Journal
SLEEP MEDICINE
Volume 16, Issue 1, Pages 19-26Publisher
ELSEVIER
DOI: 10.1016/j.sleep.2014.09.011
Keywords
Melatonin; REM sleep behavior disorder; Parasomnia; Drug therapy; Calmodulin
Categories
Funding
- National Center for Research Resources
- National Center for Advancing Translational Sciences
- National Institutes of Health (NIH) [1 UL1 RR024150-01]
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Rapid eye movement (REM) sleep behavior disorder (RBD) is a parasomnia associated with dream enactment often involving violent or potentially injurious behaviors during REM sleep that is strongly associated with synucleinopathy neurodegeneration. Clonazepam has long been suggested as the first-line treatment option for RBD. However, evidence supporting melatonin therapy is expanding. Melatonin appears to be beneficial for the management of RBD with reductions in clinical behavioral outcomes and decrease in muscle tonicity during REM sleep. Melatonin also has a favorable safety and tolerability profile over clonazepam with limited potential for drug-drug interactions, an important consideration especially in elderly individuals with RBD receiving polypharmacy. Prospective clinical trials are necessary to establish the evidence basis for melatonin and clonazepam as RBD therapies. (C) 2014 Elsevier B.V. All rights reserved.
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