Melatonin Effects in a Patient with Severe REM Sleep Behavior Disorder: Case Report and Theoretical Considerations

Kunz, Dieter; Bes, Frédérik

doi:10.1159/000119383

Cited by 77 publications

(54 citation statements)

References 6 publications

(6 reference statements)

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“…This benefit has been reported in one case report [Kunz and Bes, 1997], two open-label prospective case series of patients with RBD [Takeuchi et al 2001;Kunz and Bes, 1999] and two retrospective case series [Anderson and Shneerson, 2009;Boeve et al 2003]. Taken together, these reports include a total of 38 patients.…”

Section: Melatonin As a Therapeutic Agent In Parkinson's Diseasementioning

confidence: 80%

Therapeutic potential of melatonin and its analogs in Parkinson’s disease: focus on sleep and neuroprotection

Srinivasan¹,

Cardinali

Srinivasan

et al. 2011

Ther Adv Neurol Disord

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Sleep disorders constitute major nonmotor features of Parkinson's disease (PD) that have a substantial effect on patients' quality of life and can be related to the progression of the neurodegenerative disease. They can also serve as preclinical markers for PD, as it is the case for rapid eye movement (REM)-associated sleep behavior disorder (RBD). Although the etiology of sleep disorders in PD remains undefined, the assessment of the components of the circadian system, including melatonin secretion, could give therapeutically valuable insight on their pathophysiopathology. Melatonin is a regulator of the sleep/wake cycle and also acts as an effective antioxidant and mitochondrial function protector. A reduction in the expression of melatonin MT 1 and MT 2 receptors has been documented in the substantia nigra of PD patients. The efficacy of melatonin for preventing neuronal cell death and for ameliorating PD symptoms has been demonstrated in animal models of PD employing neurotoxins. A small number of controlled trials indicate that melatonin is useful in treating disturbed sleep in PD, in particular RBD. Whether melatonin and the recently developed melatonergic agents (ramelteon, tasimelteon, agomelatine) have therapeutic potential in PD is also discussed.

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Section: Melatonin As a Therapeutic Agent In Parkinson's Diseasementioning

confidence: 80%

Therapeutic potential of melatonin and its analogs in Parkinson’s disease: focus on sleep and neuroprotection

Srinivasan¹,

Cardinali

Srinivasan

et al. 2011

Ther Adv Neurol Disord

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“…It has already been shown that cholinergic neurons in the pedunculopontine nucleus and the laterodorsal tegmental nucleus have important roles both in sleep and motor control (Garcia-Rill 1991). Kunz and Bes, in 1997, reported a 64-year-old man with severe sleep difficulties due to a rapid eye movement (REM) sleep behaviour disorder. These individuals have a loss of REM-associated atonia which results in vigorous sleep behaviour and frequently in bodily injuries.…”

Section: Discussionmentioning

confidence: 99%

Melatonin treatment of non‐epileptic myoclonus in children

Jan¹,

Connolly

Hamilton

et al. 1999

Develop Med Child Neuro

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Oral melatonin (MLT) has been used by our Vancouver research group in the treatment of paediatric sleep disorders since 1991; slightly over 200 children, mainly with multiple disabilities, who frequently had seizures, have been treated. Three children with markedly delayed sleep onset due to recurring myoclonus were also referred for MLT treatment: two had non‐epileptic, and one had epileptic and non‐epileptic myoclonus. Low doses of oral MLT (3 to 5 mg) unexpectedly abolished their myoclonus and allowed them to sleep. There were no adverse effects. It appears that certain types of myoclonus, which might be resistant to conventional anticonvulsant medications, may respond to MLT but the mechanism of action is unclear. Further research on this novel treatment is urgently needed.

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“…However, it is associated with a number of adverse reactions, especially in older patients. Beneficial effects of melatonin in the treatment of RBD were for the first time described in 1997 [5]. The aim of this article is to describe the case of a patient who received such treatment.…”

Section: Purposementioning

confidence: 99%

“…Lek ten jest jednak obarczony szeregiem działań niepożądanych, zwłaszcza w grupie pacjentów starszych. W 1997 r. po raz pierwszy opisano korzystne działanie melatoniny w terapii RBD [5]. Celem artykułu jest opisanie przypadku pacjenta, który otrzymał takie leczenie.…”

Section: Celunclassified

REM behaviour sleep disorder – case study

Wierzbicka¹,

Szaulińska²,

Poradowska³

et al. 2017

ppn

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Purpose: REM behaviour sleep disorder (RBD) is a parasomnia and involves sudden movements and/or vocalizations that reflect the dream content. This disorder is a common symptom of neurodegenerative diseases or their prodromal symptom. Until recently, clonazepam was the most commonly used drug to relieve symptoms of RBD. The aim of the article is to describe successful RBD treatment with melatonin. Case description: A case of a 56-year-old man with a history of symptoms characteristic for RBD was presented. The initial diagnosis was confirmed by video-polysomnography in the course of which clinical episodes and periods of muscle atonia during REM sleep were recorded. The cause of RBD was not identified, an idiopathic form of the disorder was diagnosed. Melatonin was used for treatment in the target dose of 5 mg/day with a satisfactory result. Due to an increased risk of a neurodegenerative disease, the patient remained under care of a neurologist. Comment: Due to more frequently reported effectiveness of melatonin in RBD treatment with a low risk of adverse reactions and interactions with other drugs, it is worth considering its use before the decision to administer clonazepam, especially in the elderly. Key words: REM behaviour sleep disorders, melatonin, polysomnography. StreszczenieCel: Zaburzenia zachowania w czasie snu REM (RBD) należą do parasomnii i mają charakter gwałtownych ruchów i/lub wokalizacji, odzwierciedlających treść marzeń sennych. Zaburzenie to jest częstym objawem chorób neurozwyrodnieniowych lub ich objawem prodromalnym. Najczęściej stosowanym lekiem łagodzącym RBD był do niedawna klonazepam. Celem artykułu jest opis skutecznego leczenia RBD melatoniną. Opis przypadku: Przedstawiono przypadek 56-letniego mężczyzny z wywiadem objawów charakterystycznych dla RBD. Wstępne rozpoznanie potwierdzono badaniem polisomnograficznym z rejestracją wideo, w którym zarejestrowano epizody kliniczne oraz okresy atonii mięśniowej podczas snu REM. Nie ustalono przyczyny RBD, rozpoznano postać idiopatyczną zaburzenia. Zastosowano leczenie melatoniną w dawce docelowej 5 mg/dobę z zadowalającym efektem. W związku ze zwiększonym ryzykiem zachorowania na chorobę neurozwyrodnieniową pacjent pozostał pod opieką neurologa.Komentarz: Ze względu na coraz częściej opisywaną skuteczność melatoniny w leczeniu RBD, przy niskim ryzyku działań niepożą-danych i interakcji z innymi lekami, warto rozważać jej zastosowanie przed podjęciem decyzji o podawaniu klonazepamu, zwłaszcza u osób starszych. Słowa kluczowe: zaburzenia zachowania w czasie snu REM, melatonina, polisomnografia.

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Melatonin Effects in a Patient with Severe REM Sleep Behavior Disorder: Case Report and Theoretical Considerations

Cited by 77 publications

References 6 publications

Therapeutic potential of melatonin and its analogs in Parkinson’s disease: focus on sleep and neuroprotection

Therapeutic potential of melatonin and its analogs in Parkinson’s disease: focus on sleep and neuroprotection

Melatonin treatment of non‐epileptic myoclonus in children

REM behaviour sleep disorder – case study

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