The University of Kentucky Public Relations & Strategic Communications Office provides a weekly health column available for use and reprint by news media. This week's column is by Dr. Daniel Lee, medical director for the Kentucky Neuroscience Institute.

Lexington, KY, April 19, 2021 — One out of three individuals in the U.S. complain of sleep disturbances in their lifetime and 10% of the general population meet the diagnostic criteria of chronic sleep disorders. That number has risen among elderly individuals to 48% and over 50% among pregnant women. Our knowledge and understanding of sleep health have evolved over the past four decades. More than 100 specific sleep disorders have been identified. Sleep disorders require a dedicated team to provide a comprehensive approach to tackle the intricacies of complex sleep problems.

The relationship between sleep and overall physical health is well-documented. Sleep allows both the body and brain to recover during the night. A good night’s sleep ensures you’ll feel refreshed and alert the next morning.  It is also reported that sleep and health problems are bidirectional. Sleep deficiency will not only leave you feeling tired but can increase your risk for a wide range of health problems.  These include high blood pressure, heart disease, diabetes, obesity and stroke. A lack of sleep also poses additional risks for workplace injury and driving accidents. Chronic medical and psychiatric conditions can also worsen your sleep.  Chronic pain syndrome, Parkinson’s disease, anxiety disorders and depression are known to cause sleep disruption.

The recent COVID-19 pandemic has led to a dramatic uptake in insomnia which coined the term “COVIDsomnia.”  The lockdown has changed our physical activity, eating habits, electronic usage and even our sleep habits. The virus can also reach the central nervous system through the nose or the blood.  COVID preferentially affects the prefrontal cortex, basal ganglia and hypothalamus in the brain areas that are important for the regulation of sleep.  Sleep plays an important role in the regulation of our immune system; therefore, sleep deprivation can potentially reduce the immune response.  Melatonin is also known for its role in antioxidant, inflammatory and immunoregulatory properties. The aging process can lead to a decrease in melatonin production.  It has been suggested that melatonin-related mechanisms, at least partly, may be contributing to the increase in susceptibility to COVID infection among the elderly.

Sleep disorders, such as REM Sleep Behavior Disorder (RBD), may also offer a window of opportunity for us to predict future development of neurodegenerative conditions such as Parkinson’s disease in our patients. REM Sleep Behavior Disorder is a condition characterized by sudden body movements and vocalizations while a person experiences vivid dreams during REM sleep.  For individuals with RBD, normal muscle paralysis does not occur, enabling the person to physically act out their dreams. RBD can manifest as small muscle twitches and quiet sleep talking to loud shouting, punching, kicking, grabbing their bed partner, and jumping out of bed. The dreams associated with RBD are often intense and frightening. Due to the potentially violent nature of their movements, individuals with RBD can put themselves — and anyone they share their bed with — at risk of physical injury.  At Kentucky Neuroscience Institute, we are currently interested in studying those individuals with RBD by measuring their abnormal protein in their saliva called alpha synuclein protein to help us to have a better understanding of how RBD can lead to Parkinson’s disease.

At Kentucky Neuroscience Institute, our neurologists along with our psychologists, dentists, and ENT colleagues stand ready to provide comprehensive sleep medicine services for our patients in the community.