MELATONIN EFFECTS IN A PATIENT WITH SEVERE REM-SLEEP BEHAVIOR DISORDER - CASE-REPORT AND THEORETICAL CONSIDERATIONS

REM sleep behavior disorder (RED) is so far a possibly underestimated yet well-described sleep disorder. Its major impact is the vigorous sl eep behavior that often results in injuries to the patient himself or to people sleeping nearby. We treated a 64-year-old male with a clinic ally and polysomnographically confirmed diagnosis of RED with 3 mg mel atonin, which led to a significant reduction of motor activity during sleep, as measured by actigraphy (p < 0.0001 in all analyzed movement parameters), and a full clinical recovery over a 5-month treatment per iod. RED phenomena gradually returned after melatonin administration w as stopped. After 2 months' treatment, polysomnography showed no major changes except an increase of REM sleep (13 vs. 17% of sleep period t ime) and a better preservation of REM-sleep-associated muscle atonia. Our results suggest that melatonin might be able to reinforce REM slee p in RED patients by enhancing its active inhibition of motor activity .