If sleeping with a mask on doesn't work for you, other options are surgery; oral appliances; and newer, minimally invasive outpatient surgical treatments. These include the Pillar procedure, which involves using permanent stitches to firm up the soft palate; coblation, which uses radiofrequency to shrink nasal tissues; and even use of a carbon dioxide laser to shrink the tonsils.


Recent studies have also linked sleep disturbances, neurogenesis and AD.[29] 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.[29][34] These new cells are then incorporated into neuronal circuits and interestingly, the supragranular zone is found in the hippocampus.[29][34] These new cells will contribute to learning and memory and will play a role in the hippocampal-dependent memory.[29]
Sleep disturbances have been also observed in Alzheimer's disease (AD), affecting about 45% of its population.[22][24][26] Moreover, when it is based on caregiver reports this percentage is even higher, about 70%.[28] 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.[22][24][28] Additionally, changes in sleep architecture are observed in AD too.[22][24][26] 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.[28] 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.[24][28]

Waking up in the middle of the night to use the bathroom is such a common problem it has a name: nocturia . As we get older, our bodies' ability to hold fluids for long periods decreases, thanks to a decline in antidiuretic hormones. According to the National Sleep Foundation, 65 percent of older adults have sleep deprivation resulting from waking up frequently to use the bathroom.
Apnea means "no airflow." Obstructive sleep apnea was thought to be a disorder primarily of overweight, older men. But abnormal breathing during sleep can affect people of any age, any weight, and either sex. Researchers now know that in many cases of sleep apnea, the obstruction in the airways is only partial. Most people with sleep apnea have a smaller-than-normal inner throat and other subtle bone and soft-tissue differences.

Delayed sleep phase disorder is a condition where your biological clock is significantly delayed. As a result, you go to sleep and wake up much later than other people. This is more than just a preference for staying up late or being a night owl, but rather a disorder that makes it difficult for you to keep normal hours—to make it to morning classes, get the kids to school on time, or keep a 9-to-5 job.

Delayed sleep phase disorder (DSPD), inability to awaken and fall asleep at socially acceptable times but no problem with sleep maintenance, a disorder of circadian rhythms. Other such disorders are advanced sleep phase disorder (ASPD), non-24-hour sleep–wake disorder (non-24) in the sighted or in the blind, and irregular sleep wake rhythm, all much less common than DSPD, as well as the situational shift work sleep disorder.[4]
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.

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.
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.

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.


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: 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.
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