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REM sleep loss–induced elevated noradrenaline could predispose an individual to psychosomatic disorders: a review focused on proposal for prediction, prevention, and personalized treatment

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Abstract

Historically and traditionally, it is known that sleep helps in maintaining healthy living. Its duration varies not only among individuals but also in the same individual depending on circumstances, suggesting it is a dynamic and personalized physiological process. It has been divided into rapid eye movement sleep (REMS) and non-REMS (NREMS). The former is unique that adult humans spend the least time in this stage, when although one is physically asleep, the brain behaves as if awake, the dream state. As NREMS is a pre-requisite for appearance of REMS, the latter can be considered a predictive readout of sleep quality and health. It plays a protective role against oxidative, stressful, and psychopathological insults. Several modern lifestyle activities compromise quality and quantity of sleep (including REMS) affecting fundamental physiological and psychopathosomatic processes in a personalized manner. REMS loss–induced elevated brain noradrenaline (NA) causes many associated symptoms, which are ameliorated by preventing NA action. Therefore, we propose that awareness about personalized sleep hygiene (including REMS) and maintaining optimum brain NA level should be of paramount significance for leading physical and mental well-being as well as healthy living. As sleep is a dynamic, multifactorial, homeostatically regulated process, for healthy living, we recommend addressing and treating sleep dysfunctions in a personalized manner by the health professionals, caregivers, family, and other supporting members in the society. We also recommend that maintaining sleep profile, optimum level of NA, and/or prevention of elevation of NA or its action in the brain must be seriously considered for ameliorating lifestyle and REMS disturbance–associated dysfunctions.

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Abbreviations

ACh:

acetylcholine

AD:

Alzheimer’s disease

GABA:

gamma-aminobutyric acid

IgA:

immunoglobulin-A

IgM:

immunoglobulin-M

LC:

locus coeruleus

NA:

noradrenaline

NK cells:

natural killer cells

NREMS:

non-rapid eye movement sleep

Orx:

orexin

PD:

Parkinson’s disease

PPPM:

predictive, preventive, and personalized medicine

REMS:

rapid eye movement sleep

RBD:

REMS behavior disorders

REMSD:

rapid eye movement sleep deprivation

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Acknowledgments

Research support to BNM was received from Indian funding agencies viz. J. C. Bose fellowship, Department of Science and Technology (DST), Department of Biotechnology (DBT), and University Grants Commission (UGC) and Institutional Umbrella support over the years under the schemes DBT-BUILDER, DST-Improvement of Science and Technology Infrastructure (FIST) and Promotion of University Research and Scientific Excellence (PURSE), UGC-University with Potential for Excellence in Focus Area (UPEII), Departmental Research Support (DRS) and Networking.

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    Rachna Mehta, Shatrunjai Giri & Birendra N. Mallick

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Mehta, R., Giri, S. & Mallick, B.N. REM sleep loss–induced elevated noradrenaline could predispose an individual to psychosomatic disorders: a review focused on proposal for prediction, prevention, and personalized treatment. EPMA Journal 11, 529–549 (2020). https://doi.org/10.1007/s13167-020-00222-1

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