One factors that could explain this change in sleep architecture is a change in circadian rhythm, which regulates sleep. A disruption of the circadian rhythm would therefore generate sleep disturbances. Some studies show that people with AD have a delayed circadian rhythm, whereas in normal aging we will find an advanced circadian rhythm.
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.
In people who have restless legs syndrome, discomfort in the legs and feet peaks during the evening and night. They feel an urge to move their legs and feet to get temporary relief, often with excessive, rhythmic, or cyclic leg movements during sleep. This can delay sleep onset and cause brief awakening during sleep. Restless legs syndrome is a common problem among middle-aged and older adults.
^ 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)
Due to rapidly increasing knowledge about sleep in the 20th century, including the discovery of REM sleep in the 1950s and circadian rhythm disorders in the 70s and 80s, the medical importance of sleep was recognized. The medical community began paying more attention than previously to primary sleep disorders, such as sleep apnea, as well as the role and quality of sleep in other conditions. By the 1970s in the US, clinics and laboratories devoted to the study of sleep and sleep disorders had been founded, and a need for standards arose.
Obstructive sleep apnea (OSA) affects around 4% of men and 2% of women in the United States. 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. Also, they tend to report experiencing depression and insomnia in conjunction with obstructive sleep apnea. 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, at similar rates (prevalence of 3.5% and 3.57%, respectively).
On the other hand, it is during sleep that beta-amyloid residues are degraded to prevent plaque formation. It is the glymphatic system that is responsible for this and this phenomenon is called glymphatic clearance. Thus, during wakefulness, the AB burden is greater because the metabolic activity and oxidative stress are higher and there is no degradation of the protein by the glymphatic clearance whereas during sleep, the burden will be smaller as there will be less metabolic activity and oxidative stress in addition to the glymphatic clearance that occurs at this time.
Recent studies, however, have shown that several factors can interrupt this neurogenesis. These include stress and prolonged sleep deprivation (more than one day). The sleep disturbances encountered in AD could therefore suppress neurogenesis and thus impairing hippocampal functions. This would therefore contribute to diminished memory performances and the progression of AD. And progression of AD would aggravate sleep disturbances. It is a second vicious circle.
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.
A review of the evidence in 2012 concluded that current research is not rigorous enough to make recommendations around the use of acupuncture for insomnia. The pooled results of two trials on acupuncture showed a moderate likelihood that there may be some improvement to sleep quality for individuals with a diagnosis insomnia.:15 This form of treatment for sleep disorders is generally studied in adults, rather than children. Further research would be needed to study the effects of acupuncture on sleep disorders in children.
The effects of sleep disorders can be so disruptive that you will likely want immediate relief. Unfortunately, long-term cases can take a bit more time to resolve. However, if you stick with your treatment plan and regularly communicate with your doctor, you can eventually find your way to better sleep. You may also want to visit the National Sleep Foundation website for additional resources to share with your doctor.
^ 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.
Interestingly, it has been shown that the sleep-wake cycle acts on the beta-amyloid burden which is a central component found in AD. Indeed, during waking, the production of beta-amyloid protein will be more consistent than during sleep. 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. The second is that oxidative stress will also be higher and lead to increased AB production.
Interestingly, the glymphatic cleanrance occurs during the NREM sleep, and more specifically the NREM SWS sleep. As seen previously, it is a sleep stage that decreases in normal aging. So there is less glymphatic clearance and an increase in AB burden that will form the AB plaques. Therefor, in AD sleep disturbances will amplify this phenomenon.
If your snoring is loud and uneven, erupts in snorts, or you sound like you're catching your breath or there are gaps in your breathing, these are signs of obstructive sleep apnea, the most severe type of sleep-disordered breathing. People with sleep apnea stop breathing repeatedly during their sleep because of a blockage in the mouth or throat, most commonly the soft tissues in the back of the throat, which collapse and close off.