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Sleep Med. 2015 Jan;16(1):19-26. doi: 10.1016/j.sleep.2014.09.011. Epub 2014 Oct 13.

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

Author information

1
Department of Pharmacy, Shodair Children's Hospital, 2755 Colonial Dr, Helena, MT 59601, USA. Electronic address: imcgrane@shodair.org.
2
Department of Pharmacy, Mayo Clinic College of Medicine, Mayo Clinic, 1216 2nd Street Southwest, Rochester, MN 55902, USA.
3
Section of Sleep Neurology, Center for Sleep Medicine, Departments of Neurology and Medicine, Mayo Clinic College of Medicine, Mayo Clinic and Foundation, 200 1st Street Southwest, Rochester, MN 55905, USA.

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.

KEYWORDS:

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

PMID:
25454845
PMCID:
PMC4306603
DOI:
10.1016/j.sleep.2014.09.011
[Indexed for MEDLINE]
Free PMC Article

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