Materiały źródłowe

• #1 Rapid Eye Movement Sleep Behavior Disorder – StatPearls – NCBI Bookshelf

  https://www.ncbi.nlm.nih.gov/books/NBK555928/

  Rapid eye movement behavior disorder (RBD) is a parasomnia strongly linked to neurodegenerative diseases, and it can also be very disturbing and lead to injury requiring medical attention. […] This activity describes the evaluation and management of RBD and highlights the role of the healthcare team in improving care for patients with this condition. […] Counseling and management of RBD focus on injury prevention and the treatment of underlying precipitating disorders in addition to pharmacological treatment of severe cases using oral medications such as melatonin or clonazepam. […] The primary treatment goal of rapid eye movement behavior disorder is to reduce the risk of injury to the patient and bed partners. […] Patients and sleeping partners should be educated on the following: Mitigating fall risk by lowering the bed closer to the floor, Safe-guarding any firearms, knives, and other weapons, Cushioning or padding the floor or sharp furniture surfaces, Placing patients in restraining clothes or sleeping bags, Separating the sleeping partner from the patient to reduce the risk of injury.

• #2 REM Sleep Behavior Disorder: What It Is, Symptoms & Treatment

  https://my.clevelandclinic.org/health/diseases/24465-rem-sleep-behavior-disorder-rbd

  REM sleep behavior disorder (RBD) is a sleep disorder in which you physically act out your dreams unknowingly while you’re asleep. […] RBD can lead to accidental injury to yourself or your bed partner. Because of this, it’s important to seek treatment. […] The main goal of treatment for REM sleep behavior disorder (RBD) is to create a safe sleeping environment for you and your bed partner. This can involve certain strategies and medications. […] Steps to create a safer sleeping environment include: removing sharp, glass and heavy objects away from your bed, placing pillows between you and surrounding structures, placing a mattress on the floor next to your bed, or using padded bedside rails. […] If your symptoms are severe and safety measures aren’t enough to prevent injury, your healthcare provider may prescribe medication to manage your symptoms. […] It’s important to seek treatment for RBD or at the very least create a safer sleeping environment.

• #3 REM Behavior Disorder Symptoms, Causes, and Treatments

  https://www.verywellhealth.com/what-is-rem-behavior-disorder-3014772

  During the night, we naturally progress through sleep stages, including rapid eye movement (REM) sleep. REM sleep occurs periodically through the night, with the first period occurring about 90 minutes after sleep onset, lasting about 10 minutes. If our other muscles are not paralyzed during REM, we may be able to perform complex activities and enact our dreams while we remain asleep. This is called REM behavior disorder. This disorder may lead to accidental injury, including injury of bed partners. […] Most people with this disorder describe unpleasant and vivid dreams that involve intruders or attackers (people or animals). There is associated dream-enactment behavior that is often violent. Common behaviors include talking or screaming, reaching, punching, kicking, jumping or falling out of bed, running, and striking furniture. These behaviors frequently result in injury to the individual or their bed partner. The injuries may be minor (such as bruises, scratches, or cuts) or severe (such as broken bones or bleeding within the brain). People who are afflicted may complain of disrupted sleep or excessive daytime sleepiness.

• #4 REM Sleep Behavior Disorder: Treatment, Symptoms & Causes

  https://www.emedicinehealth.com/rem_sleep_behavior_disorder/article_em.htm

  REM Stage In REM sleep behavior disorder (RBD), the paralysis that normally occurs during REM sleep is incomplete or absent, and is characterized by a person acting out dreams that are vivid, intense, and sometimes violent. […] RBD is characterized by the acting out of dreams that are vivid, intense, and sometimes violent. Dream-enacting behaviors include talking, yelling, punching, kicking, sitting, jumping from bed, arm flailing, and grabbing. A common complaint includes a sleep-related injury. […] The main symptom of REM sleep behavior disorder is dream-enacting behaviors, sometimes violent, causing self-injury or injury to the bed partner. […] Seek medical care if unusual behaviors, such as violent thrashing and kicking, occur during sleep. […] Because persons with REM sleep behavior disorder have a risk of injuring themselves and their sleep partners, the safety of the sleeping environment is very important.

• #5 REM Sleep Behavior Disorder – Neurology Solutions

  https://www.neurologysolutions.com/movement-disorders/rem-sleep-behavior-disorder/

  REM (rapid eye movement) Sleep Behavior Disorder (RBD) is a chronic, non-familial sleep-related movement disorder characterized by dream enactment and the patients loss of inherent muscle atonia (the usual, temporary paralysis of the arms and legs) during REM sleep. […] RBD patients have a high risk of developing other neurodegenerative diseases over 70% of RBD patients will develop parkinsonism or dementia within 12 years of their RBD diagnosis. […] RBD is a unique condition, and as such, it can cause a variety of complications in the lives of its patients. For starters, many RBD patients end up injuring themselves or their bed partners. […] One of the most serious aspects of REM Sleep Behavior Disorder is the fact that RBD patients have a very high risk of developing atypical parkinsonism, dementia, and/or Parkinsons disease. Over 70% of RBD patients will develop either atypical parkinsonism or dementia within 12 years of receiving their RBD diagnosis.

• #6 Rapid Eye Movement (REM) Sleep Behaviour Disorder – PsychDB

  https://www.psychdb.com/sleep/parasomnias/2-rem-sleep-disorder/home

  Rapid Eye Movement (REM) Sleep Behaviour Disorder is a sleep disorder characterized by repeated episodes of arousal, often associated with vocalizations and/or complex motor behaviours arising during REM sleep. […] The patient is usually easy to arouse, and will recall events the next day. […] REM sleep behaviour disorder overwhelmingly affects males older than 50 years, but increasingly this disorder is being identified in females and in younger individuals. […] Symptoms in young individuals, particularly young females, should raise the possibility of narcolepsy or medication-induced REM sleep behaviour disorder. […] REM sleep behaviour disorder can result in injuries to bed partners, and/or falls and physical injuries to the affected individual. […] Almost 90% of patients with REM sleep behaviour disorder will go on to develop a Parkinson’s-plus disorder such as Parkinson’s disease, Lewy body dementia, or multiple system atrophy (MSA).

• #7 REM sleep behavior disorder – Diagnosis and treatment – Mayo Clinic

  https://www.mayoclinic.org/diseases-conditions/rem-sleep-behavior-disorder/diagnosis-treatment/drc-20352925

  To diagnose REM sleep behavior disorder, your doctor reviews your medical history and your symptoms. […] Your doctor may recommend that you make changes in your sleep environment to make it safer for you and your bed partner, including: Padding the floor near the bed, Removing dangerous objects from the bedroom, such as sharp items and weapons, Placing barriers on the side of the bed, Moving furniture and clutter away from the bed, Protecting bedroom windows, Possibly sleeping in a separate bed or room from your bed partner until symptoms are controlled. […] Treatment for REM sleep behavior disorder may include physical safeguards and medications. […] Examples of treatment options for REM sleep behavior disorder include: Melatonin. Your doctor may prescribe a dietary supplement called melatonin, which may help reduce or eliminate your symptoms.

• #8 REM sleep behaviour disorder: the importance of early identification in primary care | British Journal of General Practice

  https://bjgp.org/content/73/726/40

  REM (rapid eye movement) sleep behaviour disorder (RBD) is characterised by vivid dreams and dream enactment behaviour such as kicking, shouting, and punching. It can result in injuries to the person with RBD and their bed partner, and is associated with reduced quality of life and severely disrupted sleep. […] GPs have a crucial role in identifying the symptoms of RBD (and other sleep disorders) and referring patients on to a neurologist or sleep specialist for further assessment. The International RBD Study Group state that an overnight sleep study (video polysomnography [vPSG]) in a sleep laboratory is mandatory for the identification of RBD. […] In the absence of an overt NDD, diagnosis of iRBD can lead to treatment (associated with improved quality of life), as well as opportunities for risk modification and clinical trial recruitment that hold potential to slow or even stop progression to NDD.

• #9 Azthena logo with the word Azthena

  https://www.news-medical.net/health/Understanding-REM-Sleep-Behavior-Disorder.aspx

  Rapid Eye Movement (REM) sleep behavior disorder or RBD is a serious medical condition involving dream enactment behavior and loss of muscle atonia. […] RBD is characterized by sleep disruption and abnormal behaviors during sleep and typically involves dream enactment. The individual experiences loss of muscle atonia, causing anything from limb twitching to more forceful movements mirroring violent dream content. […] The first port of call for diagnosing RBD comes from witnessing the condition in action. […] Individuals diagnosed with RBD typically have a clinical history of dream enactment behaviors or other abnormal REM sleep-related behaviors. […] The definitive method for diagnosing RDB is using polysomnography (PSG). […] PSG is a type of complex sleep study used to record brain waves. PSG is non-invasive and involves monitoring oxygen levels, heart rate, breathing during sleep, and eye and leg movements. […] The precise pathological mechanisms underlying RBD are not yet known.

• #10 REM Sleep Behavior Disorder – Sleep Education by the AASM

  https://sleepeducation.org/sleep-disorders/rem-sleep-behavior-disorder/

  REM sleep behavior disorder (RBD) is a parasomnia. A parasomnia involves undesired events that happen while sleeping. […] RBD can be confused with sleepwalking and sleep terrors. In these other disorders, you are usually confused upon waking up and there is no dream reenactment. […] RBD episodes occur during REM sleep. Normal sleep consists of a series of REM dream episodes. […] RBD by itself does not cause the dreamer to be sleepy during the day. But it is often found along with other sleep disorders. […] An RBD episode often disrupts the sleep of a bed partner. This is how a person with RBD may become aware of the problem. RBD is a medical problem. It is not a psychiatric disorder. […] RBD is a disorder that can get worse over time. This can put you or your bed partner in danger. RBD also tends to be linked to other medical problems. You should seek a sleep doctor’s advice if you suspect that you might have RBD.

• #11 REM Sleep Behavior Disorder

  https://www.healthline.com/health/sleep/rem-sleep-disorder

  Rapid eye movement (REM) sleep behavior disorder (RBD) is a condition in which you act out your dreams while you sleep. […] RBD can be treated with medication. However, it often occurs with other sleep problems or conditions, which may require additional treatment. If diagnosed, you should be monitored by your doctor. […] In most cases, this condition can be successfully managed with medication. Clonazepam (Klonopin) is the most frequently used medicine. Your doctor may also prescribe melatonin, a dietary supplement that can help eliminate symptoms. You should talk to your doctor to learn which medication is best for you. […] You will likely need to take other precautions to protect yourself and your bed partner. For example: Move objects away from your bedside. Move your bed away from the window. Maintain a standard bedtime. Avoid certain medications and alcohol. Treat any other sleep disorders. […] You should also be checked regularly for neurological disorders, such as Parkinsons disease. In some cases, RBD is the first warning sign of neurodegenerative disease.

• #12 REM sleep behaviour disorder: the importance of early identification in primary care | British Journal of General Practice

  https://bjgp.org/content/73/726/40.short

  REM (rapid eye movement) sleep behaviour disorder (RBD) is characterised by vivid dreams and dream enactment behaviour such as kicking, shouting, and punching. It can result in injuries to the person with RBD and their bed partner, and is associated with reduced quality of life and severely disrupted sleep. […] It is important to recognise potential RBD because it is also strongly associated with neurodegenerative disease (NDD): RBD affects approximately 50% of people with Parkinsons disease (PD), 80% of people with dementia with Lewy bodies (DLB), and almost 100% of people with multiple system atrophy (MSA). […] Thus, identifying iRBD provides a rare opportunity to modify future risk of neurodegeneration and there are anticipated opportunities for patients with iRBD to enrol in neuroprotective drug trials to prevent progression to an overt NDD. […] WHAT SHOULD I DO IF I SUSPECT RBD? THE ROLE OF THE GP […] HOW TO MANAGE SYMPTOMS OF RBD […] CAN IRBD BE STOPPED FROM PROGRESSING TO A NEURODEGENERATIVE DISORDER?

• #13 REM sleep behaviour disorder: the importance of early identification in primary care | British Journal of General Practice

  https://bjgp.org/content/73/726/40

  REM (rapid eye movement) sleep behaviour disorder (RBD) is characterised by vivid dreams and dream enactment behaviour such as kicking, shouting, and punching. It can result in injuries to the person with RBD and their bed partner, and is associated with reduced quality of life and severely disrupted sleep. […] GPs have a crucial role in identifying the symptoms of RBD (and other sleep disorders) and referring patients on to a neurologist or sleep specialist for further assessment. The International RBD Study Group state that an overnight sleep study (video polysomnography [vPSG]) in a sleep laboratory is mandatory for the identification of RBD. […] In the absence of an overt NDD, diagnosis of iRBD can lead to treatment (associated with improved quality of life), as well as opportunities for risk modification and clinical trial recruitment that hold potential to slow or even stop progression to NDD.

• #14 Rapid eye movement sleep behavior disorder – UpToDate

  https://www.uptodate.com/contents/rapid-eye-movement-sleep-behavior-disorder/print

  Rapid eye movement (REM) sleep behavior disorder (RBD) is a parasomnia characterized by dream-enactment behaviors that emerge during a loss of REM sleep atonia. […] The main focus of treatment is to reduce behavioral events and prevent sleep-related injury; this can be achieved through changes in the sleeping environment and, if necessary, pharmacotherapy (eg, melatonin, clonazepam). […] A careful history should distinguish RBD from related parasomnias such as sleepwalking. In-laboratory video polysomnography can exclude other sleep disorders, quantify REM atonia and capture dream-enactment behaviors, confirming the diagnosis.

• #15 Rapid Eye Movement Sleep Behavior Disorder – StatPearls – NCBI Bookshelf

  https://www.ncbi.nlm.nih.gov/books/NBK555928/

  Based on current guidelines from the American Academy of Sleep Medicine (AASM), the recommended pharmacological treatment of isolated RBD in adults is immediate-release melatonin, clonazepam, or pramipexole (Conditional recommendation). […] Clonazepam is an effective treatment for RBD and has been considered for a long time as first-line pharmacological therapy. […] Other therapies for isolated RBD include dopaminergic agents (such as L-DOPA and pramipexole), paroxetine, acetylcholinesterase inhibitors (such as donepezil and rivastigmine), desipramine, clozapine, antiepileptic drugs (e.g., carbamazepine, levetiracetam), and antihypertensive medications (e.g., prazosin, clonidine). […] Management for RBD primarily involves injury risk mitigation through behavioral changes and/or pharmacological therapy.

• #16 AASM Management of REM Sleep Behavior Disorder Guideline Summary

  https://www.guidelinecentral.com/guideline/2722821/

  The AASM suggests that clinicians use clonazepam (vs no treatment) for the treatment of isolated RBD in adults. (Conditional) […] The AASM suggests that clinicians use immediate-release melatonin (vs no treatment) for the treatment of isolated RBD in adults. (Conditional) […] The AASM suggests that clinicians use pramipexole (vs no treatment) for the treatment of isolated RBD in adults. (Conditional) […] The AASM suggests that clinicians use transdermal rivastigmine (vs no treatment) for the treatment of isolated RBD in adults with mild cognitive impairment. (Conditional) […] The AASM suggests that clinicians use clonazepam (vs no treatment) for the treatment of secondary RBD due to medical condition in adults. (Conditional) […] The AASM suggests that clinicians use immediate-release melatonin (vs no treatment) for the treatment of secondary RBD due to medical condition in adults. (Conditional)

• #17 Common Sleep Disorders in Adults: Diagnosis and Management | AAFP

  https://www.aafp.org/pubs/afp/issues/2022/0400/p397.html

  REM sleep behavior disorder is characterized by complex motor behaviors during REM sleep due to a loss of REM sleep atonia. This loss of atonia may result in the acting out of dreams and can involve harmful activities for the patient and bed partner, although this does not occur every night. […] Treatment of REM sleep behavior disorder focuses on reducing the injury potential for the patient and bed partner using behavior modification as a first-line intervention. Methods to decrease the potential for injury include creating a safe sleep environment by padding or removing furniture, lowering the mattress to the floor, and using a bed alarm. […] If these methods are not successful, the use of pharmacologic therapy with melatonin or clonazepam (Klonopin) may be necessary. Melatonin should be initiated at a dose of 3 mg at bedtime and titrated up by 3 mg every two weeks to the desired effect with a ceiling of 12 mg nightly. […] There are more adverse events associated with benzodiazepine use; however, if used, clonazepam can be administered at doses between 0.25 mg and 2.0 mg at bedtime.

• #18 REM sleep behaviour disorder: the importance of early identification in primary care | British Journal of General Practice

  https://bjgp.org/content/73/726/40

  Two recommended medications to be given at night are clonazepam and melatonin. A recent review found that clonazepam (given at doses ranging from 0.125 to 3 mg) improved symptoms in about two-thirds of patients, but should be used cautiously in older adults, as it can cause morning drowsiness, confusion, and falls. Melatonin is considered a safer option with fewer side effects and, when given at doses ranging from 2 to 6 mg, has been found to improve symptoms in a third of RBD cases. […] Sleeping environment modifications are also helpful to minimise risk to people with RBD and their bed partners, including sleeping in a separate room, using pillow barricades, removing potentially dangerous items from the room, or sleeping on a mattress on the floor. […] GPs therefore play a vital role in recognising potential iRBD and applying preventive medicine approaches with the aim of trying to alter iRBD trajectories.

• #19 REM Sleep Behavior Disorder Medication: Anxiolytics, Benzodiazepines, Decarboxylase Inhibitors

  https://emedicine.medscape.com/article/1188651-medication

  Clonazepam has proven to be a highly successful treatment for RBD. It is effective in nearly 90% of patients (complete benefit in 79% of patients and partial benefit in another 11% of patients), with little evidence of tolerance or abuse. […] The treatment should be continued indefinitely, as violent behaviors and nightmares relapse promptly with discontinuation of medications in almost all patients. […] Several studies demonstrated the beneficial effect of melatonin on RBD. The effective dose of melatonin was 36 mg taken orally at bedtime. […] Other medications, such as tricyclic antidepressants, may be effective in some patients with RBD. However, tricyclics are also known to actually precipitate RBD. […] Levodopa may be very effective in patients in whom RBD is the harbinger of Parkinson disease.

• #20 AASM Management of REM Sleep Behavior Disorder Guideline Summary

  https://www.guidelinecentral.com/guideline/2722821/

  The AASM suggests that clinicians use clonazepam (vs no treatment) for the treatment of isolated RBD in adults. (Conditional) […] The AASM suggests that clinicians use immediate-release melatonin (vs no treatment) for the treatment of isolated RBD in adults. (Conditional) […] The AASM suggests that clinicians use pramipexole (vs no treatment) for the treatment of isolated RBD in adults. (Conditional) […] The AASM suggests that clinicians use transdermal rivastigmine (vs no treatment) for the treatment of isolated RBD in adults with mild cognitive impairment. (Conditional) […] The AASM suggests that clinicians use clonazepam (vs no treatment) for the treatment of secondary RBD due to medical condition in adults. (Conditional) […] The AASM suggests that clinicians use immediate-release melatonin (vs no treatment) for the treatment of secondary RBD due to medical condition in adults. (Conditional)

• #21 AASM Management of REM Sleep Behavior Disorder Guideline Summary

  https://www.guidelinecentral.com/guideline/2722821/

  The AASM suggests that clinicians use transdermal rivastigmine (vs no treatment) for the treatment of secondary RBD due to medical condition (Parkinson disease) in adults. (Conditional) […] The AASM suggests that clinicians not use deep brain stimulation (DBS; vs no treatment) for the treatment of secondary RBD due to medical condition in adults. (Conditional) […] The AASM suggests that clinicians use drug discontinuation (vs drug continuation) for the treatment of drug-induced RBD in adults. (Conditional) […] It is critically important to help patients maintain a safe sleeping environment to prevent potentially injurious nocturnal behaviors. In particular, the removal of bedside weapons, or objects that could inflict injury if thrown or wielded against a bed partner, is of paramount importance. […] Patients with severe, uncontrolled RBD should be recommended to sleep separately from their partners, or at the minimum, to place a pillow between themselves and their partners.

• #22 Rapid Eye Movement Sleep Behavior Disorder – StatPearls – NCBI Bookshelf

  https://www.ncbi.nlm.nih.gov/books/NBK555928/

  Based on current guidelines from the American Academy of Sleep Medicine (AASM), the recommended pharmacological treatment of isolated RBD in adults is immediate-release melatonin, clonazepam, or pramipexole (Conditional recommendation). […] Clonazepam is an effective treatment for RBD and has been considered for a long time as first-line pharmacological therapy. […] Other therapies for isolated RBD include dopaminergic agents (such as L-DOPA and pramipexole), paroxetine, acetylcholinesterase inhibitors (such as donepezil and rivastigmine), desipramine, clozapine, antiepileptic drugs (e.g., carbamazepine, levetiracetam), and antihypertensive medications (e.g., prazosin, clonidine). […] Management for RBD primarily involves injury risk mitigation through behavioral changes and/or pharmacological therapy.

• #23 REM Sleep Behavior Disorder | International Psychogeriatric Association

  https://www.ipa-online.org/news-and-issues/rem-sleep-behavior-disorder

  One of the amazing things about being human is that we all dream. Dreams occur in the Rapid Eye Movement (REM) stage of sleep. […] However, what would it be like if we acted out some of our dreams? In a small percentage of humans this is a reality due to a condition called REM Sleep Behavior Disorder, or RBD for short. […] The goal in treatment of RBD is to minimize danger to the patient and bed partners. The first interventions include decreasing risk by altering the environment. These include moving sharp objects, reorganizing bedroom furniture to decrease the chance of falls, placing a mattress or cushion next to the bed, using a protective barrier on the side of the bed to decrease risk of falling out of bed, and using a barrier to separate the patient from the bed partner. […] Medication interventions are also warranted for the safety of patients and their partners. The most commonly recommended medications in RBD are melatonin and clonazepam. A trial of clonazepam for patients that do not have medical contraindications is often tried first. For those that cannot tolerate clonazepam or continue to have symptoms, a trial of melatonin is warranted. Other medications that have been used to treat RBD include donepezil, rivastigmine, pramipexole, sodium oxybate, and levodopa.

• #24 REM Sleep Behavior Disorder Medication: Anxiolytics, Benzodiazepines, Decarboxylase Inhibitors

  https://emedicine.medscape.com/article/1188651-medication

  Clonazepam has proven to be a highly successful treatment for RBD. It is effective in nearly 90% of patients (complete benefit in 79% of patients and partial benefit in another 11% of patients), with little evidence of tolerance or abuse. […] The treatment should be continued indefinitely, as violent behaviors and nightmares relapse promptly with discontinuation of medications in almost all patients. […] Several studies demonstrated the beneficial effect of melatonin on RBD. The effective dose of melatonin was 36 mg taken orally at bedtime. […] Other medications, such as tricyclic antidepressants, may be effective in some patients with RBD. However, tricyclics are also known to actually precipitate RBD. […] Levodopa may be very effective in patients in whom RBD is the harbinger of Parkinson disease.

• #25 REM sleep behavior disorder – Diagnosis and treatment – Mayo Clinic

  https://www.mayoclinic.org/diseases-conditions/rem-sleep-behavior-disorder/diagnosis-treatment/drc-20352925

  To diagnose REM sleep behavior disorder, your doctor reviews your medical history and your symptoms. […] Your doctor may recommend that you make changes in your sleep environment to make it safer for you and your bed partner, including: Padding the floor near the bed, Removing dangerous objects from the bedroom, such as sharp items and weapons, Placing barriers on the side of the bed, Moving furniture and clutter away from the bed, Protecting bedroom windows, Possibly sleeping in a separate bed or room from your bed partner until symptoms are controlled. […] Treatment for REM sleep behavior disorder may include physical safeguards and medications. […] Examples of treatment options for REM sleep behavior disorder include: Melatonin. Your doctor may prescribe a dietary supplement called melatonin, which may help reduce or eliminate your symptoms.

• #26 REM Sleep Behavior Disorder: What It Is, Symptoms & Treatment

  https://my.clevelandclinic.org/health/diseases/24465-rem-sleep-behavior-disorder-rbd

  REM sleep behavior disorder (RBD) is a sleep disorder in which you physically act out your dreams unknowingly while you’re asleep. […] RBD can lead to accidental injury to yourself or your bed partner. Because of this, it’s important to seek treatment. […] The main goal of treatment for REM sleep behavior disorder (RBD) is to create a safe sleeping environment for you and your bed partner. This can involve certain strategies and medications. […] Steps to create a safer sleeping environment include: removing sharp, glass and heavy objects away from your bed, placing pillows between you and surrounding structures, placing a mattress on the floor next to your bed, or using padded bedside rails. […] If your symptoms are severe and safety measures aren’t enough to prevent injury, your healthcare provider may prescribe medication to manage your symptoms. […] It’s important to seek treatment for RBD or at the very least create a safer sleeping environment.

• #27 Rapid Eye Movement Sleep Behavior Disorder – StatPearls – NCBI Bookshelf

  https://www.ncbi.nlm.nih.gov/books/NBK555928/

  Rapid eye movement behavior disorder (RBD) is a parasomnia strongly linked to neurodegenerative diseases, and it can also be very disturbing and lead to injury requiring medical attention. […] This activity describes the evaluation and management of RBD and highlights the role of the healthcare team in improving care for patients with this condition. […] Counseling and management of RBD focus on injury prevention and the treatment of underlying precipitating disorders in addition to pharmacological treatment of severe cases using oral medications such as melatonin or clonazepam. […] The primary treatment goal of rapid eye movement behavior disorder is to reduce the risk of injury to the patient and bed partners. […] Patients and sleeping partners should be educated on the following: Mitigating fall risk by lowering the bed closer to the floor, Safe-guarding any firearms, knives, and other weapons, Cushioning or padding the floor or sharp furniture surfaces, Placing patients in restraining clothes or sleeping bags, Separating the sleeping partner from the patient to reduce the risk of injury.

• #28 AASM Management of REM Sleep Behavior Disorder Guideline Summary

  https://www.guidelinecentral.com/guideline/2722821/

  The AASM suggests that clinicians use transdermal rivastigmine (vs no treatment) for the treatment of secondary RBD due to medical condition (Parkinson disease) in adults. (Conditional) […] The AASM suggests that clinicians not use deep brain stimulation (DBS; vs no treatment) for the treatment of secondary RBD due to medical condition in adults. (Conditional) […] The AASM suggests that clinicians use drug discontinuation (vs drug continuation) for the treatment of drug-induced RBD in adults. (Conditional) […] It is critically important to help patients maintain a safe sleeping environment to prevent potentially injurious nocturnal behaviors. In particular, the removal of bedside weapons, or objects that could inflict injury if thrown or wielded against a bed partner, is of paramount importance. […] Patients with severe, uncontrolled RBD should be recommended to sleep separately from their partners, or at the minimum, to place a pillow between themselves and their partners.

• #29 REM Sleep Behavior Disorder | UPMC HealthBeat

  https://share.upmc.com/2023/12/rem-sleep-behavior-disorder-symptoms-causes-treatment/

  REM sleep behavior disorder is a type of parasomnia, or abnormal sleep behavior. It is a condition where you have sudden body movements and sometimes loud exclamations while you’re dreaming. […] REM sleep behavior disorder can get worse with time. By ignoring it, you could put yourself and your bed partner in danger of physical injury. […] Your doctor may recommend a combination of approaches to treat your REM sleep behavior disorder. […] It’s important to keep your environment safe. People with REM sleep behavior disorder are at risk for bruises, cuts, fractures, blunt trauma, and head trauma. […] Some small changes may help calm your REM sleep behavior disorder symptoms. Maintain good sleep habits, such as: Avoid alcohol and nicotine, especially before bedtime. Develop a calming bedtime routine (i.e., yoga, light stretching, or soft music). Don’t eat a big meal late in the evening. Go to bed and wake up at the same time every day, including weekends. Keep your bedroom cool and dark. Limit screen time before bed.

• #30 REM Sleep Behavior Disorder – Sleep Education by the AASM

  https://sleepeducation.org/sleep-disorders/rem-sleep-behavior-disorder/

  Safety measures need to be addressed first. Some bedroom safety precautions include: Removing weapons from your bedroom. Moving objects away from your bedside, including nightstands, lamps, or other objects that could cause injury. […] Any factors known to aggravate RBD symptoms should be avoided or treated. Your treatment plan may include: Maintaining a normal total sleep time. Sleep deprivation will increase RBD. […] RBD tends to respond to treatment with medications. Your sleep doctor can prescribe the medications that are appropriate for you. […] Here are some additional precautions that patients with RBD can take when sleeping during travel: Be aware that travel often results in sleep disruption, which may worsen symptoms of RBD.

• #31 REM Sleep Behavior Disorder Treatment & Management: Medical Care, Long-Term Monitoring

  https://emedicine.medscape.com/article/1188651-treatment

  The neurologist may consult a sleep specialist for the proper diagnosis and treatment of rapid eye movement sleep behavior disorder (RBD). RBD is treated symptomatically with various medications. However, the response varies in individual cases; therefore, all available medications should be tried before considering the patient’s RBD as intractable. […] An important aspect of management of patients with RBD is environmental safety. Potentially dangerous objects should be removed from the bedroom, and the mattress should be placed on the floor or a cushion should be placed around the bed. […] Because rapid eye movement sleep behavior disorder (RBD) has strong relationships with many neurodegenerative disorders, such as Parkinson disease, multiple system atrophy, and dementia, the neurologist always should explore the possibility of RBD in these conditions. […] Therefore, careful follow-up is needed to assess the risk of neurodegenerative disorder development, for patient counseling, and to plan for potential neuroprotective trials.

• #32 AASM Management of REM Sleep Behavior Disorder Guideline Summary

  https://www.guidelinecentral.com/guideline/2722821/

  The AASM suggests that clinicians use transdermal rivastigmine (vs no treatment) for the treatment of secondary RBD due to medical condition (Parkinson disease) in adults. (Conditional) […] The AASM suggests that clinicians not use deep brain stimulation (DBS; vs no treatment) for the treatment of secondary RBD due to medical condition in adults. (Conditional) […] The AASM suggests that clinicians use drug discontinuation (vs drug continuation) for the treatment of drug-induced RBD in adults. (Conditional) […] It is critically important to help patients maintain a safe sleeping environment to prevent potentially injurious nocturnal behaviors. In particular, the removal of bedside weapons, or objects that could inflict injury if thrown or wielded against a bed partner, is of paramount importance. […] Patients with severe, uncontrolled RBD should be recommended to sleep separately from their partners, or at the minimum, to place a pillow between themselves and their partners.

• #33 REM Sleep Behavior Disorder – StatPearls – NCBI Bookshelf

  https://www.ncbi.nlm.nih.gov/books/NBK534239/

  Bed partners should be educated on the disease, and the patients enactments during dreams are not under voluntary control. […] Patients may be advised to stop SSRI and tricyclic antidepressants that are known to cause or exacerbate RBD. […] Melatonin is now considered first-line therapy in the treatment of RBD. […] In proper clinical settings, brain imaging with MRI and EEG may be recommended to evaluate for a secondary cause of RBD. […] Patients may be advised to create a safer environment in the bedroom to avoid injuries. […] Sleep behavior disorder is often difficult to diagnose and manage. Thus, it is best managed with an interprofessional team that includes mental health nurses.

• #34 Rapid Eye Movement Sleep Behavior Disorder – StatPearls – NCBI Bookshelf

  https://www.ncbi.nlm.nih.gov/books/NBK555928/

  Early diagnosis and management of RBD provide a therapeutic window to treat the potential underlying neurodegenerative disorder. […] Evaluating and managing newly diagnosed rapid eye movement behavior disorder requires a multi-disciplinary and interprofessional effort involving the patient’s primary care provider, a sleep specialist, a neurologist, nursing staff, and pharmacists to maximize these patients’ well-being.

• #35 REM Sleep Behavior Disorder – StatPearls – NCBI Bookshelf

  https://www.ncbi.nlm.nih.gov/books/NBK534239/

  Bed partners should be educated on the disease, and the patients enactments during dreams are not under voluntary control. […] Patients may be advised to stop SSRI and tricyclic antidepressants that are known to cause or exacerbate RBD. […] Melatonin is now considered first-line therapy in the treatment of RBD. […] In proper clinical settings, brain imaging with MRI and EEG may be recommended to evaluate for a secondary cause of RBD. […] Patients may be advised to create a safer environment in the bedroom to avoid injuries. […] Sleep behavior disorder is often difficult to diagnose and manage. Thus, it is best managed with an interprofessional team that includes mental health nurses.

• #36 REM Sleep Behavior Disorder – StatPearls – NCBI Bookshelf

  https://www.ncbi.nlm.nih.gov/books/NBK534239/

  Rapid eye movement (REM) sleep behavior disorder is a parasomnia in which affected individuals act out their dreams while in the REM stage of sleep. […] This activity describes the risk factors, evaluation, and management of rapid eye movement sleep behavior disorder and highlights the role of the interprofessional team in enhancing care delivery for affected patients. […] Treatment consists of preventive measures while sleeping to avoid injury to the patient as well as the bed partner. […] The primary goal of treatment is to provide patients with a safe sleeping environment for them and their bed partners. Healthcare professionals can achieve this through non-pharmacologic approaches and pharmacotherapy if needed. […] It is important to counsel patients and their bed partners on avoidance of potentially hazardous and injuries objects near the patients, for example, firearms or glass objects.

• #37 REM Sleep Behavior Disorder – StatPearls – NCBI Bookshelf

  https://www.ncbi.nlm.nih.gov/books/NBK534239/

  Bed partners should be educated on the disease, and the patients enactments during dreams are not under voluntary control. […] Patients may be advised to stop SSRI and tricyclic antidepressants that are known to cause or exacerbate RBD. […] Melatonin is now considered first-line therapy in the treatment of RBD. […] In proper clinical settings, brain imaging with MRI and EEG may be recommended to evaluate for a secondary cause of RBD. […] Patients may be advised to create a safer environment in the bedroom to avoid injuries. […] Sleep behavior disorder is often difficult to diagnose and manage. Thus, it is best managed with an interprofessional team that includes mental health nurses.

• #38 CE Activity | REM Sleep Behavior Disorder | Nurses

  https://www.statpearls.com/nurse/ce/activity/103830

  Rapid eye movement (REM) sleep behavior disorder is a parasomnia in which affected individuals act out their dreams while in the REM stage of sleep. Unfortunately, this can involve violence and can lead to the injury of self or others without conscious awareness. […] This activity describes the risk factors, evaluation, and management of rapid eye movement sleep behavior disorder and highlights the role of the interprofessional team in enhancing care delivery for affected patients. […] Outline the treatment and management options available for rapid eye movement sleep behavior disorder. […] Explain the importance of improving coordination amongst the interprofessional team to enhance care for patients affected by rapid eye movement sleep behavior disorder and improve patient outcomes.

• #39 New AASM Guideline Advises on Management of REM Sleep Behavior Disorder

  https://consultqd.clevelandclinic.org/new-aasm-guideline-advises-on-management-of-rem-sleep-behavior-disorder

  Try medications for situations involving high risk for injury. Clonazepam, immediate-release melatonin and transdermal rivastigmine are conditionally recommended for either isolated or secondary RBD. Evidence also indicates that pramipexole may be effective for isolated RBD. […] Talk to patients about the prognosis of isolated RBD with extreme care. More than 90% of patients with isolated RBD go on to develop a neurodegenerative disorder over the coming years. Deciding how much to reveal to a patient requires careful consideration of their desire to know such alarming news, Dr. Foldvary-Schaefer explains. It could lead to years of anxiety and depression, even suicide.

• #40 Acting Out Dreams Can Signal a Serious Disorder

  https://news.cuanschutz.edu/news-stories/acting-out-dreams-can-signal-a-serious-disorder

  This is why its important for people who have dream enactment behavior disorder to go through a sleep study. We need to distinguish what they are experiencing from other sleep parasomnias that happen in other stages of sleep, because REM sleep behavior disorder can portend diagnosis of a more serious condition. […] Clonazepam is one of the main treatments, but typically, its not our preferred treatment because its a mind-altering substance that can be somewhat addictive. So, we typically prescribe melatonin. It was used in clinical trials and has shown some effectiveness. […] I think the main thing for people to know is that, even though it might seem like a funny or weird thing that your partner sometimes acts out their dreams in their sleep, its important to get checked out. And the other thing thats important is to find out if their RBD has any connection to a synucleinopathy, which could portend a more serious condition.

• #41 Rapid Eye Movement Sleep Behavior Disorder – StatPearls – NCBI Bookshelf

  https://www.ncbi.nlm.nih.gov/books/NBK555928/

  Early diagnosis and management of RBD provide a therapeutic window to treat the potential underlying neurodegenerative disorder. […] Evaluating and managing newly diagnosed rapid eye movement behavior disorder requires a multi-disciplinary and interprofessional effort involving the patient’s primary care provider, a sleep specialist, a neurologist, nursing staff, and pharmacists to maximize these patients’ well-being.

• #42 REM Sleep Behavior Disorder – StatPearls – NCBI Bookshelf

  https://www.ncbi.nlm.nih.gov/books/NBK534239/

  Rapid eye movement (REM) sleep behavior disorder is a parasomnia in which affected individuals act out their dreams while in the REM stage of sleep. […] This activity describes the risk factors, evaluation, and management of rapid eye movement sleep behavior disorder and highlights the role of the interprofessional team in enhancing care delivery for affected patients. […] Treatment consists of preventive measures while sleeping to avoid injury to the patient as well as the bed partner. […] The primary goal of treatment is to provide patients with a safe sleeping environment for them and their bed partners. Healthcare professionals can achieve this through non-pharmacologic approaches and pharmacotherapy if needed. […] It is important to counsel patients and their bed partners on avoidance of potentially hazardous and injuries objects near the patients, for example, firearms or glass objects.

• #43 Sleep Disorders | Parkinson’s Foundation

  https://www.parkinson.org/understanding-parkinsons/non-movement-symptoms/sleep-disorders

  People with rapid eye movement sleep behavior disorder (RBD) do not have the normal relaxation of the muscles during their dreams. Therefore, they act out their dreams during REM sleep. […] About half of people with PD suffer from RBD. It may develop after or along with the motor symptoms, but in most cases, it precedes the PD diagnosis by five to 10 years. […] Consider making environmental adjustments to protect the person with RBD and bed partner from injury. This may include padding the floor, creating a barrier between bed partners, or sleeping in separate beds or rooms. […] Talk to your doctor about the over-the-counter sleep aid melatonin. Doses up to 12 mg one hour before bedtime can improve RBD symptoms. […] Clonazepam has been shown in large case series to improve RBD in 80 to 90% of cases. It is often used when melatonin is not effective. The dose of clonazepam required is low, usually from 0.5 mg to 1.0 mg. The adverse effects of clonazepam include nocturnal confusion, daytime sedation and exacerbation of obstructive sleep apnea, if present.

• #44 Ask the MD: Acting Out Dreams and Parkinson’s Disease | Parkinson’s Disease

  https://www.michaeljfox.org/news/ask-md-acting-out-dreams-and-parkinsons-disease

  REM sleep behavior disorder (RBD) is a lesser-known symptom of Parkinson’s that, in some people, can precede movement symptoms (tremor, stiffness, slowness) and diagnosis by years or even decades. […] In REM sleep behavior disorder, a person acts out their dreams. Because these dreams often involve being chased or attacked, people will yell, punch, kick or even leap out of bed. […] If RBD causes injury or poses risks of harm to you or your bedpartner, your doctor may suggest medication and safety measures. […] Commonly prescribed medications for RBD are clonazepam and melatonin. […] Safety measures may include adding a bed rail, padding corners of furniture, and removing potentially dangerous objects (such as guns or sharp objects) from the bedroom. […] If you act out your dreams, talk to your doctor. […] If you do have RBD, you may want to see a movement disorder specialist (a neurologist with expertise in Parkinson’s and other movement disorders) who can check for Parkinson’s motor symptoms and talk through your risk of developing PD or related conditions.

• #45 REM Sleep Behavior Disorder in Psychiatric Populations

  https://www.psychiatrist.com/jcp/rem-sleep-behavior-disorder-psychiatric-populations/

  REM Sleep Behavior Disorder in Psychiatric Populations […] Rapid eye movement (REM) sleep behavior disorder (RBD) is a parasomnia characterized by a loss of REM-related muscle atonia and abnormal motor activities during REM sleep with consequent sleep-related injuries. It has been increasingly reported among psychiatric populations and has a potential association with use of psychotropics, particularly selective serotonin reuptake inhibitor (SSRI), tricyclic, and serotonin and noradrenergic reuptake inhibitor (SNRI) antidepressants. […] A previous case report found that cessation of SSRI treatment did not result in complete resolution of clinical RBD symptoms and polysomnographic (PSG) abnormalities. Our recent clinical epidemiologic study found that 3.8% of psychiatric outpatients might have RBD features over the past year. The prevalence is 10 times more common than that of the typical RBD in the elderly general population. In addition, the RBD features could result in sleep-related injuries and violence, with potential medicolegal repercussions.

• #46 REM Sleep Behavior Disorder in Psychiatric Populations

  https://www.psychiatrist.com/jcp/rem-sleep-behavior-disorder-psychiatric-populations/

  Modification of their current antidepressant regimen was suggested to all subjects. Bupropion was offered as the treatment of choice in this open intervention, as it has rarely been associated with RBD in previous reports. The subjects prescription history of benzodiazepines was also recorded, as benzodiazepines, especially clonazepam, are a common treatment option for RBD. […] At follow-up, group A showed improvement in clinical symptoms of RBD, especially in frequency of nightmares and dream enactments. They also had a nearly significant reduction in sleep-related injuries. However, their PSG still showed residual REMREEA. […] This study provides further insights about RBD in psychiatric populations. First, the hypothesis of antidepressant treatment as the sole cause of RBD among psychiatric patients was not fully supported. Upon withdrawal or switch of antidepressants, the clinical symptoms improved, but the PSG features persisted.

• #47 REM Sleep Behavior Disorder in Psychiatric Populations

  https://www.psychiatrist.com/jcp/rem-sleep-behavior-disorder-psychiatric-populations/

  Second, our study suggested a possible synergistic mechanism of serotonergic antidepressants in precipitating RBD symptoms by modulation of the dream mechanism and REM sleep-related muscle atonia. Changes in dream content with more vivid and intense dreams and nightmares have been reported among subjects taking serotonergic antidepressants. […] In our study, there was a parallel diminution of clinical RBD symptoms and severity of nightmares and dream enactments upon amendment of the antidepressant regimen. Thus, a distinct possibility remained that a serotonergic antidepressant could partially exert its effect by the modulation of dream mechanism.

• #48 REM Sleep Behavior Disorder and Substance Abuse | Learn More

  https://www.therecoveryvillage.com/mental-health/rem-sleep-behavior-disorder/substance-abuse/

  People with REM sleep behavior disorder (RBD) act out their dreams and often suffer from poor sleep. […] The use of drugs or alcohol can make symptoms worse. […] People who already have RBD are likely to experience more severe sleep disturbances when they use ingest substances, especially alcohol, marijuana and stimulants. […] In general, substance use degrades sleep quality and can cause insomnia or other sleep disorders. […] Alcohol affects different neurotransmitters and systems in the brain that regulate sleep. […] It can also make people restless during sleep, more prone to vivid nightmares and symptoms of RBD. […] People often act out their dreams in ways that meet the criteria for REM sleep behavior disorder when they experience alcohol withdrawal. […] Research shows that cannabis impacts REM sleep and reduces sleep quality in general.

• #49 REM Sleep Behavior Disorder and Substance Abuse | Learn More

  https://www.therecoveryvillage.com/mental-health/rem-sleep-behavior-disorder/substance-abuse/

  While reduced sleep quality can initially decrease episodes of acting out dreams, it often has a backlash effect that causes symptoms to re-emerge and become more severe over time. […] People with insomnia, RBD or other sleep disorders may resort to abusing stimulants to help them stay awake and alert the day after a poor night’s sleep. […] However, in some cases, people may turn to drugs and alcohol to temporarily improve their sleep, which may lead to addiction or dependence in the long term. […] Coordinating its treatment with substance abuse treatment is as simple as making sure physicians communicate with clinicians providing addiction treatment to ensure that medications for RBD are not interfering with treatment goals. […] It is essential that people receiving treatment for REM sleep disorders and other mental health conditions work closely with clinicians to ensure that treatment for one condition does not make another worse.

• #50 REM Sleep Behavior Disorder in Children | Dr. Mayank Shukla

  https://www.drmayankshukla.com/rem-sleep-behavior-disorder-children/

  If your child suffers from REM sleep behavior disorder, it may disrupt his or her sleep quality and behavior. […] Rapid eye movement (REM) sleep behavior disorder is a sleep disorder in which your child physically acts out vivid dreams with vocal sounds and sudden, often violent arm and leg movements during REM sleep, a stage in which you normally dont move. […] Symptoms of REM sleep disorder include: Movement, such as kicking, punching, arm flailing, or jumping from the bed in response to action-filled or violent dreams. […] A physical and neurological exam will evaluate your childs REM sleep behavior disorder and other sleep disorders. […] Depending on your childs symptoms, there are several medications to treat REM sleep disorder. Low doses of clonazepam and benzodiazepine help suppress muscle activity and relax the body during sleep. […] In order to keep your child safe, you should ideally: Either have the mattress on the floor, place cushions around the bed or place the bed against a wall.

• #51 Mount Sinai Researchers Identify Potential New Treatment for Those Who Act Out Their Dreams While Sleeping | Mount Sinai – New York

  https://www.mountsinai.org/about/newsroom/2023/mount-sinai-researchers-identify-potential-new-treatment-for-those-who-act-out-their-dreams-while-sleeping

  Mount Sinai researchers have published what they say is the first study to identify a new form of treatment for rapid eye movement (REM) sleep behavior disorder. This condition affects more than 3 million Americans, mostly adults over the age of 50, who often unknowingly physically act out their dreams with vocal sounds or sudden, violent arm and leg movements during slumber, leading to significant injury to themselves or bed partners. […] The paper also demonstrates for the first time that sleep medications known as dual orexin receptor antagonists—commonly used to treat insomnia, or difficulty falling and remaining asleep—can significantly reduce REM sleep behavior disorder. Current therapeutic options for this disorder are primarily limited to melatonin and clonazepam, also known as Klonopin, so these findings suggest a promising new treatment with potentially fewer side effects. […] Researchers hope their findings will encourage future trials of dual orexin receptor antagonists to treat REM sleep behavior disorder in humans, given that the medication is already FDA approved and available to treat people with insomnia.

• #52 REM Sleep Behavior Disorder (RBD): Clues About Brain Diseases

  https://www.webmd.com/sleep-disorders/story/REM-sleep-behavior-disorder-RBD

  Soon after learning that he had RBD, John Poma crafted a plexiglass barrier to separate him from Mary Beth in bed. […] Scientists from nine research centers have teamed up to form the North American Prodromal Synucleinopathy (NAPS) Consortium for RBD. […] Several drugs and immunotherapies targeting alpha-synuclein, the protein that clumps in RBD, are also in the works. These could be ready for clinical trials within a few years, Ju says. Some of the ways these medications would work would be to block alpha-synuclein receptors, reduce it, or thwart it from clumping. People with RBD could be the ideal group in which to test them.

• #53 Current Treatment Options for REM Sleep Behaviour Disorder

  https://www.mdpi.com/2075-4426/11/11/1204

  The search for appropriate treatments for RBD is important for preventing sleep-related injuries of both patients and their partners. In addition, due to the high described rate of the phenoconversion of iRB to synucleinopathies, it is important to try potential preventive therapies following the early detection of patients at risk. However, the ideal therapy for RBD is not currently established. […] Symptomatic therapy should be developed to prevent sleep-related falls and injuries and to improve the quality of sleep of the patients, while the development of neuroprotective therapies, at least in patients with higher risks of developing synucleinopathies, could be used to delay the clinical onset and improve the clinical course of these diseases.

• #54 REM Sleep Behavior Disorder (RBD): Clues About Brain Diseases

  https://www.webmd.com/sleep-disorders/story/REM-sleep-behavior-disorder-RBD

  Soon after learning that he had RBD, John Poma crafted a plexiglass barrier to separate him from Mary Beth in bed. […] Scientists from nine research centers have teamed up to form the North American Prodromal Synucleinopathy (NAPS) Consortium for RBD. […] Several drugs and immunotherapies targeting alpha-synuclein, the protein that clumps in RBD, are also in the works. These could be ready for clinical trials within a few years, Ju says. Some of the ways these medications would work would be to block alpha-synuclein receptors, reduce it, or thwart it from clumping. People with RBD could be the ideal group in which to test them.

• #55 Rapid Eye Movement Sleep Behavior Disorder – StatPearls – NCBI Bookshelf

  https://www.ncbi.nlm.nih.gov/books/NBK555928/

  Early diagnosis and management of RBD provide a therapeutic window to treat the potential underlying neurodegenerative disorder. […] Evaluating and managing newly diagnosed rapid eye movement behavior disorder requires a multi-disciplinary and interprofessional effort involving the patient’s primary care provider, a sleep specialist, a neurologist, nursing staff, and pharmacists to maximize these patients’ well-being.

• #56 REM Sleep Behavior Disorder – StatPearls – NCBI Bookshelf

  https://www.ncbi.nlm.nih.gov/books/NBK534239/

  Rapid eye movement (REM) sleep behavior disorder is a parasomnia in which affected individuals act out their dreams while in the REM stage of sleep. […] This activity describes the risk factors, evaluation, and management of rapid eye movement sleep behavior disorder and highlights the role of the interprofessional team in enhancing care delivery for affected patients. […] Treatment consists of preventive measures while sleeping to avoid injury to the patient as well as the bed partner. […] The primary goal of treatment is to provide patients with a safe sleeping environment for them and their bed partners. Healthcare professionals can achieve this through non-pharmacologic approaches and pharmacotherapy if needed. […] It is important to counsel patients and their bed partners on avoidance of potentially hazardous and injuries objects near the patients, for example, firearms or glass objects.

• #57 Rapid Eye Movement Sleep Behavior Disorder – StatPearls – NCBI Bookshelf

  https://www.ncbi.nlm.nih.gov/books/NBK555928/

  Early diagnosis and management of RBD provide a therapeutic window to treat the potential underlying neurodegenerative disorder. […] Evaluating and managing newly diagnosed rapid eye movement behavior disorder requires a multi-disciplinary and interprofessional effort involving the patient’s primary care provider, a sleep specialist, a neurologist, nursing staff, and pharmacists to maximize these patients’ well-being.

• #58 Current Treatment Options for REM Sleep Behaviour Disorder

  https://www.mdpi.com/2075-4426/11/11/1204

  The symptomatic treatment of REM sleep behaviour disorder (RBD) is very important to prevent sleep-related falls and/or injuries. Though clonazepam and melatonin are usually considered the first-line symptomatic therapy for RBD, their efficiency has not been proven by randomized clinical trials. […] The design of long-term, multicentre, randomized, placebo-controlled clinical trials involving a large number of patients diagnosed with isolated RBD with polysomnographic confirmation, directed towards both symptomatic and preventive therapy for RBD, is warranted. […] Despite the assumption that the first-line drugs in the therapy or RBD are clonazepam and melatonin, an ideal treatment has not been established. […] The aim of this narrative review is to provide a description of studies reported to date related to the treatment of this clinical entity.

• #59 REM sleep behaviour disorder More than just a parasomnia

  https://www.racgp.org.au/afp/2013/november/rem-sleep-behaviour-disorder

  A positive answer to the quick, single-question screen RBD1Q should encourage the GP to consider a diagnosis of RBD and refer the patient to a sleep physician or a multidisciplinary sleep clinic. […] The recognition of RBD as a treatable parasomnia that could otherwise lead to serious injury is imperative in general practice. […] Reduce injury by improving the safety of the sleep environment if any dream-enactment behaviour is suspected.

• #60 CE Activity | REM Sleep Behavior Disorder | Nurses

  https://www.statpearls.com/nurse/ce/activity/103830

  Rapid eye movement (REM) sleep behavior disorder is a parasomnia in which affected individuals act out their dreams while in the REM stage of sleep. Unfortunately, this can involve violence and can lead to the injury of self or others without conscious awareness. […] This activity describes the risk factors, evaluation, and management of rapid eye movement sleep behavior disorder and highlights the role of the interprofessional team in enhancing care delivery for affected patients. […] Outline the treatment and management options available for rapid eye movement sleep behavior disorder. […] Explain the importance of improving coordination amongst the interprofessional team to enhance care for patients affected by rapid eye movement sleep behavior disorder and improve patient outcomes.

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