REM sleep

[Spurdog1]

What is the recommended medication for the above nowadays?

[ChrisColumbus]

Unfortunately Melatonin *can* exacerbate RLS and Clonazepam can lead to daytime sleepiness etc .. perhaps Joolsg, Sue Johnson or others will have other advice...

Current Mayo Clinic advice: "Melatonin may be as effective as clonazepam and is usually well-tolerated with few side effects. Clonazepam (Klonopin). This prescription medication, often used to treat anxiety, is also the traditional choice for treating REM sleep behavior disorder, appearing to effectively reduce symptoms. Clonazepam may cause side effects such as daytime sleepiness, decreased balance and worsening of sleep apnea."

'Treatment of REM Sleep Behavior Disorder' by Youngsin Jung et al. 2016: "Melatonin dosed 3-12 mg at bedtime should be considered as the first-line therapy, followed by clonazepam 0.25-2.0 mg at bedtime if initial melatonin is judged ineffective or intolerable. However, neither agent is likely to completely stop dream enactment behaviors, so choosing a moderate target dosage of melatonin 6 mg or clonazepam 0.5 mg, or the highest tolerable dosage that reduces attack frequency and avoids adverse effects from overtreatment, is currently the most reasonable strategy."