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.
Get back to sleep when you wake up at night. Whether you have a sleep disorder or not, it’s normal to wake briefly during the night. If you’re having trouble getting back to sleep, try focusing on your breathing, meditating, or practicing another relaxation technique. Make a note of anything that’s worrying you and resolve to postpone worrying about it until the next day when it will be easier to resolve.
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.
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.
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.
Fatigue during the first trimester of pregnancy is likely caused by changing levels of hormones, such as progesterone. Toward the end of pregnancy, some women find it difficult to sleep because of the uncomfortable size of their abdomen. Some women are too excited, anxious, or worried about becoming mothers to sleep well. Other women who are pregnant complain that vivid dreams prevent them from getting restful sleep. Sleep apnea, especially if it's severe and causes your blood oxygen level to drop during sleep, is a risk to the fetus.
Idiopathic hypersomnia: a chronic neurological disease similar to narcolepsy in which there is an increased amount of fatigue and sleep during the day. Patients who suffer from idiopathic hypersomnia cannot obtain a healthy amount of sleep for a regular day of activities. This hinders the patients' ability to perform well, and patients have to deal with this for the rest of their lives.
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.
Sleep apnea is a common (and treatable) sleep disorder in which your breathing temporarily stops during sleep, awakening you frequently. If you have sleep apnea you may not remember these awakenings, but you’ll likely feel exhausted during the day, irritable and depressed, or see a decrease in your productivity. Sleep apnea is a serious and potentially life-threatening sleep disorder, so see a doctor right away and learn how to help yourself.
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.
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.
On the other hand, it is during sleep that beta-amyloid residues are degraded to prevent plaque formation. It is the glymphatic system that is responsible for this and this phenomenon is called glymphatic clearance. Thus, during wakefulness, the AB burden is greater because the metabolic activity and oxidative stress are higher and there is no degradation of the protein by the glymphatic clearance whereas during sleep, the burden will be smaller as there will be less metabolic activity and oxidative stress in addition to the glymphatic clearance that occurs at this time.
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.
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.