Fortunately, REM sleep behavior disorder can be treated in several ways. Learn what the treatment options are and the pros and cons of each.
Rapid eye movement, or REM, sleep is important to a person’s overall health. A valuable part of the sleep cycle, REM sleep is the period in which people experience dreams, and when many important maintenance functions happen in the brain. Some people experienceREM sleep behavior disorder (RBD)in which they physically act out their dreams.
Disruptions to REM sleep can cause various symptoms, such as drowsiness during the day, trouble thinking clearly andmood disorderssuch asdepressionoranxiety. In many cases, REM sleep behavior disorder progresses to much more serious diseases, such as Parkinson’s disease. Proper treatment is important to maintain a healthy sleep cycle and avoid the worst of the symptoms.
Medication
Clonazepam (Klonopin)is currently the most effective medication for RBD. About90%of cases of RBD respond well to clonazepam treatment. It is a type ofbenzodiazepinethat suppresses the central nervous system. Because clonazepam is a benzodiazepine, it is not recommended for people withsubstance use disordersor people who are at risk of drug interactions.
Melatonin is nearly as effective as clonazepam for RBD and has fewer risks and side effects. It works well as a general REM sleep medication for people with a variety of conditions that affect REM sleep, including jet lag, shift work andinsomnia.
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Safety Precautions
Variousmedicationscan disrupt REM sleep and make RBD worse.People who have RBD have to work carefully with medical professionals to make sure that the medications they are taking for other conditions do not interfere with their sleep or cause their RBD symptoms to worsen.
Medications that suppress REM sleepinclude the following:
- Stimulant drugsand medications
- Tricyclic antidepressants (TCAs)
- Monoamine oxidase inhibitor (MAOI) antidepressants
- Selective serotonin reuptake inhibitor (SSRI) antidepressants
The reason thatantidepressantsaffect REM sleep is not fully understood, though it is most likely due to their effects on levels of serotonin and natural sleep hormones. All classes of stimulants cause surges of adrenaline and dopamine that interfere with sleep. Though the reasons are different, all of these drugs and medications have the same result: people spend less time in REM sleep.
Lifestyle Changes
There are severalbehaviorsthat a person can practice to improve their REM sleep quality. Many of these can help with sleep in general. Some arenaturalways to improve REM sleep, while others are ways toavoid injuryduring an episode of REM sleep behavior disorder.
- Avoidconsumingalcoholandcaffeine
- Get plenty ofdaily exercise
- Sleep on the ground floor of an apartment building and away from windows, if possible
- Place a mattress on the floor and place cushions around the bed
- Place the bed against a wall or install guard rails
- Remove furniture with sharp corners and potentially dangerous objects from the bedroom
- Sleep in a separate room from bed partners until episodes have subsided
Treating REM Sleep Behavior Disorder and Co-Occurring Conditions
Frequently, RBD co-occurs with drug and alcohol addictions and othermental health conditions, such as depression and anxiety. Since these conditions can aggravate RBD, they need to be treated at the same time, which is a treatment approach known asdual-diagnosis care.
Thetreatmentfor these conditions may vary, and can include medications and psychotherapy. However, since certain medications, such as some classes of antidepressants, can make RBD symptoms — and ultimately depressive symptoms — worse, care must be taken to treat these other disorders in ways that do not worsen RBD.
Substance abuse can often lead to sleep disorders such as RBD. If you or a loved one are struggling with alcohol or drug dependence and poor sleep, specialized help is available.Contact The Recovery Village todayto learn about how our co-occurring disorders treatment can help you.
