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.
Sleep disturbances have been also observed in Alzheimer's disease (AD), affecting about 45% of its population. Moreover, when it is based on caregiver reports this percentage is even higher, about 70%. 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. Additionally, changes in sleep architecture are observed in AD too. 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. 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.
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.
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.
The decrease in the quantity and quality of the NREM SWS as well as the disturbances of sleep will therefore increase the AB plaques. This will first take place at the hippocampus level, from which memory is dependent. This will result in cell death at this level and will contribute to diminished memory performances and cognitive decline found in AD disease.
The most common sleep disorder is insomnia. Others are sleep apnea, narcolepsy and hypersomnia (excessive sleepiness at inappropriate times), sleeping sickness (disruption of sleep cycle due to infection), sleepwalking, and night terrors. Management of sleep disturbances that are secondary to mental, medical, or substance abuse disorders should focus on the underlying conditions.
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 addressing sleep disorders and possible solutions, there is often a lot of buzz surrounding melatonin. Research suggests that melatonin is useful in helping people to fall asleep faster (decreased sleep latency), to stay asleep longer, and to experience improved sleep quality. In order to test this, a study was conducted that compared subjects that had taken Melatonin to subjects that had taken a placebo pill in subjects with primary sleep disorders. Researchers assessed sleep onset latency, total minutes slept, and overall sleep quality in the Melatonin and placebo groups to note the differences. In the end, researchers found that melatonin decreased sleep onset latency, increased total sleep time, and improved quality of sleep significantly more than the placebo group.
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%).
At the same time, it has been shown that memory consolidation in long-term memory (which depends on the hippocampus) occurs during NREM sleep. 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. This drop in performance is one of the central symptoms of AD.
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.