Untreated Sleep Disorders Research Articles

P075 Strategies to improve sleep disorder diagnosis and management in the workplace: Perspectives of future shift workers living with sleep disorders

Abstract Shift workers with untreated sleep disorders face greater risk of negative health and safety outcomes. A population of particular concern is early-career shift workers, as 20% of young adults live with, largely undiagnosed, sleep disorders. This study aimed to explore what structures and qualities future shift workers would value in prospective workplaces regarding sleep disorder support and management. The study aims to inform the development of interventions that are acceptable to workers. Undergraduate paramedicine students were invited to complete an online survey and participate in a health services trial. The survey included validated sleep disorder screening questionnaires, with those identified at risk of a sleep disorder being offered further diagnostic testing or treatment. Participants completed a qualitative interview upon completion of the trial to discuss their experience and recommendations to improve screening and management of sleep disorders for shift workers. Seventeen paramedicine students (mean age 22.5±8.3 years, 59% female) with an undiagnosed sleep disorder were recruited into the trial. Early thematic analysis identified two key themes: Increasing education and awareness of sleep disorders and supporting access to health services. Almost half of the participants discussed the importance of increased awareness of sleep and sleep disorders during pre-employment training and in the workplace. Participants also identified convenience as an important factor in facilitating the management of sleep disorders. Facilitating access to sleep health services before workers are exposed to shift work and during early employment were suggested to improve sleep disorder identification and management for early-career shift workers.

Sleep quality of first year students at Hue University of Medicine and Pharmacy

Background: Untreated Sleep disorders contribute to neurocognitive dysfunctions, including attention deficits, impaired cognitive performance, depression, anxiety, and poor impulse control. This study aims to describe sleep quality and explore factors related to sleep quality among the freshmen students of the University of Medicine and Pharmacy, Hue University Methods: We constructed a cross-sectional study on 601 first-year students of the University of Medicine and Pharmacy, Hue University, from January to December 2022. Data were collected based on a pre-designed questionnaire. Multiple logistic regression analysis was used to identify factors affecting students' sleep quality. Results: 45,9% of freshmen students had poor sleep quality. Some factors related to sleep quality include gender, living with relatives, Internet addiction, suicidal thoughts; physical activity, and BMI index. Conclusion: There is a high percentage of freshmen students experiencing poor sleep quality. Therefore, we highly recommend students control their Internet use, increase physical activity, and think positively to improve their sleep quality Keywords: Sleep quality, Students, Physical activity, Internet addiction

Automatic IHR-based sleep stage detection using features of residual neural network

Untreated sleep disorders can harm bodily functions, and a sleep study and monitoring of sleep stages are the first steps in diagnosing these disorders. Using Polysomnography (PSG), signal scoring for sleep stage determination has become a familiar investigation in recent years. Despite its effectiveness, the procedure is time-consuming and costly. This study presents a cost-effective method for sleep classification based on Electrocardiogram (ECG) input signals. We proposed a multi-ethnic study of the Atherosclerosis dataset, including 1700 PSG, to develop a Residual Neural Network (RNN) classifier to stage sleep from Instantaneous Heart Rate (IHR) extracted from the ECG signals. The proposed system follows the following steps: ECG collection, signal preprocessing (including ECG normalization and segmentation, instant heart rate calculation and normalization, resampling, and filtering), and classification using an RNN. A Convolutional Neural Network (CNN) is used to detect sleep stages using preprocessed segments of the IHR time series of 240 samples centered on 30-s epochs as inputs. The proposed algorithm in the five-fold cross-validation achieved an accuracy of 85.32%, a kappa of 77.11%, a Sensitivity of 81.14%, a Specificity of 82.68%, and an F-1 score of 81.87%. The results show that ECG data provide valuable information about sleep stages for a large population.

The Utility of Home Sleep Apnea Testing in the Advanced Heart Failure Populations

Untreated sleep disorders form a risk of coronary artery disease, hypertension, obesity, and diabetes mellitus. Access to polysomnography is limited, especially during the COVID-19 pandemic, with home sleep apnea testing (HSAT) being a potentially viable alternative. We describe an HSAT protocol in patients with advanced heart failure (HF). In a single-center, observational analysis between 2019 and 2021 in patients with advanced HF and heart transplant (HT), 135 screened positive on the STOP-Bang sleep survey and underwent a validated HSAT (WatchPAT, ZOLL-Itamar). HSAT was successful in 123 patients (97.6%), of whom 112 (91.1%; 84 HF and 28 HT) tested positive for sleep apnea. A total of 91% of sleep apnea cases were obstructive, and 63% were moderate to severe. Multivariable linear regression showed that the apnea hypopnea index was 34% lower in the HT group than in the HF group (p=0.046) after adjusting for gender, and that this effect persisted in White patients but not among African-Americans. Patient characteristics were similar between groups, with coronary artery disease, diabetes mellitus, and hypertension as the most prevalent co-morbidities. In conclusion, sleep apnea remains prevalent in patients with HF with a high co-morbidity burden. HSAT is a feasible and effective tool for screening and diagnosis in this population.

0623 Neural Dynamics During Sleep in Parkinson’s Disease Patients

Abstract Introduction Parkinson’s Disease (PD) is a neurodegenerative disease marked by tremor, body tone changes, and cognitive decline with deficits in motor task learning. Characteristic neural patterns during non-Rapid Eye Movement (NREM) sleep have been correlated with learning procedural motor memory tasks. We seek to understand how the neural dynamics of NREM sleep (e.g., sleep spindles and slow waves) interact with motor learning ability in a neurodegenerative disease process. This information might be used to identify electrical biomarkers that could be therapeutically targeted. Methods PD subjects and healthy age-matched controls were identified by physician interview, flyering, and medical chart review. Eligibility requirements for subjects precluded severe cognitive decline and untreated sleep disorders. Baseline sleep characteristics were ascertained via survey data collected prior to and on the day of the sleep study. Subjects were fitted with EEG electrodes prior to an all night polysomnogram. Subjects were also fitted with EMG and EOG electrodes for sleep scoring purposes. Motor tasks were performed prior to and following overnight sleep. Results Surveys indicated worse sleep quality among PD subjects compared to age-matched controls prior to their sleep session. Sleep macro-architecture of PD subjects showed a smaller percentage of sleep time in N2/N3 stages, and at the spectral level, there were indications of reduced power for slow waves and spindling. Furthermore, we observed aberrant patterns of coupling between slow waves and spindling in PD subjects. Conclusion Our study has implications for sleep as a component of motor skill learning and as a marker for a neurodegenerative movement disorder. NREM sleep rhythms such as sleep spindles and slow waves, and their relationships to one another, are thought to be important in motor learning and memory. Aberrations in these rhythms and their coupling may inform potential therapies to enhance motor learning and mitigate the progression of PD. Support (If Any) NCATS of the NIH, Award Number UL1TR003015.

0347 Sleep health education and a personalized smartphone application improve sleep and productivity and reduce healthcare utilization among employees: Results of a randomized clinical trial

Abstract Introduction Sleep deficiency and undiagnosed or untreated sleep disorders are pervasive among employed adults, yet are often ignored in the context of workplace health promotion. Smartphone applications (apps) are a promising, scalable approach to improving sleep among employees. We evaluated an online sleep education program followed by access to a mobile sleep training program, the dayzz app, that promotes healthy sleep, sleep disorders awareness and intervention. Methods In a sample of daytime employees affiliated with a large healthcare organization, we evaluated the intervention (sleep education at baseline plus access to the personalized app for up to 9 months) in a parallel group, randomized controlled trial. Participants were randomly assigned to either the experimental condition that received the intervention in months 1 through 9 or the control group that was assigned to receive the intervention in month 10. In a prespecified data analysis plan, the experimental and control groups were compared in months 1 through 9; no outcome data was collected thereafter. We collected data on employee sleep, workplace outcomes, and healthcare utilization, monthly throughout the study. Results The final cohort was comprised of 794 participants assigned to the experimental and 561 to the control condition. Those assigned to the experimental condition were more likely to maintain consistent sleep schedules (OR:1.40;95%CI:1.12-1.75) and less likely to experience fatigue and sleepiness (OR:1.30;95%CI:1.08-1.57). At the 9-month follow-up assessment, the experimental group reported significantly longer sleep duration than the control group on work (experimental: 7.20hrs; control: 6.99hrs, p=0.01) and free (experimental: 8.26hrs; control: 8.04hrs, p=0.03) nights. The odds of poor sleep quality at follow-up were lower in the experimental condition (OR:0.79,95%CI:0.63-0.98) as compared to control. Mean total dollars lost due to presenteeism was less among experimental compared to control participants (p=0.0001), corresponding to an average of $274 saved per person per month. Finally, participants in the experimental group were less likely to report mental health visits (p=0.01) and had a lower rate of overall healthcare utilization (p=0.03), compared to the control group. Conclusion Results from this randomized clinical trial demonstrate that a digital workplace sleep wellness program can be beneficial to both employees and employers, by improving employee sleep and fatigue, increasing work productivity, and reducing direct healthcare costs. Support (If Any) This study was funded by dayzz Live Well Ltd.

Our Continued Experience With Using Watchpat® (itamar Medical, Ltd.), Home Sleep Testing For The Diagnosis Of Sleep Apnea In Heart Failure And Orthotopic Heart Transplant Patients.

<h3>Introduction</h3> Untreated sleep disorders are well known to significantly increase risk of coronary artery disease (CAD), hypertension (HTN), obesity, diabetes (DM), anxiety and depression. Despite maximal medical therapy, approximately 50% of patients with heart failure (HF) have moderate-to-severe sleep apnea (SA). Moreover, obstructive sleep apnea (OSA) has also been described in cardiac transplant recipients (OHT) as a significant risk factor for late graft dysfunction, thus screening and diagnosis is critical^. Access to in-lab polysomnography (PSG) has been limited throughout the pandemic leading to more reliance on home sleep testing. WatchPAT® Home Sleep Testing (WPHST) has been validated to accurately detect both obstructive as well as central sleep apnea (CSA) in the general population yet there is limited data to date that support its use in advanced HF/OHT patients. <h3>Objective</h3> Herein we describe our prospective utilization of WPHST highlighting differences in sleep apnea patterns in our HF and OHT population. <h3>Methods</h3> This is a single center, prospective, observational analysis, beginning February 22, 2020 through April 7, 2021. 50 consecutive patients that screened positive on the STOP-BANG® sleep apnea screen questionnaire were consented and assigned to WPHST and analyzed for comorbidities, and SA patterns and severity. <h3>Results</h3> Of the 50 patients enrolled, 48 patients (n=38 HF and n=10 OHT) were included in the analysis (1 failed study in each arm). Baseline characteristics were equivalent; mean age of 60 years, BMI 28.6 kg/m2, and 75% were male. A high prevalence of co-morbid conditions included CAD 52%, DM 50% and HTN 98%, (fig 1). Central/Mixed Sleep apnea accounted for 10.4% of the total cohort. Apnea Hypopnea Index (AHI) was significantly greater in the HF patient cohort vs OHT (p=0.02). However, no statistical differences were noted in nocturnal 02 sat (p=0.49). REM% was lower in the OHT compared to the HF cohort (p=0.049). <h3>Conclusion</h3> : In this limited prospective study AHI was significantly higher in the HF cohort compared to OHT. More importantly, WPHST has contributed to greater access to sleep diagnostics for high-risk patient populations throughout the pandemic. Continued work on short- and long-term outcomes is warranted.

History of the World Sleep Day

Background Sleep has also been cherished by society as a basic human need with a crucial importance for human health. People spend around one third of their lives sleeping. Nowadays, it has never been harder to achieve a restful sleep. When sleep is better understand, that will lessen the drawbacks of the different sleep disorders. Healthy sleep is important for maintaining physical and mental health in adult individuals. Sleep deprivation poses a significant risk for the individual and leads to psychological conditions, such as depression and anxiety. Several sleep disorders are known to the science. If breathing during sleep is not regular, a case of obstructive sleep apnea (OSA) may have been diagnosed. The World Sleep Day is traditionally celebrated in March, on the Friday before the Spring vernal equinox of each year. It is a global awareness and internationally recognized event, organized annually since 2008 by the World Sleep Day Committee of the World Sleep Society. Organizers aim to raise awareness of the problems with proper sleep, sleep disorders and aspects connected to it – medical, social, educational and others. Methods Scientific databases – PubMed, SCOPUS and MEDLINE were used to search for the information targeted. The following keywords – World Sleep Day, history, events, prophylaxis, sleep disorders were used. Information from the official websites of the societies involved in celebrating World Sleep Day was included as well. The aim of the following article is to study the history of the event from its foundation till today, aiming to stress out its usefulness. Results and discussion World Sleep Days has been internationally celebrated since 2008 for 15 years now. Since 2016, Bulgaria actively participates in all events organized by the World Sleep Society – Scientific symposiums, prophylactic check-ups for obstructive sleep apnea, elective disciplines in the teaching of students are organized. Importance is put on informing society about the dangers of undiagnosed and untreated sleep disorders, especially sleep apnea. Sleep medicine and Dental Sleep medicine are not recognized as medical specialties in the Republic of Bulgaria. Conclusions Problems of sleep are extremely common in our days. The situation is continuously being worsened due to the hyperconnectivity people experience with the glowing computer and mobile phone screens. It is admirable that specialists in the field and society try to raise awareness and combat the poor sleep quality consequences. Only by doing the abovementioned, alleviation of the undesirable outcomes of irregular sleep can be reached. Legislative measures should be taken in order to certify Sleep medicine and Dental sleep medicine as medical specialties in the Republic of Bulgaria.

Insufficient Sleep and Health Care Utilization: A Scoping Review

The purpose of this study was to examine healthcare costs of older adults in relation to demographic characteristics, individual health personality traits, and resilience. Data included 3,907 participants, 65 and older, collected by a large provider of Medicare Supplemental Health Insurance. The Health Personality Assessment*, Brief Resilience Scale, total healthcare cost, and demographic information were used. In our sample, the average healthcare cost was $13,283.69 (SD=30,784.87), ranging from $0–$989,084, and higher healthcare costs were found among older, male, and less health-neurotic (i.e., lower health-related anxiety) adults. Configural frequency analyses were conducted to identify “types” and patterns of healthcare costs by age and gender. The following significant patterns emerged: Women in the oldest group with high healthcare costs and women in the young-old age group who had low healthcare costs occurred significantly more than expected by chance, p<.01. Next, we hypothesized configuration patterns for resilience, health personality, and healthcare costs. Results confirmed the following “types” or patterns occurring more often than expected by chance: less-resilient individuals with high health neuroticism and high healthcare costs, p<.001, and less-resilient, less-health-conscientious adults with high healthcare costs, p<.001. The results suggest higher healthcare costs for individuals who are less resilient, more neurotic about their health, and less disciplined in their health practices. Future intervention programs may benefit from promoting resilience, reducing health neuroticism, and increasing health conscientiousness. *The Health Personality Assessment (HPA) is © 2021 United HealthCare Services, Inc. All rights reserved.

Insufficient Sleep and Health Care Utilization: A Scoping Review

Insufficient sleep is a common problem among older adults with 26% over the age of 65 reporting less than seven hours sleep in a 24 hour time period. Evidence indicates that untreated sleep disorders are associated with osteoarthritis, heart disease, hypertension, diabetes, obesity, falls, decreased cognitive performance, and decreased health related quality of life in older adults. A scoping review was undertaken to determine what is known about the association between insufficient sleep or insomnia and health care utilization. The Joanna Briggs Institute, Methodology for JBI Scoping Reviews was used to guide the review. Searches were conducted in PubMed, HINARI, Google Scholar and Cochrane databases. Twenty nine studies were included. Overall, the review indicates that reduced sleep is associated with a greater odds of difficulties in daily activities, higher rates of health care utilization and costs, and poly pharmacy. Findings also reveal sociodemographic and geographic variations in prevalence of healthy sleep duration. Although the majority of studies focused on the causes and consequences of insomnia and recommended clinical and behavioral health promotion interventions, there is a gap in studies related to the public health or economic impact of insufficient sleep. Research in this area will provide perspectives on the need to raise awareness of the importance of sleep and to incorporate the awareness into policies that improve sleep health.

Sleep Disorders in Adults with Down Syndrome.

Sleep disorders, despite being very frequent in adults with Down syndrome (DS), are often overlooked due to a lack of awareness by families and physicians and the absence of specific clinical sleep guidelines. Untreated sleep disorders have a negative impact on physical and mental health, behavior, and cognitive performance. Growing evidence suggests that sleep disruption may also accelerate the progression to symptomatic Alzheimer’s disease (AD) in this population. It is therefore imperative to have a better understanding of the sleep disorders associated with DS in order to treat them, and in doing so, improve cognition and quality of life, and prevent related comorbidities. This paper reviews the current knowledge of the main sleep disorders in adults with DS, including evaluation and management. It highlights the existing gaps in knowledge and discusses future directions to achieve earlier diagnosis and better treatment of sleep disorders most frequently found in this population.

Sleep is essential to health: an American Academy of Sleep Medicine position statement.

Sleep is a biological necessity, and insufficient sleep and untreated sleep disorders are detrimental for health, well-being, and public safety. Healthy People 2030 includes several sleep-related objectives with the goal to improve health, productivity, well-being, quality of life, and safety by helping people get enough sleep. In addition to adequate sleep duration, healthy sleep requires good quality, appropriate timing, regularity, and the absence of sleep disorders. It is the position of the American Academy of Sleep Medicine (AASM) that sleep is essential to health. There is a significant need for greater emphasis on sleep health in education, clinical practice, inpatient and long-term care, public health promotion, and the workplace. More sleep and circadian research is needed to further elucidate the importance of sleep for public health and the contributions of insufficient sleep to health disparities. Ramar K, Malhotra RK, Carden KA, etal. Sleep is essential to health: an American Academy of Sleep Medicine position statement. J Clin Sleep Med. 2021;17(10):2115-2119.

Incremental health care utilization and expenditures for sleep disorders in the United States.

To determine the incremental increases in health care utilization and expenditures associated with sleep disorders. Adults with a diagnosis of a sleep disorder (International Classification of Diseases, 10th Revision, code G47.x) within the medical conditions file of the 2018 Medical Expenditure Panel Survey medical conditions file were identified. This dataset was then linked to the consolidated expenditures file and comparisons in health care utilization and expenditures were made between those with and without sleep disorders. Multivariate analyses, adjusted for demographics and comorbidities, were conducted for these comparisons. Overall, 5.6% ± 0.2% of the study population had been diagnosed with a sleep disorder, representing approximately 13.6 ± 0.6 million adults in the United States. Those with sleep disorders were more likely to be non-Hispanic, White, and female, with a higher proportion with public insurance and higher Charlson Comorbidity Scores. Adults with sleep disorders were found to have increased utilization of office visits (16.3 ± 0.8 vs 8.7 ± 0.3, P < .001), emergency room visits (0.52 ± 0.03 vs 0.37 ± 0.02, P < .001), and prescriptions (39.7 ± 1.2 vs 21.9 ± 0.4, P < .001) vs those without sleep disorders. The additional incremental health care expenses for those with sleep disorders were increased in all examined measures: total health care expense ($6,975 ± $800, P < .001), total office-based expenditures ($1,694 ± $277, P < .001), total prescription expenditures ($2,574 ± $364, P < .001), and total self-expenditures for prescriptions ($195 ± $32, P < .001). Sleep disorders are associated with significantly higher rates of health care utilization and expenditures. By using the conservative prevalence estimate found in this study, the overall incremental health care costs of sleep disorders in the United States represents approximately $94.9 billion. Huyett P, Bhattacharyya N. Incremental health care utilization and expenditures for sleep disorders in the United States. J Clin Sleep Med. 2021;17(10):1981-1986.

Effects of Computer-Based Documentation Procedures on Health Care Workload Assessment and Resource Allocation: An Example From VA Sleep Medicine Programs.

Computer-based documentation (CBD) is used commonly throughout the world to track patient care and clinical workloads. However, if capture of clinical services within the electronic health record (EHR) is not implemented properly, patient care services and workload credit will be inaccurate, which impacts business decisions related to demand for care and resources allocated to meet the demand. Understaffing of medical personnel can contribute to delays in treatment, missed treatments, and workforce turnover. To illustrate the impact of CBD procedures on health care workload assessment and resource allocation, this article uses data from the US Department of Veterans Affairs Corporate Data Warehouse to provide examples from the Veterans Health Administration (VHA) sleep medicine programs. Inaccurate CBD led to underreporting of sleep medicine services provided at VHA facilities nationwide and contributed to insufficient allocation of resources and personnel. Recent modifications in CBD protocols (Stop Codes) improved the accuracy of data capture and reporting while providing VHA sleep programs with data they can use to advocate for workforce expansion to meet patient care needs. Inaccurate CBD of clinical workloads can result in inadequate allocation of health care personnel and resources to meet the needs of patients. Untreated sleep disorders are associated with increased risk of depression, anxiety, impaired neurocognitive functions, cardiovascular disease, motor vehicle accidents, and premature death. Educating health care providers and administrators on the importance of accurate designation of clinical services within the EHR is necessary to facilitate improvements in health care availability and delivery.

1175 Sleep Disorders Screening in Primary Care: Prevalence of Diagnosis and Treatment in the EMR

Abstract Introduction Undetected and untreated sleep disorders likely precipitate or exacerbate medical and/or psychiatric illnesses. Given this, primary care is an ideal point for managing sleep disorders, yet prior research shows that PCPs diagnose and/or treat sleep disorders at rates far below population prevalences. The purpose of this study was to determine the current rate of detection and treatment of sleep disorders within primary care settings. Methods EMR data from two health care systems was analyzed. The proportion of PCPs diagnosing and treating one or more sleep disorders was calculated (per year) for 5 years (2014-2018). Also calculated was the percent of PCP caseload diagnosed and/or treated for sleep disorders. Results The two systems comprised n=1021 PCPs. From 2014-2018, the proportion of PCPs diagnosing patients with sleep disorders fluctuated between 58-89%. The proportion treating sleep disorders fluctuated between 50-91%. Non-parametric one-sample run tests (SPSS) indicate these are random distributions (p&amp;gt;0.05). PCPs’ use of medications to treat sleep disorders is trending downward over time within one system (per linear regression, p=0.03, R-squared=0.8). Other temporal trends were not evidenced. The average percentage of diagnosed and treated patients per PCP was around 2.5% of their caseloads. Between-system differences were observed. Conclusion There is a profound mismatch between percentage of PCPs identifying patients with sleep disorders (60-90%) and the percentage of patient caseload diagnosed and/or treated for sleep disorders (2.5%). This suggests that the majority of PCPs are willing to assess for sleep health but do so in only a small minority of patients. These data, along with our survey data (elsewhere in this volume) suggest that the intention-action gap could be closed if PCPs were appropriately resourced. Support There was no funding for this study.

The effects of untreated sleep disorders in traumatic brain injury and its impact on executive function

The effects of untreated sleep disorders in traumatic brain injury and its impact on executive function

Common Sleep Disorders in Children

Sleep disorders are common in children and include both respiratory and non-respiratory causes. An awareness of these conditions is important due to the recognized complications of untreated sleep disorders in childhood. This review provides an overview of common sleep disorders in childhood including an overview of treatment options.

A growth spurt in pediatric sleep research.

A growth spurt in pediatric sleep research.

Frequency of Restless Legs Syndrome in adults with epilepsy in Turkey.

Restless Legs Syndrome (RLS) is a common disorder characterized by an irresistible urge to move the legs particularly during rest in the evenings often leading to insomnia and daytime impairment. No prior studies estimate the prevalence of RLS in a diverse sample of adults with epilepsy using standard diagnostic criteria. A total of 225 patients with epilepsy (61.8% female; mean age 33.3 ± 12.3 years) seen in the epilepsy clinic of Çukurova University Neurology Department were included. Restless Legs Syndrome diagnosis was based on structured interviews using internationally accepted criteria. Demographic and epilepsy-related variables were obtained through medical record review. The prevalence of RLS was 5.8% (n=13). Mean score on the International RLS Study Group rating scale for these subjects was 9.3 ± 3.6 (6-18). Ten (76.9%) patients with RLS scored in the mild range and the remainder in the moderate range of severity. Patients with RLS were not significantly different from others in terms of demographics, epilepsy classification or duration, treatment regimen (polytherapy vs. monotherapy), patient-reported sleep assessment, or relevant laboratory data. The prevalence of RLS in adults with epilepsy was similar to that observed in the adult general Turkish population (3.18-5.2%), although we excluded subjects with conditions associated with RLS, rendering ours a conservative estimate. While preliminary, these findings support the need for future studies exploring RLS in epilepsy given the potential impact of untreated sleep disorders and sleep deprivation on seizures and quality of life in people with epilepsy.

The Role of Sleep and Sleep Disorders in the Development, Diagnosis, and Management of Neurocognitive Disorders.

It is becoming increasingly apparent that sleep plays an important role in the maintenance, disease prevention, repair, and restoration of both mind and body. The sleep and wake cycles are controlled by the pacemaker activity of the superchiasmic nucleus in the hypothalamus but can be disrupted by diseases of the nervous system causing disordered sleep. A lack of sleep has been associated with an increase in all-cause mortality. Likewise, sleep disturbances and sleep disorders may disrupt neuronal pathways and have an impact on neurological diseases. Sleep deprivation studies in normal subjects demonstrate that a lack of sleep can cause attention and working memory impairment. Moreover, untreated sleep disturbances and sleep disorders such as obstructive sleep apnoe (OSA) can also lead to cognitive impairment. Poor sleep and sleep disorders may present a significant risk factor for the development of dementia. In this review, the underlying mechanisms and the role of sleep and sleep disorders in the development of neurocognitive disorders [dementia and mild cognitive impairment (MCI)] and how the presence of sleep disorders could direct the process of diagnosis and management of neurocognitive disorders will be discussed.