REM Sleep Behavior Disorder

Treatment

Depending on the severity of episodes, treatment usually includes making the sleep environment safer, lifestyle modifications to decrease the likelihood of episodes, and possibly medication. Patients are also regularly monitored for any signs of a neurological disorder.

Physical safeguards:

• Moving any objects that could cause injury away from the bedside
  
• Padding objects that are too heavy or impractical to move
  
• Padding the headboard
  
• Moving the bed away from windows
  
• Blocking windows with large objects such as dressers
  
• Placing padding on the floor next to the bed

Bed partners may also need to sleep separately until episodes are reduced.

Lifestyle modifications to decrease the likelihood of episodes:

• Following a regular sleep schedule to prevent sleep deprivation
  
• Avoiding certain medications and alcohol
  
• Treating other sleep disorders

Clonazepam, a benzodiazapine (tranquilizer), has traditionally been considered the best medication option for REM sleep behavior disorder (RBD) and reduces or eliminates the behavior for most patients. It's not the best choice for all patients, however, due to its potential side effects, such as decreased balance or continued sleepiness the next morning.

Melatonin, a dietary supplement, has also been found to reduce or eliminate RBD symptoms without the side effects of clonazepam and is used by some patients. However, melatonin has not yet undergone the types of clinical studies needed to more thoroughly understand its safety, side effects, potential interactions with other drugs, long-term health effects, best dosage, and how it might affect different groups of people.