section_path: Drugs and diet
section_name: Drugs and diet
paragraph_text: Drugs and diet
  
  Drugs which induce sleep, known as hypnotics, include benzodiazepines (although these interfere with REM); nonbenzodiazepine hypnotics such as eszopiclone (Lunesta), zaleplon (Sonata), and zolpidem (Ambien); antihistamines such as diphenhydramine (Benadryl) and doxylamine; alcohol (ethanol), (which exerts an excitatory rebound effect later in the night and intereferes with REM) barbiturates (which have the same problem), melatonin (a component of the circadian clock) and cannabis (which may also interfere with REM). Some opioids (including morphine, codeine, heroin, and oxycodone) also induce sleep, and can disrupt sleep architecture and sleep stage distribution. Interestingly, the endogenously produced drug gamma-hydroxybutyrate (GHB) is capable of producing high quality sleep that is indistinguishable from natural sleep architecture in humans.
  
  Stimulants, which inhibit sleep, include caffeine, an adenosine antagonist; amphetamine, methamphetamine, MDMA, empathogen-entactogens, and related drugs; cocaine, which can alter the circadian rhythm, and methylphenidate, which acts similarly; and eugeroic drugs like modafinil and armodafinil with poorly understood mechanisms. Consuming high amounts of the stimulant caffeine can result in interrupted sleep patterns and sometimes sleep deprivation. This vicious cycle can result in drowsiness which can then result in a higher consumption of caffeine in order to stay awake the next day. This cycle can lead to decreased cognitive function and an overall feeling of fatigue.
  
  Some drugs may alter sleep architecture without inhibiting or inducing sleep. Drugs that amplify or inhibit endocrine and immune system secretions associated with certain sleep stages have been shown to alter sleep architecture. The growth hormone releasing hormone receptor agonist MK-677 has been shown to increase REM in older adults as well as stage IV sleep in younger adults by approximately 50%.