Proton pump inhibitors associated with rapid eye movement sleep behaviour disorder
Ruwanthi Jayasekara1, Ian Smith2
1Respiratory Support and Sleep Centre (RSSC), Royal Papworth Hospital NHS Foundation Trust, Cambridge, UK RU-JAY@HOTMAIL.COM.
BMJ Case Reports
|January 1, 2022
Summary
Proton pump inhibitors (PPIs) may trigger REM sleep behavior disorder (REMBD). A patient
Area of Science:
- Neurology
- Sleep Medicine
- Pharmacology
Background:
- Rapid eye movement sleep behavior disorder (REMBD) is a parasomnia characterized by dream enactment.
- Current treatments for REMBD include clonazepam and temazepam, which may not be effective for all patients.
Observation:
- A 65-year-old woman with diagnosed REMBD experienced symptom recurrence despite medication.
- She identified a correlation between her REMBD symptoms and the initiation of high-dose omeprazole therapy.
- Discontinuation of omeprazole led to symptom resolution, while subsequent use of lansoprazole (another PPI) caused symptom re-emergence.
Findings:
- This case report is the first to suggest an association between proton pump inhibitors (PPIs) and the development or exacerbation of REMBD.
- The patient's REMBD symptoms resolved upon withdrawal of omeprazole and recurred upon introduction of lansoprazole.
Implications:
- Proton pump inhibitors (PPIs) should be considered a potential etiological factor in patients presenting with REMBD.
- Further research is warranted to investigate the neurobiological mechanisms underlying the potential link between PPIs and REMBD.
- Clinicians should inquire about PPI use in patients with REMBD and consider PPIs as a potential reversible cause.
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