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：

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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.

Citation： TONG Jing, PAN Xiaoli, LIANG Peng. Research progress in anesthetic drugs and techniques for sleep disorders. West China Medical Journal, 2026, 41(2): 341-345. doi: 10.7507/1002-0179.202503282 Copy

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. 中青年人群失眠現狀及其相關社會心理影響因素分析. 實用預防醫學, 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.	沈陽陽, 周俊英. 失眠藥物治療及進展. 中國臨床醫生雜志, 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, 劉雨思, 等. 瑞馬唑侖誘導睡眠平衡術在慢性失眠中的臨床應用效果. 中國新藥雜志, 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.	張釗, 王英偉. 丙泊酚對大腦功能網絡調節機制的研究進展. 國際麻醉學與復蘇雜志, 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, 張建峰, 趙倩男, 等. 多模式睡眠: 慢性失眠的創新療法. 中華麻醉學雜志, 2020, 40(5): 520-523.
31.	方七五, 錢曉焱, 鄭鑫, 等. 右美托咪定滴定判斷不寧腿綜合征的準確性. 中華麻醉學雜志, 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, 韓佳煒, 張潤琛, 等. 針灸星狀神經節治療失眠的機制研究. 天津中醫藥, 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.	顧宇, 岳馨, 韓翃, 等. 超聲引導下星狀神經節阻滯治療老年失眠癥的效果. 中國老年學雜志, 2024, 44(3): 594-597.
38.	于博, 白鵬. 電針頭穴和體穴對慢性失眠患者睡眠的影響. 世界睡眠醫學雜志, 2024, 11(11): 2446-2448, 2452.
39.	李暢, 周東升, 禹海航. 經顱交流電刺激在失眠障礙中的應用研究進展. 中華物理醫學與康復雜志, 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.	Kwa?ny A, Cuba?a WJ, W?odarczyk 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.	王堅, 丁國鵬, 宋丹丹. 低劑量艾司氯胺酮對腹腔鏡膽囊切除術日間手術患者術后睡眠障礙的影響. 華西醫學, 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, Bene? 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. 中青年人群失眠現狀及其相關社會心理影響因素分析. 實用預防醫學, 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. 沈陽陽, 周俊英. 失眠藥物治療及進展. 中國臨床醫生雜志, 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, 劉雨思, 等. 瑞馬唑侖誘導睡眠平衡術在慢性失眠中的臨床應用效果. 中國新藥雜志, 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. 張釗, 王英偉. 丙泊酚對大腦功能網絡調節機制的研究進展. 國際麻醉學與復蘇雜志, 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, 張建峰, 趙倩男, 等. 多模式睡眠: 慢性失眠的創新療法. 中華麻醉學雜志, 2020, 40(5): 520-523.
31. 方七五, 錢曉焱, 鄭鑫, 等. 右美托咪定滴定判斷不寧腿綜合征的準確性. 中華麻醉學雜志, 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, 韓佳煒, 張潤琛, 等. 針灸星狀神經節治療失眠的機制研究. 天津中醫藥, 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. 顧宇, 岳馨, 韓翃, 等. 超聲引導下星狀神經節阻滯治療老年失眠癥的效果. 中國老年學雜志, 2024, 44(3): 594-597.
38. 于博, 白鵬. 電針頭穴和體穴對慢性失眠患者睡眠的影響. 世界睡眠醫學雜志, 2024, 11(11): 2446-2448, 2452.
39. 李暢, 周東升, 禹海航. 經顱交流電刺激在失眠障礙中的應用研究進展. 中華物理醫學與康復雜志, 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. Kwa?ny A, Cuba?a WJ, W?odarczyk 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. 王堅, 丁國鵬, 宋丹丹. 低劑量艾司氯胺酮對腹腔鏡膽囊切除術日間手術患者術后睡眠障礙的影響. 華西醫學, 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, Bene? 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.

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