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.
Ask your doctor for a referral to an ear, nose, and throat (ENT) specialist, who can evaluate whether you're a candidate for Continuous Positive Airway Pressure (CPAP), a specially designed nasal mask that prevents your nasal passages from collapsing and delivers air directly into your airway. If tongue position during sleep is causing your UARS, the doctor may recommend a dental device that pushes the jaw and tongue forward and prevents the tongue from blocking the opening to the throat.
Narcolepsy is a sleep disorder that involves excessive, uncontrollable daytime sleepiness. It is caused by a dysfunction of the brain mechanism that controls sleeping and waking. If you have narcolepsy, you may have “sleep attacks” in the middle of talking, working, or even driving. Although no cure yet exists, a combination of treatments can help control symptoms and enable you to enjoy many normal activities.
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.
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.
Interestingly, the glymphatic cleanrance occurs during the NREM sleep, and more specifically the NREM SWS sleep. As seen previously, it is a sleep stage that decreases in normal aging. So there is less glymphatic clearance and an increase in AB burden that will form the AB plaques. Therefor, in AD sleep disturbances will amplify this phenomenon.
Recent studies have also linked sleep disturbances, neurogenesis and AD. 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. These new cells are then incorporated into neuronal circuits and interestingly, the supragranular zone is found in the hippocampus. These new cells will contribute to learning and memory and will play a role in the hippocampal-dependent memory.
Sort of a milder cousin of sleep apnea, UARS occurs when some type of resistance slows or blocks air in the nasal passages. The most common causes are mild nasal congestion or a tongue position during sleep that blocks breathing. Because the resistance makes it harder work simply to breathe, your body is half-waking up over and over again during the night, so you don't feel refreshed in the morning.
Insomnias This type of sleep disorder involves the inability to fall asleep or stay asleep. MORE>>Hypersomnias Hypersomnias are a group of sleep disorders that causes a person to be excessively sleepy. People with a hypersomnia may fall asleep at times that are inconvenient or even dangerous, such as at work or while driving. MORE>>Sleep Related Breathing Disorders Sleep disorders that involve difficulty breathing during sleep are classified as sleep related breathing disorders. Obstructive sleep apnea is the most common disorder of this type, however there are a number of variations of sleep apnea. MORE>>Circadian Rhythm Sleep-Wake Disorders Conditions in which the sleep times are out of alignment. A patient with one of these disorders does not follow the normal sleep times at night. MORE>>Parasomnias Parasomnias are a group of sleep disorders that involve unwanted events or experiences that occur while you are falling asleep, sleeping or waking up. MORE>>Sleep Movement Disorders This classification of sleep disorders includes conditions that cause movement during or prior to sleep. These disorders can make it difficult to fall asleep or stay asleep, or to get restful sleep. MORE>>
One factors that could explain this change in sleep architecture is a change in circadian rhythm, which regulates sleep. A disruption of the circadian rhythm would therefore generate sleep disturbances. Some studies show that people with AD have a delayed circadian rhythm, whereas in normal aging we will find an advanced circadian rhythm.
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.