A novel treatment for intense dreams in REM sleep behavior disorder

summary: A new potential treatment for rapid eye movement (REM) sleep behavior disorder has been identified.

This study established a new model detailing disease progression through neurodegeneration associated with tau protein accumulation. Researchers found that a dual orexin receptor antagonist, commonly used for insomnia, significantly reduced the symptoms of the disorder.

This discovery introduced a new treatment option with potentially fewer side effects.

important facts:

  1. Researchers at Mount Sinai have discovered a new treatment for REM sleep behavior disorder that affects more than 3 million Americans and involves acting out dreams while sleeping.
  2. This study presented a new model showing how this disorder develops through neurodegeneration associated with tau protein accumulation.
  3. Sleeping pills known as dual orexin receptor antagonists, commonly used for insomnia, have been found to significantly alleviate this disorder, opening up promising new treatment options.

sauce: Mount Sinai Hospital

Researchers at Mount Sinai announced the first study to identify a new treatment for rapid eye movement (REM) sleep behavior disorder.

The condition affects more than 3 million Americans, most of whom are adults over the age of 50, who unknowingly experience dreams in their sleep by voices or sudden, violent movements of their arms or legs. are often reproduced in reality, causing serious injury to themselves and their bed partners.

The new research neuroscience journaloutlines a new model to better characterize how REM sleep behavior disorder develops through neurodegeneration (the loss of brain cell function over time) associated with tau protein accumulation.

This model may provide early biomarkers of impending brain deterioration and guide future prevention and treatment.

The paper also demonstrated for the first time that hypnotics known as dual orexin receptor antagonists, commonly used to treat insomnia, difficulty falling asleep or difficulty falling asleep, can significantly reduce REM sleep behavior disorders.

Because current treatment options for this disease are mainly limited to melatonin and clonazepam, also known as klonopin, these findings suggest promising new treatments that may have fewer side effects.

“We were interested in understanding how sleep quality declines as neurodegeneration progresses, and whether there are ways to mitigate such changes.” Corresponding author Andrew W. Varga, M.D., Associate Professor of Medicine, said. He received his (pulmonary, critical care, and sleep medicine) from the Icahn School of Medicine, Mount Sinai.

“We have identified a new model in which REM sleep behavior disorder can develop due to neurodegeneration associated with tau protein accumulation, and a new treatment that can minimize REM sleep behavior disorder. bottom.”

Mount Sinai researchers used a mouse model to examine the brain after abnormal deposition of tau, a protein that normally helps stabilize the internal skeleton of nerve cells in the brain. studied disease.

The researchers found that wakefulness, stages of REM sleep (sleeping while dreaming), stages of non-REM sleep (sleep without dreaming), length of sleep, transition from wakefulness to sleep, and several factors Behavioral status was analyzed, including how it relates to age.

Nearly a third of the elderly subjects exhibited dream-fulfilling behaviors reminiscent of REM sleep behavior disorder, such as chewing and limb extension.

After administering two doses of a dual orexin receptor antagonist over a 24-hour period to assess sleep in the light and dark phases, the researchers found that the drug not only shortened the time it took to fall asleep, but also It has been observed to increase both sleep quality and duration. The level of dream fulfillment has also declined.

Given that the drug is already FDA-approved and available for the treatment of insomnia patients, the researchers believe that the results of this study may prove useful as a dual orexin receptor antagonist for treating REM sleep behavior disorder in humans. We hope to facilitate future clinical trials of

“While we had expected to find poor sleep quality due to progressive neurodegeneration associated with tau accumulation, the observation of dream fulfillment was surprising,” said lead author and assistant professor of medicine Corey Kam. Dr. (Pulmonary, Critical Care and Sleep Medicine) said. ) at Icahn on Mount Sinai.

“It was even more surprising and exciting to observe that a dual orexin receptor antagonist can significantly minimize dream fulfillment behavior.”

About this sleep research news

author: Andrew W. Varga
sauce: Mount Sinai Hospital
contact: Andrew W. Varga – Mount Sinai Hospital
image: Image credited to Neuroscience News

Original research: closed access.
“Effects of Aging and Dual Orexin Receptor Antagonists on Non-REM Oscillations, Including Sleep Architecture and REM Behavioral Disorder Phenotypes in a PS19 Mouse Model of Tauopathy” (Andrew W. Varga, et al.) neuroscience journal


Effects of Aging and Dual Orexin Receptor Antagonists on Non-REM Oscillations, Including Sleep Architecture and REM Behavioral Disorder Phenotypes in the PS19 Mouse Model of Tauopathy

Despite the proposed importance of these electrophysiological features for learning and memory, the effects of tau pathology on sleep microarchitectural features, including slow oscillations, spindles, and their connections, have been poorly studied. do not have. Dual orexin receptor antagonists (DORA) are known to promote sleep, but it is unclear if and how they affect sleep microarchitecture in cases of tauopathy.

In a PS19 mouse model of tauopathy (MAPT P301S, both male and female), young PS19 mice aged 2–3 months exhibited markedly reduced spindle duration and output compared with littermate controls, and slow oscillations ( SO) show sleep electrophysiological features with increased density. However, there is no significant tau hyperphosphorylation, tangle formation, or neurodegeneration at this age.

As PS19 mice age, they experience a decrease in REM sleep time, an increase in NREM and REM sleep fragmentation, an increase in the frequency of short wakefulness at the macro level, and a decrease in spindle density, SO density, and spindle SO. There is evidence of a characteristic sleep disturbance. Bonding at the micro level. In approximately 33% of aged PS19 mice, abnormal goal-directed behaviors seemingly consistent with REM behavioral disorders (RBD) were observed in REM, including chewing, paw grasping, and forelimb/hindlimb extension.

Oral administration of DORA-12 to aged PS19 mice shortened bout duration but increased NREM and REM sleep durations, without altering spindle-SO binding, SO or spindle output. Spindle density, spindle duration and SO density increased. band, or arousal index.

We observed a significant effect of DORA-12 on objective measures of RBD, thereby encouraging future exploration of DORA’s effects on sleep-mediated cognition and RBD treatment.

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