Systems and methods for Discontinuous Reception (DRX)-aware Carrier Sense Adaptive Transmission (CSAT) communication in shared spectrum are disclosed. An access point, for example, may receive signals via a medium in accordance with a first RAT, and identify utilization of the medium associated with the first RAT based on the received signals. Based on the identified utilization of the medium, operation of a second RAT may be cycled between activated and deactivated periods of transmission over the medium in accordance with a Time Division Multiplexing (TDM) communication pattern. A Medium Access Control (MAC) Control Element (CE) may be transmitted to an access terminal associated with the second RAT to activate or deactivate the access terminal in accordance with the TDM communication pattern. The timing of the MAC CE transmission may be based on the TDM communication pattern and a DRX pattern associated with the access terminal.