On the other hand, it is during sleep that beta-amyloid residues are degraded to prevent plaque formation.[29][30][32] It is the glymphatic system that is responsible for this and this phenomenon is called glymphatic clearance.[29][30][32] 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.[30][29]
Narcolepsy is a brain disorder that causes excessive daytime sleepiness. There is sometimes a genetic component, but most patients have no family history of the problem. Though dramatic and uncontrolled "sleep attacks" have been the best-known feature of narcolepsy, in reality many patients do not have sleep attacks. Instead, they experience constant sleepiness during the day.

Primary sleep disorders are most common in men and women over the age of 65. About half of the people claim to have some sleep problem at one point. It is most common in the elderly because of multiple factors. Factors include increased medication use, age-related changes in circadian rhythms, environmental and lifestyle changes [3] and pre diagnosed physiological problems and stress. The risk of developing sleep disorders in the elderly is especially increased for sleep disordered breathing, periodic limb movements, lestless legs syndrome, REM sleep behavior disorders, insomnia and circadian rhythm disturbances.[3]


Now consider noise. If a ticking clock disturbs you, buy one that doesn't tick, or use your phone. Turn clock radios and MP3 players to the wall and cover lighted screens. Lay in supplies of earplugs, eye masks, and anything else that helps screen out light as well as sound. Some people find a fan or white-noise machine is soothing and blocks out street noise. If you don't like wearing earplugs or an eye mask when you fall asleep, keep them on your bedside table in case you wake up later. Many people find they're more sensitive to light and sound in the middle of the night.


Recent studies, however, have shown that several factors can interrupt this neurogenesis.[29] These include stress and prolonged sleep deprivation (more than one day).[29] The sleep disturbances encountered in AD could therefore suppress neurogenesis and thus impairing hippocampal functions.[29] This would therefore contribute to diminished memory performances and the progression of AD.[29] And progression of AD would aggravate sleep disturbances.[29] It is a second vicious circle.  

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.


Recent studies have also linked sleep disturbances, neurogenesis and AD.[29] Indeed, it is now known that neurogenesis exists and that the subgranular zone and the subventricular zone keep on creating new neurons even in an adult brain.[29][34] These new cells are then incorporated into neuronal circuits and interestingly, the supragranular zone is found in the hippocampus.[29][34] These new cells will contribute to learning and memory and will play a role in the hippocampal-dependent memory.[29]
Women often experience sleepless nights and daytime fatigue in the first and third trimesters of their pregnancy. During the first trimester, frequent trips to the bathroom and morning sickness may disrupt sleep. Later in pregnancy, vivid dreams and physical discomfort may prevent deep sleep. After delivery, the new baby's care or the mother's postpartum depression may interrupt sleep.
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]
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]

A study that was resulted from a collaboration between Massachusetts General Hospital and Merck describes the development of an algorithm to identify patients will sleep disorders using electronic medical records. The algorithm that incorporated a combination of structured and unstructured variables identified more than 36,000 individuals with physician-documented insomnia.[62]
The decrease in the quantity and quality of the NREM SWS as well as the disturbances of sleep will therefore increase the AB plaques.[29][30] This will first take place at the hippocampus level, from which memory is dependent.[29][30] This will result in cell death at this level and will contribute to diminished memory performances and cognitive decline found in AD disease.[29]
Idiopathic hypersomnia: a chronic neurological disease similar to narcolepsy in which there is an increased amount of fatigue and sleep during the day. Patients who suffer from idiopathic hypersomnia cannot obtain a healthy amount of sleep for a regular day of activities. This hinders the patients' ability to perform well, and patients have to deal with this for the rest of their lives.[15]

A catch-all term for the inability to fall or stay asleep, sleeplessness is -- as sufferers know -- a very serious problem. It's sleeplessness whenever something, whether it's physical pain, anxiety, or an underlying condition, prevents you from falling asleep within a reasonable amount of time or staying asleep long enough to achieve a good night's sleep.
^ 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.
^ Jump up to: a b c Cao, Xiao-Lan; Wang, Shi-Bin; Zhong, Bao-Liang; Zhang, Ling; Ungvari, Gabor S.; Ng, Chee H.; Li, Lu; Chiu, Helen F. K.; Lok, Grace K. I. (2017-02-24). "The prevalence of insomnia in the general population in China: A meta-analysis". PLoS ONE. 12 (2): e0170772. doi:10.1371/journal.pone.0170772. ISSN 1932-6203. PMC 5325204. PMID 28234940.
Now consider noise. If a ticking clock disturbs you, buy one that doesn't tick, or use your phone. Turn clock radios and MP3 players to the wall and cover lighted screens. Lay in supplies of earplugs, eye masks, and anything else that helps screen out light as well as sound. Some people find a fan or white-noise machine is soothing and blocks out street noise. If you don't like wearing earplugs or an eye mask when you fall asleep, keep them on your bedside table in case you wake up later. Many people find they're more sensitive to light and sound in the middle of the night.
Another systematic review noted 7-16% of young adults suffer from delayed sleep phase disorder. This disorder reaches peak prevalence when people are in their 20s.[57] Between 20 and 26% of adolescents report a sleep onset latency of >30 minutes. Also, 7-36% have difficulty initiating sleep.[59] Asian teens tend to have a higher prevalence of all of these adverse sleep outcomes than their North American and European counterparts.[59]
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.
Chronic sleep disorders in childhood, which affect some 70% of children with developmental or psychological disorders, are under-reported and under-treated. Sleep-phase disruption is also common among adolescents, whose school schedules are often incompatible with their natural circadian rhythm. Effective treatment begins with careful diagnosis using sleep diaries and perhaps sleep studies. Modifications in sleep hygiene may resolve the problem, but medical treatment is often warranted.[35]
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.[49][50]
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.)
×