Drugs That Increase REM Sleep | Safer Options And Risks

REM sleep shapes dreams, mood, and learning, so it makes sense that people search for ways to boost it. Many wonder if drugs that increase REM sleep can fix tired mornings or foggy memory.

Some medicines do change REM sleep, including a few that raise its share of the night for certain groups of patients. At the same time, large groups of commonly used drugs push REM down or fragment it, and chasing more dreaming without a clear plan can backfire.

This guide walks through the main drug classes linked to higher REM sleep, who might receive them, and what trade offs they bring. It also sets out non drug steps for healthier sleep so you can talk with your doctor or a sleep specialist from a stronger starting point.

What Is REM Sleep And Why It Matters

Sleep runs in repeating cycles that move through light sleep, deeper stages, and rapid eye movement, or REM, sleep. During REM, brain activity rises again, breathing and heart rate vary, muscles go limp, and vivid dreams tend to appear.

Research links REM sleep to memory processing, learning new skills, and emotional balance. Many adults spend roughly a quarter of the night in this stage, spread across several short periods that grow longer toward morning.

One helpful overview comes from the NHLBI stages of sleep, which describes how non REM and REM sleep repeat across the night. The Sleep Foundation REM sleep overview explains how changes in this stage can affect thinking, mood, and daytime energy.

Drug Class	Example Medicines	Typical Effect On REM Sleep*
Dual Orexin Receptor Antagonists (DORAs)	Suvorexant, Lemborexant, Daridorexant	Promote sleep in insomnia and tend to preserve or increase REM while also raising total sleep time.
Cholinesterase Inhibitors	Donepezil, Rivastigmine	Some trials show higher REM percentage and density, along with more vivid dreaming in adults with dementia.
Antidepressant Bupropion	Bupropion SR, Bupropion XL	Does not usually suppress REM and in some studies raised REM time or REM activity in certain patients.
Sodium Oxybate	Sodium Oxybate, Low Sodium Oxybate	Reorganizes sleep in narcolepsy, with more deep sleep and shifts in REM timing that can normalize disturbed patterns.
Traditional Antidepressants	Fluoxetine, Venlafaxine, Amitriptyline	Often delay and suppress REM, even when mood improves, and can trigger REM sleep behavior disorder in some cases.
Benzodiazepines And Z Drugs	Temazepam, Clonazepam, Zolpidem	Usually blunt deep sleep and can reduce or fragment REM despite longer total sleep time.
Melatonin And Related Agents	Melatonin, Ramelteon	Shift sleep timing; effects on REM differ by dose and person, with small changes up or down.
Stimulants / Wake Promoters	Modafinil, Amphetamine Mixes	Promote wakefulness and often delay REM; REM rebound can appear when the drug stops.

*Summaries reflect research in specific disorders; actual effects vary with diagnosis, dose, and other medicines.

Drugs That Increase REM Sleep And How They Work

Only a few drug groups truly count as drugs that increase REM sleep, and even those change far more than dreaming alone. This section explains the main ones and the situations in which sleep specialists tend to use them.

Dual Orexin Receptor Antagonists For Insomnia

Orexin is a brain messenger that keeps people awake and alert. Dual orexin receptor antagonists, often called DORAs, block orexin signals so the drive to stay awake drops and sleep can start more easily.

Unlike older sleeping pills, DORAs usually let the brain pass through natural non REM and REM stages instead of knocking the person into light sleep only. Trials in insomnia show longer total sleep time, fewer awakenings, and a pattern that still contains the usual share of REM sleep.

How DORAs Affect REM Sleep

Polysomnography studies suggest that DORAs may slightly increase both REM and non REM sleep in some patients with insomnia, while keeping the overall balance closer to normal sleep than many older hypnotics. That can help people who lie awake for long stretches or wake up many times at night, yet still keep dreaming cycles in place.

DORAs are prescription drugs. They can cause morning sleepiness, confusion in older adults, and rare complex sleep behaviors such as eating or activity while not fully awake. People with breathing problems, liver disease, or those who take other sedating medicines need careful review with a clinician before starting them.

Cholinesterase Inhibitors Such As Donepezil

Cholinesterase inhibitors such as donepezil are mainly used for Alzheimer disease and related memory disorders. They raise levels of acetylcholine, a brain chemical that helps nerve cells communicate and also plays a strong role in REM sleep.

Several studies in older adults with dementia found that donepezil increased the percentage of the night spent in REM sleep and boosted REM density, the number of rapid eye movements during that stage. For some patients, this shift goes along with clearer thinking or better daytime function.

Limits Of Using Donepezil For REM Sleep

Donepezil is not a general REM booster for healthy sleepers. It can worsen insomnia, trigger intense dreams or nightmares, and cause nausea, weight loss, or slow heart rate. Sleep specialists may lean on its REM effects when treating conditions such as REM sleep behavior disorder in people who already need the drug for dementia, but they rarely prescribe it only to increase dreaming.

Antidepressant Bupropion

Bupropion stands out among antidepressants because it does not reliably suppress REM sleep. Some research in people with depression has shown higher REM time, increased REM activity, or denser eye movements during REM after weeks of bupropion treatment.

At the same time, bupropion often lengthens the delay to the first REM period, and its REM effects vary across studies. The main reason to choose bupropion is mood, energy, or help with smoking cessation, not REM alone.

When Bupropion Might Help REM Sleep

For a person with depression who already has low REM time from other antidepressants, switching to bupropion can sometimes restore a more typical dream pattern. That choice still needs a full review of seizure risk, blood pressure, anxiety level, and current medicines, because bupropion can raise seizure risk in prone patients and may worsen restlessness or insomnia for some.

Sodium Oxybate In Narcolepsy

Sodium oxybate, and its newer low sodium version, are night time medicines for narcolepsy with cataplexy. They deepen sleep during the night and often lead to fewer awakenings and better alertness during the day.

Sleep studies show that sodium oxybate increases deep slow wave sleep and changes REM timing in ways that can stabilize abnormal patterns seen in narcolepsy. In some patients, REM becomes more organized and closer to the timing seen in people without narcolepsy.

Why Sodium Oxybate Needs Close Supervision

Sodium oxybate is tightly controlled because of its strong sedating effect and abuse potential. It can slow breathing, especially when mixed with alcohol, opioids, or other sedatives. For that reason, only specialist clinics prescribe it, and it is not an option for someone simply hoping to dream more or raise REM time.

Medication Choices That Increase REM Sleep Duration

In real life, medication choices that increase REM sleep duration appear in a narrow set of situations. Doctors weigh the whole picture: daytime symptoms, other health problems, other medicines, and how disrupted the person’s sleep pattern looks on a study.

Groups that might receive a drug with REM boosting effects include:

• Adults with chronic insomnia who still feel unrefreshed after trying behavioral therapy and basic sleep habits, where a DORA may help.
• People with narcolepsy, where sodium oxybate can improve fragmented sleep and abnormal REM timing.
• Adults with Alzheimer disease or related disorders who take donepezil for memory, and as a side effect gain more structured REM sleep.
• Patients with depression who respond better to bupropion than to REM suppressing antidepressants.

Most people with simple insomnia do not start with drugs that increase REM sleep. They start with better sleep scheduling, less caffeine late in the day, and cognitive behavioral therapy for insomnia, which has a strong evidence base and carries fewer risks than long term pills.

Risks Of Relying On REM Sleep Drugs

Every medicine that changes REM sleep also changes other systems in the brain and body. Side effects, interactions, and long term questions matter just as much as the dream stage itself.

Common concerns include next day grogginess, balance problems and falls in older adults, complex sleep behaviors, mood shifts, blood pressure changes, and breathing issues during sleep. Some drugs also raise seizure risk or strain the liver or kidneys.

Approach	Possible Upsides	Main Concerns
DORAs For Insomnia	More total sleep, fewer awakenings, REM preserved or slightly higher.	Morning sleepiness, confusion in frail adults, complex sleep behaviors, cost.
Donepezil And Other Cholinesterase Inhibitors	Higher REM share, possible gains in memory and daytime function.	Insomnia, nightmares, nausea, slow heart rate, not suited to healthy sleepers.
Bupropion	Mood lift, energy, no clear REM suppression and sometimes more REM activity.	Insomnia, anxiety, seizure risk in prone people, blood pressure changes.
Sodium Oxybate	Deeper night sleep in narcolepsy, fewer awakenings, more stable REM timing.	Breathing suppression, abuse risk, strict dispensing rules, salt load with some forms.
Melatonin And Related Agents	Shift in sleep timing, mild help with jet lag or delayed sleep phase.	Mixed data on long term safety and REM effects, interactions with other medicines.
Non Drug Sleep Therapy	Better sleep quality, more stable cycles, benefits that last after treatment ends.	Needs time, effort, and access to skilled therapists or digital programs.

Side Effects And Safety Limits

People with lung disease, sleep apnea, heart rhythm problems, or a history of falls carry extra risk when taking sedating medicines. Adding alcohol, opioids, or antihistamines on top raises that risk even further.

Women who are pregnant, trying to conceive, or breastfeeding need tailored advice before starting any drug that acts on the brain. The same holds for teenagers, who have different sleep needs and may react differently to these medicines.

Drug Interactions And Medical History

Many REM active medicines pass through the same liver enzymes as antidepressants, seizure medicines, and blood thinners. That means dose changes on one drug can change blood levels of another, sometimes in ways that raise side effect risk.

Before starting a new sleep or mood drug, doctors usually review recent lab results, heart rhythm strips when needed, and the full medication list, including over the counter pills and herbal products. Honest sharing on caffeine, alcohol, nicotine, and recreational drug use also shapes safe dosing.

Why Quick Fix Pills Rarely Solve Poor Sleep

Short acting pills can help for a limited time, yet chronic sleep trouble often stems from sleep apnea, restless legs, chronic pain, trauma, or long running stress. If those roots stay in place, tinkering with REM alone rarely fixes daytime fatigue.

In some cases, extra REM without treatment of the underlying problem can even worsen daytime symptoms, as with untreated sleep apnea or REM sleep behavior disorder. For that reason, specialists usually start with a broad sleep assessment before they recommend drugs that touch REM.

Non Drug Ways To Build Healthy REM Sleep

Habits and daytime routines shape REM sleep just as powerfully as pills, and for many people they matter more. These steps do not act as quickly as a tablet, yet they carry far fewer risks and often bring steadier gains.

Regular Sleep Schedule

A consistent bed time and wake time keep the body clock steady, which helps REM cycles land at the same points each night. Large swings between weekdays and weekends can compress REM or push it into shorter windows near morning.

Most adults feel and function best with seven to nine hours in bed at night. Picking a target wake time, then counting back that range, gives a realistic window for sleep instead of short, irregular stretches.

Light, Activity, And Caffeine

Bright light soon after waking helps reset the body clock and promotes sleepiness at night. Dimmer light and calmer activities in the last hour before bed make it easier for REM rich cycles to unfold later in the night.

Heavy meals, vigorous exercise, or strong caffeine late in the evening can delay sleep onset and shift REM into shorter segments. Many people do better when the last caffeinated drink lands at least six hours before bed.

Bedroom Setting And Sleep Disorders

A quiet, cool bedroom, a comfortable mattress, and as few interruptions as possible help the brain cycle through deep sleep and REM without repeated awakenings. That simple mix often does more for REM than any drug.

Loud snoring, gasping during sleep, waking up choking, or acting out dreams can point toward sleep apnea or REM sleep behavior disorder. Anyone with these signs should talk with a doctor or sleep clinic about testing, since treating the underlying disorder often restores a healthier mix of REM and non REM sleep.

Main Takeaways On REM Sleep Drugs

A small group of prescription medicines can increase REM sleep or restore more normal REM patterns, mainly in people with insomnia, narcolepsy, dementia, or depression. Each of these medicines comes with benefits, limits, and safety questions that extend far beyond dreaming.

For many people, better sleep hygiene, therapy for insomnia, and treatment of hidden sleep disorders do more for energy, mood, and long term health than chasing higher REM time with pills. If you are worried about your dreaming, dream loss, or vivid nightmares, bring those details to your clinician and ask whether a full sleep assessment, not just a quick prescription, makes sense for you.

This article can guide questions and expectations, but it cannot replace personal medical advice. Never start, stop, or change any prescription or over the counter medicine that affects sleep without working with your own doctor or sleep specialist.