REVIEW
Ecstasy and sleep disturbance: Progress towards elucidating
a role for the circadian system
Rowan P OGEIL, Shantha MW RAJARATNAM and Jillian H BROADBEAR
School of Psychology and Psychiatry, Monash University, Clayton, Victoria, Australia
Abstract
MDMA (ecstasy) is an illicit drug which has pharmacological actions on the serotonin system, leading
to a number of physiological and behavioral changes. Research conducted in both animals and
humans has focused on how ecstasy use affects systems or functions in which serotonin has a
regulatory role including mood, sleep and circadian rhythms. In this paper we review the evidence
with respect to changes in sleep and circadian rhythms following ecstasy use. Studies of the
subjective measurement of sleep have suggested that there are changes in sleep quality and
duration following ecstasy use, while research utilizing objective measures including polysomnog-
raphy has highlighted changes in sleep architecture following ecstasy use. Collectively these
findings suggest that there are consequences associated with ecstasy use, and the implications of
these findings for ecstasy users will be examined. Finally, preliminary evidence from the animal
literature implicating ecstasy as having specific effects on the circadian system will be reviewed. A
discussion of the limitations of the current evidence for such a claim is presented, and possible
directions for future research are explored.
Key words: circadian rhythms, ecstasy, MDMA, mood, sleep.
INTRODUCTION
Historical background and
usage of MDMA
The synthesis of 3,4 methylenedioxymethamphet-
amine (MDMA), colloquially known as “ecstasy”, was
first described in a German patent in 1912 lodged by
the pharmaceutical company Merck.
1
Reports of MDMA
use were not common until the 1970s, when MDMA
found favour within a psychotherapeutic environment.
2
The reported therapeutic utility of using MDMA as an
adjunct to psychotherapy was its facilitation of openness
about emotional experiences and accompanying loss of
defensive anxiety when interacting with the therapist.
2
These perception- and mood-altering properties
resulted in MDMA being labelled as an “entactogen”,
meaning “producing a touching within”, effects which
are distinguishable from those caused by other
amphetamine-like drugs.
3
Despite MDMA being characterized as a schedule 1
drug in the US in 1986, its use has continued to increase
worldwide, with its popularity attributed to a number of
factors including: its emotive effects, engendering a
sense of closeness to others and feelings of intimacy;
4,5
the sense of euphoria and heightened sensory awareness
reported following use;
6,7
its ability to prolong alertness
allowing users to dance all night at a rave; and its
relative acceptability as a “safe party drug” compared
with other drugs, including cocaine, heroin and
methamphetamine.
8,9
Correspondence: Mr Rowan P Ogeil, School of Psychology
and Psychiatry, Monash University, Building 17, Clayton,
Vic. 3800, Australia. Email: Rowan.Ogeil@monash.edu
Accepted 1 July 2011.
Sleep and Biological Rhythms 2012; 10: 3–13 doi:10.1111/j.1479-8425.2011.00510.x
3 © 2011 The Authors
Sleep and Biological Rhythms © 2011 Japanese Society of Sleep Research