Treatment Recommendations for People Who Act Out Their Dreams While Asleep

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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.  

The guideline, available online as an accepted paper in the Journal of Clinical Sleep Medicine, updates the AASM’s previous guidance published in 2010. Several clinical trials conducted in the last decade have contributed new evidence to the published literature, providing additional support for the recommendations.  

“REM sleep behavior disorder is common, affecting more than 80 million people worldwide,” said lead author Dr. Michael Howell, chair of the AASM task force and a professor and division head of sleep medicine in the department of neurology at the University of Minnesota in Minneapolis.

The symptoms of REM sleep behavior disorder are often ignored for years, usually until an injury occurs to the dreamer or the bed partner. REM sleep behavior disorder often occurs due to an underlying neurological disorder, such as dementia with Lewy bodies, Parkinson’s disease, multiple system atrophy, narcolepsy, or stroke. 

The guideline provides recommendations for specific medications, such as clonazepam and immediate-release melatonin, that clinicians should consider when treating REM sleep behavior disorder in adults.

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