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]
^ 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)
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.

Competence in sleep medicine requires an understanding of a myriad of very diverse disorders, many of which present with similar symptoms such as excessive daytime sleepiness, which, in the absence of volitional sleep deprivation, "is almost inevitably caused by an identifiable and treatable sleep disorder", such as sleep apnea, narcolepsy, idiopathic hypersomnia, Kleine–Levin syndrome, menstrual-related hypersomnia, idiopathic recurrent stupor, or circadian rhythm disturbances.[52] Another common complaint is insomnia, a set of symptoms which can have a great many different causes, physical and mental. Management in the varying situations differs greatly and cannot be undertaken without a correct diagnosis.[citation needed]
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.
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 addition, an evidence-based synopses suggests that the sleep disorder, idiopathic REM sleep behavior disorder (iRBD), may have a hereditary component to it. A total of 632 participants, half with iRBD and half without, completed self-report questionnaires. The results of the study suggest that people with iRBD are more likely to report having a first-degree relative with the same sleep disorder than people of the same age and sex that do not have the disorder.[19] More research needs to be conducted to gain further information about the hereditary nature of sleep disorders.
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]

The neurodegenerative conditions are commonly related to brain structures impairment, which might disrupt the states of sleep and wakefulness, circadian rhythm, motor or non motor functioning.[22][24] On the other hand, sleep disturbances are also frequently related to worsening patient's cognitive functioning, emotional state and quality of life.[24][27][28] Furthermore, these abnormal behavioural symptoms negatively contribute to overwhelming their relatives and caregivers.[24][27][28] Therefore, a deeper understanding of the relationship between sleep disorders and neurodegenerative diseases seems to be extremely important, mainly considering the limited research related to it and the increasing expectancy of life.[22][28]


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]
Although the exact mechanisms and the causal relationship between sleep disturbances and AD are not yet clear, these findings already provide a better understanding. In addition, they open up ideas for the implementation of treatments to curb the cognitive decline of patients suffering from this disease. In the same way, it also makes it possible to better target at risk population.
According to one meta-analysis, the two most prevalent sleep disorders among children are confusional arousals and sleep walking.[57] An estimated 17.3% of kids between 3 and 13 years old experience confusional arousals.[57] About 17% of children sleep walk, with the disorder being more common among boys than girls.[57] The peak ages of sleep walking are from 8 to 12 years old.[57] A different systematic review offers a high range of prevalence rates of sleep bruxism for children. Between 15.29 and 38.6% of preschoolers grind their teeth at least one night a week. All but one of the included studies reports decreasing bruxist prevalence as age increased as well as a higher prevalence among boys than girls.[58]
There are many possible causes of restless legs syndrome, including kidney failure, nerve disorders, vitamin and iron deficiencies, pregnancy, and some medications (such as antidepressants). Recent studies have shown a strong genetic link and researchers have been able to isolate a gene that may be responsible for at least 40% of all cases of the disorder.
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."
Both night terrors and sleepwalking arise during NREM sleep and occur most often in children between the ages of 3 and 5 years old. A night terror can be dramatic: Your child may wake up screaming, but unable to explain the fear. Sometimes children who have night terrors remember a frightening image, but often they remember nothing. Night terrors are often more frightening for parents than for their child. Sleepwalkers can perform a range of activities -- some potentially dangerous, like leaving the house -- while they continue to sleep.

Apnea means "no airflow." Obstructive sleep apnea was thought to be a disorder primarily of overweight, older men. But abnormal breathing during sleep can affect people of any age, any weight, and either sex. Researchers now know that in many cases of sleep apnea, the obstruction in the airways is only partial. Most people with sleep apnea have a smaller-than-normal inner throat and other subtle bone and soft-tissue differences.

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]
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]
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]

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.


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]
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]

What to do: If you suspect you have a circadian rhythm disorder, take steps to get your body onto a regular sleep schedule. Choose a bedtime and wake-up time that work for you, and follow the same routine each day, even on weekends. This can be tough for those who have to get up early during the week but like to stay up later on weekends, but do your best to craft a compromise between your work week and weekend habits. The important thing is to avoid the trap of sleeping from 10 p.m. to 6 a.m. during the week, then suddenly shifting to late nights and late mornings on the weekends. This will inevitably leave you with insomnia on Sunday night, which in turn sets you up to start the week exhausted on Monday morning.
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