Emerging Evidence Indicates Survival Benefits of REM-Inhibition Therapy in ALS Patients
Emerging research suggests that pharmacological REM sleep inhibition may offer survival benefits for ALS patients, indicating a new direction in disease management and therapy development.
Recent research presented at the American Thoracic Society 2025 International Conference suggests a potential survival advantage for patients with amyotrophic lateral sclerosis (ALS) who undergo REM sleep inhibition through pharmacological means. The study, led by Dr. Cosmo Fowler from Emory University School of Medicine, analyzed data from the TriNetX research network involving 17,444 ALS patients prescribed riluzole.
The investigators focused on two cohorts: one with patients prescribed antidepressants associated with REM sleep suppression over the past three years (the REM-inhibited group), comprising 14.3%, and another receiving antidepressants not linked to REM suppression (non-REM-inhibited group), comprising 2.1%. Patients who received both types were excluded to ensure clarity.
Prior to matching for age, race, and gender, the REM-inhibited group showed a significantly higher two-year survival rate (47.18%) compared to the non-REM-inhibited group (41.06%), with a hazard ratio of 1.21. After applying propensity score matching to control confounding variables, the trend towards improved survival persisted, with a survival rate of 48.13% versus 41.06%. Although the statistical significance was borderline, the findings suggest that targeting REM sleep pathways pharmacologically might influence disease progression.
Dr. Fowler commented that, despite the study’s retrospective nature and inherent limitations, these results highlight a promising avenue for ALS treatment strategies that focus on sleep modulation. Further prospective research is necessary to validate these observations and potentially incorporate REM-inhibition therapies into clinical practice.
This innovative study underscores the importance of sleep regulation in ALS management and opens new pathways for therapeutic intervention aimed at prolonging patient survival.
Source: https://medicalxpress.com/news/2025-05-trend-survival-benefit-rem-inhibition.html
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