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.


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.
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]
What to do: Ask your doctor if your restless leg syndrome might be caused by another health condition or by a medication you're taking. Diabetes, arthritis, peripheral neuropathy, anemia, vitamin B deficiency, thyroid disease, and kidney problems can all contribute to restless leg syndrome. Medications that can cause restless leg syndrome as a side effect include antidepressants, antihistamines, and lithium. Treating the underlying condition or changing medications may banish the symptoms. Restless leg syndrome has been linked to deficiencies in iron and B vitamins, particularly folate, so talk to your doctor about boosting your intake of these nutrients.
What to do: Talk to experts about sleeplessness, and you'll be told to practice good "sleep hygiene." What this means is that you need to take your lack of sleep seriously and look at your sleep habits and physical surroundings to see what might be preventing you from sleeping well. Start with your evening habits: What do you do in the hours before bed? Eliminate late-night eating, drinking, and computer use and your chances of falling asleep quickly and sleeping soundly are much greater. Use the last hour before bed to do things that relax you, like taking a warm bath, meditating, or reading.
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]
If sleeping with a mask on doesn't work for you, other options are surgery; oral appliances; and newer, minimally invasive outpatient surgical treatments. These include the Pillar procedure, which involves using permanent stitches to firm up the soft palate; coblation, which uses radiofrequency to shrink nasal tissues; and even use of a carbon dioxide laser to shrink the tonsils.

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.  
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]

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]
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]
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 Alzheimer's disease, in addition to cognitive decline and memory impairment, there is also significant sleep disturbances with a modified sleep architecture.[30][29] The latter may consist in sleep fragmentation, a reduction in sleep duration, insomnia, an increase daytime naping, a decreased quantity og some sleep stages and a resemblance between some sleep stages (N1 and N2).[29] More than 65% of people with Alzheimer's disease suffer from this type of sleep disturbance.[29]
Although we do not know the causual relationship, we know that the more the AD progresses, the more we find sleep disorders.[29] In the same way, the more sleep disorders there are, the more the disease progresses, forming a vicious circle.[29] Taken this into account, sleep disturbances are no longer a symptom of AD and relationship between sleep disturbances and AD is bidirectional.[30]
A population susceptible to the development of sleep disorders is people who have experienced a traumatic brain injury (TBI). Because many researchers have focused on this issue, a systematic review was conducted to synthesize their findings. According to their results, TBI individuals are most disproportionately at risk for developing narcolepsy, obstructive sleep apnea, excessive daytime sleepiness, and insomnia.[20] The study's complete findings can be found in the table below:
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.
Throughout the decades as more research and studies were conducted, the amount of sleep disorders being discovered began to rapidly increase. In 1990 The AASM, along with other professional societies including the European Sleep Research Society, The Japanese Society of Sleep Research, and the Latin American Sleep Society published the International Classification of Sleep Disorders (ICSD), which is a "primary diagnostic, epidemiological, and coding resource for clinicians and researchers in the field of sleep and sleep medicine."
^ Tranah, Gregory J.; Blackwell, Terri; Stone, Katie L.; Ancoli‐Israel, Sonia; Paudel, Misti L.; Ensrud, Kristine E.; Cauley, Jane A.; Redline, Susan; Hillier, Teresa A. (2011). "Circadian activity rhythms and risk of incident dementia and mild cognitive impairment in older women". Annals of Neurology. 70 (5): 722–732. doi:10.1002/ana.22468. ISSN 1531-8249.
Stay cool at night. Make sure your bedroom is at the right temperature to help ensure a good night’s sleep. The National Sleep Foundation suggests setting the temperature between 60 and 67 degrees Fahrenheit for optimal sleep. Using cooling sheets and pillows can also help, especially for women in menopause who are experiencing hot flashes at night, says Dr. Alyssa Dweck, assistant clinical professor of obstetrics and gynecology at the Mount Sinai School of Medicine and co-author of “V is for Vagina.”
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