^ 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.
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. 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.
Due to rapidly increasing knowledge about sleep in the 20th century, including the discovery of REM sleep in the 1950s and circadian rhythm disorders in the 70s and 80s, the medical importance of sleep was recognized. The medical community began paying more attention than previously to primary sleep disorders, such as sleep apnea, as well as the role and quality of sleep in other conditions. By the 1970s in the US, clinics and laboratories devoted to the study of sleep and sleep disorders had been founded, and a need for standards arose.
Obstructive sleep apnea (OSA) affects around 4% of men and 2% of women in the United States. In general, this disorder is more prevalent among men. However, this difference tends to diminish with age. Women experience the highest risk for OSA during pregnancy. Also, they tend to report experiencing depression and insomnia in conjunction with obstructive sleep apnea. In a meta-analysis of the various Asian countries, India and China present the highest prevalence of the disorder. Specifically, about 13.7% of the Indian population and 7% of Hong-Kong's population is estimated to have OSA. The two groups experience daytime OSA symptoms such as difficulties concentrating, mood swings, or high blood pressure, at similar rates (prevalence of 3.5% and 3.57%, respectively).
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.