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Sleep is fundamental for living animals. Although they are not conscious during sleep, their brains are continuously working. This neural activity during sleep can be reflected by neural oscillations closely related to cognitive function. While the relationship between neural activity in sleep and cognition has been extensively investigated, it is not fully understood how neural activity in sleep and relevant memory are modulated by specific receptors. In particular, I focused on melatonin receptors and their agonist, ramelteon. While the effects of ramelteon on sleep have been widely documented, it is still poorly understood how ramelteon affects learning and memory as well as neural activity in sleep. To address this question, I first recorded neural oscillations in the neocortex of rats treated with ramelteon and found that ramelteon promoted non-rapid eye movement (NREM) sleep and increased fast gamma power in the primary motor cortex during NREM sleep. I then evaluated the behavioral performance of ramelteon-treated mice using the novel object recognition task and the spontaneous alternation task, demonstrating that ramelteon enhanced object recognition memory and spatial working memory. These results shed light on new aspects of the functions of melatonin receptors.

Sedative hypnotics are among the classes of drugs reported to influence falls. However, the effects of the sedative hypnotic drugs, suvorexant and ramelteon, on falls are not well known. Therefore, we conducted this retrospective case-control study to examine the association of the use of these two sedative hypnotics with the risk of falls. Conducted at the Sapporo Medical University Hospital in Japan, our study included 360 patients with fall incidents and 819 randomly selected control patients. Patients in the fall group were significantly older with a lower body mass index, and had a history of falls, disabilities in activities of daily living, cognitive impairment, and delirium. Monovariate analysis revealed that patients in the fall group frequently used ramelteon [odds ratio (OR) 2.38, 95% confidence interval (CI): 1.49-3.81, p<0.001], but rarely used suvorexant (OR 0.66, 95% CI: 0.29-1.39, p=0.317), compared with control patients. Furthermore, multivariate analysis revealed that ramelteon use did not increase the risk of falls (adjusted OR 1.43, 95% CI: 0.82-2.48, p=0.207), whereas suvorexant use significantly decreased the risk of falls (adjusted OR 0.32, 95% CI: 0.13-0.76, p=0.009). Although ramelteon tends to be used in patients at a high risk of falls, it may not increase the risk of falls. In contrast, the use of suvorexant may reduce the risk of falls.