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.
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]
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.
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.

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]

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]
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]

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]

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]
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]
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.

^ Jump up to: a b c d e f g h i j k l m n o p q r s t u Walker, Matthew P.; Jagust, William J.; Winer, Joseph R.; Mander, Bryce A. (2016-08-01). "Sleep: A Novel Mechanistic Pathway, Biomarker, and Treatment Target in the Pathology of Alzheimer's Disease?". Trends in Neurosciences. 39 (8): 552–566. doi:10.1016/j.tins.2016.05.002. ISSN 0166-2236. PMID 27325209.

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]
As suggested by its name, PLMD is an involuntary movement disorder. (An older name, nocturnal myoclonus , is rarely used anymore.) People with this problem experience sudden, involuntary leg movements during the night, such as kicking or jerking. The difference between this and restless leg syndrome is that, unless the kicking wakes you up, you don't know you're doing it. You don't experience the tingling and discomfort that leads you to consciously move your legs, as with restless leg syndrome. At least 80 percent of people with restless leg syndrome have PLMD, but the reverse isn't true.
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