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.
Narcolepsy is characterized by “sleep attacks” that occur during the day. This means that you will suddenly feel extremely tired and fall asleep without warning. The disorder can also cause sleep paralysis, which may make you physically unable to move right after waking up. Although narcolepsy may occur on its own, it is also associated with certain neurological disorders, such as multiple sclerosis.
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]
^ 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.
Fatigue during the first trimester of pregnancy is likely caused by changing levels of hormones, such as progesterone. Toward the end of pregnancy, some women find it difficult to sleep because of the uncomfortable size of their abdomen. Some women are too excited, anxious, or worried about becoming mothers to sleep well. Other women who are pregnant complain that vivid dreams prevent them from getting restful sleep. Sleep apnea, especially if it's severe and causes your blood oxygen level to drop during sleep, is a risk to the fetus.
What to do: See a doctor, who will likely first check you for underlying conditions related to PLMD. Diabetes, thyroid disorders, anemia, and a number of other conditions can cause PLMD. If you do have another condition, the doctor will treat it and see if the PLMD goes away. The next step is to control the involuntary movements with medication. Drugs that suppress muscle contractions work well for preventing PLMD. The doctor may also prescribe medication to help you sleep more deeply, with the idea of preventing the involuntary movements from keeping you in light sleep.

Recent studies, however, have shown that several factors can interrupt this neurogenesis.[29] These include stress and prolonged sleep deprivation (more than one day).[29] The sleep disturbances encountered in AD could therefore suppress neurogenesis and thus impairing hippocampal functions.[29] This would therefore contribute to diminished memory performances and the progression of AD.[29] And progression of AD would aggravate sleep disturbances.[29] It is a second vicious circle.  
Chronic sleep disorders in childhood, which affect some 70% of children with developmental or psychological disorders, are under-reported and under-treated. Sleep-phase disruption is also common among adolescents, whose school schedules are often incompatible with their natural circadian rhythm. Effective treatment begins with careful diagnosis using sleep diaries and perhaps sleep studies. Modifications in sleep hygiene may resolve the problem, but medical treatment is often warranted.[35]
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]
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]
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.

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]
^ 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.

One factors that could explain this change in sleep architecture is a change in circadian rhythm, which regulates sleep.[29] A disruption of the circadian rhythm would therefore generate sleep disturbances.[29] Some studies show that people with AD have a delayed circadian rhythm, whereas in normal aging we will find an advanced circadian rhythm.[29][31]


Fatigue during the first trimester of pregnancy is likely caused by changing levels of hormones, such as progesterone. Toward the end of pregnancy, some women find it difficult to sleep because of the uncomfortable size of their abdomen. Some women are too excited, anxious, or worried about becoming mothers to sleep well. Other women who are pregnant complain that vivid dreams prevent them from getting restful sleep. Sleep apnea, especially if it's severe and causes your blood oxygen level to drop during sleep, is a risk to the fetus.

Delayed sleep phase disorder is a condition where your biological clock is significantly delayed. As a result, you go to sleep and wake up much later than other people. This is more than just a preference for staying up late or being a night owl, but rather a disorder that makes it difficult for you to keep normal hours—to make it to morning classes, get the kids to school on time, or keep a 9-to-5 job.
Keep a pen and paper next to your bed. If you're often kept awake by racing thoughts and worries and you tend to make to-do lists in your head, keep a pen or pencil and a small pad of paper handy and write them down. As you put each item down on paper, imagine yourself setting aside that concern. (Again, use a book light; don't turn on the overhead or a bright bedside light to write.)
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