Mount Sinai researchers have conducted a study identifying a new treatment for rapid eye movement (REM) sleep behavior disorder. Published in the Journal of Neuroscience, the study outlines a new model to characterise how REM sleep behavior disorder develops due to neurodegeneration – when brain cells lose function over time – which is associated with the accumulation of tau protein. This model could guide future prevention and treatment, providing an early-life biomarker of impending deterioration of the brain.
The study also demonstrated, for the first time, that sleep medications known as dual orexin receptor antagonists can significantly reduce REM sleep behavior disorder. Current therapeutic options for this disorder are primarily limited to melatonin and clonazepam. These findings suggest a promising new treatment with potentially fewer side effects.
The researchers used a mouse model to study neurodegenerative disorders by examining the brain following abnormal deposits of tau, a protein that normally helps stabilise the internal skeleton of nerve cells in the brain. They analysed behavioural states including wakefulness, phases of REM, phases of non-REM, length of sleep, transitions from waking to sleep, and how some factors are related to age.
Nearly a third of the older subjects exhibited dream enactment behaviours reminiscent of REM sleep behavior disorder, including chewing and limb extension. After administering a dual orexin receptor antagonist twice during a 24-hour period, to evaluate sleep in light and dark phases, the researchers observed that the medication not only reduced the time it took to fall asleep and increased both the quality and duration of sleep but also reduced levels of dream enactment.
Researchers hope their findings will encourage future trials of dual orexin receptor antagonists to treat REM sleep behavior disorder in humans, given that the medication is already FDA approved and available to treat people with insomnia.
“We anticipated finding breakdown of sleep quality with progressive neurodegeneration related to tau accumulation, but the observation of dream enactment was a surprise,” says lead author Korey Kam, PhD, assistant professor of medicine (pulmonary, critical care and sleep medicine) at Icahn Mount Sinai. “It was even more surprising and exciting to observe that a dual orexin receptor antagonist could significantly minimise the dream enactment behaviours.”
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News Source : Sleep Review
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