A Case Report

Gary D. Conrad, M.D.

Abstract

Lion’s mane mushrooms (Hericium erinaceus), belongingto the Hericiaceae family of Basidiomycota fungi, are notable for their large,white, shaggy appearance, much like the mane of a lion. Various cultures haveunique, idiosyncratic names for these mushrooms. In France, they are sometimescalled pom pom (du) blanc for their resemblance to white pom-poms, inJapan, lion’s mane mushrooms – yamabushitake – are also known as “mountainpriest mushrooms” due to their similarity to monks’ ornamental wear, and amongthe indigenous Gitxsan Nation in Canada, they are referred to as kaedatsots,meaning “bird hat” (1). In this case report, lion’s mane mushrooms appear to offerbenefit in the treatment of obstructive sleep apnea.

KeywordsLion’s mane mushroomsHericium erinaceusYamabushitakeObstructive sleep apneaMood disordersSleep scoresPro-BDNFBDNFIntroduction

I have experienced obstructive sleep apnea (OSA) for anumber of years and have managed this problem successfully with continuouspositive airway pressure (CPAP) therapy. In addition, over the past six months, I have been undergoing evaluationfor suspected multiple sclerosis (MS). While awaiting the test results, followingthe Hippocratic dictum of primum non nocere, “Do no harm,” realizingthat lion’s mane mushrooms (LMM) have a low risk of adverse reactions, usuallyminor, I began taking a product that contained lion’s mane mycelium/fermentedbrown rice biomass, one gram by mouth daily.  My reasoning was that one of the constituentcompounds of LMM – erinacines – may protect nervous tissue and supportregeneration, potentially being of benefit in MS. (1)

Ultimately, my neurological workup for MS was negative, yetafter starting LMM, I serendipitously noticed a substantial improvement in mysleep quality and “myAir” scores, which included the parameters of usage hours,mask seal, apnea events per hour, and mask on/off occurrences.  While one hundred is a perfect score, any levelabove seventy is considered to be acceptable. My average sleep score in the thirty-dayperiod prior to taking LMM was 81.37, while my average sleep score in the thirty-dayperiod after beginning LMM was 95.36, a striking enhancement.

Discussion

The reason for the improvement in my sleep quality afterbeginning LMM is likely multifactorial. One possibility is LMM’s potential abilityto ameliorate anxiety and depression. This paper (2) demonstrated just that, butits strength is limited by a small sample size. I confess I have faced significantstress over the past six months, so alleviating my mood may have contributed toimproved sleep quality. Another relevant study, while limited by low subject numbersand the lack of a placebo group, offers further insight into the impact of LMMon mood as well as sleep disorders (3). The authors discovered that LMMimproved mood and sleep quality in obese patients, and the positiveeffects persisted after eight weeks of LMM wash-out, causing the authors tospeculate that LMM “might affect neuronal plasticity.”  While pro-BDNF (brain-derived neurotrophicfactor) levels were increased by LMM in this study, actual BDNF levels were notchanged. BDNF has a major role in neuronal survival and growth, acts as aneurotransmitter modulator, and participates in neuronal plasticity, criticalfor memory and learning. Decreased levels of BDNF are associated withneurodegenerative diseases with neuronal loss, such as Parkinson’s disease,Alzheimer’s disease, multiple sclerosis and Huntington’s disease (4).  It is suspected that an increase in the BDNFprecursor, pro-BDNF, is likely to lead to a rise in levels of BDNF, though thateffect was not seen in this study. Incidentally, endurance training of moderateintensity in healthy young men can also increase BDNF levels (5).

Conclusions

LMM can possibly provide benefit for those with mood disorders as well as sleep dysfunction, and while the mechanisms of such improvements are unclear, I find intriguing the speculation that increased levels of pro-BDNF, eventually leading to increased levels of BDNF, may result in clinical amelioration of both mood and sleep. While I can find no previous clinical studies that indicate betterment of sleep quality with the use of LMM in OSA, I believe my positive experience merits further investigation.

Acknowledgments

I would like to thank Andrew Weil, M.D., my colleague andmentor in integrative medicine, for his invaluable suggestions and review ofthis article. Also, credit to Jerry Angelini, MS, who also contributed byproviding current research articles as well as editorial assistance.  Dr. Chris Corbett is deeply appreciated for hiscritique of this paper.  I am grateful toDr. Gladys Lewis, who has previously edited several of my books, and she kindlyagreed to apply her skills to this article. Thanks to Tracy Massengale, APRN-C,and Jasmine Long of the Oklahoma Sleep Institute for their efforts to obtain mysleep score data.

ReferencesHannah Bauman; Jasmine Zenderland, Food as Medicine: Lion’s Mane (Hericium erinaceus, Hericiaceae), HerbalEGram, American Botanical Council, September 2024Mayumi Nagano; Kuniyoshi Shimizu; Ryuichiro Kondo; Chickako Hayashi; Daigo Sato; Katsuyuki Kitagawa; Koichiro Ohnuki. Reduction of depression and anxiety by 4 weeks Hericium erinaceus intake. Biomed Res. 2010 Aug;31(4):231-7.Luisella Vigna; Federica Morelli; Gianna M Agnelli; Filomena Napolitano; Daniela Ratto; Alessandra Occhinegro; Carmine Di Iorio; Elena Savino; Carolina Girometta; Federico Brandalise; Paola Rossi. Hericium erinaceus Improves Mood and Sleep Disorders in Patients Affected by Overweight or Obesity: Could Circulating Pro-BDNF and BDNF Be Potential Biomarkers? Evid Based Complement Alternat Med. 2019 Apr 18, 2019.Siresha Bathina; Undurti N. Das. Brain-derived neurotrophic factor and its clinical implications.  Arch Med Sci. 2015 Dec 11;11(6):1164–1178.Zoladz JA; Pilc A, Majerczak J; Grandys M; Zapart-Bukowska J; Duda K. Endurance training increases plasma brain-derived neurotrophic factor concentration in young healthy men. J Physiol Pharmacol. 2008;59(Suppl. 7):119–32.

About the Author

Gary D. Conrad, MD, is an author and an emergency andintegrative physician. He has retired after forty-three years of practice inemergency medicine.  He can be reached atgarydconradbooks@gmail.com.