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]
Interestingly, it has been shown that the sleep-wake cycle acts on the beta-amyloid burden which is a central component found in AD.[29][30] Indeed, during waking, the production of beta-amyloid protein will be more consistent than during sleep.[29][30][32] This is explained by two phenomena. The first is that the metabolic activity will be higher during waking and thus will secrete more beta-amyloid protein.[29][30] The second is that oxidative stress will also be higher and lead to increased AB production.[29][30]
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.
Ask your doctor for a referral to an ear, nose, and throat (ENT) specialist, who can evaluate whether you're a candidate for Continuous Positive Airway Pressure (CPAP), a specially designed nasal mask that prevents your nasal passages from collapsing and delivers air directly into your airway. If tongue position during sleep is causing your UARS, the doctor may recommend a dental device that pushes the jaw and tongue forward and prevents the tongue from blocking the opening to the throat.
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:
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.
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.

Histamine plays a role in wakefulness in the brain. An allergic reaction over produces histamine causing wakefulness and inhibiting sleep[37] Sleep problems are common in people with allergic rhinitis. A study from the N.I.H. found that sleep is dramatically impaired by allergic symptoms and that the degree of impairment is related to the severity of those symptoms [2]s[38] Treatment of allergies has also been shown to help sleep apnea.[39]
Sleep apnea is a common (and treatable) sleep disorder in which your breathing temporarily stops during sleep, awakening you frequently. If you have sleep apnea you may not remember these awakenings, but you’ll likely feel exhausted during the day, irritable and depressed, or see a decrease in your productivity. Sleep apnea is a serious and potentially life-threatening sleep disorder, so see a doctor right away and learn how to help yourself.
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]
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 review of the evidence in 2012 concluded that current research is not rigorous enough to make recommendations around the use of acupuncture for insomnia.[40] The pooled results of two trials on acupuncture showed a moderate likelihood that there may be some improvement to sleep quality for individuals with a diagnosis insomnia.[40]:15 This form of treatment for sleep disorders is generally studied in adults, rather than children. Further research would be needed to study the effects of acupuncture on sleep disorders in children.


Competence in sleep medicine requires an understanding of a myriad of very diverse disorders, many of which present with similar symptoms such as excessive daytime sleepiness, which, in the absence of volitional sleep deprivation, "is almost inevitably caused by an identifiable and treatable sleep disorder", such as sleep apnea, narcolepsy, idiopathic hypersomnia, Kleine–Levin syndrome, menstrual-related hypersomnia, idiopathic recurrent stupor, or circadian rhythm disturbances.[52] Another common complaint is insomnia, a set of symptoms which can have a great many different causes, physical and mental. Management in the varying situations differs greatly and cannot be undertaken without a correct diagnosis.[citation needed]
What to do: If you suspect you have a circadian rhythm disorder, take steps to get your body onto a regular sleep schedule. Choose a bedtime and wake-up time that work for you, and follow the same routine each day, even on weekends. This can be tough for those who have to get up early during the week but like to stay up later on weekends, but do your best to craft a compromise between your work week and weekend habits. The important thing is to avoid the trap of sleeping from 10 p.m. to 6 a.m. during the week, then suddenly shifting to late nights and late mornings on the weekends. This will inevitably leave you with insomnia on Sunday night, which in turn sets you up to start the week exhausted on Monday morning.
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