"has demonstrated expertise in the diagnosis and management of clinical conditions that occur during sleep, that disturb sleep, or that are affected by disturbances in the wake-sleep cycle. This specialist is skilled in the analysis and interpretation of comprehensive polysomnography, and well-versed in emerging research and management of a sleep laboratory."[51]

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.
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.
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.
People who have insomnia don't feel as if they get enough sleep at night. They may have trouble falling asleep or may wake up frequently during the night or early in the morning. Insomnia is a problem if it affects your daytime activities. Insomnia has many possible causes, including stress, anxiety, depression, poor sleep habits, circadian rhythm disorders (such as jet lag), and taking certain medications.

People who have insomnia don't feel as if they get enough sleep at night. They may have trouble falling asleep or may wake up frequently during the night or early in the morning. Insomnia is a problem if it affects your daytime activities. Insomnia has many possible causes, including stress, anxiety, depression, poor sleep habits, circadian rhythm disorders (such as jet lag), and taking certain medications.

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]

Specialists in Sleep Medicine were originally certified by the American Board of Sleep Medicine, which still recognizes specialists. Those passing the Sleep Medicine Specialty Exam received the designation "diplomate of the ABSM." Sleep Medicine is now a recognized subspecialty within internal medicine, family medicine, pediatrics, otolaryngology, psychiatry and neurology in the United States. Certification in Sleep Medicine shows that the specialist:
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]
Interestingly, the glymphatic cleanrance occurs during the NREM sleep, and more specifically the NREM SWS sleep.[29][30][32] As seen previously, it is a sleep stage that decreases in normal aging.[30] So there is less glymphatic clearance and an increase in AB burden that will form the AB plaques.[32][29][30] Therefor, in AD sleep disturbances will amplify this phenomenon.
Interestingly, it has been shown that the sleep-wake cycle acts on the beta-amyloid burden which is a central component found in AD.[29][30] Indeed, during waking, the production of beta-amyloid protein will be more consistent than during sleep.[29][30][32] 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.[29][30] The second is that oxidative stress will also be higher and lead to increased AB production.[29][30]
What to do: This condition requires evaluation by an otolaryngologist, who can look at your nose, mouth, and throat to see what's interrupting your breathing and how to repair that process. You'll also need a sleep test in which your oxygen levels are measured. Often, the first treatment doctors will recommend is a Continuous Positive Airway Pressure (CPAP) device, a specially designed nasal mask that blows air directly into your airways. Studies have shown CPAP masks to be extremely effective in treating sleep apnea. However, many people don't like wearing them -- and, of course, it doesn't work if you don't wear it.
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