I have REM behavioral sleep disorder It is very

Patient

Q: I have REM behavioral sleep disorder. It is very scary bc I have two small children that sleep with me sometimes. My dr out me on 1mg klonopin, but it doesn't seem to be working. What else can I do?

Doctor

A:   Hi.
Thanks for your query.
Read and understood your problem.
I checked understand how scary this disorder is.

As the medicines for this disorder are prescription based, you will have to talk to your Doctor for alteration of dosage and /or change over to another ones.

If you please tell me the exact symptoms, I may be in a position to suggest additional therapy. Please provide me with the details.

Awaiting for yours.

Comments / Follow Ups

Patient: S/s include talking/yelling in sleep. Sitting up in bed. Crying. Punching and kicking. It is as if I act out my dreams. If my dreams are about physical fighting (which most are, for some reason), then I physically act out the fight in my sleep. It always wakes me up. When I was younger I would also sleep walk and talk. I also remember hitting the wall once. I was probably about 10yrs old at that time. The 1mg klonopin hs just isn't working. I was wondering about adding melatonin? Can I take both? My reg dr is who prescribed the klonopin.
Doctor: Thanks for your feedback.
Since the duration of your problem is long, just Klonopin alone may not work.
Melatonin may work, but again this is a prescription medicine and your Doctor need to prescribe. You may please discuss this with your Registered Doctor as whether these two can be taken together or not is a decision that your Doctor has to take. There are conflicting reports about this combination.
So we have to go by the expert's opinion. Your Doctor takes into account the whole history you must have shared with Him.

As also you must be aware that the medical therapy may need continuous taking, no interruptions to be done as the recurrence rate is very high if the medicines are stooped.

Another most important aspect is your safety as per the history you have just given. Simple safety measures are always missed out/forgotten/ left unattended.
For example: padding the floor, keeping bedroom without the objects that can be a cause of trauma, never to latch the door, Not allowing kinds to sleep with or get separated the moment they are slept and use your own bed, bed railing or even more preferable is to sleep on the floor.
These are apparently small but most important things to do.
Let the kids never see what the Mother does through, they are very tender mentally.

Getting the evaluation and investigations and treatment at the super-specialty centers with the Doctors well trained into sleep disorders is the best way. They know the recent advances, can decide the best one for you on personalized basis.

Take care.
Have great time ahead and healthy life.



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