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.
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:
Interestingly, the glymphatic cleanrance occurs during the NREM sleep, and more specifically the NREM SWS sleep.[29][30][32] As seen previously, it is a sleep stage that decreases in normal aging.[30] So there is less glymphatic clearance and an increase in AB burden that will form the AB plaques.[32][29][30] Therefor, in AD sleep disturbances will amplify this phenomenon.
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]
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]
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]
Restless leg syndrome (RLS) is an overwhelming need to move the legs. This urge is sometimes accompanied by a tingling sensation in the legs. While these symptoms can occur during the day, they are most prevalent at night. RLS is often associated with certain health conditions, including ADHD and Parkinson’s disease, but the exact cause isn’t always known.
Get back to sleep when you wake up at night. Whether you have a sleep disorder or not, it’s normal to wake briefly during the night. If you’re having trouble getting back to sleep, try focusing on your breathing, meditating, or practicing another relaxation technique. Make a note of anything that’s worrying you and resolve to postpone worrying about it until the next day when it will be easier to resolve.
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]
Insomnias This type of sleep disorder involves the inability to fall asleep or stay asleep. MORE>>Hypersomnias Hypersomnias are a group of sleep disorders that causes a person to be excessively sleepy. People with a hypersomnia may fall asleep at times that are inconvenient or even dangerous, such as at work or while driving. MORE>>Sleep Related Breathing Disorders Sleep disorders that involve difficulty breathing during sleep are classified as sleep related breathing disorders. Obstructive sleep apnea is the most common disorder of this type, however there are a number of variations of sleep apnea. MORE>>Circadian Rhythm Sleep-Wake Disorders Conditions in which the sleep times are out of alignment. A patient with one of these disorders does not follow the normal sleep times at night. MORE>>Parasomnias Parasomnias are a group of sleep disorders that involve unwanted events or experiences that occur while you are falling asleep, sleeping or waking up. MORE>>Sleep Movement Disorders This classification of sleep disorders includes conditions that cause movement during or prior to sleep. These disorders can make it difficult to fall asleep or stay asleep, or to get restful sleep. MORE>>
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.
What to do: See your dentist for an exam. Bite problems are often a cause of bruxism, and it's a good idea to check for damage to your teeth. It's likely she'll suggest lifestyle changes, such as cutting out alcohol before bed. If you chew gum, stop -- the habitual chewing action can make it more likely you'll grind your teeth at night. Wearing a dental guard or splint at night is usually the next step for bruxism. Your dentist will fit you with a device that prevents your jaw from clenching. Other treatments include Botox injections to the jaw muscle, and a biofeedback device called Grindcare.
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