Melatonin effects in a patient with severe REM sleep behavior disorder: case report and theoretical considerations.
REM sleep behavior disorder (RBD) is so far a possibly underestimated yet well-described sleep disorder. Its major impact is the vigorous sleep behavior that often results in injuries to the patient himself or to people sleeping nearby. We treated a 64-year-old male with a clinically and polysomnographically confirmed diagnosis of RBD with 3 mg melatonin, which led to a significant reduction of motor activity during sleep, as measured by actigraphy (p < 0.0001 in all analyzed movement parameters), and a full clinical recovery over a 5-month treatment period. RBD phenomena gradually returned after melatonin administration was stopped. After 2 months' treatment, polysomnography showed no major changes except an increase of REM sleep (13 vs. 17% of sleep period time) and a better preservation of REM-sleep-associated muscle atonia. Our results suggest that melatonin might be able to reinforce REM sleep in RBD patients by enhancing its active inhibition of motor activity.
Kunz
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Department of Psychiatry, Freie Universität Berlin, Germany. dkunz@zedat.fu-berlin.de
Bes
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D006801:Humans; D008297:Male; D008550:Melatonin / Q000627:therapeutic use*; D008875:Middle Aged; D009043:Motor Activity / Q000502:physiology; D017286:Polysomnography; D012894:Sleep Stages; D012893:Sleep Wake Disorders / Q000188:drug therapy* / Q000523:psychology; D012895:Sleep, REM / Q000187:drug effects*
D008550:Melatonin