* Findings suggest drug may not impair memory, attention

* Merck's sleep drug now before FDA

By Julie Steenhuysen

CHICAGO, April 3 (Reuters) - A study in rats and monkeys suggests an experimental Merck & Co sleep drug may help induce sleep without causing the memory loss and attention problems sometimes seen in the commonly used drugs Ambien and Lunesta, company researchers said on Wednesday.

Experiments in animals suggest Merck's sleep drug Suvorexant, now before the U.S. Food and Drug Administration, may avoid these side effects, the company said.

Insomnia affects about 10 percent of U.S. adults, and roughly a third of these individuals take drugs to help them sleep. Most sleep aids, including Sanofi's Ambien or Sunovion Pharmaceuticals' Lunesta, act on a key neurotransmitter in the brain called GABA.

"These treatments work by forcing the brain to go to sleep," said study leader Jason Uslaner of Merck in an interview on the website of Science Translational Medicine, which published the study.

GABA receptors are important to many brain regions, including those important for cognition, which is likely why common sleep aids can cause memory loss and attention problems.

"When you hit those, you don't just hit the sleep system," John Renger, executive director and head of neruoscience basic research at Merck and one of the study's authors, said in a telephone interview.

Suvorexant is part of a class of drugs called Dual Orexin Receptor Antagonists or DORAs, which work by blocking chemical messengers called orexins. Orexins are responsible for keeping people awake. Levels of this compound rise during the day and fall at night.

Orexins originate in a specific region of the hypothalamus, so targeting them may have less impact on other brain functions, Renger said.

For this study, the team wanted to find out what would happen if someone is awakened on this drug and has a very high level of it in their system.

"How impaired would they be?" Renger said.

To test this, the researchers did a series of experiments on rhesus monkeys and rats. First, the team trained monkeys to perform a common attention test in which they needed to respond quickly to a blinking light on a screen and remember what they touched. Monkeys given GABA inhibitors were much slower in responding to the prompt, and in some cases, missed it altogether, while monkeys given a potent orexin blocker called DORA-22 did not show these attention issues, Renger said.

The team also saw differences in a simple memory test in rats. Rats were first exposed to a colored object, and then later exposed to it again. Typically, rats that recall an object show less interest in it when they are shown it again.

In the study, rats given GABA blockers were less likely to recall the objects than those given DORA-22.

Emmanuel Mignot of Stanford University, who wrote a commentary on the study in the same journal, said the findings show promise.

"Are DORAs the perfect hypnotics? Only long-term use in large numbers of insomnia patients will reveal whether these drugs will be preferred to GABAergic hypnotics, and whether they produce rare complications, including narcolepsy-like symptoms in predisposed individuals," Mignot wrote.

So far, Merck has not seen any cases of narcolepsy, a sleep disorder marked by daytime sleepiness, in its late-stage clinical trials, Renger said.

The most common side effects from Suvorexant have been headache and sleepiness. No serious drug-related side effects have been reported.


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  • Lullabies


    Soothing music before bedtime can really do the trick. A 2005 study found that older people who listened to 45 minutes of soft tunes before hitting the hay reported a <a href="http://www.blackwellpublishing.com/nursing/news/news.asp?id=124" target="_hplink">35 percent improvement in their sleep problems</a>.

    But it doesn't have to be Brahms, if that's not your style. As long as the music was soft and slow -- around 60 to 80 beats per minute -- it can spur <a href="http://news.bbc.co.uk/2/hi/health/4228707.stm" target="_hplink">physical changes known to promote sleep</a>, like a slower heart rate and breathing, the BBC reported.

    "We know that when a person closes their eyes they induce a certain frequency of brain waves," says Decker. Slow music may have a similar effect, he surmises, leading to sleep onset.

    <em>Flickr photo by <a href="http://www.flickr.com/photos/llimaorosa/112246369/" target="_hplink">Llima</a></em>




  • Warm Milk


    It was once thought that a glass of warm milk at bedtime would help send you off to dreamland because of the tryptophan, <em>The New York Times</em> reported, but milk and other protein-rich foods actually <a href="http://www.nytimes.com/2007/09/04/health/04real.html" target="_hplink">block tryptophan's sleepiness-inducing effects</a>. However, there might still be a psychological benefit to that warm milk, the <em>Times</em> concluded, calling it "as soothing as a favorite old blanket."

    "There have been some studies showing that when infants receive warm milk before bed, they'll dream a little bit more," says Decker, but the results don't hold true in adults. "It may be one of those myths that because it happens in children, adults think it may be true for them, too," he explains. However, many adults are actually at least slightly lactose intolerant, he says, meaning a warm mlik at bedtime may just lead to discomfort.

    <em>Flickr photo by <a href="http://www.flickr.com/photos/julianrod/152930252/" target="_hplink">julianrod</a></em>




  • Counting Sheep


    If your goal is to bore yourself to sleep, you might try counting sheep, or counting backwards by multiples of three or any of a number of other counting-related mind-numbers. But a 2002 study found that <a href="http://www.ncbi.nlm.nih.gov/pubmed/11863237" target="_hplink">imagining a more relaxing scene might be more effective</a>.

    The study observed 41 people with insomnia over a number of nights and asked them to try a variety of different sleep-inducing techniques, like counting sheep.

    On the nights they were told to imagine relaxing scenes like a beach, a massage or a walk in the woods, <a href="http://www.mentalfloss.com/blogs/archives/53137" target="_hplink">they fell asleep an average of 20 minutes sooner</a> than on the nights they were told to count sheep or were given no instructions, Mental Floss reported.

    Decker agrees. "Counting sheep in and of itself may not help," but can act as a ritual that prepares us for sleep, making it not unlike meditation. Counting sheep -- or more relaxing guided imagery -- helps us "focus on something other than life's stressors," he says. "Thinking about a soothing environment may be more restful than the way you spent the last eight hours!"

    <em>Flickr photo by <a href="http://www.flickr.com/photos/narciss/3716241331/" target="_hplink">Kr. B.</a></em>




  • Breathing Exercises


    Focusing on the breath, whether it's as part of a pre-bed yoga sequence or just a tuned-in awareness, can also have meditation-like effects in preparing for bed, says Decker, like lowering the heart rate.

    <em>Flickr photo by <a href="http://www.flickr.com/photos/perfectoinsecto/2363255713/" target="_hplink">Perfecto Insecto</a></em>




  • Warm Bath


    Your body temp <a href="http://www.health.com/health/condition-article/0,,20189095,00.html" target="_hplink">dips about two hours before bedtime</a>, <em>Health </em>magazine reported, a natural change that "triggers our brain for sleep onset", says Decker. Soaking in a warm bath beforehand boosts your temperature temporarily, but results in a dramatic, rapid cooldown after you get out that relaxes you and eases you into sleep.

    It's not necessarily the bath that lulls you to sleep, it's that resulting cooling of your body temperature, Decker emphasizes. Research shows that people who take a warm bath before bed not only <a href="http://www.ncbi.nlm.nih.gov/pubmed/2578367" target="_hplink">fall asleep more quickly</a>, but also report better quality of sleep, he says.




  • Alcohol


    Many people swear by a drink to unwind at the end of the day, but alcohol before bed can actually <a href="http://www.huffingtonpost.com/2012/07/04/fourth-of-july-sleep_n_1644627.html#slide=1176662" target="_hplink">disrupt your sleep</a>. You'll be more likely to wake up more often in the early-morning hours, wake up and not be to fall back to sleep or have disturbing dreams. "As alcohol is metabolized by the liver, it has a disruptive effect," says Decker. It takes a few hours to metabolize, he says, so a drink with dinner shouldn't be a problem, but anything too close to bedtime can be counterproductive.

    <em>Flickr photo by <a href="http://www.flickr.com/photos/rob-qld/2889139445/" target="_hplink">Rob Qld</a></em>




  • Get Out Of Bed


    It sounds crazy -- how will you ever get to sleep if you're not even in bed?! -- but it works, says Decker.

    "When a person stays in bed and they can't sleep, the bedroom can induce a certain level of anxiety," he says. "We say after 15 or 20 minutes, get out of bed, sit in another part of the house until you feel a little groggy, then go back to sleep," he says. "Staying in bed can condition you to become anxious in bed."

    A small 2011 study published in the <em>Archives of Internal Medicine</em> found that among the <a href="http://healthland.time.com/2011/01/27/cant-sleep-it-may-help-to-get-out-of-bed/" target="_hplink">adults studied who reported trouble sleeping</a>, those who spent <a href="http://www.thirdage.com/news/insomnia-cant-sleep-get-out-bed_1-26-2011 " target="_hplink">less time in bed had better sleeping habits</a>.

    <em>Flickr photo by <a href="http://www.flickr.com/photos/perfectoinsecto/3948115802/" target="_hplink">Perfecto Insecto</a></em>




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