Esketamine Optimized the Efficacy of Dexmedetomidine in Treating Sleep Disorders with Comorbid Depression.
Yitong Ding, Zhengye Wang, Jing Huang, Yanzi Yi, Zhouquan Wu
Neuropsychiatric Disease and Treatment 2025 DOI: 10.2147/NDT.S530265 (opens in new tab)
Study at a glance
AI-extracted from the abstract| Characteristics | Randomized controlled trial Peer reviewed |
|---|---|
| Sample size | 84 |
| Population | Patients with comorbid insomnia and depression |
| Interventions | Dexmedetomidine Esketamine |
| Duration | 3-day treatment, 1-month follow-up |
| Topics | Depression Esketamine |
| Keywords | Dexmedetomidine Polysomnography Insomnia treatment Sleep disorders Sleep improvement Sleep therapy Somnipathy Sleep management Sleep medicine Depression management Mood disorders Mood improvement Psychiatric treatment Affective disorders Mental health Psychopharmacology Drug therapy Medication Combination therapy Pharmacotherapy Psychotropic drugs Sleep research Sleep study Clinical investigation Medical research Sleep assessment Sleep science |
| Citations | 3 |
| Key findings | Adding esketamine to dexmedetomidine significantly increased total sleep time, N3 sleep proportion, and reduced depression scores compared to dexmedetomidine alone in patients with comorbid insomnia and depression. |
Abstract
Although Dexmedetomidine (DEX) can induce sleep that resembles natural sleep, it has demonstrated limited efficacy in patients with comorbid insomnia and depression. On the other hand, Esketamine (ESK) has shown a potent antidepressant effect. Herein, we aimed to establish whether esketamine could enhance the therapeutic efficacy of DEX in treating patients with comorbid insomnia and depression. We recruited 84 patients with comorbid insomnia and depression who were randomized into two groups for a 1-month follow-up study: the DE group (receiving dexmedetomidine and esketamine) and the DS group (receiving dexmedetomidine and saline). Outcome measures included polysomnographic monitoring (PSG), Montgomery-Åsberg Depression Rating Scale (MADRS), Pittsburgh Sleep Quality Index (PSQI), Sleep Numeric Rating Scale (SNRS), and serum brain-derived neurotrophic factor (BDNF) concentrations. The primary outcome was a comparison of PSG parameters recorded at baseline (D0) and on treatment day 3 (D3). After 3 days of treatment, patients in DE group had a significant increase in total sleep duration, duration and proportion of N3 sleep (P < 0.05), a significant decrease in proportion of N2 sleep and proportion of REM sleep (P < 0.05), and a significant decrease in depression score and sleep numeric rating scale score (P < 0.05), as compared with DS group. Improvements in sleep were associated with improvements in MADRS score and increases in BDNF. Oral dryness was the most frequent adverse event (AE). When combined with ESK, DEX improved patients' depression scores, further extended total sleep time, increased the N3 sleep proportion, and enhanced deep sleep continuity, with few AEs.
Comparable studies
Other randomized controlled trials on esketamine for depression, most cited first.