Hmm... a tricky question, this one.
I must admit that you know a lot more than me about these inflammatory states, and RBD, than me! But, judging from the inflammatory cytokines you mentioned, then some antidepressants may actually be useful - many AD's are known to cause disruptions in sleep though... on the other hand, you have increased REM-sleep, yes? So, this may not be such a bad thing then...
Anyways, when you mentioned the hypothalamus I immediately started thinking about one perticular compound: BUPROPION! : D
It affects the hypothalamus specifically, it's rather unusual as an antidepressant as such. It decreases TNF-alpha and interferon-gamma, but sadly I don't see that you mentioned IG as a marker elevated in RBD? The effect may then be limited. What is clear though, is that Bupropion definitively alters sleep-structure! Whether or not that would be in a good way for you, remains to be seen.
A curious note btw... apparently some of that effect on inflammatory cytokines is supposedly through the inhibition of prostaglandins?? The reason it's curious, is because Prostaglandins are lipids... Prostaglandin inhibitors such as NSAID's are apparently also useful for hypotension, which is certainly a plus.
The bad note though, is that Bupropion could of course increase your blood-pressure through it's NDRI-effects...
I also had a look into Lewy Body Dementia, since RBD can sometimes evolve into that, as one grows older, and I sadly must say that some of the things here looked problematic... There's mention of decreased activity of the Dopamine Transporter in the disease, and Bupropion inhibits DAT... There's also mention of how Anticholinergic compounds can worsen sleep-behaviour, and Bupropion is an anticholinergic. (different receptors than what they mention though, not muscarinic, but nicotinic) So, best read up a lot on Bupropion and it's possible effects on people with both RBD and Lewy-Body dementia, if you decide to use it.
Very curious this... I almost feel as if there's some kind of underlying connecting thread in your diseases... lipids and RBD and the lewy bodies... HMMm! Have you looked into Alpha-Synuclein? Do you have Parkinsons or Dementia in your family? Apparently Alpha-Synuclein is expressed a lot in the Thalamus, which borders the Hypothalamus - could there be a connection? I dunno'... but it's interesting, certainly.
Anyways, there's something called APOCYNIN, which could possibly be useful here... it inhibits NOX, which is a result of alpha-synuclein - and RBD seems to be connected to Dopamine, and since dopamine disturbances can be seen in both Lewy-Body Dementia and Parkinsons, then perhaps there might be something to it, yes?
It would be helpful if you could test yourself, do a full blood-panel for every inflammatory marker of BRD, to see which markers are specific to YOU - that way, would be able to select anti-inflammatory compounds which are more likely to work, even without the two drugs you cannot take.
My take though, is that you need something to put you to sleep after becoming fully awake, yet more healthy, from Bupropion - so, let's take a look at the hypothalamus! = ) Here's an old favourite of mine, Alpha-2-agonist - perhaps Dexmedetomidine
combined with gabapentin is something you could take in the evening? Along with Apocynin.
Anyways, in short, test this:
1. Bupropion in the morning
2. Dexmedetomidine + Apocynin in the evening
References:
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Analgesic and anti-inflammatory activities of bupropion in animal models
https://www.ncbi.nlm...les/PMC4314873/
https://en.wikipedia...i/Prostaglandin
Researchers find simple blood test could help depression patients find right treatment
https://www.ctvnews....tment-1.3350590
(different disease, yes, but the basic idea may be possible to apply to any number of diseases)
NADPH oxidase 1, mediates alpha-synucleinopathy in Parkinson’s disease
https://www.ncbi.nlm...les/PMC3501265/
(NOX-1 inhibitors might be useful in lowering the effects of alpha-synuclein - look into those, they're anti-inflammatories, yes?)
https://en.wikipedia.org/wiki/Apocynin
Neuronal ensembles sufficient for recovery sleep and the sedative actions of α2 adrenergic agonists.
https://www.ncbi.nlm...pubmed/25706476
https://en.wikipedia...Dexmedetomidine