Alexis Fernandez-Preiksa

And normally people with REM sleep disorder will have to put measures into place to

so they're less likely to injure themselves based on how their room is set up or maybe to sleep closer to the wall so they're not falling out of the bed and things like that.

Now, the lack of muscle atonia in REM sleep behavior disorder, it's due to this disrupted regulation of muscle tone during this stage of sleep because in a typical sleep cycle,

including REM sleep, the brain is sending signals to inhibit muscle activity through a whole range of different neurotransmitters that are involved, which I'll go into in a second.

And that's what results in the paralysis.

And this paralysis is obviously a protective mechanism that is preventing you from acting out your sleep and getting hurt.

And when it's disrupted, you're getting this disorder.

And the exact cause of it is not fully understood, but we do know that it's got to do with a dysfunction in...

the brain regions that are responsible for the regulation of REM sleep and muscle latonia, and also the release of different neurotransmitters that are involved in REM sleep disorder and in taking care of muscle latonia.

So the neurotransmitters that are involved are the ones that are going to be involved in regulating your sleep-wake cycles, ones that are involved with muscle activity.

And even though we don't completely understand the mechanisms behind it, we know that there are the following neurotransmitters that we're going to mention in a second that play a key role in this disorder.

So the first one is a neurotransmitter called acetylcholine.

So acetylcholine is released in the brainstem, and it activates the motor neurons, okay, that are responsible for muscle atonia.

So in REM sleep disorder, there's going to be an imbalance in acetylcholine levels, and this leads to the inability to achieve muscle paralysis.

So then you continue moving the muscles instead of paralyzing the muscles.

Then we've got GABA.

GABA is also heavily involved.

GABA, as you probably know because I've banged on about it so much, is the primary inhibitory neurotransmitter in the brain.

So it's the one that inhibits activity in the brain.

And of course, because its role is inhibition, it plays a massive role in relaxing the muscles.