Subjective experiences during dexmedetomidine- or propofol-induced unresponsiveness and non-rapid eye movement sleep in healthy male subjects.
Katja Valli, Linda Radek, Roosa E Kallionpää, Annalotta Scheinin, Jaakko Långsjö, Kaike Kaisti, Oskari Kantonen, Jarno Korhonen, Tero Vahlberg, Antti Revonsuo, Harry Scheinin
British Journal of Anaesthesia August 1, 2023 DOI: 10.1016/j.bja.2023.04.026 (opens in new tab)
Study at a glance
AI-extracted from the abstract| Characteristics | Within-subject experimental study Peer reviewed |
|---|---|
| Sample size | 39 |
| Population | Healthy males |
| Interventions | dexmedetomidine propofol |
| Topics | Dreaming |
| Keywords | Anaesthesia Awareness Consciousness Dexmedetomidine Propofol Sleep Unresponsiveness |
| Registration | NCT01889004 |
| Key findings | Anaesthetic-induced unresponsiveness and NREM sleep are characterised by disconnected conscious experiences with corresponding recall frequencies and content. |
Abstract
Anaesthetic-induced unresponsiveness and non-rapid eye movement (NREM) sleep share common neural pathways and neurophysiological features. We hypothesised that these states bear resemblance also at the experiential level. We compared, in a within-subject design, the prevalence and content of experiences in reports obtained after anaesthetic-induced unresponsiveness and NREM sleep. Healthy males (N=39) received dexmedetomidine (n=20) or propofol (n=19) in stepwise doses to induce unresponsiveness. Those rousable were interviewed and left unstimulated, and the procedure was repeated. Finally, the anaesthetic dose was increased 50%, and the participants were interviewed after recovery. The same participants (N=37) were also later interviewed after NREM sleep awakenings. Most subjects were rousable, with no difference between anaesthetic agents (P=0.480). Lower drug plasma concentrations were associated with being rousable for both dexmedetomidine (P=0.007) and propofol (P=0.002) but not with recall of experiences in either drug group (dexmedetomidine: P=0.543; propofol: P=0.460). Of the 76 and 73 interviews performed after anaesthetic-induced unresponsiveness and NREM sleep, 69.7% and 64.4% included experiences, respectively. Recall did not differ between anaesthetic-induced unresponsiveness and NREM sleep (P=0.581), or between dexmedetomidine and propofol in any of the three awakening rounds (P>0.05). Disconnected dream-like experiences (62.3% vs 51.1%; P=0.418) and memory incorporation of the research setting (88.7% vs 78.7%; P=0.204) were equally often present in anaesthesia and sleep interviews, respectively, whereas awareness, signifying connected consciousness, was rarely reported in either state. Anaesthetic-induced unresponsiveness and NREM sleep are characterised by disconnected conscious experiences with corresponding recall frequencies and content. Clinical trial registration. This study was part of a larger study registered at ClinicalTrials.gov (NCT01889004).
Comparable studies
Other experimental studies on dreaming, most cited first.
| Study | Year | Design | Participants |
|---|---|---|---|
| Lucid Dreaming Verified by Volitional Communication during Rem Sleep Selected subjects proficient in lucid dreaming | 1981 | Experimental study | n = 5 |
| Incorporation of concern- and nonconcern-related verbal stimuli into dream content. Seven male subjects studied during sleep Stages 2 and REM | 1981 | Experimental study | n = 7 |
| Lucid Dreaming and Alpha Activity: A Preliminary Report Good dream recallers | 1982 | Experimental study | n = 10 |
| Lucid dreaming during NREM sleep: Two case reports | 2012 | Sleep laboratory study | |
| The Dream Catcher experiment: blinded analyses failed to detect markers of dreaming consciousness in EEG spectral power. Human participants during sleep | 2020 | Experimental study with blinded classification | n = 9 |
Citations in the library
Cited by 9
- Effect of Intraoperative Intravenous Infusion of Esketamine Combined with Dexmedetomidine on Postoperative Sleep Disturbance in Patients Undergoing Radical Mastectomy. Drug Design, Development and Therapy 2025
- Study protocol: Cerebral characterization of sensory gating in disconnected dreaming states during propofol anesthesia using fMRI Frontiers in Neuroscience February 13, 2024
- Feasibility of a Multicomponent Protocol to Promote Dreaming during Surgical Anesthesia Anesthesiology February 3, 2026
- Neurophysiological Markers of (Dis)Connectedness: Insights from Ketamine Neuromethods 2025
- Dreaming during anaesthesia: a scoping review. British Journal of Anaesthesia August 1, 2026
and 4 more in the library
Cites 14
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- Dreaming of the sleep lab PLoS One October 6, 2021
- Distinct EEG signatures differentiate unconsciousness and disconnection during anaesthesia and sleep. British Journal of Anaesthesia February 9, 2022
- On no man's land: Subjective experiences during unresponsive and responsive sedative states induced by four different anesthetic agents. Consciousness and Cognition November 1, 2021
and 9 more in the library