J Korean Neurol Assoc.  2021 May;39(2):68-74. 10.17340/jkna.2021.2.2.

Recent Update on Treatment and Management of Rapid Eye Movement Sleep Behavior Disorder

  • 1Department of Neurology, Kyung Hee University Hospital at Gangdong, Kyung Hee University School of Medicine, Seoul, Korea


Rapid eye movement sleep behavior disorder (RBD) is a parasomnia that is characterized by dream-enactment behavior, which can often result in sleep related injury. RBD is strongly associated with neurodegenerative disease especially with alpha-synucleinopathy. More than 70% of the patients convert to neurodegenerative disease including Parkinson’s disease or diffuse Lewy body dementia with a median period of 7.5 years. Treatment for RBD is currently focused on symptomatic treatment to prevent the injury. First step is establishing safe sleep environment to avoid injury. Clonazepam and melatonin are most commonly used medication for symptomatic treatment for RBD, however, well-designed randomized clinical trials are lacking. Prognostic counselling with longitudinal follow-up is also crucial in managing patients with RBD, which should be individualized for each patient with regular systematic follow-up evaluation.


REM sleep behavior disorder; Therapeutics; Clonazepam; Melatonin; Counseling
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