Clonazepam (Klonopin) is highly effective in the treatment of REM sleep behavior disorder (RBD), relieving symptoms in nearly 90% of patients with little evidence of tolerance or abuse. The response usually begins within the first week, often on the first night. The initial dose is 0.5 mg at bedtime, with some persons requiring a rapid increase to 1 mg. After years of continued treatment, moderate limb twitching with sleep talking and more complex behaviors can reemerge. The treatment should be continued for as long as your doctor says. If you decide to stop, the medicine should be slowly tapered, watching for signs of withdrawal such as nightmares or agitation.
Other drugs, such as tricyclic antidepressants, may be effective in some persons with RBD. However, tricyclics are also known to precipitate RBD in some patients.
Karen D.' s husband was not sleeping well. Every night after he settled into bed, Karen would start to snore -- loudly and all night long.
"My husband had been complaining for years about my snoring, and it was getting worse," says Karen, of Boston. "Even when I went away with my girlfriends, no one wanted to share a room with me."
While Karen's snoring was keeping everyone within earshot awake, it was also affecting her own sleep. For as long as she could remember, the Bostonian lumbered through...