A Case Report

Gary D. Conrad, M.D.

Abstract

Lion’s mane mushrooms (Hericium erinaceus), belonging to the Hericiaceae family of Basidiomycota fungi, are notable for their large, white, shaggy appearance, much like the mane of a lion. Various cultures have unique, idiosyncratic names for these mushrooms. In France, they are sometimes called pom pom (du) blanc for their resemblance to white pom-poms, in Japan, lion’s mane mushrooms – yamabushitake – are also known as “mountain priest mushrooms” due to their similarity to monks’ ornamental wear, and among the 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 offer benefit in the treatment of obstructive sleep apnea.

Keywords

• Lion’s mane mushrooms
• Hericium erinaceus
• Yamabushitake
• Obstructive sleep apnea
• Mood disorders
• Sleep scores
• Pro-BDNF
• BDNF

Introduction

I have experienced obstructive sleep apnea (OSA) for a number of years and have managed this problem successfully with continuous positive airway pressure (CPAP) therapy.  In addition, over the past six months, I have been undergoing evaluation for suspected multiple sclerosis (MS). While awaiting the test results, following the Hippocratic dictum of primum non nocere, “Do no harm,” realizing that lion’s mane mushrooms (LMM) have a low risk of adverse reactions, usually minor, I began taking a product that contained lion’s mane mycelium/fermented brown rice biomass, one gram by mouth daily.  My reasoning was that one of the constituent compounds of LMM – erinacines – may protect nervous tissue and support regeneration, potentially being of benefit in MS. (1)

Ultimately, my neurological workup for MS was negative, yet after starting LMM, I serendipitously noticed a substantial improvement in my sleep 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 level above seventy is considered to be acceptable. My average sleep score in the thirty-day period prior to taking LMM was 81.37, while my average sleep score in the thirty-day period after beginning LMM was 95.36, a striking enhancement.

Discussion

The reason for the improvement in my sleep quality after beginning LMM is likely multifactorial. One possibility is LMM’s potential ability to ameliorate anxiety and depression. This paper (2) demonstrated just that, but its strength is limited by a small sample size. I confess I have faced significant stress over the past six months, so alleviating my mood may have contributed to improved sleep quality. Another relevant study, while limited by low subject numbers and the lack of a placebo group, offers further insight into the impact of LMM on mood as well as sleep disorders (3). The authors discovered that LMM improved mood and sleep quality in obese patients, and the positive effects persisted after eight weeks of LMM wash-out, causing the authors to speculate that LMM “might affect neuronal plasticity.”  While pro-BDNF (brain-derived neurotrophic factor) levels were increased by LMM in this study, actual BDNF levels were not changed. BDNF has a major role in neuronal survival and growth, acts as a neurotransmitter modulator, and participates in neuronal plasticity, critical for memory and learning. Decreased levels of BDNF are associated with neurodegenerative 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 BDNF precursor, pro-BDNF, is likely to lead to a rise in levels of BDNF, though that effect was not seen in this study. Incidentally, endurance training of moderate intensity 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 and mentor in integrative medicine, for his invaluable suggestions and review of this article. Also, credit to Jerry Angelini, MS, who also contributed by providing current research articles as well as editorial assistance.  Dr. Chris Corbett is deeply appreciated for his critique of this paper.  I am grateful to Dr. Gladys Lewis, who has previously edited several of my books, and she kindly agreed 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 my sleep score data.

References

1. Hannah Bauman; Jasmine Zenderland, Food as Medicine: Lion’s Mane (Hericium erinaceus, Hericiaceae), HerbalEGram, American Botanical Council, September 2024
2. Mayumi 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.
3. 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.
4. Siresha Bathina; Undurti N. Das. Brain-derived neurotrophic factor and its clinical implications.  Arch Med Sci. 2015 Dec 11;11(6):1164–1178.
5. 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 and integrative physician. He has retired after forty-three years of practice in emergency medicine.  He can be reached at garydconradbooks@gmail.com.