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]
Some of the biggest differences between the 2nd and 3rd editions are how the various sleep disorders were divided into categories. The 2005 edition used 3 broad categories to organize all of the sleep disorders under either dysommnias (disorders making getting to sleep or staying asleep difficult), parasomnias (disorders that intrude into the sleep process), and sleep disorders associated with a mental, neurologic, or other medical disorders (disorders whose symptoms are not primary unto themselves but caused by other conditions).
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.
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]
In people who have restless legs syndrome, discomfort in the legs and feet peaks during the evening and night. They feel an urge to move their legs and feet to get temporary relief, often with excessive, rhythmic, or cyclic leg movements during sleep. This can delay sleep onset and cause brief awakening during sleep. Restless legs syndrome is a common problem among middle-aged and older adults.
The natural internal clock that controls our 24-hour cycle of sleep and waking, circadian rhythms are easily upset by changes in schedule, and they're greatly affected by light and darkness. Jet lag is the best known circadian rhythm disorder, but this sensitive inner clock can also be disrupted by changes in routine resulting in an erratic sleep schedule.
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