Researchers identify a potential new treatment for those who act out their dreams in their sleep – ScienceDaily

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The new study, published in the neuroscience journal on May 25, describes a novel model to better characterize how REM sleep behavior disorder develops due to neurodegeneration, when brain cells lose their function over time, which is associated with the accumulation of tau protein. This model provides an early-in-life biomarker of impending brain decline, which could guide future prevention and treatment.

The paper also demonstrates for the first time that sleep medications known as dual orexin receptor antagonists, commonly used to treat insomnia or difficulty falling asleep and staying asleep, can significantly reduce REM sleep behavior disorder. Current therapeutic options for this disorder are mostly limited to melatonin and clonazepam, also known as Klonopin, so these findings suggest a promising new treatment with fewer potential side effects.

“We were interested in understanding all the ways sleep quality deteriorates as neurodegeneration progresses and whether there were any ways to mitigate such changes,” said corresponding author Andrew W. Varga, MD, PhD, Associate Professor of Medicine (Pulmonary, Critical Care and Sleep Medicine) at the Icahn School of Medicine at Mount Sinai. “We identified a novel model in which REM sleep behavior disorder can develop, due to neurodegeneration associated with tau protein accumulation, and a novel therapy that could minimize REM sleep behavior disorder.”

The Mount Sinai researchers used a mouse model to study neurodegenerative disorders by examining the brain for abnormal deposits of tau, a protein that normally helps stabilize the inner skeleton of nerve cells in the brain. They analyzed behavioral states, including wakefulness, REM (dream sleep) phases, non-REM (dreamless sleep) phases, sleep duration, transitions from wakefulness to sleep, and how some factors relate to sleep. age. Nearly one third of the older subjects exhibited dream enactment behaviors reminiscent of REM sleep behavior disorder, including chewing and limb extension. After administering a dual orexin receptor antagonist twice over a 24-hour period to assess sleep in the light and dark phases, the researchers found that the drug not only reduced the time it took to fall asleep but also increased both quality and duration of sleep, but also reduced levels of dream representation.

The researchers hope their findings will encourage future trials of dual orexin receptor antagonists to treat REM sleep behavior disorder in humans, since the drug is already FDA-approved and available to treat people with insomnia.

“We anticipated finding a disruption of sleep quality with progressive neurodegeneration related to tau accumulation, but the observation of dream representation came as a surprise,” said 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 minimize dream enactment behaviors.”

The research was supported by funding from the Alzheimer’s Association and the Merck Investigator Studies Program.