Sleep

REM Sleep Behavior Disorder

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REM Sleep Behavior Disorder

  • Epidemiology
  1. More common in men than women
  • Signs
  1. Increased motor tone during sleep
  2. Patient acts out dreams during REM Sleep
    1. Flails limbs
    2. Vocalizes
    3. May fall out of bed
  • Complications
  1. Risk of injury to patient or bed partner
  • Diagnosis
  • Management
  1. Treat underlying causes (e.g. Obstructive Sleep Apnea, Narcolepsy, discontinue causative medications)
  2. Remove fragile or dangerous objects from around the bed
  3. Melatonin at bedtime
    1. Titrate up over 3 g at bedtime every 2 weeks until symptoms improve or to maximum of 12 mg at bedtime
  4. Clonazepam 0.5 to 2 mg at bedtime