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.
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]
^ 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.
At the same time, it has been shown that memory consolidation in long-term memory (which depends on the hippocampus) occurs during NREM sleep.[29][33] This indicates that a decrease in the NREM sleep will result in less consolidation and therefore poorer memory performances in hippocampal-dependent long-term memory.[29][33] This drop in performance is one of the central symptoms of AD.[29]  
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]

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]
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.
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]
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]
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]
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.
Obstructive sleep apnea (OSA) affects around 4% of men and 2% of women in the United States.[63] In general, this disorder is more prevalent among men. However, this difference tends to diminish with age. Women experience the highest risk for OSA during pregnancy.[64] Also, they tend to report experiencing depression and insomnia in conjunction with obstructive sleep apnea.[65] In a meta-analysis of the various Asian countries, India and China present the highest prevalence of the disorder. Specifically, about 13.7% of the Indian population and 7% of Hong-Kong's population is estimated to have OSA. The two groups experience daytime OSA symptoms such as difficulties concentrating, mood swings, or high blood pressure,[66] at similar rates (prevalence of 3.5% and 3.57%, respectively).[63]
A systematic review states 7.6% of the general population experiences sleep paralysis at least once in their lifetime. Its prevalence among men is 15.9% while 18.9% of women experience it. When considering specific populations, 28.3% of students and 31.9% of psychiatric patients have experienced this phenomenon at least once in their lifetime. Of those psychiatric patients, 34.6% have panic disorder. Sleep paralysis in students is slightly more prevalent for those of Asian descent (39.9%) than other ethnicities (Hispanic: 34.5%, African descent: 31.4%, Caucasian 30.8%).[67]

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]


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]
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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