Talking Sleep New AASM Clinical Practice Guideline: Management of REM Sleep Behavior Disorder
Feb 10, 2023
Dr. Michael Howell, a professor and vice chair for education at the University of Minnesota, dives into the new clinical practice guidelines for managing REM Sleep Behavior Disorder (RBD). He discusses the historical context of RBD and its links to neurodegenerative diseases. Key topics include innovative treatments like the voice-activated POSI pad and the importance of non-pharmacological strategies. Howell emphasizes the need for personalized care and ongoing communication between patients and providers for the best outcomes.
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Discovery of REM Sleep Behavior Disorder
- REM sleep behavior disorder (RBD) was discovered in humans in 1982 by Drs. Schenk Carlos and Mark Mahald along with Andrea Patterson.
- This discovery linked human RBD to the earlier observations of cats exhibiting dream enactment due to brainstem lesions.
Prevent Injury in RBD
- Prioritize bedroom safety and ask about weapons and vulnerabilities to prevent injury in RBD.
- Not all RBD patients require medication; watchful waiting is suitable if dream enactment is modest and not injurious.
Pharmacotherapy Updates for RBD
- Clonazepam and immediate-release melatonin remain conditional recommendations for RBD treatment.
- Rivastigmine, an acetylcholinesterase inhibitor, is newly recommended for RBD, especially with cognitive symptoms.
