Emerging Research: Sleep Studies
Emerging Research: Sleep Studies
by Corey Bliss
A pair of recently published studies is changing the conversation about sleep habits for those living with and at risk of developing Alzheimer’s and other forms of dementia. We’re sharing the key findings of each study and some practical tips to help individuals with dementia (and those who care for them) get more quality shuteye:
Recharge with an Afternoon Nap
A study in the journal General Psychiatry evaluated the effects of regular afternoon napping on a group of 2,114 older adults in China. Overall, individuals who took afternoon naps showed significantly higher cognitive performance and mental agility on standardized tests like the MMSE compared with those who did not nap.
Regular afternoon naps of 2 hours or less were also associated with better cognitive function, specifically with orientation, language, and memory. When we nap, we usually stay in the NREM (non rapid eye movement) sleep phase. Other studies have shown that NREM sleep is especially important for these particular aspects of cognition.
“The hypothesis is that there’s inflammation in the brain, and napping can help to cleanse the brain,” explains Dr. Jeannine Forrest, PhD, RN, an expert educator and mentor to families impacted by Alzheimer’s and related dementias. “I found that to be both practical and fascinating.” In general, naps help to promote energy and overall positive cognitive behaviors later on in the day.
“In my clinical practice, I frequently recommend afternoon naps or ‘brain rest time’ for people with dementia to prevent or at least diminish what we used to call ‘sundowning,’” Dr. Forrest shares.
Reduce Your Risk with a Good Night’s Sleep
A 30-year-long study of 8,000 adults supported by the National Institute on Aging indicates that individuals in their 50s and 60s who sleep less than 6 hours each night may be more likely to develop a form of dementia later in life.
Compared to normal sleep of at least 7 hours per night, consistent shortened sleep in middle age was associated with a 30% increased risk of developing dementia by about age 77. The researchers adjusted for many characteristics that can influence sleep patterns or dementia risk, including smoking, alcohol use, mental illness, physical activity level, diet, education level, and underlying conditions such as hypertension. The correlation between short sleep and dementia risk held true in each instance.
There is more work to be done to understand exactly how short sleep contributes to developing dementia and how different sleep features (duration, disturbance, sleep apnea, and sleep-wake regulation) over the course of adulthood shape that risk.
For instance, there are studies of two Alzheimer’s proteins, amyloid and tau, that suggest that sufficient sleep – and deep sleep – helps clear these proteins from the brain and limits the production of plaques and tangles, the hallmarks of Alzheimer’s disease. Inadequate sleep can therefore lead to an increased buildup of these bodies in the brain. And as noted in The New York Times, it’s also possible that the sleep-dementia relationship is “bidirectional,” with poor sleep fueling dementia, which further reduces sleep due to disruptions in circadian rhythms, which worsens dementia.
Hopefully, future research will help identify windows of opportunity for therapeutic sleep interventions to proactively reduce risk over time and improve quality of life at every stage.
Quality Sleep for Quality of Life
In the meantime, practicing good sleep hygiene is an active step we can all take to stay healthy, happy, and well. Although the tips below are tailored to support those living with Alzheimer’s and other forms of dementia, taking a more mindful approach to sleep leads to better outcomes for everyone.
Address chronic pain: Seek out the right treatments for chronic pain and other common conditions like sleep apnea that can interrupt or prevent a good night’s sleep.
Establish a nighttime routine: Set a consistent bedtime and wake time, even on weekends. Create a relaxing atmosphere by playing soft music and dimming the lights as bedtime approaches.
Create a calm, soothing environment: Remove electronic devices, such as TVs, computers, and smart phones, from the bedroom. Set the room at a cool, comfortable temperature (60-67 degrees).
Get moving during the day: Encourage physical activity, such a short walk or light stretching, in the morning or midday hours. Too much activity at the end of the day can have the opposite effect.
Avoid stimulants before bedtime: Caffeine, alcohol, nicotine, and eating large meals before bed can all lead to a restless, wakeful night’s sleep.
Check for medication side effects: Some medications may interfere with sleep. It may be possible to change the medication regimen or dosage timing to minimize those effects.
Consider alternative sleep remedies: Consult with your physician about melatonin or CBD supplements in lieu of sleep medications. These options can be especially beneficial for those with mild to moderate dementia. Spritz a lavender essential oil spray on pillows and bedding to create a relaxing sensory experience. Try using a blackout eye mask to block out ambient light and early morning sunshine.
Understand personal sleep habits: The Sleep Solution by W. Chris Winter, MD, is a fantastic resource to help you design custom sleep interventions to fit your (or your loved one’s) lifestyle.