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PD – Multifactorial Sleep — SCE Neurology MCQ

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HardSleep DisordersPD – Multifactorial SleepSCE Neurology

A 76-year-old with Parkinson disease has injurious dream enactment despite environmental safety measures. He has recurrent nocturnal falls, takes several sedating medicines and has coexisting obstructive sleep apnoea. Which pharmacological approach is most appropriate to discuss first with his specialist?

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Correct answer: D — A cautious trial of melatonin while reviewing sedatives and optimising sleep-apnoea treatment

In an older person with falls, sedative burden and obstructive sleep apnoea, melatonin is often the safer pharmacological option for REM sleep behaviour disorder. Clonazepam can be effective but may worsen falls, cognition and sleep-disordered breathing.

Reference: NICE NG71, Parkinson’s disease in adults: https://www.nice.org.uk/guidance/ng71/chapter/Recommendations