Treatment of parasomnias

Alberto Ramos, MD, FAAN, University of Miami, Miller School of Medicine, Miami, FL, discusses the treatment options for parasomnias. Dr Ramos states that the utmost priority is that the patient is safe; parasomnias, by definition, are abnormal behaviors during sleep, which could ultimately cause harm. Therefore, it is vital to ensure that patients are in a safe and comfortable environment. Dr Ramos describes methods of ensuring safety by installing bed railings, lowering the bed to floor level, or removing potentially hazardous items and furniture that a patient could fall into. Concerning treatment for non-REM sleep parasomnias, the most common type of medication are benzodiazepines, particularly clonazepam. However, there have not been any randomized clinical trials showing that one medication is superior to the other, and treatment selection is based on observational and case-control studies. Dr Ramos states that the two primary medications utilized for REM sleep parasomnias are melatonin and clonazepam. These medications help minimize abnormal behaviors during sleep. This interview took place at the American Academy of Neurology 2022 Congress in Seattle, WA.