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.
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]
With over 80 listed sleep disorders, and more that are being researched, it's important for patients suffering from the various types of sleep disorders to seek medical treatment. If you believe that your sleep problems may be caused by a disorder, there are many things you can do to solve your sleep issues from DIY tips and tricks such as practicing better sleep hygiene, to contacting a sleep clinic to schedule an inlab sleep study, or an at home sleep test for certain pre-screened disorders such as obstructive sleep apnea.
Neurodegenerative diseases have been often associated with sleep disorders, mainly when they are characterized by abnormal accumulation of alpha-synuclein, such as multiple system atrophy (MSA), Parkinson's disease (PD) and Lewy body disease (LBD).[21][22][23][24][25][26][27] For instance, people diagnosed with PD have often presented different kinds of sleep concerns, commonly regard to insomnia (around 70% of the PD population), hypersomnia (more than 50% of the PD population), and REM sleep behavior disorder (RBD) - that may affect around 40% of the PD population and it is associated with increased motor symptoms.[21][22][23][24][25][27] Importantly, RBD has been also highlighted as a strong precursor of developing dementia in PD patients over several years in prior, which seems to be a great opportunity for improving the treatments of the disease.[22][24]
^ Jump up to: a b c Cao, Xiao-Lan; Wang, Shi-Bin; Zhong, Bao-Liang; Zhang, Ling; Ungvari, Gabor S.; Ng, Chee H.; Li, Lu; Chiu, Helen F. K.; Lok, Grace K. I. (2017-02-24). "The prevalence of insomnia in the general population in China: A meta-analysis". PLoS ONE. 12 (2): e0170772. doi:10.1371/journal.pone.0170772. ISSN 1932-6203. PMC 5325204. PMID 28234940.
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.
According to one meta-analysis, the mean prevalence rate for North America and Western Europe is estimated to be 14.5±8.0%. Specifically in the United States, the prevalence of restless leg syndrome is estimated to be between 5 and 15.7% when using strict diagnostic criteria. RLS is over 35% more prevalent in American women than their male counterparts.[68]

Specialists in Sleep Medicine were originally certified by the American Board of Sleep Medicine, which still recognizes specialists. Those passing the Sleep Medicine Specialty Exam received the designation "diplomate of the ABSM." Sleep Medicine is now a recognized subspecialty within internal medicine, family medicine, pediatrics, otolaryngology, psychiatry and neurology in the United States. Certification in Sleep Medicine shows that the specialist:


^ 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.
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.
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]
^ Jump up to: a b c Cao, Xiao-Lan; Wang, Shi-Bin; Zhong, Bao-Liang; Zhang, Ling; Ungvari, Gabor S.; Ng, Chee H.; Li, Lu; Chiu, Helen F. K.; Lok, Grace K. I. (2017-02-24). "The prevalence of insomnia in the general population in China: A meta-analysis". PLoS ONE. 12 (2): e0170772. doi:10.1371/journal.pone.0170772. ISSN 1932-6203. PMC 5325204. PMID 28234940.
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.
^ 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.
^ Jump up to: a b c Cao, Xiao-Lan; Wang, Shi-Bin; Zhong, Bao-Liang; Zhang, Ling; Ungvari, Gabor S.; Ng, Chee H.; Li, Lu; Chiu, Helen F. K.; Lok, Grace K. I. (2017-02-24). "The prevalence of insomnia in the general population in China: A meta-analysis". PLoS ONE. 12 (2): e0170772. doi:10.1371/journal.pone.0170772. ISSN 1932-6203. PMC 5325204. PMID 28234940.
^ Hirshkowitz, Max (2004). "Chapter 10, Neuropsychiatric Aspects of Sleep and Sleep Disorders (pp 315-340)" (Google Books preview includes entire chapter 10). In Stuart C. Yudofsky; Robert E. Hales (eds.). Essentials of neuropsychiatry and clinical neurosciences (4 ed.). Arlington, Virginia, USA: American Psychiatric Publishing. ISBN 978-1-58562-005-0. ...insomnia is a symptom. It is neither a disease nor a specific condition. (from p. 322)

Restless legs syndrome (RLS) is a sleep disorder that causes an almost irresistible urge to move your legs (or arms) at night. The urge to move occurs when you’re resting or lying down and is usually due to uncomfortable, tingly, aching, or creeping sensations. There are plenty of ways to help manage and relieve symptoms, though, including self-help remedies you can use at home.

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.
Idiopathic hypersomnia: a chronic neurological disease similar to narcolepsy in which there is an increased amount of fatigue and sleep during the day. Patients who suffer from idiopathic hypersomnia cannot obtain a healthy amount of sleep for a regular day of activities. This hinders the patients' ability to perform well, and patients have to deal with this for the rest of their lives.[15]
Research suggests that hypnosis may be helpful in alleviating some types and manifestations of sleep disorders in some patients.[41] "Acute and chronic insomnia often respond to relaxation and hypnotherapy approaches, along with sleep hygiene instructions."[42] Hypnotherapy has also helped with nightmares and sleep terrors. There are several reports of successful use of hypnotherapy for parasomnias[43][44] specifically for head and body rocking, bedwetting and sleepwalking.[45]
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]
Although more research should be done to increase the reliability of this method of treatment, research suggests that music therapy can improve sleep quality in acute and chronic sleep disorders. In one particular study, participants (18 years or older) who had experienced acute or chronic sleep disorders were put in a randomly controlled trial and their sleep efficiency (overall time asleep) was observed. In order to assess sleep quality, researchers used subjective measures (i.e. questionnaires) and objective measures (i.e. polysomnography). The results of the study suggest that music therapy did improve sleep quality in subjects with acute or chronic sleep disorders, however only when tested subjectively. Although these results are not fully conclusive and more research should be conducted, it still provides evidence that music therapy can be an effective treatment for sleep disorders.[47]
Sleep apnea, obstructive sleep apnea, obstruction of the airway during sleep, causing lack of sufficient deep sleep, often accompanied by snoring. Other forms of sleep apnea are less common.[10] Obstructive sleep apnea (OSA) is a medical disorder that is caused by repetitive collapse of the upper airway (back of the throat) during sleep. For the purposes of sleep studies, episodes of full upper airway collapse for at least ten seconds are called apneas[11]
The neurodegenerative conditions are commonly related to brain structures impairment, which might disrupt the states of sleep and wakefulness, circadian rhythm, motor or non motor functioning.[22][24] On the other hand, sleep disturbances are also frequently related to worsening patient's cognitive functioning, emotional state and quality of life.[24][27][28] Furthermore, these abnormal behavioural symptoms negatively contribute to overwhelming their relatives and caregivers.[24][27][28] Therefore, a deeper understanding of the relationship between sleep disorders and neurodegenerative diseases seems to be extremely important, mainly considering the limited research related to it and the increasing expectancy of life.[22][28]
According to one meta-analysis, the two most prevalent sleep disorders among children are confusional arousals and sleep walking.[57] An estimated 17.3% of kids between 3 and 13 years old experience confusional arousals.[57] About 17% of children sleep walk, with the disorder being more common among boys than girls.[57] The peak ages of sleep walking are from 8 to 12 years old.[57] A different systematic review offers a high range of prevalence rates of sleep bruxism for children. Between 15.29 and 38.6% of preschoolers grind their teeth at least one night a week. All but one of the included studies reports decreasing bruxist prevalence as age increased as well as a higher prevalence among boys than girls.[58]
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]
^ Tranah, Gregory J.; Blackwell, Terri; Stone, Katie L.; Ancoli‐Israel, Sonia; Paudel, Misti L.; Ensrud, Kristine E.; Cauley, Jane A.; Redline, Susan; Hillier, Teresa A. (2011). "Circadian activity rhythms and risk of incident dementia and mild cognitive impairment in older women". Annals of Neurology. 70 (5): 722–732. doi:10.1002/ana.22468. ISSN 1531-8249.
Delayed sleep phase disorder (DSPD), inability to awaken and fall asleep at socially acceptable times but no problem with sleep maintenance, a disorder of circadian rhythms. Other such disorders are advanced sleep phase disorder (ASPD), non-24-hour sleep–wake disorder (non-24) in the sighted or in the blind, and irregular sleep wake rhythm, all much less common than DSPD, as well as the situational shift work sleep disorder.[4]
What to do: Ask your doctor if your restless leg syndrome might be caused by another health condition or by a medication you're taking. Diabetes, arthritis, peripheral neuropathy, anemia, vitamin B deficiency, thyroid disease, and kidney problems can all contribute to restless leg syndrome. Medications that can cause restless leg syndrome as a side effect include antidepressants, antihistamines, and lithium. Treating the underlying condition or changing medications may banish the symptoms. Restless leg syndrome has been linked to deficiencies in iron and B vitamins, particularly folate, so talk to your doctor about boosting your intake of these nutrients.
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