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REM Sleep Behavior Disorder – Diagnosis & Treatment


Diagnosis


RBD is a disorder that can get worse over time. This can put you or your bed partner in danger. RBD also tends to be linked to other medical problems. You should seek a doctor’s advice if you suspect that you might have RBD.

The doctor will ask you about your medical history. Your family history may also provide important details. The doctor should do a full exam. This should include a neurologic exam. You may be asked to complete a sleep diary. This will monitor your progress before and after treatment. You may be asked to rate your sleep with the Epworth Sleepiness Scale. This will help show how your sleep is affecting your daily life. Be sure to inform the doctor of any past or present use of any of the following:
  • Drugs
  • Alcohol
  • Medications
Also tell the doctor if you have ever had any other sleep disorder. You may also need to see a neurologist.

Tests may be needed if your medical exam shows something abnormal. People with RBD are at risk for other sleep disorders. As a result, your doctor will likely have you take an overnight sleep study. This is called a polysomnogram. It charts your brain waves, heart beat, and breathing as you sleep. It also records how your arms and legs move. This shows if there are other disorders that are related to your sleep problems. Examples of these disorders include sleep apnea and periodic limb movement disorder. The best sleep study will also record your sleep on video. This will show if you get out of the bed and do anything unusual during the night.

Treatment


RBD tends to respond to treatment with medications. Clonazepam is often used. However, treatment also requires the following:
  • Bedroom safety precautions
    • Move objects away from the patient’s bedside. This includes night stands, lamps, or other objects that could cause injury.
    • Move the bed away from the window.
    • Place a large object such as a dresser in front of the window.
  • Maintain a normal total sleep time. Sleep deprivation will increase RBD. Monitor for any sleepiness.
  • Avoid certain medications and alcohol. They can cause or increase RBD.
  • Treat any and all other sleep disorders that will disrupt your sleep and increase RBD.
  • Undergo regular monitoring for any neurologic symptoms. This includes tremor or other Parkinson symptoms.