Melatonin therapy for REM sleep behavior disorder: A critical review of evidence

Ian R. McGrane, Jonathan G. Leung, Erik K. St. Louis, Bradley F. Boeve

Research output: Contribution to journalReview articlepeer-review

133 Scopus citations


Rapid eye movement (REM) sleep behavior disorder (RBD) is a parasomnia associated with dream enactment often involving violent or potentially injurious behaviors during REM sleep that is strongly associated with synucleinopathy neurodegeneration. Clonazepam has long been suggested as the first-line treatment option for RBD. However, evidence supporting melatonin therapy is expanding. Melatonin appears to be beneficial for the management of RBD with reductions in clinical behavioral outcomes and decrease in muscle tonicity during REM sleep. Melatonin also has a favorable safety and tolerability profile over clonazepam with limited potential for drug-drug interactions, an important consideration especially in elderly individuals with RBD receiving polypharmacy. Prospective clinical trials are necessary to establish the evidence basis for melatonin and clonazepam as RBD therapies.

Original languageEnglish
Pages (from-to)19-26
Number of pages8
JournalSleep Medicine
Issue number1
StatePublished - Jan 1 2015


  • Calmodulin
  • Drug therapy
  • Melatonin
  • Parasomnia
  • REM sleep behavior disorder


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