0704 A PSG Study of the Effect of Clonazepam and Melatonin on REM Sleep without Atonia in Isolated REM Sleep Behavior Disorder

Abstract Introduction Although very few prospective clinical trials are available assessing the benefits of drugs in isolated REM sleep behavior disorder (iRBD), clonazepam and melatonin considered as first-line treatment options. However, while evidence supporting efficacy these two compounds on behavioral outcomes seems to be clear, it is not clear if they able significantly modify main polysomnographic (PSG) feature iRBD, i.e. without atonia (RSWA). For this reason, we carried-out an observational cross-sectional retrospective PSG study effects RSWA. Methods A total 83 iRBD patients (70 males 13 females, age range 50.9-83.2 years) were enrolled study: 43 drug-free, 21 taking at bedtime chronically (>6 months) (0.5-2 mg), seven extended-release alone (2-3 12 a combination (same doses above). studies assessed for all subjects, including measurement automatic index (RAI) periodic leg movements during sleep, well series demographic variables, such age, onset, disease duration, global impression scale (severity improvement), mini-mental state evaluation, RBD severity scale. Results None showed significant differences between groups considered. All low average values RAI, expected, there no clonazepam, melatonin, or them (drug-free 0.778±0.184, 0.797±0.183, clonazepam+melatonin 0.692±0.224, 0.673±0.228; ANOVA F = 1.329, p 0.271), despite scale-improvement was reported “much improved” “minimally treated patients. Conclusion This confirms our previous findings smaller patient only suggest that both might beneficial some manifestations but unable its underlying neurophysiology. also indicate agents do seem interfere with core mechanisms other modifying need discovered iRBD. Support (if any)