National Sleep Foundation

Chapter 6: Parasomnias

Treatment for Rapid Eye Movement Sleep Behavior Disorder (RBD)

Treatment for patients with RBD can help reduce the frequency and severity of their episodes.

Non-pharmacological Treatment

Non-pharmacological management of RBD includes altering the sleep environment to ensure the safety of the patient and the bed partner. Precautions include moving furniture away from the bed; placing sharp objects out of the way; putting the mattress on the floor; having a soft surface next to the bed to cushion falls; and moving the bed partner to another room)1 2.  

Pharmacological Treatment

Clonazepam (in doses of 0.25 to 2.0 mg) is effective in suppressing behavioral symptoms and muscle activity in patients with RBD, but it does not restore atonia. It is also associated with the usual side effects of benzodiazepines, such as EDS and decreased cognition.3

Melatonin (in doses of 9-12 mg) has been shown to be effective in treating RBD.4

References

  1. Schenck CH, Mahowald MW. REM sleep behavior disorder: clinical, developmental, and neuroscience perspectives 16 years after its formal identification in SLEEP. Sleep. 2002;25:120-138.
  2. Boeve, B., REM sleep behavior disorder:updated review of the core features, the RBD-neurodegenerative disease association, evolving concepts, controversies, and future directions, Ann N Y Acad Sci;1184:15-54, 2010.
  3. Gagnon JF, Postuma RB, Mazza S, Doyon J, Montplaisir J. Rapid-eye-movement sleep behaviour disorder and neurodegenerative diseases. Lancet Neurol. 2006;5:424-432.
  4. Gagnon JF, Postuma RB, Mazza S, Doyon J, Montplaisir J. Rapid-eye-movement sleep behaviour disorder and neurodegenerative diseases. Lancet Neurol. 2006;5:424-432.