Deep Sleep May Help Prevent Dementia as We Age
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When it comes to brain health and strengthening memories, a good night’s rest is essential. New research highlights how important slumber is for older adults, finding that enhancing or maintaining deep sleep — also known as slow-wave sleep — could stave off dementia.
The study, published Monday in JAMA Neurology, indicates that people over 60 years old who experience as little as a 1 percent reduction in their deep sleep per year may face a 27 percent higher likelihood of developing impairment in memory, thinking, and the ability to make decisions.
“We know that the slow-wave sleep is critically important, and for an aging brain, it supports memory consolidation and helps to flush the brain of toxins that accumulate when we’re awake,” says lead study author Matthew Pase, PhD, an associate professor at the Monash School of Psychological Sciences and the Turner Institute for Brain and Mental Health in Melbourne, Australia.
“We found that as people aged, however, the amount of deep, restorative stages of sleep declined, and those who had greater declines in slow-wave sleep had a high risk of going on to get dementia.”
Results Support the Restorative Powers of Sleep
For the analysis, Dr. Pase and his team followed about 350 participants with an average age of 69, who completed two overnight sleep studies in the time periods 1995 to 1998 and 2001 to 2003. There was an average of five years between the two studies. All research subjects had no dementia at the time of the second overnight sleep assessment.
Over the next 17 years of follow-up, 52 cases of dementia were recorded. The findings revealed that each percentage decrease in deep sleep per year was associated with a 27 percent increase in the risk of dementia, and a 32 percent greater risk of Alzheimer’s disease dementia.
Because the study was observational, it was not designed to determine whether the decline in slow-wave sleep was causal or directly responsible for the elevated neurodegeneration risk, according to the researchers.
The authors added that individuals who had heart disease, took medications that affect sleep (such as antidepressants and sedatives), or carried the APOE e4 gene — which is a marker for Alzheimer’s disease according to the National Institute on Aging — were more likely to experience a decline in deep sleep.
“Having at least one APOE e4 gene doubles or triples the risk of getting Alzheimer’s disease,” says Pase. “Some people have two APOE e4 genes, one from each parent. Having two genes increases the risk of getting Alzheimer’s disease even more — about eight- to twelvefold.”
Still, Pase stresses that an association between slow-wave sleep and dementia was observed independent of these factors.
For Yuko Hara, PhD, director of Aging and Alzheimer’s Prevention at the Alzheimer’s Drug Discovery Foundation, the findings are in line with previous research demonstrating that slow-wave sleep is important for brain health and protection from dementia.
“Beta-amyloid and tau, biological markers of Alzheimer’s disease — as well as other toxic proteins and waste products that form in the brain — are best cleared from the brain through a waste clearance pathway called the glymphatic system, and this clearance mechanism is most active during sleep,” says Dr. Hara, who was not involved in the study.
“This is why if you don’t get enough sleep in the long-term, you could have toxic proteins build up in the brain.”
Taking Steps to Improve Sleep
Based on the study results, Pase and his colleagues concluded that deep sleep loss may be a modifiable dementia risk factor. Seniors, who are especially prone to sleep troubles, may want to be more proactive in taking measures to get a better night’s rest. The Alzheimer’s Drug Discovery Foundation offers the following tips:
- Go to bed and get up at around the same time each day.
- Abstain from caffeinated drinks after lunch.
- Avoid alcohol several hours before bedtime. “It can take two to three hours for your body to eliminate alcohol,” says Hara. “Alcohol can cause you to feel awake or you may wake up during the night.”
- Get regular exercise. “However, avoid exercising within a few hours before bedtime if you have trouble falling asleep,” says Hara.
- Keep your room dark and comfortable at night.
- Use your bed only for sleep and sex.
When it comes to taking sleep aids or medications, Hara advises proceeding with caution, and consulting with a healthcare provider.
She warns, for example, that experts often do not recommend melatonin for elderly people with dementia, due to risks of falls and other adverse events.
“Not all medications improve the quality of sleep, and some treatments carry brain health risks,” says Hara. “It is important to talk to your doctor so you can discuss the best options for improving sleep, including changing lifestyle factors.”
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