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.
This clock is a small part of the brain called the suprachiasmatic nucleus of the hypothalamus. It sits just above the nerves leaving the back of our eyes. Light and exercise "reset" the clock and can move it forward or backward. Abnormalities related to this clock are called circadian rhythm disorders ("circa" means "about," and "dies" means "day").
With over 80 listed sleep disorders, and more that are being researched, it's important for patients suffering from the various types of sleep disorders to seek medical treatment. If you believe that your sleep problems may be caused by a disorder, there are many things you can do to solve your sleep issues from DIY tips and tricks such as practicing better sleep hygiene, to contacting a sleep clinic to schedule an inlab sleep study, or an at home sleep test for certain pre-screened disorders such as obstructive sleep apnea.
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.
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.
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.
What to do: See a doctor, who will likely first check you for underlying conditions related to PLMD. Diabetes, thyroid disorders, anemia, and a number of other conditions can cause PLMD. If you do have another condition, the doctor will treat it and see if the PLMD goes away. The next step is to control the involuntary movements with medication. Drugs that suppress muscle contractions work well for preventing PLMD. The doctor may also prescribe medication to help you sleep more deeply, with the idea of preventing the involuntary movements from keeping you in light sleep.
Sleep disturbances have been also observed in Alzheimer's disease (AD), affecting about 45% of its population. Moreover, when it is based on caregiver reports this percentage is even higher, about 70%. As well as in PD population, insomnia and hypersomnia are frequently recognized in AD patients, which have been associated with accumulation of Beta-amyloid, circadian rhythm sleep disorders (CRSD) and melatonin alteration. Additionally, changes in sleep architecture are observed in AD too. Even though with ageing the sleep architecture seems to change naturally, in AD patients it is aggravated. SWS is potentially decreased (sometimes totally absent), spindles and the time spent in REM sleep are also reduced, while its latency is increased. The poorly sleep onset in AD has been also associated with dream-related hallucination, increased restlessness, wandering and agitation, that seem to be related with sundowning - a typical chronological phenomenon presented in the disease.
In Alzheimer's disease, in addition to cognitive decline and memory impairment, there is also significant sleep disturbances with a modified sleep architecture. 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). More than 65% of people with Alzheimer's disease suffer from this type of sleep disturbance.
^ 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.
Now consider noise. If a ticking clock disturbs you, buy one that doesn't tick, or use your phone. Turn clock radios and MP3 players to the wall and cover lighted screens. Lay in supplies of earplugs, eye masks, and anything else that helps screen out light as well as sound. Some people find a fan or white-noise machine is soothing and blocks out street noise. If you don't like wearing earplugs or an eye mask when you fall asleep, keep them on your bedside table in case you wake up later. Many people find they're more sensitive to light and sound in the middle of the night.
The natural internal clock that controls our 24-hour cycle of sleep and waking, circadian rhythms are easily upset by changes in schedule, and they're greatly affected by light and darkness. Jet lag is the best known circadian rhythm disorder, but this sensitive inner clock can also be disrupted by changes in routine resulting in an erratic sleep schedule.