Sleep disorders are a group of conditions that affect the ability to sleep well on a regular basis. Whether they are caused by a health problem or by too much stress, sleep disorders are becoming increasingly common in the United States. In fact, more than 75 percent of Americans between ages 20 and 59 report having sleeping difficulties fairly regularly.
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]
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]
Although we do not know the causual relationship, we know that the more the AD progresses, the more we find sleep disorders.[29] In the same way, the more sleep disorders there are, the more the disease progresses, forming a vicious circle.[29] Taken this into account, sleep disturbances are no longer a symptom of AD and relationship between sleep disturbances and AD is bidirectional.[30]
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]

Interestingly, the glymphatic cleanrance occurs during the NREM sleep, and more specifically the NREM SWS sleep.[29][30][32] As seen previously, it is a sleep stage that decreases in normal aging.[30] So there is less glymphatic clearance and an increase in AB burden that will form the AB plaques.[32][29][30] Therefor, in AD sleep disturbances will amplify this phenomenon.
On the other hand, it is during sleep that beta-amyloid residues are degraded to prevent plaque formation.[29][30][32] It is the glymphatic system that is responsible for this and this phenomenon is called glymphatic clearance.[29][30][32] Thus, during wakefulness, the AB burden is greater because the metabolic activity and oxidative stress are higher and there is no degradation of the protein by the glymphatic clearance whereas during sleep, the burden will be smaller as there will be less metabolic activity and oxidative stress in addition to the glymphatic clearance that occurs at this time.[30][29]
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]
In addressing sleep disorders and possible solutions, there is often a lot of buzz surrounding melatonin. Research suggests that melatonin is useful in helping people to fall asleep faster (decreased sleep latency), to stay asleep longer, and to experience improved sleep quality. In order to test this, a study was conducted that compared subjects that had taken Melatonin to subjects that had taken a placebo pill in subjects with primary sleep disorders. Researchers assessed sleep onset latency, total minutes slept, and overall sleep quality in the Melatonin and placebo groups to note the differences. In the end, researchers found that melatonin decreased sleep onset latency, increased total sleep time, and improved quality of sleep significantly more than the placebo group.[49][50]
Due to rapidly increasing knowledge about sleep in the 20th century, including the discovery of REM sleep in the 1950s and circadian rhythm disorders in the 70s and 80s, the medical importance of sleep was recognized. The medical community began paying more attention than previously to primary sleep disorders, such as sleep apnea, as well as the role and quality of sleep in other conditions. By the 1970s in the US, clinics and laboratories devoted to the study of sleep and sleep disorders had been founded, and a need for standards arose.
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]
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.
Sort of a milder cousin of sleep apnea, UARS occurs when some type of resistance slows or blocks air in the nasal passages. The most common causes are mild nasal congestion or a tongue position during sleep that blocks breathing. Because the resistance makes it harder work simply to breathe, your body is half-waking up over and over again during the night, so you don't feel refreshed in the morning.
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