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Los Angeles Times
12-06-2025
- Health
- Los Angeles Times
Why REM Sleep Behavior Disorder Is a Warning Sign for Parkinson's and Other Brain Diseases
REM Sleep Behavior Disorder (RBD) might sound like something out of a sleepwalker's nightmare, but it's a very real—and increasingly important—sleep disorder. RBD occurs when the normal muscle paralysis, known as muscle atonia, during REM (rapid eye movement) sleep disappears, allowing individuals to physically act out their dreams during dream sleep. REM sleep is one of several sleep stages, also referred to as paradoxical sleep or active sleep, and is characterized by rapid eye movements and vivid dreaming. This loss of muscle atonia can involve anything from flailing limbs to more aggressive or even violent behaviors, potentially resulting in injury to the sleeper or their bed partner. Once seen as a rare curiosity, RBD is now recognized as both a disruptive parasomnia and a warning sign of more serious neurological conditions—especially neurodegenerative disorders known as synucleinopathies, such as Parkinson's disease, Lewy body dementia, and multiple system atrophy (MSA). This dual significance places RBD at a unique crossroads between sleep medicine and neurology. Pinpointing RBD isn't just about noticing odd behavior at night. While many patients (or more often, their partners) report vivid, sometimes violent dream enactment, true diagnosis requires polysomnography—an overnight sleep study that records brain activity, muscle tone, and eye movements. RBD diagnosis relies on identifying abnormal behaviors during the REM stage of the sleep cycle. Specifically, clinicians look at the REM stage as a specific sleep stage for the presence or absence of muscle atonia—REM sleep without atonia indicates a loss of the muscle paralysis that should naturally occur during this phase. According to a 2017 review in Mayo Clinic Proceedings [1], this diagnostic confirmation is vital—not just to guide treatment, but also to identify those at heightened risk for developing a neurodegenerative disorder. And that risk is real. A 2025 study titled The Many Faces of REM Sleep Behavior Disorder [4] found that individuals with idiopathic RBD (i.e., RBD not linked to medications or other causes) have a significant chance of developing Parkinson's or DLB within a decade. This makes RBD one of the most robust prodromal biomarkers in neurology today. First and foremost, in managing RBD, we need to keep patients and partners safe. That often means adapting the sleep environment—removing sharp objects, padding furniture, or even sleeping separately if necessary. RBD often coexists with other sleep disorders which can complicate management and require a comprehensive approach. But pharmacological treatment can also be very effective. Two drugs are front runners: The 2025 International RBD Study Group consensus [2] also explores new territory, finding potential benefit from cholinesterase inhibitors like rivastigmine and dopamine agonists such as pramipexole. However, these are still under investigation and treatment must be individualized based on symptom severity, age and co-existing conditions. Good sleep hygiene and lifestyle modifications are also important. Avoiding sleep deprivation and ensuring a sufficient sleep period helps promote enough sleep and enough REM sleep which are critical for overall health and RBD management. Perhaps the most exciting—and urgent—aspect of RBD is its predictive value. Multiple studies show RBD isn't just a symptom; it may be an early sign that the brain is already undergoing neurodegenerative changes long before other signs appear. REM sleep plays a crucial role in brain development and maintaining the brain's ability to process information and regulate emotions, making its disruption particularly important in the context of RBD. Advanced neuroimaging and cerebrospinal fluid biomarkers have shown early pathology in many patients with idiopathic RBD. This aligns with broader research on alpha-synuclein accumulation in the brain—key in Parkinson's and DLB development [5]. A 2020 review in Frontiers in Neurology [3] reminds us we need to watch for neurologic signs. Ongoing brain research and sleep research will continue to uncover why REM sleep is important for early detection of neurodegenerative changes. That means screening not only for motor symptoms but for early cognitive changes—because acting out dreams today could mean dementia tomorrow. New studies are looking at what might contribute to or worsen RBD risk and severity. These are early days but here are some findings: A full night's sleep typically has four or five cycles of alternating REM and NREM sleep (also called non REM sleep). Each sleep cycle has light sleep, deep sleep and REM (also called paradoxical sleep or desynchronized sleep). During the deep sleep stage of NREM, breathing slows, blood pressure drops and the immune system is boosted. REM sleep (also called active sleep, dream sleep or rapid eye movement REM) is characterized by rapid eye movements, vivid dreaming and variable brain waves. Most people experience REM sleep several times a night. Sleep cycles repeat throughout the night and after each cycle a new sleep cycle begins. Adults need seven to nine hours of sleep to complete enough cycles for optimal health. Sleep deprivation or a shortened sleep period can reduce enough REM sleep and deep sleep leading to negative health sleep apnea and other sleep disorders can disrupt sleep architecture reducing sleep time and quality of both REM and NREM sleep. Daytime naps can supplement nighttime sleep and help those who haven't slept enough at night. Sleep medicine reviews and sleep research have shown the importance of maintaining healthy sleep cycles for the brain to function and overall well-being. These findings support a holistic approach to RBD care—one that considers sleep hygiene, lifestyle and even dietary factors as part of the treatment. REM Sleep Behavior Disorder is no longer just a sleep curiosity—it's a diagnostic warning sign that may sound years before neurodegenerative disease sets in. While traditional treatments like clonazepam and melatonin work for symptom control, newer research points to the possibility of disease interception. As we learn more about sleep, neurobiology and behavior, RBD may become a key entry point for early intervention in Parkinson's, DLB and related conditions. The future of sleep medicine will shape the future of neurology—and for those with RBD that's good news. [1] St Louis, E. K., & Boeve, B. F. (2017). REM Sleep Behavior Disorder: Diagnosis, Clinical Implications, and Future Directions. Mayo Clinic proceedings, 92(11), 1723–1736. [2] During, E. H., Malkani, R., Arnulf, I., Kunz, D., Bes, F., De Cock, V. C., Ratti, P. L., Stefani, A., Schiess, M. C., Provini, F., Schenck, C. H., & Videnovic, A. (2025). Symptomatic treatment of REM sleep behavior disorder (RBD): A consensus from the international RBD study group - Treatment and trials working group. Sleep medicine, 132, 106554. [3] Roguski, A., Rayment, D., Whone, A. L., Jones, M. W., & Rolinski, M. (2020). A Neurologist's Guide to REM Sleep Behavior Disorder. Frontiers in neurology, 11, 610. [4] Arnaldi, D., Mattioli, P., Orso, B., Massa, F., Pardini, M., Morbelli, S., Nobili, F., Figorilli, M., Casaglia, E., Mulas, M., Terzaghi, M., Capriglia, E., Malomo, G., Solbiati, M., Antelmi, E., Pizza, F., Biscarini, F., Puligheddu, M., & Plazzi, G. (2025). The Many Faces of REM Sleep Behavior Disorder. Providing Evidence for a New Lexicon. European journal of neurology, 32(4), e70169. [5] Hu M. T. (2020). REM sleep behavior disorder (RBD). Neurobiology of disease, 143, 104996. [6] Coelho, J., Samalin, L., Yrondi, A., Iftimovici, A., Philip, P., & Micoulaud-Franchi, J. A. (2025). La santé du sommeil comme marqueur et cible d'intervention dans les troubles psychiatriques [Sleep health as a marker and target for health interventions in psychiatric disorders]. Medicine sciences : M/S, 41(5), 477–489. [7] Wang, P., Chen, X., Na, M., Flores-Torres, M. H., Bjornevik, K., Zhang, X., Chen, X., Khandpur, N., Rossato, S. L., Zhang, F. F., Ascherio, A., & Gao, X. (2025). Long-Term Consumption of Ultraprocessed Foods and Prodromal Features of Parkinson Disease. Neurology, 104(11), e213562. [8] Mondino, A., Jadidian, A., Toth, B. A., Hambrecht-Wiedbusch, V. S., Floran-Garduno, L., Li, D., York, A. K., Torterolo, P., Pal, D., Burgess, C. R., Mashour, G. A., & Vanini, G. (2025). Regulation of REM and NREM Sleep by Preoptic Glutamatergic Neurons. Sleep, zsaf141. Advance online publication.
Time of India
02-06-2025
- Health
- Time of India
Japanese Walking vs Running: Which is better for burning calories and losing weight?
Japanese interval walking alternating slow and brisk paces — offers a low-impact, beginner-friendly fitness method. Compared to running, it supports heart health and weight loss with less joint strain, making it ideal for a wide range of users. Tired of too many ads? Remove Ads Understanding Japanese Interval Walking Cardiovascular Benefits: Similar Aims, Different Paths Tired of too many ads? Remove Ads Calorie Burn: Which Is More Efficient? Choosing What Works for You FAQs What is Japanese interval walking? Who created this fitness method? As fitness trends evolve, a method gaining traction globally is the Japanese style of interval walking — a practice rooted in structured alternation between gentle and brisk walking. Often compared to running, this technique, developed through clinical research in Japan, has prompted many health enthusiasts to question: Which is more beneficial — Japanese walking or running?The Japanese Interval Walking Training (IWT) method, formulated by researchers including Dr Hiroshi Nose and documented in Mayo Clinic Proceedings, recommends a simple yet effective format: walk at a low intensity for three minutes, then switch to a faster pace for the next three, repeating this cycle five times. This 30-minute session alternates effort to build cardiovascular endurance without high-impact traditional walking, IWT introduces intervals that elevate heart rate, mimicking the exertion pattern of more intense workouts while maintaining accessibility for beginners, seniors, or individuals recovering from injury, as mentioned in a report by Tom's running and interval walking are recognised as strong cardio activities, known to improve heart health, boost metabolism, and strengthen muscles and joints. From mood enhancement to stress reduction, the psychological gains are substantial with both also contributes to weight management, though results will depend on the combination of physical activity and diet, particularly maintaining a caloric distinction lies in intensity and accessibility. Running demands greater cardiovascular and muscular engagement and may not suit everyone due to its higher impact on joints. Japanese interval walking, by contrast, offers a lower-impact, beginner-friendly option that still challenges the body through its built-in variation of those aiming to shed weight, calorie expenditure is often a key metric. According to available estimates, a 155-pound adult running a 5K at a slight incline can burn approximately 375 calories, as per a report by Tom's comparison, the same individual performing a 30-minute Japanese interval walk is expected to burn between 100 and 200 calories, depending on effort, speed, and running clearly provides a higher caloric output in a shorter span, interval walking offers a viable, sustainable path for those unable or unwilling to engage in high-impact exercises. Devices such as fitness trackers can aid individuals in monitoring their personal metrics, providing a clearer picture of what works best for question of which is 'better' — Japanese walking vs running — ultimately rests on personal needs and preferences. If injury risk or low stamina is a concern, interval walking may be a gentler entry point into regular exercise. Running, however, remains the go-to for those seeking faster results in terms of calorie burn and cardiovascular needs also vary. While running may require specialised footwear and activewear, walking can be done with minimal gear, although supportive shoes are still a walking method alternating 3 minutes of gentle walking with 3 minutes of brisk walking, repeated for 30 minutes. Developed in Japan, it builds endurance while being easy on the researchers, including Dr. Hiroshi Nose, developed the method, and it's been documented in medical journals like Mayo Clinic Proceedings.
Tom's Guide
01-06-2025
- Health
- Tom's Guide
Japanese walking vs running — which is best for you?
So you're looking to increase your cardiovascular endurance, and you don't know whether to prioritize running or the Japanese Interval Walking Training (IWT) method that's growing in popularity right now. Below, we put the two head-to-head to help you decide which is best for your routine. In case you hadn't heard of it, the Japanese IWT method involves alternating your pace as you walk. You'll walk for three minutes at a low intensity, followed by three minutes at a higher intensity, repeated five times. It was developed in Japan by researchers, and is supported by the research of Dr Hiroshi Nose published in Mayo Clinic Proceedings. You can read what happened when our fitness editor tried Japanese walking for a week. Both interval walking and running are great forms of cardio. They'll both raise your heart rate and metabolism, and strengthen your muscles and joints over time. You can also expect both walking and running to help boost your mood and reduce your stress levels. They can also be used to lose weight, if paired with a good diet. If weight loss is your goal, you'll want to focus on being in a calorie deficit, which means burning more calories than you consume. If weight loss is your goal, you might be keen to know which form of cardio is likely to burn more calories. While the exact number of calories you burn depends on a number of factors, including intensity, workout length and biological factors like age, weight, sex, hormones and more. The best way to keep track of how many calories you're burning is to wear one of the best fitness trackers, which will do this for you. We have our concerns about Google's long-term plans for the brand, but right now, the Fitbit Charge 6 is the best fitness tracker on the market today thanks to its lightweight and diminutive size, support for an enormous range of workout types, and a smattering of useful smart features like Google Wallet and Google Maps. That said, as a rough guide, according to the Omni calculator, a 155-pound adult will burn around 375 calories running a 5K at a gradient of 1%. On the other hand, a 155-pound adult doing a 30-minute interval workout is more likely to burn between 100-200 calories, although this number will vary based on how hard you push yourself and any incline you cover. If you're looking to burn calories, you'll get there faster with running. Of course, burning calories isn't the only reason to work out. If you're a complete beginner or you're recovering from an injury, walking is much lower impact, so it might be a better place to start. Get instant access to breaking news, the hottest reviews, great deals and helpful tips. What's more, if you're heading out for a run, you'll need a pair of supportive sneakers (check out the best running shoes to buy right now here), and probably a sports bra. As walking is lower impact, you won't need fancy equipment, although we'd recommend comfy shoes here too. The Saucony Ride 18 is our favorite running shoe for beginners. It's a no-fuss shoe that's comfortable, reliable, and responsive. And, you can get it for less than $100. The real answer to this question is which form of cardio to you enjoy the most. If you hate running, or running for 30 minutes is unachievable right now, it might be that interval walking is great way to burn more calories than you would if you walked at a steady pace. If you're a marathon runner, you might find walking intervals leave you wanting to move faster. There's no right or wrong, and both are fantastic ways to add more movement to your day and look after your physical and mental health.
Axios
10-04-2025
- Health
- Axios
Women find hope at New Albany menopause clinic
Mood swings, sleepless nights, uncontrollable crying — Nancy Thompson was in a dark place, until a local physician "turned the lights back on." Driving the news: OhioHealth's new Menopause and Midlife Clinic recently opened in New Albany, a first for Central Ohio. Why it matters: The specialized office is addressing a treatment gap preventing millions of women like Thompson from getting the care they need. The big picture: Menopause is something every woman goes through, but doctors aren't required to learn much about it and research is underfunded. Experiences can be so severe and varied that some women, including Oprah, feel like they're dying. But symptoms are often dismissed and misdiagnosed. Only about 7% of OB-GYN residents reported feeling adequately prepared to manage menopause, per a 2019 survey published in Mayo Clinic Proceedings. By the numbers: As of Jan. 30, just 106 health care providers in Ohio were credentialed as Menopause Society Certified Practitioners, per data provided to Axios. That's compared to well over 1,500 OB-GYN providers. Zoom in: One certified practitioner is Pragna Patel, the new OhioHealth clinic's first and only physician. There's such high demand that she's scheduling new patient consultations into September, though a cancellation list may get some women in sooner. OhioHealth is working to add more providers, and a second clinic is planned for the new Women's Center opening in 2027 on Riverside Hospital's campus, spokesperson Stephanie Stanavich tells Axios. What they're saying: "Women in midlife have really been overlooked, so a lot of women are coming in here very excited, very eager, very grateful," Patel says. Between the lines: Misinformation about the risks of hormone therapy, even among providers, has also kept the once-common treatment out of reach for many patients in recent years. Reality check: For Thompson, it's been life-changing after struggling for years with symptoms ranging from heart palpitations to hair loss and brain fog at work. After her primary doctor mentioned the clinic, she drove 90 minutes from her home in Northeast Ohio for her first appointment and received a prescription. The bottom line: "I have her number saved in my phone as 'Dr. Patel, lifesaver,'" Thompson tells Axios. "I have my life back."
Yahoo
25-03-2025
- Health
- Yahoo
2 drug combination lowers cholesterol better than just a statin, researchers say
Statins are very cheap and highly effective cholesterol-lowering drugs -- but high-risk heart patients may have an even better option, a new evidence review says. Combining statins with another drug, ezetimibe, significantly reduces the risk of death in patients with clogged arteries, according to findings published Sunday in Mayo Clinic Proceedings. Using a high-dose statin with ezetimibe significantly reduces levels of "bad" LDL cholesterol, increasing a person's chances of reaching healthy levels by 85%, researchers found. The combo also brought about a 19% reduction in risk of death from any cause; a 16% reduction in heart-related deaths; an 18% decrease in the risk of a major cardiovascular health problem; and a 17% decline in stroke risk. This combination therapy would prevent more than 330,000 deaths a year worldwide among patients who have already suffered a heart attack, including almost 50,000 deaths in the U.S. alone, researchers said. "This study confirms that combined cholesterol lowering therapy should be considered immediately and should be the gold standard for treatment of very high-risk patients after an acute cardiovascular event," senior researcher Dr. Peter Toth, a professor of clinical family and community medicine at the University of Illinois, said in a news release. Up to now, studies have been inconsistent regarding whether to provide combo cholesterol-lowering therapy immediately for high-risk patients, even before they suffer a heart attack or stroke. Typically, doctors wait at least two months before adding any medication to a statin, to see how well statins alone will lower cholesterol, Toth said. "This approach does not require additional funding or reimbursement of new expensive drugs," he said. "In fact, it may translate into lower rates of first and subsequent heart attacks and stroke, and their complications like heart failure, which are extremely costly for all healthcare systems." For the new evidence review, researchers pooled data from 14 studies involving more than 108,000 heart patients at very high risk for a heart attack, stroke or other heart-related health problem. Results were even more pronounced in an additional analysis that enabled a direct comparison of different therapies, researchers said. "This showed a 49% reduction in all-cause mortality and a 39% reduction in major adverse cardiovascular events, when compared to high dose statin therapy alone," said lead researcher Dr. Maciej Banach, a professor of cardiology at the John Paul II Catholic University of Lublin in Poland. Ezetimibe works by reducing the amount of cholesterol the intestines can absorb from food. Statins have a different mechanism - they work by interfering with the liver's ability to make cholesterol. Both drugs are available as inexpensive generics. "Our findings underline the importance of the adages 'the lower for better for longer' but also the equally important 'the earlier the better' for treating patients at high risk of cardiovascular conditions and to avoid further medical complications and deaths," Toth said. More information The Cleveland Clinic has more on cholesterol levels. Copyright © 2025 HealthDay. All rights reserved.
