Aurora RN, Zak RS, Maganti RK. Best practice guide for the treatment of REM sleep behavior disorder. J Clin Sleep Med. 2010;6:85–95. [PMC free article] [Google Scholar] 6. McCarter SJ, Boswell CL, St Louis EK, et al. Treatment outcomes in REM sleep behavior disorder. Sleep Med. 2013;14:237–42. doi: 10.1016/j.sleep.2012.09.018. Gabapentin is considered highly effective for the treatment of insomnia for a few reasons. First and foremost, it improves sleep quality by reducing spontaneous arousal in the brain. It also increases total sleep time thanks to fewer awakenings and its ability to help individuals go to sleep faster. For a long time, numerous sleep alterations induced by nocturnal epilepsy have been described. Such alterations include sleep fragmentation, decrement of sleep efficiency, increment of the wake time after sleep onset (WASO), increment of light sleep, and decrement of sleep depth. On the other hand, Preliminary evidence indicates that gabapentin can attenuate insomnia, bolster sleep quality, and increase total sleep duration. Moreover, gabapentin has been shown to increase slow-wave sleep (SWS), promote sleep maintenance, and decrease unwanted awakenings throughout the night. Purpose: The older antiepileptic drugs (AEDs) have a variety of effects on sleep, including marked reduction in rapid-eye-movement (REM) sleep, slow-wave sleep (SWS), and sleep latency, and an increase in light sleep. The effects of the newer AEDs on sleep are unknown. Adults reporting occasional disturbed sleep received gabapentin 500 mg (n = 125), 250 mg (n = 125), or placebo (n = 127) 30 min prior to bedtime and were in bed from 17:00 to 01:00, ∼5 h before their habitual bedtime. Sleep was assessed by PSG, post-sleep questionnaire, and the Karolinska Sleep Diary (KSD). Some studies have found that gabapentin may increase slow-wave sleep, also known as deep sleep, which is crucial for physical restoration and cognitive function. Additionally, it may reduce sleep fragmentation, leading to fewer nighttime awakenings and improved sleep continuity. stage 1 sleep or one epoch of any other stage, in min-utes), sleep efficiency (SE; TST divided by time in bed, expressed as a percentage), REM latency (time from sleep onset to the first epoch of REM sleep, in minutes), percentage TST spent in nonREM stages 1, 2, and slow-wave sleep (SWS, stages 3 and 4 combined), and REM Research findings on gabapentin’s effects on REM sleep have yielded mixed results, highlighting the complexity of sleep pharmacology. Some studies have reported a reduction in REM sleep duration in patients taking gabapentin, while others have found no significant changes. Unlike some traditional sleep medications that can suppress REM sleep, gabapentin appears to have a more balanced effect on sleep architecture, potentially preserving the natural progression through sleep stages. When compared to conventional sleep aids like benzodiazepines or z-drugs, gabapentin offers some distinct advantages. REM sleep behavior disorder is classified as a parasomnia, a group of sleep disorders involving undesirable physical events or experiences that happen while falling asleep, sleeping, or waking from sleep. REM sleep is characterized by rapid eye movements and dream activity, and it normally involves skeletal paralysis. This paralysis — or fluence sleep by reducing seizures. The older antiepilep-tic drugs as a rule have no long lasting effects on sleep quality, but some can have negative effects, by REM sleep reduction and daytime sleepiness. Concerning newer antiepileptic drugs, Gabapentin can improve slow wave and REM sleep; Pregabaline also seems to show positive impact on sleep. Discussion. This study revealed that without consideration of the type of sleep outcomes, gabapentin was significantly superior to placebos for the treatment for sleep disorders secondary to RLS, neuropathic pain, alcohol dependence, hot flashes in menopause, fibromyalgia, phantom limb pain, HIV-associated sensory neuropathies, and bipolar disorder. Results: Polysomnographic study revealed increased sleep efficiency and slow-wave sleep, decreased wake after sleep onset, and spontaneous arousal index after gabapentin treatment. The biochemical blood test revealed decreased prolactin levels in the morning after treatment. Regarding the link between dreaming and neurophysiology, 60 years of debates has been necessary to get rid of the rapid eye movement (REM) sleep hypothesis of dreaming, and it is now acknowledged by a majority of dream researchers, be they neuroscientist or not, that REM sleep is neither necessary nor sufficient to get a dream report and that ment (REM) and slow-wave sleep (SWS), and most antidepres-sant medications (tricyclic antidepressants and selective serotonin reuptake inhibitors) also decrease REM sleep.7 This is potentially important because REM sleep and SWS are required for certain forms of learning.8 Furthermore, treatment with benzodiazepines Most studies show that gabapentin improves slow wave sleep (“deep sleep”) and total sleep time. Two small studies showed that gabapentin may help people with primary insomnia and occasional sleep disturbance improve total sleep time and wakefulness in the morning. Normalization of the percentage of REM sleep, a significant reduction of REM sleep without muscle atonia, a significant reduction of stage shifts in REM, and a significant reduction in epochs considered to be movement time in REM by PSG. III (NA) Takeuchi et al., 2001 : 15 PSG confirmed RBD patients treated with 3–9 mg/day of melatonin. Regardless the type of sleep outcomes, gabapentin showed stable efficacy in the treatment for sleep disturbance in patients with medical illness with a relatively high risk of treatment discontinuation and drug withdrawal when used at an average dose of approximately 1,800 mg/day. Daytime and nocturnal seizures fragment sleep, reducing the percentage of rapid-eye-movement (REM) sleep and slow-wave sleep (SWS) . Many of the older AEDs reduce the percentage of REM and SWS and increase arousals, awakenings, and stage shifts, suggesting a tendency for sleep fragmentation.
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