In the UK, knowledge of sleep medicine and possibilities for diagnosis and treatment seem to lag. Guardian.co.uk quotes the director of the Imperial College Healthcare Sleep Centre: "One problem is that there has been relatively little training in sleep medicine in this country – certainly there is no structured training for sleep physicians."[55] The Imperial College Healthcare site[56] shows attention to obstructive sleep apnea syndrome (OSA) and very few other sleep disorders. Some NHS trusts have specialist clinics for respiratory and/or neurological sleep medicine.
None of these general approaches is sufficient for all patients with sleep disorders. Rather, the choice of a specific treatment depends on the patient's diagnosis, medical and psychiatric history, and preferences, as well as the expertise of the treating clinician. Often, behavioral/psychotherapeutic and pharmacological approaches are not incompatible and can effectively be combined to maximize therapeutic benefits. Management of sleep disturbances that are secondary to mental, medical, or substance abuse disorders should focus on the underlying conditions.
Narcolepsy is a brain disorder that causes excessive daytime sleepiness. There is sometimes a genetic component, but most patients have no family history of the problem. Though dramatic and uncontrolled "sleep attacks" have been the best-known feature of narcolepsy, in reality many patients do not have sleep attacks. Instead, they experience constant sleepiness during the day.

Primary sleep disorders are most common in men and women over the age of 65. About half of the people claim to have some sleep problem at one point. It is most common in the elderly because of multiple factors. Factors include increased medication use, age-related changes in circadian rhythms, environmental and lifestyle changes [3] and pre diagnosed physiological problems and stress. The risk of developing sleep disorders in the elderly is especially increased for sleep disordered breathing, periodic limb movements, lestless legs syndrome, REM sleep behavior disorders, insomnia and circadian rhythm disturbances.[3]


According to one meta-analysis, the mean prevalence rate for North America and Western Europe is estimated to be 14.5±8.0%. Specifically in the United States, the prevalence of restless leg syndrome is estimated to be between 5 and 15.7% when using strict diagnostic criteria. RLS is over 35% more prevalent in American women than their male counterparts.[68]
According to one meta-analysis, the two most prevalent sleep disorders among children are confusional arousals and sleep walking.[57] An estimated 17.3% of kids between 3 and 13 years old experience confusional arousals.[57] About 17% of children sleep walk, with the disorder being more common among boys than girls.[57] The peak ages of sleep walking are from 8 to 12 years old.[57] A different systematic review offers a high range of prevalence rates of sleep bruxism for children. Between 15.29 and 38.6% of preschoolers grind their teeth at least one night a week. All but one of the included studies reports decreasing bruxist prevalence as age increased as well as a higher prevalence among boys than girls.[58]
What to do: Talk to experts about sleeplessness, and you'll be told to practice good "sleep hygiene." What this means is that you need to take your lack of sleep seriously and look at your sleep habits and physical surroundings to see what might be preventing you from sleeping well. Start with your evening habits: What do you do in the hours before bed? Eliminate late-night eating, drinking, and computer use and your chances of falling asleep quickly and sleeping soundly are much greater. Use the last hour before bed to do things that relax you, like taking a warm bath, meditating, or reading.

Combining results from 17 studies on insomnia in China, a pooled prevalence of 15.0% is reported for the country.[60] This is considerably lower than a series of Western countries (50.5% in Poland, 37.2% in France and Italy, 27.1% in USA).[60] However, the result is consistent among other East Asian countries. Men and women residing in China experience insomnia at similar rates.[60] A separate meta-analysis focusing on this sleeping disorder in the elderly mentions that those with more than one physical or psychiatric malady experience it at a 60% higher rate than those with one condition or less. It also notes a higher prevalence of insomnia in women over the age of 50 than their male counterparts.[61]

Frequently having trouble sleeping can be a frustrating and debilitating experience. You sleep badly at night, which leaves you feeling dead-tired in the morning and whatever energy you have quickly drains throughout the day. But then, no matter how exhausted you feel at night, you still have trouble sleeping. And so the cycle begins again, taking a serious toll on your mood, energy, efficiency, and ability to handle stress. Ignoring sleep problems and disorders can damage your physical health and lead to weight gain, car accidents, impaired job performance, memory problems, and strained relationships. If you want to feel your best, stay healthy, and perform up to your potential, quality sleep is a necessity, not a luxury.
Obstructive sleep apnea (OSA) affects around 4% of men and 2% of women in the United States.[63] In general, this disorder is more prevalent among men. However, this difference tends to diminish with age. Women experience the highest risk for OSA during pregnancy.[64] Also, they tend to report experiencing depression and insomnia in conjunction with obstructive sleep apnea.[65] In a meta-analysis of the various Asian countries, India and China present the highest prevalence of the disorder. Specifically, about 13.7% of the Indian population and 7% of Hong-Kong's population is estimated to have OSA. The two groups experience daytime OSA symptoms such as difficulties concentrating, mood swings, or high blood pressure,[66] at similar rates (prevalence of 3.5% and 3.57%, respectively).[63]

The decrease in the quantity and quality of the NREM SWS as well as the disturbances of sleep will therefore increase the AB plaques.[29][30] This will first take place at the hippocampus level, from which memory is dependent.[29][30] This will result in cell death at this level and will contribute to diminished memory performances and cognitive decline found in AD disease.[29]
Sleep apnea, obstructive sleep apnea, obstruction of the airway during sleep, causing lack of sufficient deep sleep, often accompanied by snoring. Other forms of sleep apnea are less common.[10] Obstructive sleep apnea (OSA) is a medical disorder that is caused by repetitive collapse of the upper airway (back of the throat) during sleep. For the purposes of sleep studies, episodes of full upper airway collapse for at least ten seconds are called apneas[11]

Both night terrors and sleepwalking arise during NREM sleep and occur most often in children between the ages of 3 and 5 years old. A night terror can be dramatic: Your child may wake up screaming, but unable to explain the fear. Sometimes children who have night terrors remember a frightening image, but often they remember nothing. Night terrors are often more frightening for parents than for their child. Sleepwalkers can perform a range of activities -- some potentially dangerous, like leaving the house -- while they continue to sleep.
Sleep disturbances have been also observed in Alzheimer's disease (AD), affecting about 45% of its population.[22][24][26] Moreover, when it is based on caregiver reports this percentage is even higher, about 70%.[28] As well as in PD population, insomnia and hypersomnia are frequently recognized in AD patients, which have been associated with accumulation of Beta-amyloid, circadian rhythm sleep disorders (CRSD) and melatonin alteration.[22][24][28] Additionally, changes in sleep architecture are observed in AD too.[22][24][26] Even though with ageing the sleep architecture seems to change naturally, in AD patients it is aggravated. SWS is potentially decreased (sometimes totally absent), spindles and the time spent in REM sleep are also reduced, while its latency is increased.[28] The poorly sleep onset in AD has been also associated with dream-related hallucination, increased restlessness, wandering and agitation, that seem to be related with sundowning - a typical chronological phenomenon presented in the disease.[24][28]
A population susceptible to the development of sleep disorders is people who have experienced a traumatic brain injury (TBI). Because many researchers have focused on this issue, a systematic review was conducted to synthesize their findings. According to their results, TBI individuals are most disproportionately at risk for developing narcolepsy, obstructive sleep apnea, excessive daytime sleepiness, and insomnia.[20] The study's complete findings can be found in the table below:
Women often experience sleepless nights and daytime fatigue in the first and third trimesters of their pregnancy. During the first trimester, frequent trips to the bathroom and morning sickness may disrupt sleep. Later in pregnancy, vivid dreams and physical discomfort may prevent deep sleep. After delivery, the new baby's care or the mother's postpartum depression may interrupt sleep.

There are many possible causes of restless legs syndrome, including kidney failure, nerve disorders, vitamin and iron deficiencies, pregnancy, and some medications (such as antidepressants). Recent studies have shown a strong genetic link and researchers have been able to isolate a gene that may be responsible for at least 40% of all cases of the disorder.
Combining results from 17 studies on insomnia in China, a pooled prevalence of 15.0% is reported for the country.[60] This is considerably lower than a series of Western countries (50.5% in Poland, 37.2% in France and Italy, 27.1% in USA).[60] However, the result is consistent among other East Asian countries. Men and women residing in China experience insomnia at similar rates.[60] A separate meta-analysis focusing on this sleeping disorder in the elderly mentions that those with more than one physical or psychiatric malady experience it at a 60% higher rate than those with one condition or less. It also notes a higher prevalence of insomnia in women over the age of 50 than their male counterparts.[61]
Both night terrors and sleepwalking arise during NREM sleep and occur most often in children between the ages of 3 and 5 years old. A night terror can be dramatic: Your child may wake up screaming, but unable to explain the fear. Sometimes children who have night terrors remember a frightening image, but often they remember nothing. Night terrors are often more frightening for parents than for their child. Sleepwalkers can perform a range of activities -- some potentially dangerous, like leaving the house -- while they continue to sleep.
In addition, an evidence-based synopses suggests that the sleep disorder, idiopathic REM sleep behavior disorder (iRBD), may have a hereditary component to it. A total of 632 participants, half with iRBD and half without, completed self-report questionnaires. The results of the study suggest that people with iRBD are more likely to report having a first-degree relative with the same sleep disorder than people of the same age and sex that do not have the disorder.[19] More research needs to be conducted to gain further information about the hereditary nature of sleep disorders.
Frequently having trouble sleeping can be a frustrating and debilitating experience. You sleep badly at night, which leaves you feeling dead-tired in the morning and whatever energy you have quickly drains throughout the day. But then, no matter how exhausted you feel at night, you still have trouble sleeping. And so the cycle begins again, taking a serious toll on your mood, energy, efficiency, and ability to handle stress. Ignoring sleep problems and disorders can damage your physical health and lead to weight gain, car accidents, impaired job performance, memory problems, and strained relationships. If you want to feel your best, stay healthy, and perform up to your potential, quality sleep is a necessity, not a luxury.
"has demonstrated expertise in the diagnosis and management of clinical conditions that occur during sleep, that disturb sleep, or that are affected by disturbances in the wake-sleep cycle. This specialist is skilled in the analysis and interpretation of comprehensive polysomnography, and well-versed in emerging research and management of a sleep laboratory."[51]
Obstructive sleep apnea (OSA) affects around 4% of men and 2% of women in the United States.[63] In general, this disorder is more prevalent among men. However, this difference tends to diminish with age. Women experience the highest risk for OSA during pregnancy.[64] Also, they tend to report experiencing depression and insomnia in conjunction with obstructive sleep apnea.[65] In a meta-analysis of the various Asian countries, India and China present the highest prevalence of the disorder. Specifically, about 13.7% of the Indian population and 7% of Hong-Kong's population is estimated to have OSA. The two groups experience daytime OSA symptoms such as difficulties concentrating, mood swings, or high blood pressure,[66] at similar rates (prevalence of 3.5% and 3.57%, respectively).[63]
Waking up in the middle of the night to use the bathroom is such a common problem it has a name: nocturia . As we get older, our bodies' ability to hold fluids for long periods decreases, thanks to a decline in antidiuretic hormones. According to the National Sleep Foundation, 65 percent of older adults have sleep deprivation resulting from waking up frequently to use the bathroom.
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