Neurological Sleep Medicine

What Is Neurological Sleep Medicine?

Neurological sleep medicine is the specialised field that evaluates and treats sleep disorders connected to the brain, spinal cord, nerves and muscles. It combines clinical neurology with sleep science, and it exists to answer two questions at the same time: what happens to your body during sleep, and what your nervous system is doing to cause it. It is most relevant when sleep problems are persistent, unusual or disruptive, and when they occur alongside conditions such as epilepsy, Parkinson’s disease, stroke, dementia, migraine, neuromuscular disease, chronic pain or traumatic brain injury.

This is different from general advice about bedtime routines. This specialty looks for specific sleep-wake disorders and the mechanisms behind them. Those mechanisms may involve abnormal breathing during sleep, irregular electrical activity in the brain, a disrupted circadian rhythm, abnormal muscle tone during dreaming, repetitive limb movements, impaired alertness systems, medication effects or the sleep consequences of an existing neurological disease. The distinction matters, because two people with the same complaint — waking exhausted every morning, for example — can have entirely different disorders that need entirely different treatment.

The evaluation may include a specialist consultation, a neurological examination, a review of your previous records, structured sleep questionnaires, laboratory sleep testing, daytime sleepiness testing, movement monitoring over days or weeks and, when indicated, coordination with other specialists. It sits within the broader discipline of sleep medicine, but it adds something specific: a neurologist trained in sleep can interpret your symptoms in the context of epilepsy, movement disorders, cognitive disorders, stroke, headache, and nerve and muscle disease.

Treatment is personalised. Depending on the diagnosis, it may include positive airway pressure therapy for sleep-disordered breathing, adjustments to existing medication made by your treating doctor, targeted medicines for narcolepsy or restless legs syndrome, behavioural treatment for insomnia, circadian rhythm planning, safety measures for parasomnias, treatment of the underlying neurological disease, or referral for dental, ear-nose-throat, pulmonary, psychiatric, paediatric or rehabilitation input. The goal is not simply more hours of sleep. It is better sleep quality, safer nights, clearer days and a more stable neurological picture.

Is sleep medicine neurology?

Sleep medicine is not exclusively neurology, but neurology is one of its core parent specialities. Sleep disorders cross many systems — the airway, the lungs, the heart, the mind — so pulmonologists, psychiatrists, ear-nose-throat surgeons and paediatricians also train and practise in sleep medicine. What people usually mean by “sleep medicine neurology” is the part of the field practised by neurologists: the evaluation of sleep disorders that begin in, or act on, the nervous system. That is the territory of neurological sleep medicine, sometimes called sleep neurology. It becomes the right lens when the question is not only how you sleep, but what your brain is doing while you sleep — when dream enactment might point to a movement disorder, or when a nighttime episode could be a seizure rather than a parasomnia.

What does neurological mean?

Neurological means relating to the nervous system: the brain, the spinal cord, the peripheral nerves and the junctions where nerves meet muscle. A neurological symptom is one produced by that system — weakness, numbness, tremor, memory change, seizures or disturbed coordination. Sleep belongs on that list more often than people expect. Sleep is generated, staged and timed by networks in the brain, which is why it is frequently one of the first functions to change when the nervous system is under strain, and why unusual sleep symptoms deserve a neurological perspective rather than generic reassurance.

When Sleep Becomes a Neurological Concern

Sleep is often the first part of life to change when the brain or nervous system is under strain. You may wake repeatedly through the night, act out dreams, feel unable to stay awake during the day, experience frightening movements during sleep, or notice that memory, mood and concentration are no longer reliable. For many patients, the problem is not simply “poor sleep”. It may be a neurological sleep disorder that needs specialist evaluation.

Specialist evaluation matters most when symptoms are unusual, persistent, disruptive or linked with conditions such as epilepsy, Parkinson’s disease, stroke, dementia, migraine, neuromuscular disease, chronic pain or traumatic brain injury. It is also relevant when sleep apnea, insomnia or restless legs symptoms begin to affect neurological function, cognition, safety or quality of life — sleepiness at the wheel, memory lapses at work, injuries during the night.

Many people arrive at this point after months or years of uncertainty. You may have tried lifestyle changes, medication, sleep apps, home remedies or a series of fragmented consultations without a clear explanation. Some patients worry about serious neurological disease. Others are concerned about falling asleep while driving, dozing at work, memory problems, nighttime injuries or changes a bed partner has noticed. Parents seek answers for a child with unusual sleep behaviours or excessive daytime sleepiness. Older adults come for evaluation because dream enactment, confusion at night or abnormal movements can signal a neurological disorder.

Treatment matters because sleep is not separate from health. Disrupted sleep can worsen blood pressure, metabolic control, mood, pain sensitivity, immune function, attention and neurological recovery. In people with brain or nerve disorders, untreated sleep problems can intensify symptoms that are already difficult to manage. A careful neurological sleep evaluation identifies the cause, distinguishes one disorder from another, and produces a treatment plan that fits your medical history, your lifestyle and your long-term goals — rather than another round of trial and error.

Who May Need Neurological Sleep Medicine?

A neurological sleep medicine consultation is worth considering when sleep problems are persistent, complex, potentially dangerous or accompanied by neurological symptoms. The reasons people are referred vary widely. Some cannot sleep; others cannot stay awake. Some are referred after a bed partner observes behaviours the patient does not remember. Others need evaluation because sleep changes are complicating a known neurological diagnosis such as Parkinson’s disease or epilepsy.

The symptoms that typically prompt referral fall into recognisable groups:

• Excessive sleepiness: daytime sleepiness that does not match the hours slept, sudden sleep attacks, difficulty waking, or dozing during meetings, conversations or driving.
• Disordered breathing: loud snoring with witnessed pauses in breathing, gasping arousals, morning headaches or a dry mouth on waking.
• Movements and behaviours: restless or painful legs at night, repeated kicking during sleep, dream enactment, sleepwalking, night terrors, nighttime confusion or seizures during sleep.
• Insomnia and fragmented sleep: chronic difficulty falling asleep or staying asleep, unexplained awakenings, or waking far too early.
• Unusual experiences around sleep: vivid hallucinations while falling asleep or waking, sleep paralysis, or sudden loss of muscle tone triggered by laughter or strong emotion.
• Daytime consequences: poor concentration, irritability, low mood, fatigue, memory complaints or declining performance at work or school.

Diagnosis begins with a detailed clinical history. The physician asks about the timing of sleep, your bedtime routine, awakenings, breathing, movements, dreams, medications, caffeine and alcohol use, travel schedule, shift work and daytime alertness. A bed partner’s observations are often the most valuable evidence available, because you cannot watch yourself sleep. The neurological examination may assess cognition, eye movements, strength, reflexes, sensation, coordination, gait and signs of movement disorders.

Sleep testing is used when the history alone cannot confirm a diagnosis. An overnight sleep study, called polysomnography, records brain waves, eye movements, muscle activity, breathing, oxygen levels, heart rhythm and body position while you sleep. Additional tests can measure daytime sleep tendency, circadian rhythm patterns or movement activity over several days. In selected cases, video monitoring helps distinguish parasomnias from nocturnal seizures or other events — a distinction that changes treatment entirely.

You may also benefit from this kind of evaluation when previous treatment has not worked as expected. A person using positive airway pressure therapy may still feel sleepy because of a second sleep disorder, a medication effect, insufficient sleep time, depression, periodic limb movements or narcolepsy. Someone treated for insomnia may actually have restless legs syndrome or a circadian rhythm disorder. A person with nighttime episodes may need careful differentiation between epilepsy and non-epileptic sleep behaviours. This kind of layered problem is exactly where the field is most useful.

How do I know if I have a neurological disease?

You cannot reliably diagnose a neurological disease from symptoms alone, and no single sleep symptom proves one. What clinicians look for is a pattern: symptoms that persist or progress, that cluster together — dream enactment alongside changes in smell, movement or handwriting, for example — or that begin at an unusual age. Many sleep complaints turn out to have non-neurological explanations, including medication effects, mood disorders, breathing problems or simple sleep deprivation. Equally, some neurological conditions announce themselves through sleep years before other signs appear. The honest answer is therefore an assessment, not a checklist: a structured history, an examination and, where indicated, testing can separate a harmless sleep habit from a disorder that needs treatment.

Conditions and Indications Addressed

The field covers a broad range of disorders and sleep-related neurological concerns. They can occur alone or in combination, and many patients have more than one contributing factor — which is one reason single-symptom treatment so often disappoints.

• Sleep apnea and sleep-disordered breathing: repeated airway obstruction or unstable breathing during sleep can lower oxygen levels, fragment sleep and contribute to daytime sleepiness, morning headache, cardiovascular strain and cognitive complaints. Neurological patients can be particularly vulnerable after stroke or with neuromuscular disease, when the muscles and reflexes that protect the airway are weakened. Sleep apnea also matters because it is treatable, and treating it can change the whole clinical picture.
• Narcolepsy and central hypersomnia disorders: these conditions affect the brain systems that regulate wakefulness itself. Symptoms may include irresistible sleepiness, sudden sleep episodes, cataplexy — a loss of muscle tone triggered by emotion — sleep paralysis and dream-like hallucinations when falling asleep or waking.
• Insomnia with neurological complexity: chronic difficulty falling asleep, staying asleep or waking too early may be tied to pain, migraine, anxiety, medication use, neurodegenerative disease, restless legs syndrome or circadian disruption. When insomnia coexists with frequent headaches, coordinated care with headache medicine can address both problems together rather than one at a time.
• Restless legs syndrome and periodic limb movement disorder: uncomfortable sensations in the legs and repetitive limb movements can disrupt sleep and are often linked to iron metabolism, kidney disease, pregnancy, neuropathy or certain medications. Identifying the contributor matters as much as suppressing the symptom.
• REM sleep behavior disorder: during normal REM sleep, the body’s muscles are relaxed. In this disorder that relaxation fails, and patients may move, shout, punch, kick or act out their dreams. It can cause injury to the patient or bed partner and may be associated with certain neurological conditions, which makes proper evaluation and follow-up important.
• Parasomnias: sleepwalking, night terrors, confusional arousals and similar behaviours arise from partial awakenings. Evaluation is important when events are frequent, injurious, atypical or begin in adulthood, when other explanations must be excluded.
• Sleep-related epilepsy: some seizures occur mainly or only during sleep. Video sleep testing and neurological assessment help distinguish seizures from parasomnias or movement disorders — three problems that can look alike in a bedroom but require completely different management.
• Circadian rhythm sleep-wake disorders: the body clock may run delayed, advanced or irregular. This is common in shift workers, frequent travellers, adolescents, older adults and patients with neurological or visual disorders, and it is often mislabelled as ordinary insomnia.
• Sleep problems in neurological disease: Parkinson’s disease, dementia, multiple sclerosis, stroke, traumatic brain injury, migraine, neuropathy and neuromuscular conditions can all disturb sleep and alertness — and disturbed sleep can, in turn, worsen the underlying condition.
• Medication-related sleep disturbance: some medicines can cause insomnia, sleepiness, abnormal dreams, restless legs symptoms or altered breathing during sleep. A structured review can identify contributing factors, so that any change can be considered by your treating doctor with the full picture in view.

What are the most common neurological problems?

Among the neurological conditions seen most often in clinical practice are headache disorders such as migraine, stroke, epilepsy, dementia, Parkinson’s disease, peripheral neuropathy and multiple sclerosis. Every one of them has a sleep dimension. Stroke raises the likelihood of sleep-disordered breathing; epilepsy and sleep deprivation aggravate each other in both directions; Parkinson’s disease is closely linked with REM sleep behavior disorder and fragmented nights; dementia disturbs the circadian rhythm; neuropathy and migraine both erode sleep through pain. This overlap is why sleep evaluation is increasingly built into neurological care rather than treated as an afterthought.

How Evaluation and Treatment Are Performed

The process begins before you enter a sleep laboratory. Where available, your medical records, previous sleep study reports, medication lists, neurological imaging, blood tests and specialist notes are reviewed in advance. This preparation shapes the visit: it tells the clinical team what has already been ruled out, what remains uncertain and which test is most likely to answer the remaining question.

The first step is a specialist consultation. The physician takes a detailed sleep and neurological history, reviews your symptoms and examines you where appropriate. Expect specific questions rather than general ones. When did the sleep problem begin? Are you sleepy, tired, or both — and can you tell the difference? Does sleepiness occur only in passive situations, or suddenly during activity? Has anyone witnessed pauses in your breathing? Are there movements, vocalisations or injuries during sleep? Is there a history of seizures, stroke, head injury, migraine, Parkinsonism or cognitive change? Which medications and supplements do you take, and at what times of day?

The next step is choosing the right test, because not every patient needs the same evaluation. Suspected obstructive sleep apnea may call for overnight polysomnography or a carefully selected home sleep apnea test, depending on the clinical picture. Suspected narcolepsy usually requires an overnight study followed by a multiple sleep latency test the next day, measuring how quickly you fall asleep and whether REM sleep appears unusually early. Dream enactment, possible nocturnal seizures or unusual movements may call for video polysomnography with expanded brain wave or muscle monitoring.

What happens during an overnight sleep study?

An in-laboratory overnight sleep study, or polysomnography, is non-invasive and follows a predictable sequence:

1. You arrive in the evening and settle into a private, monitored room designed for clinical observation.
2. A sleep technologist places sensors on your scalp, face, chest, abdomen and legs. Nothing pierces the skin.
3. Through the night, the equipment records brain waves, eye movements, chin and leg muscle activity, airflow, breathing effort, oxygen level, heart rhythm and body position, while trained sleep technologists follow the recording live.
4. Video may run alongside the physiological signals, so that any movement or behaviour can be matched to what your brain and body were doing at that exact moment.
5. In the morning the sensors are removed, and you can usually leave — unless daytime testing has been planned for the same visit.

For some patients, additional testing continues into the day. The multiple sleep latency test measures the degree of daytime sleepiness through scheduled nap opportunities. The maintenance of wakefulness test may be used in selected cases to evaluate the ability to stay awake. Actigraphy — a wrist-worn movement monitor — may be recommended over several days or weeks to study sleep-wake patterns in ordinary life, outside the laboratory. Sleep diaries and questionnaires add the context that technology alone cannot capture.

Each channel of the recording answers a different question. Brain wave monitoring determines sleep stages and can detect abnormal electrical patterns. Breathing sensors show whether sleep is being interrupted by airway obstruction or altered respiratory control. Oxygen monitoring identifies drops that stress the brain and heart. Muscle sensors reveal periodic limb movements, loss of the normal muscle relaxation of REM sleep, or other unusual motor activity. Video correlation lets physicians decide whether an event is a parasomnia, a seizure-like episode, a movement disorder or something else entirely.

After testing, the physician interprets the results against your symptoms and history — a sleep report is not a list of measurements, it has to be clinically integrated. A mild breathing abnormality may be highly relevant in a patient with stroke risk or severe daytime sleepiness, while another patient with the same finding needs evaluation for a separate cause. Periodic limb movements may be incidental in one person and significant in another. Dream enactment may require both immediate safety counselling and longer-term neurological follow-up.

How do you treat someone with a neurological disorder?

There is no single treatment for “neurological disorders” — care depends entirely on the underlying condition. It usually combines disease-specific treatment, such as seizure management in epilepsy or movement therapy in Parkinson’s disease, with symptom control, rehabilitation and attention to sleep, mood and general health. Within this specialty, that principle translates into targeted plans built around the confirmed diagnosis rather than the presenting complaint.

For sleep-disordered breathing, therapy may include positive airway pressure, positional strategies, weight-related counselling, referral for an oral appliance through dental sleep medicine, or evaluation of airway anatomy where appropriate. For restless legs syndrome, treatment may include iron evaluation, a structured medication review and specific medicines when symptoms are clinically significant. For narcolepsy and central hypersomnia, wake-promoting medication prescribed and monitored by the treating physician, scheduled sleep planning and safety counselling may be considered. For insomnia, evidence-based behavioural treatment is often the centrepiece, sometimes combined with treatment of underlying pain, mood or neurological symptoms.

Parasomnias and REM sleep behavior disorder require particular attention to safety. You may be advised to remove dangerous objects from the bedroom, protect your bed partner, reduce triggers such as sleep deprivation and alcohol, and consider medication when events are frequent or risky. If nocturnal seizures are suspected, neurological testing and epilepsy management are coordinated. In patients living with Parkinson’s disease, dementia, stroke, multiple sclerosis or neuromuscular disease, the sleep plan is integrated with the broader neurological care plan — including neurological rehabilitation where mobility, cognition or daily function are affected.

How long all of this takes depends on the complexity of the case. A consultation may be completed in a single outpatient visit; an overnight sleep study typically requires arrival in the evening and departure the next morning; daytime sleepiness testing can extend through much of the following day. Some treatments begin immediately after diagnosis. Others require follow-up visits, medication titration by your treating doctor, device adjustment or coordination with another specialty.

Recovery from the testing itself is usually simple, because the tests are non-invasive. Some people feel tired after a night in an unfamiliar laboratory environment, but most can resume normal activities the next day — unless daytime testing is planned, or they have been advised not to drive because of sleepiness. Recovery from the disorder being treated depends on the condition, its severity and adherence to therapy. Some patients notice improvement quickly after effective breathing treatment or a medication change made by their doctor. Others improve gradually, as sleep patterns stabilise and the treatment is refined over follow-up.

Why Acting Early Matters

Sleep disorders are easy to minimise, because symptoms build gradually and occur at night, when you may not be aware of them at all. Yet delayed evaluation can allow a treatable problem to affect health, safety and neurological function for years. Excessive sleepiness increases the risk of accidents, including driving and workplace incidents. Repeated nighttime oxygen drops burden the cardiovascular system and may worsen cognitive performance, especially in patients who are already vulnerable.

Untreated insomnia tends to become self-reinforcing: anxiety about sleep grows, and irregular habits take root. Restless legs syndrome can lead to chronic sleep loss and daytime impairment if its underlying contributors are never addressed. REM sleep behavior disorder can injure the patient or the bed partner. Nocturnal seizures need timely diagnosis because they may require specific treatment and safety planning. And in established neurological disease, poor sleep can worsen movement symptoms, mood, pain, fatigue and rehabilitation progress.

Early assessment also prevents mismatched treatment. A patient with sleep apnea may be given sleeping tablets when breathing interruptions are the real issue. A person with narcolepsy may be told to simply sleep more, when the actual problem is impaired regulation of wakefulness. Someone with dream enactment may be treated as if the problem were purely psychological, when neurological sleep testing is what is needed. An accurate diagnosis guides better decisions and shortens the trial-and-error phase that exhausts so many patients.

Benefits of Treatment

The benefits of specialist sleep care depend on the diagnosis, but effective treatment can improve both nighttime sleep and daytime neurological function.

Benefit	What It Means for You
More accurate diagnosis	Specialist assessment and sleep testing distinguish between conditions that can look similar in daily life — parasomnias, seizures, sleep apnea, narcolepsy or movement disorders — so treatment targets the right problem.
Improved daytime alertness	Treating the cause of sleep disruption may reduce sleepiness, sharpen concentration and support safer driving, work and daily activities.
Better neurological symptom control	Optimising sleep can help reduce the burden of fatigue, headache, pain sensitivity, mood changes and movement symptoms in selected patients.
Reduced nighttime risk	For patients with abnormal movements, dream enactment or nocturnal seizures, treatment and practical safety planning may lower the chance of injury.
Personalised treatment planning	Care is tailored to your diagnosis, medical history, medications, travel needs, lifestyle and long-term neurological health, rather than to a generic protocol.

Recovery and Follow-Up Timeline

Because neurological sleep medicine is largely diagnostic and non-invasive, the timeline centres on testing, treatment initiation and gradual symptom improvement rather than physical healing.

Time Period	What You Can Expect
Day 1	You attend a consultation and may complete questionnaires or begin sleep testing. If an overnight study is scheduled, sensors are placed in the evening and monitoring continues while you sleep.
First Week	Sleep study results are interpreted and discussed with you. A treatment plan may begin — device therapy, medication changes decided by your treating doctor, behavioural recommendations or further neurological evaluation.
First Month	Most patients are adjusting to therapy. Symptoms such as sleepiness, awakenings, restless legs sensations or abnormal behaviours are monitored, and treatment is refined based on response and comfort.
Longer Term	Follow-up focuses on sustained benefit, adherence to therapy, medication safety and coordination with care for any underlying neurological condition. Some patients need repeat testing if symptoms change over time.

What Influences Outcomes and a Good Result

A good result begins with the right diagnosis. Sleep symptoms overlap heavily, and a single complaint such as fatigue can have several simultaneous causes. Outcomes are stronger when the evaluation includes a detailed history, the appropriate sleep test, careful interpretation and honest attention to coexisting medical or neurological conditions.

The underlying disorder matters most. Obstructive sleep apnea, restless legs syndrome, narcolepsy, circadian rhythm disorders and parasomnias each respond to different treatments on different timelines. Some conditions can improve substantially with targeted therapy. Others require long-term management, and it is better to know that from the start. In chronic neurological disease, the realistic goal may be to reduce symptom burden, improve safety and support daily function — not to eliminate every sleep symptom.

Severity also shapes the course. Patients with severe sleep fragmentation, marked oxygen drops, frequent abnormal movements or long-standing insomnia may need more time and more follow-up before they feel the difference. Medication effects can be significant too: sedatives, antidepressants, stimulants, pain medicines, allergy medicines and some neurological medications can alter sleep architecture, breathing, movements and alertness. A careful medication review, with any changes made by your treating doctor, is often a central part of the plan.

Adherence is another major influence. Positive airway pressure therapy works best when the mask fits comfortably, the pressure settings are right and you receive support during the adjustment period. Behavioural treatment for insomnia depends on consistency over weeks, not days. Circadian rhythm treatment hinges on the timing of light exposure, your sleep schedule and daily habits. Restless legs treatment may require correcting an iron deficiency or avoiding specific triggers. Patients who understand why each recommendation exists tend to keep following it.

General health and lifestyle pull on the same rope. Weight changes, alcohol, caffeine, irregular working hours, frequent long-haul travel, stress, pain and mood disorders all influence sleep. If you have recently crossed several time zones, jet lag can temporarily affect testing and treatment adjustment, so recent travel, work schedules and home circumstances are all worth discussing when the plan is made.

Finally, good outcomes depend on communication. Report whether you feel more alert, whether your bed partner notices a change, whether a device is comfortable, whether a medicine causes side effects, and whether symptoms persist despite treatment. Sleep medicine is iterative by nature. A thoughtful follow-up plan allows care to be adjusted as your condition evolves, rather than fixed at the first visit and never revisited.

How Multidisciplinary Care Supports a Sleep Diagnosis

Complex sleep problems are rarely solved by a single specialist working alone, because sleep disorders rarely respect specialty boundaries. A patient with sleep apnea may also have heart rhythm concerns or stroke risk. A patient with REM sleep behavior disorder may need neurological follow-up for movement symptoms. A child with unusual sleep behaviours may require paediatric neurology input. A patient with insomnia may also need evaluation of chronic pain, migraine, anxiety or medication effects. At Acibadem, neurological sleep medicine sits within a broader hospital environment where neurology, pulmonology, cardiology, psychiatry, otolaryngology, paediatrics and rehabilitation teams can collaborate when a case requires it, and that multidisciplinary discussion supports complex decision-making — particularly when symptoms are not explained by a single cause.

The diagnostic pathways described on this page are central to how the work is done. Sleep laboratories and neurophysiology services may use overnight polysomnography, video monitoring, brain wave recording, respiratory monitoring, oxygen measurement, limb movement assessment and daytime sleepiness testing, according to the clinical indication. These tools let clinicians observe what you cannot report yourself: breathing patterns, sleep stages, oxygen changes, muscle activity, abnormal movements and the precise timing of events.

Experienced interpretation is the other half of the equation. The same recording can mean different things depending on your symptoms, age, medical history, neurological examination and medications. A neurological sleep specialist determines whether a finding is the main diagnosis, a contributing factor or an incidental observation — a distinction that matters most to patients who have already received conflicting opinions or incomplete explanations. For someone weighing a second opinion, a structured evaluation of this kind can clarify the diagnosis and give a more confident basis for the next decision.

Continuity is the final piece. Some therapies, such as device-based treatment for sleep-disordered breathing or long-term medication for narcolepsy, need ongoing management well beyond the initial evaluation. Structured reports, clear device settings and written recommendations help the physicians who follow you over the long term continue treatment consistently, adjust it when your condition changes and avoid repeating tests that have already answered their question.

Understanding What Comes Next

If sleep is affecting your alertness, safety, neurological health or quality of life, the most useful next step is understanding what a proper evaluation involves — which is what this page has set out. Neurological sleep medicine is most valuable when symptoms are complex, unusual, associated with a neurological condition or not improving with standard approaches. A structured evaluation brings the relevant pieces together: your history, the neurological context, sleep test findings and realistic treatment options. What it delivers, at its best, is a clear explanation of what is happening during your sleep and a practical, personalised plan for improving your health and daily function — with honest expectations about what treatment can and cannot achieve for your particular diagnosis.