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.


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 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]
^ Keckeis, Marietta; Lattova, Zuzana; Maurovich-Horvat, Eszter; Beitinger, Pierre A.; Birkmann, Steffen; Lauer, Christoph J.; Wetter, Thomas C.; Wilde-Frenz, Johanna; Pollmächer, Thomas (2010). Finkelstein, David (ed.). "Impaired Glucose Tolerance in Sleep Disorders". PLoS ONE. 5 (3): e9444. doi:10.1371/journal.pone.0009444. PMC 2830474. PMID 20209158.

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.
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]
Apnea means "no airflow." Obstructive sleep apnea was thought to be a disorder primarily of overweight, older men. But abnormal breathing during sleep can affect people of any age, any weight, and either sex. Researchers now know that in many cases of sleep apnea, the obstruction in the airways is only partial. Most people with sleep apnea have a smaller-than-normal inner throat and other subtle bone and soft-tissue differences.
Even if you’ve struggled with sleep problems for so long that it seems normal, you can still learn to sleep better. You can start by tracking your symptoms and sleep patterns, and then making healthy changes to your daytime habits and bedtime routine. If self-help doesn’t do the trick, you can turn to sleep specialists who are trained in sleep medicine. Together, you can identify the underlying causes of your sleeping problem and find ways to improve your sleep and quality of life.
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.
The most common sleep disorder is insomnia.[2] Others are sleep apnea, narcolepsy and hypersomnia (excessive sleepiness at inappropriate times), sleeping sickness (disruption of sleep cycle due to infection), sleepwalking, and night terrors. Management of sleep disturbances that are secondary to mental, medical, or substance abuse disorders should focus on the underlying conditions.
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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