Aging And Cognitive Function
As it is mentioned, dementia is a common disease among the elderly but just preclinical impairments may be expected decades before certain diagnosis and cognitive decline may not be seen until discussed mechanisms including the accumulation of amyloid and NFT, inflammatory processes, BBB disruption, loss of synapses, and neuron loss have reached a certain threshold .
Therefore, based on the related mechanisms that can lead insomnia to the development of AD, and with attention to the high prevalence of insomnia and sleep disorders among the elderly age group, it can be assumed that insomnia has possible effects on AD pathogenesis and cognitive deficit in older adults with Alzheimers disease risk.
Sundowning How Behaviour Can Change As The Night Draws In
Sundowning is a term used to describe behavioural changes that usually happen in the late afternoon/early evening. People with Alzheimerâs may experience symptoms such disorientation, confusion, hallucinations, agitation and aggression at these times. 20
To some degree, sundowning is linked to the changes in the light/dark cycle, as it has been observed that incidence increases among dementia patients during winter when there is less natural light.
Another contributing factor can be increasing levels of mental and physical exhaustion that have built up over the day. This tiredness can intensify feelings of stress and anxiety.
Sundowning affects every person differently but for some it can mean that they find it difficult to sleep at night, often wandering and remaining highly agitated throughout the night-time hours.
Thereâs no one clear causative explanation for sundowning but thereâs a host of methods that can be used to try to reduce its effects.
How The Brain Cleanses Itself
The brain takes the time in the final hours of sleep to literally take out the trash and clean up, Dr. Chelsie Rohrscheib, a neuroscientist and sleep specialist at sleep technology company Tatch, told Healthline.
Our brain and body undergo many essential biological functions that only occur during sleep, including clearance of toxic waste products that build up in the brain, Rohrscheib said. The accumulation of a specific type of brain waste called beta-amyloid is thought to be the primary cause of Alzheimers disease.
Most of the removal of beta-amyloid occurs during the deepest stages of sleep, Rohrscheib said. When sleep is restricted to less than seven hours, the brain has less time to clear beta-amyloid away, leading to toxic levels of accumulation and raising the risk of developing Alzheimers.
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Causes Of Sleeping Problems
It is important to try to recognise what may be causing the problem is it the environment, the dementia or the medications used? This will help to decide on which strategies may be helpful.
Some families and carers find that keeping a log or diary may help them see the pattern of behaviour that may be developing, enabling the cause of the problem to be pinpointed.
Medication Interactions Or Side Effects
If someone complains of memory problems, Hashmi says his first question is always, Did you recently start a new medication?
Older adults are more likely than younger people to develop cognitive impairment as a side effect of a medication, and drug toxicity is the culprit in as many as 12 percent of patients who present with suspected dementia, research shows.
Many types of prescriptions and over-the-counter drugs can affect your cognition, but the most common include those for sleep, urinary incontinence, pain, anxiety and allergies. Taking too many medications can also affect your ability to think clearly and remember things, Hashmi observes. Research from the Lown Institute shows that nearly half of older adults take five or more prescription medications.
Even a prescription youve been on for many years can trigger confusion. The reason why, Hashmi explains, is that your kidneys and liver become less effective at clearing drugs from your body as you get older, so a medication can build up in your system over time and cause problems.
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How Does Dementia Change Sleep Patterns
Circadian rhythm is a collection of physical and psychological processes that guide our sleep-wake cycle by responding to indicators in our environment. People with dementia experience fundamental changes in their circadian rhythm that work against getting quality sleep on a regular schedule.
The suprachiasmatic nucleus is the part of the brain that serves as our internal clock and responds to cues, such as light, to indicate when we should be alert and when we should feel sleepy. Individuals who have Alzheimers diseasethe most common type of dementiaoften have damaged cells in the SCN and decreased cellular activity in this part of the brain. The result of this dysfunction is that patients are often unable to follow a 24-hour sleep-wake cycle and instead sleep excessively during the day and sleep much less at night.
Additionally, dementia is associated with changes in sleep structure. When we sleep, our bodies cycle through a series of sleep stages, from light sleep , to deep sleep , and then dream sleep . Slow-wave sleep and REM sleep are critical parts of how sleep works to restore the body and mind. People with dementia spend less time in slow-wave sleep and REM sleep and more time in the earlier stages of sleep. This reduction of deep sleep and REM sleep can worsen as dementia progresses.
Does Poor Sleep Cause Dementia
Studies have long questioned the sleep-dementia relationship similar to the chicken-and-egg metaphor. Which comes firstdoes poor sleep cause dementia, or does dementia cause poor sleep? Research suggests the answer to both questions is yes.
In a long-term study, Harvard Medical School followed 2,800 individuals ages 65 and older. Researchers found that individuals who slept under five hours per night were twice as likely to develop dementia compared to those who slept six to eight hours per night. A different study of nearly 8,000 participants found a 30% increase in dementia risk was associated with sleeping six hours or less at age 50, 60 and 70, compared to a normal sleep duration of seven hours.
Experts are still trying to understand why inadequate sleep increases risk of dementia however, one theory involves a protein in our brains called beta amyloid. Beta amyloid is the protein that makes up the plaque found in the brains of people with impaired brain function and Alzheimers, a neurodegenerative disease. During the day, our brains naturally make this protein. At night when we sleep, our brains flush the protein away. The idea is that insufficient sleep limits the brains ability to remove beta amyloid and other substances, causing them to build up until they cause dementia.
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Sleep Time And Dementia
There appears to be a U-shaped curve when it comes to sleep length and cognitive decline. That means problems show up if you sleep too little or too much. But a lack of sleep is more likely to raise your chances of dementia.
Hereâs what research says about sleep time and dementia:
Short sleep . Research shows that one night of serious sleep loss raises your levels of beta-amyloid and tau. Those are proteins linked to Alzheimerâs disease. Insomnia also disrupts your slow wave sleep, which plays a part in learning and memory.
Long sleep . Itâs less clear why long sleep raises your chances of dementia. But your body may need more sleep to work well if you have another health condition, like sleep apnea or depression.
Other Sleep Issues In People With Dementia
Sundowning is a phenomenon in which individuals with dementia experience increased agitation later in the day and in the evening. The symptoms of sundowning include confusion, anxiety, wandering, and yelling. Sundowning can contribute to insomnia and other sleep problems when these behaviors continue into the night. Possible causes of sundowning include the circadian rhythm changes that occur in dementia, as well as fatigue, depression, and pain.
People with dementia may also talk, yell, or cry out at night if they cannot sleep. Some dementia patients have a tendency to wander away from their homes, which can be especially dangerous at night. In dementia patients with REM sleep behavior disorder, shouting, grabbing, jumping, and other behaviors are related to dream enactment during sleep.
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How To Support Good Overall Sleep
Thereâs a host of simple lifestyle changes we can all incorporate into our daily routines to ensure weâre setting ourselves up for a good nightâs sleep and these are no different for people with Alzheimerâs.
Maintaining a daytime routine in which wake time, meals and bed time are fairly consistent is a good first step. This may not always be simple to implement for someone who has Alzheimerâs, but keeping mealtimes as regular as possible can provide some level of routine.
Getting adequate exposure to sunlight is also important in helping to keep your body clock regulated, so spending some time outside every day when possible is a good idea.
Take time to exercise each day. This can be as simple as going for a nice walk, which also ticks the box of getting exposure to sunlight! Regular exercise helps to create a sleep debt and can help you sleep better at night.
Avoid caffeine, alcohol and nicotine in the evening as these all stimulate the body and mind when it needs to be winding down.
Limit screentime in the hour before bed. This includes TVs, computer, tablets and smart phones, which all emit blue light and can interfere with sleep.
Create a consistent and relaxing night-time routine to help relax and unwind before bed. Whether itâs taking a bath or reading a nice book before bed, a regular bedtime wind-down routine can set you up for a good nightâs rest.
Does Too Much Sleep Affect Cognition
Many studies looking at the effects of sleep on thinking have found that it isnt only a lack of sleep that can be problematic. In many cases, research has discovered that both too little and too much sleep are associated with cognitive decline.
The explanation for this association remains unclear. It is not known if excess sleep is caused by a coexisting health condition that may also predispose someone to cognitive problems. Overall, these research findings are an important reminder that recommendations for healthy sleep involve both a minimum and a maximum.
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Million Americans Suffer From Chronic Sleep Disorders
According to recent data, about 70 million Americans suffer from chronic sleep disorders.
Sleep deprivation is a serious issue affecting many peoples lives and health. Poor sleep habits can lead to memory loss, difficulty concentrating and learning new information, weight gain or weight loss resistance, depression, and anxiety.
These issues can take their toll on the average persons life by making it more difficult for them to function at work or school and in personal relationships with others.
Some people may also develop physical ailments such as heart disease or diabetes if they dont get enough restful sleep each night due to symptoms like insomnia .
Caring For The Caregivers
When we talk about the effects of Alzheimerâs on sleep, itâs important not to overlook the fact that thereâs a whole army of caregivers who are also at high risk of experiencing sleep problems.
Caring for someone with Alzheimerâs is a full-time task and it can be both mentally and physically exhausting. As a caregiver, if your sleep is being compromised or youâre struggling to sleep, then you shouldnât feel as if youâre fighting a lone battle.
Surveys show that around 70% of caregivers for people with dementia report problems sleeping. The majority sleep for fewer than seven hours per night and up to a fifth use alcohol or medication to get to sleep. 21222324
These figures are worrisome and show that thereâs a definite need for greater support for caregivers of people with Alzheimerâs.
Encouragingly, thereâs plenty of research looking into the best ways to improve the sleep and overall quality of life of people in caregiving roles.
Research has shown that non-medical interventions are successful in improving sleep in caregivers and may additionally help to reduce stress levels. 21
Sleepstationâs drug-free and clinically validated sleep improvement programme can help you to identify your sleep problems and will give you the tools you need to get your sleep back on track.
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How Does Dementia Affect Sleep
While poor and insufficient sleep can be risk factors of dementia, sleep problems are also a known symptom of having dementia. Healthy brain function requires healthy sleep, which means our bodies must cycle through the various sleep stages.
Throughout the night a person can go through four to six sleep cycles that vary in length. During stages 3 and 4, the body restores itself, making these stages essential for cognitive function and overall health. People with dementia spend less time in the later stages of sleep and more time in the earlier stages, which can also worsen as dementia progresses.
Additionally, dementia changes the bodys natural sleep-wake cycle, or circadian rhythm. Individuals who have Alzheimers disease often have damaged cells in the brains suprachiasmatic nucleus and lower cellular activity. Because of this dysfunction, patients are often unable to follow a 24-hour sleep-wake cycle and instead sleep more during the day and less at night.
What Is Sleep Deprivations Link With Dementia
One night of poor sleep can cause issues with your thinking the next day. But many months or years of inadequate sleep may lead to more serious and chronic problems with your thinking. For example, one study found that people who sleep less than 4 hours a night may struggle more with their thinking, learning, and memory abilities.
Research is ongoing, but so far, a history of sleep trouble does seem to increase the risk of dementia for some people. One study suggests sleep deprivation could increase your dementia risk by 20%. In middle age, even getting less than 6 hours of sleep per night may increase your dementia risk in the future.
Scientists are beginning to probe the complex relationship between the brain changes involved in poor sleep and those in very early-stage Alzheimers. People who slept six hours or less per night in their 50s and 60s were more likely to develop dementia later in life. The findings suggest that inadequate sleep duration could increase dementia risk and emphasizes the importance of good sleep habits.
Nearly 60 percent of older adults have some kind of chronic sleep disturbance.
Its long been known that people with Alzheimers often have sleep difficulties. Now scientists are probing the link between sleep and Alzheimers earlier in the disease process and in cognitively normal adults. They wonder if improving sleep with existing treatments might help memory and other cognitive functionsand perhaps delay or prevent Alzheimers.
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Can Sleep Disorders Affect Cognition
Sleep disorders frequently involve insufficient or fragmented sleep, so it comes as little surprise that they can be linked to cognitive impairment.
Insomnia, which can involve problems with both falling asleep and staying asleep through the night, has been connected to both short- and long-term cognitive problems.
Obstructive sleep apnea is another one of the most common sleep disorders. It occurs when the airway gets blocked, which then leads to lapses in breathing during sleep and reduced oxygen in the blood.
OSA has been linked with daytime sleepiness as well as notable cognitive problems related to attention, thinking, memory, and communication. Studies have also found that people with sleep apnea have a higher risk of developing dementia.
Dementia And Sleep: What Do We Know About This Link
Dementia affects at least 55 million people worldwide and the number is increasing by about 10 million every year. In part, this is because we are living longer, but dementia is not an inevitable part of aging. So, are there ways to decrease our risk of developing dementia? Much research is currently focusing on the potential role of sleep.
According to the World Health Organization , dementia is currently the seventh leading cause of death among all diseases and one of the major causes of disability and dependency among older people globally.
The WHO states that around 55 million people have dementia, and by 2050 the number is likely to be almost 140 million. Between 60% and 70% of people with dementia have Alzheimers disease.
Dementia is primarily a disease of old age, although 9% of cases. However, dementia is not an inevitable consequence of aging.
There is a genetic component to dementia if you have a close relative with dementia, this might increase your risk. However, several studies have shown that even those with a hereditary risk can reduce it by adopting a healthy diet, exercising regularly, and avoiding smoking and too much alcohol.
Sleep, he noted, is a factor that can either be protective or risky for cognitive health. The effects of sleep on cognitive health depend on the attributes of an individuals sleep, including the quality, quantity, frequency, and even the regularity of sleep.
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Sleep And Dementia Risks
Sleep is a complex biological process. Aging-related changes in sleep timing and quality are associated with cognitive disorders.
Medical News Today discussed this study with Dr. Verna Porter, a neurologist and director of the Dementia, Alzheimers Disease, and Neurocognitive Disorders at Providence Saint Johns Health Center in Santa Monica, CA, who was not involved in the current research.
It is important for studies to evaluate populations other than white , largely urban populations from North America or Western Europe. This study evaluates rural adults from China with unique socioeconomic, cultural, education and lifestyle practices, Dr. Porter said.
Older adults in rural China typically go to sleep earlier, rise earlier, and
Research shows that dementia occurs more often in the countrys rural regions than in its developed parts.
The present studys aim was to examine the associations of self-reported sleep characteristics with incident dementia, Alzheimers disease , and cognitive decline, while taking into account their potential interactions with demographic features and APOE genotype.