How a Lack of Sleep Could Be Behind Alzheimer’s

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Sleep and Alzheimer’sIt’s already known that a lack of sleep is a major problem for those suffering from dementia. Alzheimer’s patients often experience sleep deprivation and sleep disorders.

The negative effects of little sleep are unquestionable. It can boost stress, affect cognitive function, and lower quality of life. These problems are exacerbated in people with Alzheimer’s disease.

Insomnia and Alzheimer’s go hand in hand, often accompanied by sleep apnea. What most of us don’t know, however, is that it’s possible sleep disorders could actually be a cause of Alzheimer’s.

A Little Bit About Alzheimer’s Disease

You’ve definitely heard of Alzheimer’s before and you likely know someone who has it. It could be someone you are very close to, therein affecting you very deeply. Caring for someone with Alzheimer’s is very taxing. It can be crushing to see a person you love so removed from their former self.Alzheimer’s is the most common form of dementia and affects roughly 4.5 million Americans. That number is expected to rise as the population ages. Although Alzheimer’s is closely associated with aging, it is not a normal occurrence. Alzheimer’s affects a person’s thoughts, memory, and speech; making it very difficult to carry out many of the daily activities you currently take for granted. These cognitive disabilities kick in because brain tissue is lost—and that same brain tissue that is gone can disrupt the circadian rhythm (sleep/wake/metabolic cycle), causing sleep troubles, wandering, and agitation.

Sleep Deprivation in Alzheimer’s Patients

Not getting enough sleep is common for Alzheimer’s patients. The disruptions in sleep usually depend on the stage of the disease. Those who are in the early stages may wake up and feel tired or disoriented, while those who’ve experienced progression in Alzheimer’s might awaken frequently throughout the night or fall asleep randomly during the day. The more advanced the disease, the less likely it becomes for a night of regular, uninterrupted sleep.

This merits all kinds of negative effects. Not only does it make Alzheimer’s patients more tired and disoriented, but it alters their metabolism, body temperature, wakefulness, and sleep cycle. Sleep also creates an opportunity for the brain to clean itself—a sort of detox, if you will—by flushing out waste products of neural activity. It’s still unknown that this cleanup (or lack thereof) impacts Alzheimer’s and your health, but I’m confident that it does.

Alzheimer’s and Sleep Apnea

Sleep apnea is a dangerous condition that is associated with obesity, high blood pressure, and heart disease, which can increase the risk of a stroke or heart attack. But did you know it may also be genetically linked to Alzheimer’s? A Stanford University study found that obstructive sleep apnea shares a common gene associated with chronic illness. Now, it is hard to tell if the obstructive sleep apnea is a contributor to the cause of Alzheimer’s by severely limiting the number of quality hours of sleep you get each night or if there’s some other connection, but it is an area that’s being explored.

Sleep, Alzheimer’s and Beta-Amyloid Plaque

An important study from John Hopkins Bloomberg School of Health shows that research links disturbed sleep to brain function in aging adults. People with Alzheimer’s were shown to spend more time awake than people without it, as well as having a more fragmented sleep schedule; they got up more often and slept at various periods during the day as opposed to overnight. This is very important because sleep patterns are closely linked to an amino acid called beta-amyloid.

Beta-amyloids are parts of proteins found in the fatty membrane that surrounds nerve cells. There are approximately 100 billion nerve cells in the brain (and the brain is roughly 60% fat). Needless to say, there are a lot of beta-amyloids. Because of their composition, beta-amyloids can create a plaque, or even bind together, which results in cognitive impairment. Beta-amyloid clusters and plaques are closely associated with Alzheimer’s. The research done by John Hopkins explicitly showed that beta-amyloid levels are regulated, and that clusters and plaques can be removed by regular sleep.

During the study, people who slept for less than five hours every night experienced more beta-amyloid buildup than those who slept at least five hours every night.

How to Get Adequate Sleep

I think it’s safe to say that sleep plays an important role in cognitive function, and is something that should be considered as a preventative measure for dementia and Alzheimer’s. Although the cause is not firmly established, improving sleeping patterns is a beneficial practice, regardless. Adopting healthy sleep patterns as soon as possible can not only improve your life and health in the short term, but it may prevent or delay Alzheimer’s and its symptoms.

Getting adequate sleep on a regular cycle is very important to manage Alzheimer’s symptoms and prevent cognitive decline. Keeping your sleep pattern consistent, whether it’s during the week or on weekends, should be a priority. Setting an environment that is conducive to sleep is an essential step in making this happen. Here are some ways to optimize your sleep environment:

Turn Off Screens

The lights that emanate from smartphones, tablets, and TVs all provide stimulus that can prevent you from falling asleep.

Set a Schedule and Stick to It

Try to start winding down by dimming the lights and relaxing about two hours before bedtime. When it’s time for bed, go to your bed and attempt to fall asleep. Set your alarm for the time you want to wake up, and get out of bed when it sounds. If you need a short nap during the day, take it. But limit its duration to 20-30 minutes. Over time, you should adjust to your sleep schedule.

When You Get Out of Bed, Go Into a Bright Room

Seeing the sun in the morning and exposing yourself to natural light will help you wake up and adjust your sleep cycle.

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Sources:
“Poor sleep may be linked to Alzheimer’s Disease,” Fisher Center for Alzheimer’s Research foundation, 2015; https://www.alzinfo.org/articles/poor-sleep-may-be-linked-to-alzheimers-disease/, last accessed April 15, 2015.
Adam P. Spira, PhD, Alyssa A. Gamaldo, PhD, Yang An, MS, et al: “Self-Reported Sleep and Beta-Amyloid Deposition in Community-Dwelling Older Adults.” Andrew S. P. Lim, MD; Lei Yu, PhD; Matthew Kowgier, PhD, et al: “Modification of the Relationship of the Apolipoprotein E E4 Allele to the Risk of Alzheimer Disease and Neurofibrillary Tangle Density by Sleep.” JAMA Neurology Oct. 21, 2013.
Whiteman, H., “Lack of sleep may increase Alzheimer’s risk,” Medical News Today, October 22, 2013; http://www.medicalnewstoday.com/articles/267710.php, last accessed April 15, 2015.
Vitiello, M., “Alzheimer’s Disease and Sleep,” National Sleep Foundation web site. 2015; http://sleepfoundation.org/sleep-disorders-problems/alzheimers-disease-and-sleep, last accessed April 15, 2015.


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Dr. Victor Marchione, MD

About the Author, Browse Victor's Articles

Victor Marchione, MD received his Bachelor of Science Degree in 1973 and his Medical Degree from the University of Messina in 1981. He has been licensed and practicing medicine in New York and New Jersey for over 20 years. Dr. Marchione is a respected leader in the field of smoking cessation and pulmonary medicine. He has been featured on ABC News and World Report, CBS Evening News and the NBC Today Show and is the editor of the popular The... Read Full Bio »