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Previous studies of sleep in the elderly subjects have revealed a decrease in the amount of slow-wave sleep, and rapid eye
movement (REM) sleep, reduction of nocturnal melatonin secretion, and advancement of the sleep phase. In addition,
periodic limb movements during sleep (PLMs) are commonly observed in the elderly and often cause sleep disturbances.
PLMs are generally considered to produce sleep fragmentation by provoking arousals. Recent studies have demonstrated the
effect of YKS on the sleep architecture in the elderly patients who complained subjective sleep disturbances. After treated
with YKS, polysomnography studies revealed increases in total sleep time, sleep efficiency and stage II sleep. Decreases in
electroencephalogical arousals and PLMs were also reported. YKS has reported to be effective and well tolerated in the elderly
patients who complained of sleep disturbances. Yokukan-San (YKS: Tsumura Co. Ltd. Japan), a traditional herbal prescription,
was developed as a remedy for restlessness and agitation. YKS contains several herbal medicines (Atractylodis lanceae rhizoma,
Hoelen, Cnidii rhizoma, Angelicae radix, Bupleuri radix, Glycyrrhizae radix, and Uncariae ramulus et uncus). Angelicae radix,
an important component of YKS, is known to affect dopamine, γ-aminobutyric acid (GABA), and serotonin receptors. In aged
rats, YKS has been reported to improve the decreased level of dopamine in the prefrontal cortex. YKS has been indicated to
ameliorate age-related impairments of working memory via the dopaminergic system. Therefore, YKS may be effective for
improving the decreased dopaminergic neuronal function that is responsible for the emergence of PLMs and restless legs
syndrome (RLS). Animal studies have demonstrated that YKS exhibits an anxiolytic effect mediated by GABA receptors. These
pharmacological actions on dopaminergic and GABAergic systems may be beneficial for reducing PLM and treating sleep
disturbances including RLS.
Hideto Shinno is Graduated from Hiroshima University School of Medicine (MD) and (PhD). He received National License of Medical Doctor. Currently he is working as Professor at Department of Liaison Psychiatry, Kagawa University School of Medicine, Kagawa, Japan.