title: Effects of acute 3,4-methylenedioxymethamphetamine on sleep and daytime sleepiness in MDMA users: a preliminary study.
abstract: OBJECTIVE
  3,4-Methylenedioxymethamphetamine (MDMA) affects monoamine neurotransmitters that play a critical role in sleep and daytime alertness. However, the acute effects of MDMA on sleep and daytime sleepiness have not been studied under placebo-controlled conditions. This study was designed to establish the effects of acute MDMA or placebo administration and sleep restriction on sleep and daytime sleepiness.
  
  
  METHODS
  Participants with a history of MDMA use were studied on 3 sessions of 3 nights (baseline, treatment, and recovery) and 2 days (following night 2 and 3) per session. On treatment nights (night 2), participants received placebo or 2 mg/kg of MDMA or underwent a restricted bed schedule with placebo. Sleep restriction was a positive control to compare sleep loss and consequent sleepiness associated with MDMA use. The scheduled sleep period was 8 hours long on nonrestricted nights, and standard sleep recordings and daytime sleepiness tests were conducted. Age-matched controls received 1 night and day of standard sleep and daytime sleepiness testing.
  
  
  METHODS
  Sleep laboratory.
  
  
  METHODS
  Seven recreational MDMA-users and 13 matched control subjects.
  
  
  RESULTS
  Acute MDMA shortened sleep primarily by increasing sleep latency, and it reduced stage 3/4 sleep and suppressed rapid eye movement (REM) sleep. The MDMA-reduced sleep time was not associated with increased daytime sleepiness the following day, as was seen in the sleep-restriction condition. Compared with control subjects, the MDMA users on the first night in the laboratory had shorter total sleep times and less stage 3/4 sleep. Average daily sleep latency on daytime sleepiness tests the day after nighttime placebo administration was increased in MDMA users compared with the control subjects, and MDMA users had an elevated number of sleep-onset REM periods on these tests, compared with control subjects.
  
  
  CONCLUSIONS
  Acute MDMA administration disrupts sleep and REM sleep, specifically, without producing daytime sleepiness such as sleep restriction does. Compared with control subjects, recreational MDMA users showed evidence of hyperarousal and impaired REM function. The mechanism behind these effects is likely due to the deleterious effects of MDMA on catecholamines.
authors.affiliation: Sleep Disorders & Research Center Henry Ford Health System, Detroit, Michigan 48202, USA. srandal1@hfhs.org
authors.forename: Surilla
authors.initials: S
authors.lastname: Randall
authors.forename: Chris-Ellyn
authors.initials: CE
authors.lastname: Johanson
authors.forename: Manuel
authors.initials: M
authors.lastname: Tancer
authors.forename: Timothy
authors.initials: T
authors.lastname: Roehrs
mesh_terms: D018759:Adrenergic Uptake Inhibitors / Q000008:administration & dosage / Q000494:pharmacology*; D000328:Adult; D019969:Amphetamine-Related Disorders / Q000150:complications / Q000503:physiopathology / Q000523:psychology*; D015331:Cohort Studies; D004311:Double-Blind Method; D005260:Female; D006801:Humans; D008297:Male; D018817:N-Methyl-3,4-methylenedioxyamphetamine / Q000008:administration & dosage / Q000494:pharmacology*; D017286:Polysomnography; D020127:Recovery of Function; D012890:Sleep / Q000187:drug effects*; D013997:Time Factors; D014851:Wakefulness / Q000187:drug effects*; D055815:Young Adult
chemical_list: D018759:Adrenergic Uptake Inhibitors; D018817:N-Methyl-3,4-methylenedioxyamphetamine