Melatonin: a safe and effective treatment for rem sleep disorder in an elderly patient - a case report
Year: 2023
Type: conference-paper
Study design: Case Report
Abstract: Introduction: REM sleep disorder is a parasomnia characterized by the loss of atonia during REM sleep, resulting in dream enactment behavior. It is commonly associated with dementia with Lewy bodies (DLB) and is prevalent in up to 90% of individuals with this condition. Treatment for REM sleep disorder typically involves a combination of antipsychotics and melatonin, which can regulate sleep and reduce symptoms. The aim is to report a case of using melatonin for REM sleep disorder in an elderly patient. This is a case report study. The information of this work was obtained through review of the medical record. Case report: A 87-years-old female with DLB. After 36 months of dementia onset, the patient experienced dysregulation of the sleep-wake cycle, with nocturnal awakenings, visual hallucinations, and vocalizations and complex motor behaviors during REM sleep. The patient was initially prescribed olanzapine 5 mg once a day, which led to three episodes of dysregulation per week. Clonazepam 0.5 mg was added to the treatment, in combination with environmental measures and maintenance treatment for DLB, resulting in two episodes per week. After three months, clonazepam was replaced by melatonin 3 mg, which led to a reduction in episodes to five per month. The dosage of melatonin was later increased to 6 mg, which reduced the frequency of dysregulation to three episodes per month. Olanzapine was eventually replaced by quetiapine 25 mg once daily, leading to only one episode per month. Conclusion: Melatonin was found to be effective in reducing agitation and other symptoms without causing any side effects in the patient. It is important for healthcare professionals to consider the use of melatonin in the treatment of REM sleep disorder, particularly in elderly patients.
Language: English
Topic: Sleep and related disorders
Subfield: Experimental and Cognitive Psychology
Field: Psychology
Domain: Social Sciences
Open Access status: gold
OpenAlex ID: W4383755311