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Insomnia is a pervasive sleep disorder affecting numerous patients across diverse demographical populations and comorbid disease states. Contributing factors are often a complex interaction of biological, psychological, and social components, requiring a multifaceted approach in terms of both diagnosis and management. In the setting of Alzheimer's disease, insomnia is an even more complicated issue, with a higher overall prevalence than in the general population, greater complexity of contributing etiologies, and differences in diagnosis (at times based on caregiver observation of sleep disruption rather than subjective complaints by the individual with the disorder), and requiring more discretion in terms of treatment, particularly in regard to adverse effect profile concerns. There also is growing evidence of the bidirectional nature of sleep disruption and Alzheimer's disease, with insomnia potentially contributing to disease progression, making the condition even more paramount to address. The objective of this review was to provide the clinician with an overview of treatment strategies that may have value in the treatment of disturbed sleep in Alzheimer's disease. Nonpharmacological approaches to treatment should be exhausted foremost; however, pharmacotherapy may be needed in certain clinical scenarios, which can be a challenge for clinicians given the paucity of evidence and guidelines for treatment in the subpopulation of Alzheimer's disease. Agents such as sedating antidepressants, melatonin, and site-specific γ-aminobutyric acid agonists are often employed based on historical usage but are not necessarily supported by high-quality trials. Newer agents such as dual orexin receptor antagonists have demonstrated some promise but still need further evaluation.

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UNSTRUCTURED Blockchain is an innovative decentralized ledger-based technology that was invented in 2008. Initial utilization was developed for the cryptocurrency bitcoin, but the utility of the technology extends well beyond just that of currency. Much of the value of blockchain exists in the revolutionary ability to transmit and validate data without a third party. Blockchain has significant room for utility in healthcare as a whole, with most of its potential still being very much untapped with the technology still in its incipience. Sleep medicine is an area of medicine that is particularly primed for implementation of blockchain, being a field immensely reliant on data transmission from technology in the form of sleep diagnostics, sleep-related consumer technologies, and therapeutic devices for clinical care to optimally function. Data exchange and entry points for logistics of diagnosis and management of sleep disorders is often fairly profuse and involving multiple parties, making blockchain technology particularly advantageous. Blockchain, like any technology, is not without its limitations, and more research and development is needed before it can be integrated to its potential. However, in blockchain exists the prospect of revolutionizing the way patients’ data interacts with the healthcare system as a whole as well as adjunctive systems which aid in conducting clinical care.