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.

A nocturnal movement disorder, restless leg syndrome can feel like itchiness, tingling, or prickling that makes you feel like you have to move your legs. Your legs may also move without your control while you sleep. You may or may not be aware of waking during the night, but restless leg syndrome causes sleep problems by preventing deep, restful sleep.


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.

A study that was resulted from a collaboration between Massachusetts General Hospital and Merck describes the development of an algorithm to identify patients will sleep disorders using electronic medical records. The algorithm that incorporated a combination of structured and unstructured variables identified more than 36,000 individuals with physician-documented insomnia.[62]


In Alzheimer's disease, in addition to cognitive decline and memory impairment, there is also significant sleep disturbances with a modified sleep architecture.[30][29] The latter may consist in sleep fragmentation, a reduction in sleep duration, insomnia, an increase daytime naping, a decreased quantity og some sleep stages and a resemblance between some sleep stages (N1 and N2).[29] More than 65% of people with Alzheimer's disease suffer from this type of sleep disturbance.[29]
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]

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.
Sleep dentistry (bruxism, snoring and sleep apnea), while not recognized as one of the nine dental specialties, qualifies for board-certification by the American Board of Dental Sleep Medicine (ABDSM). The resulting Diplomate status is recognized by the American Academy of Sleep Medicine (AASM), and these dentists are organized in the Academy of Dental Sleep Medicine (USA).[53] The qualified dentists collaborate with sleep physicians at accredited sleep centers and can provide oral appliance therapy and upper airway surgery to treat or manage sleep-related breathing disorders.[54]

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.


Keep a pen and paper next to your bed. If you're often kept awake by racing thoughts and worries and you tend to make to-do lists in your head, keep a pen or pencil and a small pad of paper handy and write them down. As you put each item down on paper, imagine yourself setting aside that concern. (Again, use a book light; don't turn on the overhead or a bright bedside light to write.)
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