National Guideline Clearinghouse | Best practice guide for the treatment of REM sleep behavior disorder (RBD).

Guideline Title
Best practice guide for the treatment of REM sleep behavior disorder (RBD).

Bibliographic Source(s)
Aurora RN, Zak RS, Maganti RK, Auerbach SH, Casey KR, Chowdhuri S, Karippot A, Ramar K, Kristo DA, Morgenthaler TI, Standards of Practice Committee, American Academy of Sleep Medicine. Best practice guide for the treatment of REM sleep behavior disorder (RBD). J Clin Sleep Med 2010 Feb 15;6(1):85-95. [99 references] PubMed


Guideline Status
This is the current release of the guideline.

full-text:
National Guideline Clearinghouse | Best practice guide for the treatment of REM sleep behavior disorder (RBD).





J Clin Sleep Med. 2010 Feb 15;6(1):85-95.

Best practice guide for the treatment of REM sleep behavior disorder (RBD).
Aurora RN, Zak RS, Maganti RK, Auerbach SH, Casey KR, Chowdhuri S, Karippot A, Ramar K, Kristo DA, Morgenthaler TI; Standards of Practice Committee; American Academy of Sleep Medicine.

Mount Sinai Medical Center, New York, NY, USA.

Erratum in:

J Clin Sleep Med. 2010 Apr 15;6(2):table of contents.

Abstract
Summary of Recommendations: Modifying the sleep environment is recommended for the treatment of patients with RBD who have sleep-related injury. Level A Clonazepam is suggested for the treatment of RBD but should be used with caution in patients with dementia, gait disorders, or concomitant OSA. Its use should be monitored carefully over time as RBD appears to be a precursor to neurodegenerative disorders with dementia in some patients. Level B Clonazepam is suggested to decrease the occurrence of sleep-related injury caused by RBD in patients for whom pharmacologic therapy is deemed necessary. It should be used in caution in patients with dementia, gait disorders, or concomitant OSA, and its use should be monitored carefully over time. Level B Melatonin is suggested for the treatment of RBD with the advantage that there are few side effects. Level B Pramipexole may be considered to treat RBD, but efficacy studies have shown contradictory results. There is little evidence to support the use of paroxetine or L-DOPA to treat RBD, and some studies have suggested that these drugs may actually induce or exacerbate RBD. There are limited data regarding the efficacy of acetylcholinesterase inhibitors, but they may be considered to treat RBD in patients with a concomitant synucleinopathy. Level C.

PMID: 20191945 [PubMed - indexed for MEDLINE]PMCID: PMC2823283
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full-original-text:
Best Practice Guide for the Treatment of REM Sleep Behavior Disorder (RBD)