Materiały źródłowe

• #1 Current Treatment Options for REM Sleep Behaviour Disorder

  https://pmc.ncbi.nlm.nih.gov/articles/PMC8624088/

  The symptomatic treatment of REM sleep behaviour disorder (RBD) is very important to prevent sleep-related falls and/or injuries. […] The development of potential preventive therapies against the phenoconversion of isolated RBD to synucleinopathies should be another important aim of RBD therapy. […] 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. […] 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.

• #1 Current Treatment Options for REM Sleep Behaviour Disorder

  https://pmc.ncbi.nlm.nih.gov/articles/PMC8624088/

  Ideally, the design of therapeutical trials for RBD should pursue two main types of objectives: the adequate symptomatic therapy for RBD symptoms and the possibility of developing neuroprotective (preventive) strategies. […] 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.

• #2 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. […] 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. […] 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.

• #3

  https://link.springer.com/article/10.1007/s11940-016-0433-2

  The benefit of hypnosis, especially in those with psychiatric RBD, also requires further study. […] RBD is an attractive target for future neuroprotective treatment trials to prevent evolution of overt parkinsonism or memory decline, but currently, there are no known effective treatments and future trials will be necessary to determine if RBD is an actionable time point in the evolution of overt synucleinopathy. […] McCarter SJ et al. Factors associated with injury in REM sleep behavior disorder. Sleep Med. 2014;15(11):13328. This paper reviewed the frequency of injury in untreated REM sleep behavior disorder, finding that 55% of idiopathic RBD patients reported injury prior to treatment, 11.3% with serious injuries such as subdural hematomas. While not discussing treatment per se, the alarming frequency of injury suggest that treatment to prevent injury should be a major priority in the care of RBD patients.

• #4 New AASM guideline: Management of REM sleep behavior disorder

  https://aasm.org/new-guideline-provides-treatment-recommendations-for-people-who-act-out-their-dreams-while-asleep/

  DARIEN, IL- A new clinical practice guideline developed by the American Academy of Sleep Medicine provides recommendations for the management of REM sleep behavior disorder in adults. […] This clinical practice guideline provides clinicians with insight on how best to prevent sleep-related injury and how to provide patients with a risk assessment for neurological disease. […] The guideline also emphasizes the need for patients to maintain a safe sleeping environment to prevent injuries while sleeping. The guideline suggests removing bedside objects that could easily injure someone while asleep. […] To reduce the risk of injuries, people with severe REM sleep behavior disorder should be advised to sleep separately from their partners until treated.

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

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

  Treatment for REM sleep behavior disorder may include physical safeguards and medications. […] 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. […] 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. Melatonin may be as effective as clonazepam and is usually well-tolerated with few side effects. Clonazepam (Klonopin). This prescription medication, often used to treat anxiety, is also the traditional choice for treating REM sleep behavior disorder, appearing to effectively reduce symptoms. Clonazepam may cause side effects such as daytime sleepiness, decreased balance and worsening of sleep apnea. […] Doctors continue to study several other medications that may treat REM sleep behavior disorder. Talk with your doctor to determine the most appropriate treatment option for you.

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

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

  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. Sharp furniture like nightstands should be moved away or their edges and headboard should be padded. To reduce the risk of injurious falls, a soft carpet, rug, or mat should be placed next to the bed. 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. […] The AASM suggests that clinicians use clonazepam (vs no treatment) for the treatment of isolated RBD in adults. (Conditional)

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

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

  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 drug discontinuation (vs drug continuation) for the treatment of drug-induced RBD 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)

• #7 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

  Maintaining a safe sleeping environment for patients with rapid-eye movement (REM) sleep behavior disorder (RBD) and their bed partners is critically important to prevent injury from falling out of bed, thrashing limbs or even unknowingly using a readily available weapon. Fortunately, evidence indicates that, in addition to environmental changes that patients can make, medications may help remediate the condition. […] Create a safe environment for patients and bed partners. Padding sharp corners on nightstands, putting a soft mat on the floor next to the bed, and placing pillows between the patient and sleeping partner can help prevent injury. Most important is to remove heavy items and firearms from reach. […] 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.

• #7 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

  If possible, discontinue implicated medications for drug-induced RBD. Likely culprits are beta-blockers and selective serotonin reuptake inhibitors. […] Don’t treat RBD with deep brain stimulation. Although it is effective for Parkinson’s disease, there is no evidence that deep brain stimulation improves RBD, so it should not be considered for this indication. […] 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.

• #8 REM Sleep Behavior Disorder Guidelines: Guidelines Summary

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

  In 2023, the American Academy of Sleep Medicine (AASM) published guidelines on the management of rapid eye movement sleep behavior disorder (RBD) in adults. […] For adults with idiopathic (isolated) RBD, the guidelines suggest the following treatments over no treatment: Clonazepam, Immediate-release melatonin, Pramipexole. […] Transdermal rivastigmine is suggested over no treatment for the management of mild cognitive impairment in adults with idiopathic (isolated) RBD. […] For adults with RBD due to a medical condition, the guidelines suggest the following treatments over no treatment: Clonazepam, Immediate-release melatonin. […] Transdermal rivastigmine is suggested over no treatment for the management of secondary RBD in patients with Parkinson disease. […] The guidelines suggest against deep brain stimulation for the treatment of secondary RBD due to a medical condition. […] For adults with drug-induced RBD, the guidelines suggests discontinuation of the inciting drug. However, the severity of comorbid conditions for which the inciting drug is taken and the consequences of eliminating treatment must be taken into consideration before drug discontinuation.

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

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

  In most cases, there’s nothing you can do to prevent RBD. This is because the condition has risk factors that you can’t prevent or change, such as your age or having narcolepsy or a neurodegenerative condition. […] If substances like alcohol cause RBD or make it worse, stopping the use of these substances can make RBD go away.

• #10 SciELO Brasil – REM sleep behavior disorder: update on diagnosis and management REM sleep behavior disorder: update on diagnosis and management

  https://www.scielo.br/j/anp/a/NyW6ysTnXjDj8kRrWFKmyLp/

  In individuals with drug-induced or drug-exacerbated RBD, drug discontinuation is only recommended if clinically safe for the patient, particularly in the context of psychiatric disorders when the psychiatrist should be consulted. For example, dream enactment may improve after decreasing or discontinuing an antidepressant, but clinicians should remember that this may take several months. If antidepressant discontinuation is not psychiatrically safe, bupropion, a drug with a lower serotoninergic profile, may be an option, especially since no case of bupropion-induced or exacerbated RBD has been reported. […] RBD may precede the onset of cognitive and motor symptoms related to synucleinopathies. Future studies should define clinical, radiological, laboratory, and neurophysiological variables (biomarkers) that can be used, individually or in combination, to predict the risk of developing synucleinopathies, and the associated timelines, ideally forecasting the type of future pathology. These biomarkers could potentially become the targets of neuroprotective strategies that could prevent the emergence, or slow down the progression, of neurodegenerative diseases.

• #11 REM sleep behavior disorder in Parkinson’s disease | NSS

  https://www.dovepress.com/considering-rem-sleep-behavior-disorder-in-the-management-of-parkinson-peer-reviewed-fulltext-article-NSS

  REM sleep behavior disorder (RBD) is a parasomnia characterized by dream-enacting behavior and loss of physiological muscle atonia during REM sleep (REM sleep without atonia, RSWA). […] Managing of RBD includes pharmacological interventions (Clonazepam, Melatonin), bedroom interventions aimed to mitigate the risk of injuries improving the safety of both the patient and the bed-partner, in order to reduce dream-enacting behaviors, associated nightmares and consequent injuries, and to improve the quality of life. Moreover, in managing RBD it is important to inform the patient about the association between RBD and neurodegenerative disorders and scheduling follow-up neurological examinations in order to early recognize any sign of synucleinopathies. […] Up to now, neuroprotective and disease-modifying therapy are not available, in order to arrest or slow down the neurodegenerative process of alphasynucleinopathy. RBD population represents an ideal candidate to neuroprotective or disease-modifying clinical trial. Thus, the identification of multimodal biomarkers, both diagnostic and prognostic, of neurodegeneration is crucial.

• #11 REM sleep behavior disorder in Parkinson’s disease | NSS

  https://www.dovepress.com/considering-rem-sleep-behavior-disorder-in-the-management-of-parkinson-peer-reviewed-fulltext-article-NSS

  RBD patients, both isolated and associated with PD, are at risk of injuries, to themselves or to bedpartner, related to complex-motor dream-enacting behaviors. […] Regular physical exercise is advisable in patients with PD and sleep disorders. In a recent meta-analysis has been found that exercise had a significant positive effect on subjective sleep quality in people with PD. […] The benefits of multidisciplinary intensive rehabilitation treatment (MIRT) on sleep disorders in PD have been highlighted.

• #12 Pharmacological Treatment for Rapid Eye Movement Sleep Behavior Disorder

  https://www.chronobiologyinmedicine.org/journal/view.php?number=87

  Rapid eye movement (REM) sleep behavior disorder (RBD) is a parasomnia characterized by abnormal movement during REM sleep. […] The current guidelines for RBD treatment include modification of the sleep environment to reduce the risk of sleep-related injury and pharmacological treatment. […] Clonazepam, a potent, long-acting benzodiazepine, has long been regarded as the first-line treatment for RBD. […] The existing data on the effects of clonazepam on the REM sleep parameters in RBD patients are inconsistent. […] Melatonin, produced and secreted mainly in the pineal gland at night, plays an important role in regulating diverse circadian rhythms, including sleep. […] Given the proposed mechanism of action for melatonin in RBD, melatonin receptor antagonists could be potentially useful agents for RBD treatment.

• #13

  https://link.springer.com/article/10.1007/s11940-016-0433-2

  Melatonin dosed 312 mg at bedtime should be considered as the first-line therapy, followed by clonazepam 0.252.0 mg at bedtime if initial melatonin is judged ineffective or intolerable. […] However, neither agent is likely to completely stop dream enactment behaviors, so choosing a moderate target dosage of melatonin 6 mg or clonazepam 0.5 mg, or the highest tolerable dosage that reduces attack frequency and avoids adverse effects from overtreatment, is currently the most reasonable strategy. […] Alternative second- and third-line therapies with anecdotal efficacy include temazepam, lorazepam, zolpidem, zopiclone, pramipexole, donepezil, ramelteon, agomelatine, cannabinoids, and sodium oxybate. […] A novel non-pharmacological approach is a bed alarm system, although this may be most useful in patients who also report sleep walking or a history of leaving their bed during dream enactment episodes.

• #13

  https://link.springer.com/article/10.1007/s11940-016-0433-2

  The benefit of hypnosis, especially in those with psychiatric RBD, also requires further study. […] RBD is an attractive target for future neuroprotective treatment trials to prevent evolution of overt parkinsonism or memory decline, but currently, there are no known effective treatments and future trials will be necessary to determine if RBD is an actionable time point in the evolution of overt synucleinopathy. […] McCarter SJ et al. Factors associated with injury in REM sleep behavior disorder. Sleep Med. 2014;15(11):13328. This paper reviewed the frequency of injury in untreated REM sleep behavior disorder, finding that 55% of idiopathic RBD patients reported injury prior to treatment, 11.3% with serious injuries such as subdural hematomas. While not discussing treatment per se, the alarming frequency of injury suggest that treatment to prevent injury should be a major priority in the care of RBD patients.

• #14 REM Sleep Behavior Disorder – Neurology Solutions

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

  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. […] Common treatment strategies may include: Modifying the sleep environment, to reduce sleep-related injuries […] Magnesium and melatonin are supplements that are typically helpful in reducing RBD severity […] Clonazepam is a prescription medication commonly used in RBD […] Baclofen and pramipexole have also been shown to be helpful in some patients.

• #15 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. […] 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. […] GPs also have a key role in addressing medical and lifestyle dementia risk factors, such as hypertension, physical inactivity, and smoking in this group who are at high risk for developing NDDs. […] GPs therefore play a vital role in recognising potential iRBD and applying preventive medicine approaches with the aim of trying to alter iRBD trajectories.

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

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

  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.

• #17 REM Sleep Behavior Disorder – Symptoms, Diagnosis, Treatment

  https://project-sleep.com/rem-sleep-behavior-disorder/

  Helpful lifestyle strategies include keeping healthy sleep habits (also called sleep hygiene) and learning about RBD. […] Social support, through connecting with other people who have RBD and their families, can empower people to understand RBD and learn strategies to live well with RBD. […] Regular monitoring for symptoms that could be a sign of other neurological disorders, such as tremors, is important.

• #18 RBD Resources — NAPS Consortium for REM Sleep Behavior Disorder

  https://www.naps-rbd.org/rbd

  REM Sleep Behavior Disorder (RBD) is a sleep disorder which causes individuals to talk, move (sometimes violently) or engage in other dream-enacting behavior while asleep. […] Currently, there are no treatments to slow or prevent these neurodegenerative disorders; however, there are some promising treatments on the near horizon. […] Ultimately, we hope to enroll our registry participants in a clinical trial for preventive treatments against synucleinopathies. […] Under certain circumstances, taking part in the NAPS study may initially require you to undergo clinical sleep study, also known as a polysomnogram, at a NAPS site to confirm the diagnosis of RBD. […] The NAPS Consortium is recruiting people with Idiopathic RBD, meaning that the RBD is not due to any known cause. […] If you think you might have RBD but it has not been diagnosed officially, you will need to see a sleep doctor at an accredited sleep center. […] If study requirements are met, we may be able to support travel to a research site.

• #19 REM Sleep Behavior Disorder and Prodromal Neurodegeneration – Where Are We Headed? | Tremor and Other Hyperkinetic Movements

  https://tremorjournal.org/articles/10.5334/tohm.171

  Rapid eye movement (REM) sleep behavior disorder (RBD) is characterized by loss of normal atonia during REM sleep, such that patients appear to act out their dreams. […] RBD patients provide an important opportunity they are the ideal group to include in clinical trials of neuroprotective therapies for preventing synuclein-mediated neurodegeneration. RBD patients have two essential characteristics required for such a trial. First, they have a very high risk of disease conversion, and second, the latency is long enough that the intervention can be provided early enough to affect change. […] Can a neuroprotective trial for RBD be developed? Such a trial would have numerous challenges to overcome. First, the long latency to development of defined disease, although a major advantage in terms of opportunity to intervene early, does imply that trials would need to be of sufficiently long duration. […] Regardless of these challenges, there is probably no other clinical group that can provide the combination of specificity for prodromal PD and adequate lead time that is so essential to a successful neuroprotective trial.

• #20 Study IDs Potential Treatment for REM Sleep Behavior Disorder

  https://sleepreviewmag.com/sleep-disorders/parasomnias/rem-parasomnias/surprising-study-identifies-potential-new-treatment-rem-sleep-behavior-disorder/

  Mount Sinai researchers have published a study identifying a new form of treatment for rapid eye movement (REM) sleep behavior disorder. […] This model provides an early-life biomarker of impending deterioration of the brain, which could guide future prevention and treatment. […] 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. […] It was even more surprising and exciting to observe that a dual orexin receptor antagonist could significantly minimize the dream enactment behaviors.

• #21 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. […] 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. […] 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.

• #22 A Case of Intractable REM Sleep Behavior Disorder Improved With Nasal Continuous Positive Airway Pressure Therapy

  https://www.e-jsm.org/journal/view.php?number=382

  Rapid eye movement (REM) sleep behavior disorder (RBD) is characterized by dream enactment behavior and REM sleep without atonia and is traumatic for the patient and/or bedpartner. […] The standard treatment for RBD is the maintenance of a safe bedroom environment and medications, including clonazepam, immediate-release melatonin, and pramipexole. […] Although OSA is common in patients with RBD, the influence of comorbid OSA on RBD symptoms remains unclear. […] Several studies suggested OSA treatment with continuous positive airway pressure (CPAP) improved RBD symptoms and RWA on night polysomnography (PSG). […] The RBD symptoms improved with nasal CPAP therapy. […] Clinicians should be aware of concomitant OSA when patients have intractable RBD symptoms, and CPAP therapy may help improve RBD symptoms.

• #23 REM Sleep Behavior Disorder Treatment – Good Health Psych

  https://goodhealthpsych.com/disorders/rem-sleep-behavior-disorder-treatment/

  The path to managing RBD starts with a comprehensive sleep study to understand the individual’s unique sleep patterns and symptoms severity. Based on the findings, a personalized treatment plan is developed, typically involving medication, lifestyle changes, and behavioral therapy. […] Medications are commonly used to reduce the frequency and severity of RBD episodes. Concurrently, lifestyle modifications, such as creating a safe sleep environment and practicing good sleep hygiene, are recommended to enhance sleep quality. Behavioral therapy may also be employed to manage associated symptoms such as stress and anxiety. […] Through active participation in the treatment process, individuals can expect a significant improvement in their sleep quality, a reduction in the incidence of violent sleep behaviors, and an overall better quality of life.

• #23 REM Sleep Behavior Disorder Treatment – Good Health Psych

  https://goodhealthpsych.com/disorders/rem-sleep-behavior-disorder-treatment/

  Rapid Eye Movement (REM) Sleep Behavior Disorder (RBD) is a complex sleep disorder in which individuals physically act out vivid, often violent dreams. These episodes can pose a risk of injury to the individual or their bed partner and can significantly disrupt sleep quality. RBD treatment is uniquely tailored for individuals diagnosed with this disorder. […] The goal of the treatment is to ensure safety during sleep, improve sleep quality, and enhance overall health and wellbeing. Treatments for RBD typically involve a combination of pharmacotherapy, lifestyle modifications, and behavioral interventions, each personalized to meet the individual’s unique needs. […] Treatment for REM Sleep Behavior Disorder (RBD) typically involves a combination of medication management and lifestyle modifications: Medication, Sleep Hygiene Practices, Regular Follow-ups, Cognitive Behavioral Therapy (CBT).

• #24 REM Sleep Behavior Disorder | UPMC HealthBeat

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

  – Pad the corners of furniture in the room. […] – Remove any weapons from the bedroom. […] – Remove sharp objects from the bedroom. […] 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.

• #25

  https://healthmatch.io/rem-sleep-behavior-disorder

  REM sleep behavior disorder is a relatively rare disorder that affects less than 1% of the global population. […] Treating REM sleep behavior disorder can involve a combination of medication, lifestyle changes, and injury prevention techniques via a treatment plan customized to your individual needs. […] Making lifestyle changes to reduce or eliminate the potential triggers of REM sleep behavior disorder is often recommended as part of a treatment plan. […] If you have REM sleep behavior disorder, creating a safe sleep environment is an essential step. Many individuals with the disorder report injuries, including bruising, cuts, fractures, blunt trauma, and head trauma. […] Injury prevention techniques may include: Moving furniture, clutter, and other objects away from your bedside area, Moving your bed away from the window, Placing padding on the floor surrounding your bed, Putting the mattress on the floor.

• #26

  https://www.aurorahealthcare.org/services/sleep-disorders/rem-sleep-behavior-disorder-rbd

  Managing REM sleep behavior disorder often involves a combination of medication and lifestyle changes. Clonazepam, a medication commonly used to treat anxiety, is often prescribed for RBD. […] Melatonin supplements may also be effective. Additionally, making your sleep environment safer by removing dangerous objects and padding the floor around your bed can prevent injuries. Stress management techniques and maintaining a consistent sleep schedule can also improve REM sleep and reduce RBD episodes.

• #27

  https://www.advocatehealth.com/health-services/sleep-medicine/rem-sleep-behavior-disorder-rbd

  REM sleep behavior disorder typically includes medications and lifestyle adjustments. […] Creating a safer sleep environment by removing hazardous objects and padding the area around your bed can help prevent injuries. Additionally, stress management and maintaining a regular sleep schedule can help improve REM sleep quality and reduce RBD episodes.

• #28 Treating REM sleep behavior disorder: Best practices – Sleep Education

  https://sleepeducation.org/treating-rem-sleep-behavior-disorder-best-practices/

  Recently the AASM reviewed all of the current research and developed a best practice guide for the treatment of RBD. It was published last month in the Journal of Clinical Sleep Medicine. […] The guide recommends two steps in the treatment of RBD. The first step is injury prevention. The second step is the ongoing use of medication to control the symptoms. […] So it is important to create a safe sleeping environment. […] These methods of injury prevention should be continued while taking medication. […] Treatment for RBD should be supervised by a board-certified sleep specialist.

• #29 RBD (REM Sleep Behavior Disorder) Specialist Near Me

  https://www.koalasleepcenters.com/rbd-treatment-specialist

  The optimal treatment for REM Sleep Behavior Disorder varies depending on the individual’s specific symptoms, the root cause of the condition, and any co-existing health issues. A multifaceted approach typically includes medications, physical safeguards, and health and lifestyle interventions. […] The optimal treatment for REM Sleep Behavior Disorder varies depending on the individual’s specific symptoms, the root cause of the condition, and any co-existing health issues. A multifaceted approach typically includes medications, physical safeguards, and health and lifestyle interventions. […] The optimal treatment for REM Sleep Behavior Disorder varies depending on the individual’s specific symptoms, the root cause of the condition, and any co-existing health issues. A multifaceted approach typically includes medications, physical safeguards, and health and lifestyle interventions. Medications such as melatonin and clonazepam are commonly used to mitigate symptoms, while physical safeguards aim to prevent injury during episodes. These safeguards may involve removing hazardous objects from the bedroom, installing bed barriers, or sleeping in separate rooms from partners until the disorder is under control. […] Tailoring treatment to each patient’s unique needs is essential for effectively managing RBD and enhancing the individual’s quality of life.

• #30 Management of RBD — NAPS Consortium for REM Sleep Behavior Disorder

  https://www.naps-rbd.org/management-of-rbd

  The most important goal that is relevant to almost every patient who presents with parasomnias is to minimize or prevent injury during sleep. […] Safety interventions take into consideration affected patients as well as their bed partners. Examples include sleeping separately from bed partners and making the bedroom as safe as possible, such as by moving furniture away from the bed, or removing any potential weapons. […] Patients are advised to have a close clinical follow up with their sleep doctor or clinician to make sure that treatment provides adequate control of disruptive movements while potential side effects are identified and addressed.

• #31

  https://journals.lww.com/ebp/fulltext/2017/01000/what_is_the_best_treatment_for_rem_sleep_behavior.18.aspx

  In patients with RBD, melatonin decreases the amount of REM sleep without atonia and improves subjective symptom scores (SOR: C, single small RCT). […] Clonazepam and melatonin are associated with reduced REM sleep behaviors and injuries (SOR: C, single descriptive survey). […] A bed alarm may prevent injury in patients with medication-refractory RBD (SOR: C, small case series).

• #32 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. […] The development of potential preventive therapies against the phenoconversion of isolated RBD to synucleinopathies should be another important aim of RBD therapy. […] 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.

• #33 REM sleep behavior disorder: update on diagnosis and management – Arquivos de Neuro-Psiquiatria

  https://www.arquivosdeneuropsiquiatria.org/article/rem-sleep-behavior-disorder-update-on-diagnosis-and-management/

  REM sleep behavior disorder (RBD) is characterized by a loss of atonia of skeletal muscles during REM sleep, associated with acting out behaviors during dreams. […] Proper diagnosis of this condition will enable the use of future neuroprotective strategies before motor and cognitive symptoms. […] Treatment of RBD involves guidance on protecting the environment and avoiding injuries to the patient and bed partner/roommate. Use of medications are also reviewed in the article. The development of neuroprotective medications will be crucial for future RBD therapy.

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

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

  As RBD patients are at high risk of hurting themselves and their bed partners while acting out their dreams, improving safety within the bedroom environment and treatment with exogenous melatonin or clonazepam are recommended. […] Securing the bed environment by physically removing hazards and lowering the bed has been recommended as the first-line treatment by an expert consensus. […] Additionally, these guidelines propose that melatonin and clonazepam represent first-line medication treatment but their dosage and duration have not been standardised. […] 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.

• #35 REM Sleep Behavior Disorder

  https://www.sleepdallas.com/rem-sleep-behavior-disorder.html

  REM sleep behavior disorder is a condition in which paralysis does not occur during the REM sleep stage and a persons body and voice perform their dreams while they sleep. […] The condition typically requires treatment, as it can increase the risk of injury to oneself or others. […] Because of this, early diagnosis and treatment are very important. […] Treatment of REM sleep behavior disorder must be tailored to the individual. In some cases, medications like melatonin or clonazepam will be prescribed for the treatment of this disorder. […] Another common path of treatment is lifestyle changes and injury prevention techniques. This could range from determining and avoiding triggers that contribute to the disorder to taking steps to establish a safe sleep environment. […] Some recommendations for injury prevention may include: Removing sharp objects and weapons from the bedroom, Placing padding on the floor around the bed, Installing padded bed rails on the side of the bed, Putting the mattress on the floor, Moving furniture and clutter away from the bed, Padding the corners of furniture in the bedroom, Protecting bedroom windows.

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