Sleep Well Clinic

09/11/2025

Rapid-eye-movement sleep behaviour disorder (RBD) is a parasomnia causing motor behaviours and vocalizations during sleep, which can lead to injuries in patients and their bed partners. Adult-onset RBD generally precedes a neurodegenerative synucleinopathy, while other cases can be associated with antidepressant use, neurotrauma and narcolepsy.
The symptomatic treatment of RBD should encompass a full clinical assessment in which contributing factors should systemically be evaluated (antidepressants, obstructive sleep apnea, etc.). The evaluation and treatment paradigm should preferably include the patient, bed partner, and family/caregiver.
Despite the rapidly increasing knowledge about RBD, effective symptomatic treatment of RBD remains a significant challenge. The diagnosis of RBD is frequently delayed. Physicians and health care providers are frequently not familiar with this disorder. Once diagnosed, treatment options are limited and may be associated with adverse effects that limit their use.
This paper summarises the evidence supporting the use of clonazepam, melatonin, rivastigmine, and pramipexole, the four agents currently recommended by the American Academy of Sleep Medicine.
https://www.sciencedirect.com/science/article/abs/pii/S1389945725002291?via%3Dihub

06/11/2025

Partners sleeping separately is on the rise:
New survey data from the AASM shows that 31% of U.S. adults are choosing to sleep apart from their partner to get better rest. Most common among 35–44-year-olds, this trend is sparking conversations about what it really means to sleep well. Those who are 65 or older were the least likely (18%) to sleep in separate beds or separate rooms.
Along with choosing separate sleep spaces, the survey data also reveals adults are changing their behaviours to accommodate bed partners, too. Over one-third (37%) of respondents say they go to sleep at a different time than desired to accommodate a bed partner, and 15% of people say they use a silent alarm. Males were more likely than females to report implementing these habits in both categories.
It is important to highlight that if you are sleeping in a separate room because your partner is snoring excessively, please bring it to their attention so they can speak with a health care professional, such as the Sleep Well Clinic.
Healthy sleep is essential for healthy relationships, no matter how it’s achieved. Preferred room temperature, work schedules, and even preferences for white noise, pets in the room or light sources can be factors to take into consideration.

05/11/2025

In addition to sleep duration, sleep timing is another important but significantly understudied sleep characteristic that may be closely associated with cardiovascular disease (CVD) mortality. To investigate optimal sleep timing, these researchers assessed the associations of sleep timing with all-cause and CVD mortality in a large sample of older adults.
Compared with the intermediate group, both early and late midpoint groups were associated with a higher risk of all-cause mortality
For the first time, researchers identified U-shaped associations of sleep timing with all-cause and CVD mortality by identifying the specific sleep timing points associated with the lowest mortality risk, explicitly from 11:00 PM to 6:00 AM.
The associations of early and late sleep timing with risk of all-cause mortality were more pronounced in males, older people, and those with a high CVD genetic risk score.
https://jcsm.aasm.org/doi/10.5664/jcsm.11762

04/11/2025

Yoga, tai chi, walking and running are particularly effective in managing insomnia, according to a study published in BMJ Evidence-Based Medicine. The study reviewed 22 clinical trials and found yoga improved sleep efficiency by 15%, tai chi helped to increase total sleep time by more than 50 minutes, and walking and running reduced insomnia severity. The researchers suggested several explanations for the findings. The calming effects of yoga may help alleviate anxiety and depression symptoms, which interfere with sleep. Tai chi emphasizes breath control and physical relaxation to help reduce anxiety. Walking and running may dampen cortisol production (the stress hormone) and boost the sleep hormone melatonin. Future studies that focus on the frequency and intensity of these exercises could lead to more formal guidelines.
https://ebm.bmj.com/content/early/2025/07/09/bmjebm-2024-113512

03/11/2025

Evaluation of a novel smart mandibular advancement device for nightly monitoring of treatment:
A current gap in oral appliance therapy, relative to continuous positive airway pressure, in the management of obstructive sleep apnea is access to nightly therapy data. The aim of this pilot study was to evaluate the performance of a novel intraoral, multisensory array embedded within a mandibular advancement device (MAD).
This pilot study demonstrates the feasibility of estimating clinically relevant therapy data with high accuracy from a sensor system within a MAD. The ability to provide clinicians with relevant sleep metrics including AHI, total sleep time, adherence, sleep position, and response to MAD therapy on a nightly basis has the potential to enhance clinical uptake of MAD therapy. Further research is required to validate these results in a larger sample over a longer term.
https://jcsm.aasm.org/doi/10.5664/jcsm.11736

02/11/2025

Sleep disorders and sexual function in women:
Highlights
• Sleep disorders are strongly linked to sexual dysfunction in women- insomnia, obstructive sleep apnoea, or circadian rhythm disorders, may adversely affect sexual desire, arousal, and satisfaction.
• Hormones like oestrogen and cortisol regulate sleep and sexual health.
• Sleep and sexual function change across the menstrual cycle, pregnancy, and menopause.
• Poor sleep quality is associated with higher rates of sexual dysfunction.
Also, depression and anxiety can exacerbate both sleep and sexual dysfunction.
https://www.maturitas.org/article/S0378-5122(25)00433-5/abstract

30/10/2025

A study in the journal Neurology indicates that about 90% of people with isolated REM sleep behaviour disorder develop Parkinson's disease or Lewy body dementia. The study shows that individuals with iRBD who exhibit changes in brain free water levels are eight times more likely to develop Lewy body dementia, and those with a lower DTI-ALPS index in the left hemisphere are 2.4 times more likely to develop Parkinson's.
What is REM sleep behaviour disorder?
This is a condition where you physically or verbally act out in your sleep.
Its symptoms include thrashing around, shouting, and “sudden, often violent arm and leg movements during REM sleep”. It is also known as “dream-enacting behaviour”.
You might accidentally hit your partner in your sleep, swear while you’re dreaming, or fall out of bed. Per the Cleveland Clinic, about 80% of those with the condition get injured from the actions in their sleep.
Usually, our brain prevents our limbs from moving during our dream cycle. With REM sleep behaviour disorders, though, this doesn’t work.
According to the Mayo Clinic, it can come on gradually and get worse over time.
But the type most heavily linked to Lewy body dementia and Parkinson’s is isolated, or idiopathic, REM sleep disorder.
This issue, which affects about 2% of the population and “commonly presents in males >50 years”, comes with no other obvious neurological conditions – hence why this particular type is described as “isolated”.
Speak to your doctor if you or your partner notice that you’re “acting out” your dreams, especially if you’re injuring yourself or others.

Two landmark international studies show that brain biomarkers can predict whether people with REM sleep behaviour disorder (iRBD) will develop Parkinson’s disease or dementia with Lewy bodies (DLB).

29/10/2025

A study published in the journal Sleep linked nonrestorative sleep to a 14% increased risk of major cardiac and cerebrovascular events, rising to 26% for adults under 60. Nonrestorative sleep (NRS) is defined as “feeling unrefreshed upon awakening that is not attributed to a lack of sleep.
The study, which analysed data from more than 86,000 adults, found that nonrestorative sleep was associated with higher rates of ischemic heart disease and heart failure.
https://academic.oup.com/sleep/advance-article-abstract/doi/10.1093/sleep/zsaf290/8258631?redirectedFrom=fulltext&login=true

28/10/2025

A study presented at the European Respiratory Society conference found that long-term exposure to air pollution, specifically PM10 particles, may worsen obstructive sleep apnoea. PM10 concentration is the amount of tiny particles, 10 micrometres or smaller, released into the air by modern pollutants such as vehicle exhausts and industry. The study analysed data from 19,325 OSA patients across 25 European cities and found a significant association between higher PM10 levels and increased OSA severity, with regional variations in the impact. The study highlights the importance of considering environmental factors in managing OSA and suggests that improving air quality could mitigate the condition's severity.
The study adds to the body of evidence suggesting that environmental factors such as air quality, seasonal shifts and temperature play a more important role in the severity of OSA than previously thought. It reminds us that tackling air pollution isn't just good for the planet, it's also vital for our lungs and our sleep quality too.
https://www.ersnet.org/

27/10/2025

Emerging evidence suggests that sleep plays a powerful role in obesity and related conditions (diabetes, cardiovascular disease, and hypertension).
A recent cross-sectional study found a sleep duration of less than 7 hours increased the overweight and obesity rate nearly twofold compared with sleeping 7-9 hours, while a recent randomized controlled trial found that insufficient sleep predicted poor weight-loss maintenance with liraglutide.
A strong link exists between sleep and obesity, and it seems to be a bidirectional association, poor sleep predisposes one to obesity and weight gain, while obesity promotes poor sleep.
Poor sleep may cause obesity via several pathways:
Poor sleep could lead to altered substrate utilisation- poor sleep reduces insulin sensitivity.
Appetite regulation is another possible pathway. There’s some evidence (though not as compelling as initially thought) that poor sleep causes increases in ghrelin and decreases in leptin, two potent appetite-regulating hormones.
In addition, people with overweight/obesity and poor sleep often have a reduced inability to resist calorie-dense foods.
Less sleep mar result in less physical activity, which results in reduced energy expenditure and, if caloric intake stays the same, altered energy balance.
Sleep disorders such as sleep apnoea can also sabotage weight-loss efforts, adults with sleep apnoea lost less weight than those who didn’t have sleep apnoea in lifestyle intervention studies.
Curtailed sleep also significantly slows resting metabolic rate and increases risk of sarcopenic obesity.
Does Improving Sleep Improve Weight Loss?
At this stage, we should consider ‘adequate sleep’ as a third pillar of healthy lifestyle behaviour alongside diet and exercise for healthy weight maintenance and prevention of weight gain. Healthier sleep can help people eat healthier food — among many other benefits to overall health and well-being — and therefore help reduce weight gain and other cardio-metabolic conditions.

23/10/2025

Teenagers who live in areas with high violence rates are more likely to suffer from sleep deprivation and engage in violent behaviour themselves, according to a new study. The research, which analysed data from more than 44,000 teenagers, found that those who slept fewer than eight hours a night were more likely to witness violence and participate in similar behaviour (such as such as fighting or carrying a weapon).
The less sleep a teen got, the more likely they were to report having witnessed neighbourhood violence. For those averaging four hours or fewer, the odds of having been exposed to violence were nearly three times higher.
That same pattern held true for violent behaviour. Teens who got too little sleep were more likely to report carrying a weapon, fighting, skipping school out of fear, or being threatened or injured at school.
This is one of the first studies to connect community violence with how much teenagers actually sleep. This study is a reminder that sleep isn’t just an individual health habit, it’s also shaped by the safety and stability of the communities kids live in.

Cornelia L Griggs, Reagan A Collins, Josélio R de Oliveira Filho, Peter T Masiakos, Chana A Sacks, Rebecca Robbins; The relationship between insufficient s

22/10/2025

Addressing insomnia may help stave off cognitive decline, according to a study in the journal Neurology. For this research, 2,750 people underwent about five years of annual neurological assessments and brain imaging along with evaluations of sleep habits to investigate the association between insomnia and brain changes.
Insomnia was found to be linked to a 40% increased risk of cognitive impairment, according to the data. People who had insomnia but increased their sleep time or utilized medication did not experience the same detriment to their cognitive health.
If you have been experiencing insomnia for more than 3 months it is considered chronic, get in touch with our clinic to discuss treatment options.
https://www.neurology.org/doi/10.1212/WNL.0000000000214155?utm_medium=email&_hsenc=p2ANqtz-9DAOTNBptDOGzyz5dwDv0ELseTsZ19gem6mS_QccXrv16j75XVw5JdOeb4ncLYHgMrJQyVM9kBdOxhfp3GTI5JIyJxdoULpbwSPldl-MRDXLbgio8&_hsmi=379258773&utm_content=379258773&utm_source=hs_email