Article

Recent Reports in Treatment for REM Sleep Behavior Disorder in Traditional Chinese Medicine and Kampo in Japan

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Abstract

Objectives: This study was performed to review the research trends in treatment for REM sleep behavior disorder (RBD) in Traditional Chinese Medicine (TCM) and Kampo in Japan. Methods: We searched articles in CNKI (China National Knowledge Infrastructure) under the key words, "RBD", and Chinese words related with it in Traditional Chinese Medicine, Traditional Chinese Medicinal Herbs and Combination of Traditional Chinese Medicine With Western Medicine' field, and also in CiNii (Citation Information by NII); we also searched articles in Kampo Square in Japan under the key words, "RBD" and Japanese words related with it. We found 10 papers, and then selected 6 of them except the non-clinical and unrelated studies. We then analyzed their way of diagnosis, treatments, study type and etc.. Results: 6 studies were divided into 4 case reports, one control study, and one literature review study. All of the studies reported that Herbal medicine for RBD was effective as much as Western medicine like clonazepam and paroxetine. However, the quality and the quantity of these clinical studies were not enough. Conclusions: It seems that the researches for RBD have gradually been performed in TCM and Kampo. We hope that our study can activate/push forward clinical research for this disorder in Korean traditional medicine.

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Objectives: This study examined the case of a 69-year-old man with a history of stroke and Alzheimer’s disease who had been diagnosed with probable-rapid eye movement sleep behavior disorder (probable-RBD).Methods: The patient was treated with herbal medicine ( Ukgan-san, Ukgansangayonggolmoryeo-tang , and powdered Gamisoyo-san extract), Western medicine (clonazepam, antiplatelet, psychotropic agents, antihypertensive drugs, and others), and acupuncture. Their effects were evaluated by the frequency and severity of sleep-related behavioral symptoms.Results: After treatment, the observed frequency and severity of sleep-related behavior decreased.Conclusion: The results suggest that using traditional Korean medicine with clonazepam can be effective in the treatment of patients with probable-RBD.
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In the International Classification of Sleep Disorders(ICSD), REM sleep behavior disorder(RBD) and nightmares are classified as 'parasomnias usually associated with REM sleep'. RBD can be defined as the intermittent absence of REM sleep EMG atonia and the appearance of the elaborate motor activity associated with dream mentation. Bilateral pontine tegmental lesions in cats induce RBD-like behavior, but in human cases, more than 60% are idiopathic. Polysomnograpy shows characteristic findings in REM sleep and treatment with clonazepam is highly effective. With nightmares as long, frightening dream decreasing with age, their persistence or apperance in adults is related with certain drugs, trauma, personality and psychotic episode. Psychotherapy, behavior techniques or medication is used for treatment, but all of nightmares do not require treatment.
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