1236 Impact of Medication Use on REM Sleep Without Atonia: Differentiating Medication Effect from Depression Diagnosis Article Swipe
Jad El Ahdab
,
Carlos López Rodríguez
,
Matheus Araújo
,
James Bena
,
Shannon L. Morrison
,
Noah Andrews
,
Michael Saribalas
,
Nancy Foldvary‐Schaefer
·
YOU?
·
· 2025
· Open Access
·
· DOI: https://doi.org/10.1093/sleep/zsaf090.1236
YOU?
·
· 2025
· Open Access
·
· DOI: https://doi.org/10.1093/sleep/zsaf090.1236
Introduction REM Sleep without Atonia (RSWA) is the polysomnographic biomarker of REM Sleep Behavior Disorder (RBD). RSWA is associated with serotonergic (SSRIs/SNRIs) antidepressants (ADs). The effects of other ADs and depression on RSWA are unknown. We analyzed the relationship between AD use and RSWA by depression diagnosis status aiming to determine whether RSWA is influenced by the diagnosis of depression, serotonergic agents, or ADs in general. Methods Polysomnograms at Cleveland Clinic (September 2018-October 2024) with >10% REM sleep and RSWA scoring by chin and flexor digitorum superficialis signals were included. Cases were categorized by depression status (yes=923; no=564), then stratified by AD use including any AD (SSRIs-386, SNRIs-181, bupropion-145, trazodone-117, tricyclic AD-60, mirtazapine-29), serotonergic (SSRI/SNRI), non-serotonergic (bupropion-n=145, mirtazapine-n=), and AD-free (n=653), and finally by gender. RSWA was quantified by AASM V2.6 criteria. Wilcoxon rank sum tests compared RSWA% between depression and medication status groups. Results are shown as median (IQR). Results A total of 1,487 were included: mean age 52.9±16.7, 47.2% female. Depression (vs no depression) was predominantly present in females (56.7% vs. 31.7%, p< 0.001) but had similar RSWA% (3.9[0.5, 14.6] vs 4.2[0.0, 18.0], p=0.72). RSWA% was 6.3[1.1,19.2], 6.7[1.3, 18.3], 0.7[0.0, 6.3], and 2.9[0.0, 11.4] in any AD, serotonergic, non-serotonergic, and drug free AD groups, respectively (p< 0.001). Serotonergic and AD-free groups without depression had higher RSWA% than those with depression (11.8[3.4, 31.5]/3.2[0.0, 14] vs 7.4[1.5, 20]/2.5[0.0, 9.4], p=0.04/p=0.038). For serotonergic ADs, this relationship was present only in women. RSWA did not differ in the any AD and non-serotonergic group by depression status (p=0.56). Conclusion RSWA is influenced by AD use rather than depression itself. Serotonergic agents are associated with higher RSWA% than non-serotonergic ADs, particularly in patients without depression. A possible explanation is that RSWA may be mediated by serotonin, as patients without depression, and thus without serotonergic depletion, appear more sensitive to the effects of serotonergic ADs. Our findings support the use of non-serotonergic agents over serotonergic agents, if clinically appropriate in populations at risk for RBD and ⍺-synucleinopathies. This work has important implications on quantification of RSWA for the diagnosis of RBD. Support (if any)
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Metadata
- Type
- article
- Language
- en
- Landing Page
- https://doi.org/10.1093/sleep/zsaf090.1236
- https://academic.oup.com/sleep/article-pdf/48/Supplement_1/A533/63221091/zsaf090.1236.pdf
- OA Status
- bronze
- Related Works
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- OpenAlex ID
- https://openalex.org/W4410502097
All OpenAlex metadata
Raw OpenAlex JSON
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https://openalex.org/W4410502097Canonical identifier for this work in OpenAlex
- DOI
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https://doi.org/10.1093/sleep/zsaf090.1236Digital Object Identifier
- Title
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1236 Impact of Medication Use on REM Sleep Without Atonia: Differentiating Medication Effect from Depression DiagnosisWork title
- Type
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articleOpenAlex work type
- Language
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enPrimary language
- Publication year
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2025Year of publication
- Publication date
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2025-05-01Full publication date if available
- Authors
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Jad El Ahdab, Carlos López Rodríguez, Matheus Araújo, James Bena, Shannon L. Morrison, Noah Andrews, Michael Saribalas, Nancy Foldvary‐SchaeferList of authors in order
- Landing page
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https://doi.org/10.1093/sleep/zsaf090.1236Publisher landing page
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https://academic.oup.com/sleep/article-pdf/48/Supplement_1/A533/63221091/zsaf090.1236.pdfDirect link to full text PDF
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YesWhether a free full text is available
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bronzeOpen access status per OpenAlex
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https://academic.oup.com/sleep/article-pdf/48/Supplement_1/A533/63221091/zsaf090.1236.pdfDirect OA link when available
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Depression (economics), Medicine, Sleep (system call), Psychiatry, Psychology, Pediatrics, Computer science, Operating system, Macroeconomics, EconomicsTop concepts (fields/topics) attached by OpenAlex
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0Total citation count in OpenAlex
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10Other works algorithmically related by OpenAlex
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| primary_location.source.host_organization_lineage | https://openalex.org/P4310311648, https://openalex.org/P4310311647 |
| primary_location.source.host_organization_lineage_names | Oxford University Press, University of Oxford |
| primary_location.license | |
| primary_location.pdf_url | https://academic.oup.com/sleep/article-pdf/48/Supplement_1/A533/63221091/zsaf090.1236.pdf |
| primary_location.version | publishedVersion |
| primary_location.raw_type | journal-article |
| primary_location.license_id | |
| primary_location.is_accepted | True |
| primary_location.is_published | True |
| primary_location.raw_source_name | SLEEP |
| primary_location.landing_page_url | https://doi.org/10.1093/sleep/zsaf090.1236 |
| publication_date | 2025-05-01 |
| publication_year | 2025 |
| referenced_works_count | 0 |
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