Melatonin therapy for REM sleep behavior disorder: A critical review of evidence

Ian R. McGrane, Jonathan G. Leung, Erik K St Louis, Bradley F Boeve

Research output: Contribution to journalArticle

64 Citations (Scopus)

Abstract

Rapid eye movement (REM) sleep behavior disorder (RBD) is a parasomnia associated with dream enactment often involving violent or potentially injurious behaviors during REM sleep that is strongly associated with synucleinopathy neurodegeneration. Clonazepam has long been suggested as the first-line treatment option for RBD. However, evidence supporting melatonin therapy is expanding. Melatonin appears to be beneficial for the management of RBD with reductions in clinical behavioral outcomes and decrease in muscle tonicity during REM sleep. Melatonin also has a favorable safety and tolerability profile over clonazepam with limited potential for drug-drug interactions, an important consideration especially in elderly individuals with RBD receiving polypharmacy. Prospective clinical trials are necessary to establish the evidence basis for melatonin and clonazepam as RBD therapies.

Original languageEnglish (US)
Pages (from-to)19-26
Number of pages8
JournalSleep Medicine
Volume16
Issue number1
DOIs
StatePublished - Jan 1 2015

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REM Sleep Behavior Disorder
Melatonin
Clonazepam
REM Sleep
Sleep
Parasomnias
Therapeutics
Polypharmacy
Behavior Therapy
Drug Interactions
Clinical Trials
Safety
Muscles
Pharmaceutical Preparations

Keywords

  • Calmodulin
  • Drug therapy
  • Melatonin
  • Parasomnia
  • REM sleep behavior disorder

ASJC Scopus subject areas

  • Medicine(all)

Cite this

Melatonin therapy for REM sleep behavior disorder : A critical review of evidence. / McGrane, Ian R.; Leung, Jonathan G.; St Louis, Erik K; Boeve, Bradley F.

In: Sleep Medicine, Vol. 16, No. 1, 01.01.2015, p. 19-26.

Research output: Contribution to journalArticle

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