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REM Sleep Behavior Disorder
Aka: REM Sleep Behavior Disorder
- Epidemiology
- More common in men than women
- Signs
- Increased motor tone during sleep
- Patient acts out dreams during REM Sleep
- Flails limbs
- Vocalizes
- May fall out of bed
- Complications
- Risk of injury to patient or bed partner
- Associated Conditions
- Parkinsonism (and related Movement Disorders)
- Spinocerebellar Ataxia
- Severe Obstructive Sleep Apnea
- Narcolepsy
- Selective Serotonin Reuptake Inhibitors
- Diagnosis
- Polysomnogram
- Management
- Treat underlying causes (e.g. Obstructive Sleep Apnea, Narcolepsy, discontinue causative medications)
- Remove fragile or dangerous objects from around the bed
- Melatonin at bedtime
- Titrate up over 3 g at bedtime every 2 weeks until symptoms improve or to maximum of 12 mg at bedtime
- Clonazepam 0.5 to 2 mg at bedtime
- References
- Aurora (2010) J Clin Sleep Med 6(1): 85-95 [PubMed]
- Ramar (2013) Am Fam Physician 88(4): 231-8 [PubMed]