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KMID : 1002120090060010024
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Journal of Korean Sleep Research Society
2009 Volume.6 No. 1 p.24 ~ p.28
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Treatment of REM Sleep Behavior Disorder
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Moon Hye-Jin
Nam Hyun-Woo
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Abstract
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REM sleep behavior disorder (RBD) is clinically characterized by the intermittent loss of normal skeletal muscle atonia during rapid eye movement (REM) sleep with the appearance of elaborate motor activity associated with dream mentation. Clonazepam, a sedating benzodiazepine, is currently regarded as the treatment of choice for RBD. In patients with contraindications to clonazepam, in those unresponsive to clonazepam, or in whom tolerance or serious side effects are observed, a therapeutic trial with melatonin up to 12 mg is recommended. The effect of acetylcholinesterase inhibitors and dopaminergics on RBD symptoms needs future validation. There is no clear evidence of beneficial effect of bilateral subthalamic nucleus stimulation despite the improvement of the sleep architecture.
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KEYWORD
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REM sleep behavior disorder, Clonazepam, Melatonin, Pramipexole, Levodopa
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