Abstract
Pase et al.1 stated changes in REM sleep may not be a marker of prodromal dementia, but may actually be protective against cognitive decline, and further studies were needed. The authors used a model to account for confounding factors including antidepressant use, which is known to suppress REM sleep in healthy and depressed patients.2 If REM sleep is protective for dementia, it would be interesting to perform a longitudinal prospective cohort study with polysomnogram data to analyze if exposure to medications that reduce REM sleep has an increased incidence of dementia. This may be confounded by psychiatric factors, such as heightened anxiety being implicated as a possible risk factor for dementia.3 However, medications, such as duloxetine, are often used for nonpsychiatric indications (e.g., neurogenic pain).
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