing a consistent sleep schedule and creating a sleep-conducive environment 4
• Practicing relaxation techniques, such as cognitive behavioral therapy for insomnia (CBT-I), which has been shown to be effective in improving sleep quality and duration 5, 6, 7
• Avoiding stimulating activities before bedtime and avoiding caffeine and electronics before sleep 4
• Engaging in regular physical activity, but not too close to bedtime 4
• Avoiding naps during the day, or keeping them short and early in the day 4

Cognitive Behavioral Therapy for Insomnia (CBT-I)

CBT-I is a non-pharmacological approach that has been shown to be effective in improving sleep quality and duration. The core components of CBT-I include:

• Sleep restriction therapy
• Stimulus control therapy
• Sleep hygiene
• Cognitive therapy CBT-I can be delivered in various formats, including individual therapy sessions, group therapy, and self-help materials 6, 8

Benefits of CBT-I

The benefits of CBT-I include:

• Improved sleep quality and duration
• Increased sleep efficiency
• Reduced sleep onset latency
• Reduced wakefulness after sleep
• Improved overall health and well-being CBT-I has been shown to be effective in both the short-term and long-term, with effects lasting up to a year after therapy 7