Sleep well, Fight Dementia: 10 Tips for Better Sleep

Learn how to improve your sleep quality

  Reading a government report might make you want to yawn but we advise you stay awake long enough to pay attention to the latest report from the Center of Disease Control (CDC) on sleep patterns across the United States. The results, suggesting that more than a third of American adults (i.e. those over 18) dont get enough sleep, arent a massive surprise but they are eye-opening. We have known for a long time that many people are seriously sleep-deprived and the report merely confirms that view. The CDC report also tells us the regions most associated with insomnia: Hawaii, the Southeast and Appalachia.

The recommended amount of sleep is seven hours per night and the CDC paper, based on the self-reports of more than 400,000 people contacted by telephone, found that 11.8% reported five hours or less of sleep over a twenty-four hour period and 23% said they get six hours. At the other end of the scale, 8% of subjects reported they slept nine hours or more. It is possible that there were subjects who slept even more, but they werent awake when the CDC researcher called to question them. There do appear to be some ethnic differences with Whites and Hispanics sleeping more than native Hawaiians, Pacific Islanders and Afro-Americans.

Apart from the fact that self-reported sleep data may not be reliable, six hours sleep a night is often considered acceptable by some experts, and its the quality of sleep not just the quantity that is critical, these new data on sleeplessness are still cause for alarm.

Poor sleep is associated with an increased risk of obesity, diabetes and heart disease but what makes poor sleep a real health nightmare is its association with cognitive decline. Were not talking about the fogginess that can follow a poor nights sleep, were talking about an increased risk of dementia. Recent observational studies indicate that individuals who are not getting a full, restful nights sleep are more prone to diseases of the brain such as Alzheimers Disease, as well as other cognition problems. Turns out hitting that snooze alarm one more time may be your brains way of letting you know that you need more (and better quality!) rest.

We know that sleep is a critical physical function during which your body not only recharges but your mind consolidates information, making sleep important for memory and learning as well as health. There is a complex regulation of sleep that occurs in the brain, involving hormones and specific neural pathways. So there are dangers that poor sleep will impact you in both the short and long-term. In addition to poor sleep itself, many people take sleep aids which themselves are potentially harmful in the long-term. About 4% of American adults use sleep aids and that number increases to 7% among seniors. Sleep aids can be addictive and moreover, need to be prescribed with consideration of other medications that the patient is taking. Many seniors in particular take numerous medications, some of which can interact negatively with sleep aids. In addition, sleep aids should be considered in the context of other sleep-related lifestyle behaviors including alcohol and food intake.

There are several types of sleep disorders that lie behind the CDC statistics. These are specific sleep-depriving medical conditions distinct from environmental factors like Noisy-Neighbor Syndrome (NNS), or Live Under a Flight Path Condition (LUFPC).

Types of Sleep Disorders

  Its important to understand that there are various phases of sleep, that range from very light, to much deeper, slow wave sleep. The latter is critical and it is assumed that many restorative functions of sleep occur in this deep sleep state. Many of the sleep disorders impact not just, or even, the amount of sleep but its quality.  

Insomnia occurs when individuals have difficulty falling asleep, staying asleep and may have poor sleep quality or duration. This can occur for several reasons: disruption to the biological process of sleep or due to psychological issues, like stress and anxiety.

A second group of disorders are considered sleep-related breathing disorders, or sleep apnea, and include snoring, Upper Airway Resistance Syndrome (UARS), Obstructive Sleep Apnea (OSA) and Central Sleep Apnea (CSA). In these conditions, airway obstructions cause the patient to wake up with alarming regularity as they try to breathe. Some people with this condition are waking up almost constantly and one of the difficulties of this condition is that it is very difficult to get a long enough time asleep to reach the important deep sleep phase. Its not uncommon for such patients to think that have slept for hours but to simply not get the benefits of deeper sleep.

Sleep and Dementia

 
Recent studies with self-reporting (questionnaires) and using objective sleep measures (wrist actigraphy) show that the links between cognitive disorders and low quality sleep are coming into sharper focus; it is thought that poor sleep quality is linked to many pivotal changes in your body, such as lower cerebrospinal fluid levels, inflammation, change in immune modulation (both peripherally and centrally), and even altered metabolism in the brain. It has definitely been linked to poor memory consolidation and difficulty forming long-term memories. Sleep-disordered breathing may decrease the clearance of amyloid beta, which is an aberrant protein strongly associated with Alzheimers disease, from the brain. These changes can be highly detrimental to the neurons, neural connections, and ultimately, memory cognition and overall brain health.

While there is still much work to be done to concretely tie cognitive disorders to essential sleep patterns, the current work being done in the field is impressive enough to suggest that getting into a regular habit of healthy sleep may help ward off dementia, or at least significantly slow its advance. In one study, increased daytime sleepiness was associated with an increased risk of cognitive decline in an older population. Another study showed that reduction of sleep time and changes in sleep pattern were associated with a 75% increase in risk for dementia and a 50% increase in risk for Alzheimers.

So, getting a reasonable amount of quality sleep is important not just for your functioning the following day but maybe for the rest of your life. There are some simple lifestyle behaviors that you can implement that will increase the length and quality of your sleep. We have included some tips below from the workbook section of our book Avoid Alzheimers: Build a Better Brain. So, if youre dreaming about getting better sleep please read on.



10 Tips for Better Sleep

  1. Schedule your sleep time and try to keep to the schedule. Go to bed within 20 minutes of the same time each night, and wake up the same time every morning.
  2. Exercise for 30 minutes during the day (but not after 5 pm).
  3. Stop drinking coffee or other sources of caffeine at least 8 hours before bedtime.
  4. Dont eat a meal at least 4 hours before bedtime.
  5. Dont eat snacks at least 90 minutes before bedtime.
  6. Dont drink alcohol at least 4 hours before going to bed.
  7. Remove electronic screens such as TVs, computers, iPads or other gadgets in your bedroom. Have books and magazines instead.
  8. Use calming materials and colors for your bedding.
  9. Keep the room cool and dark, almost pitch black, using thick curtains.
  10. Invest in a good pillow.
 

 
Poor quality sleep is almost certainly going to lead to less energy, and energy is critical for health. When you are tired, you are less likely to exercise and more likely to eat poorly. When you are tired the brain seeks energy and in this state it is easy to reach for non-nutritious foods that give you a quick fix, like sugary snacks. There is a cascading effect of poor sleep and its not difficult to see why poor sleep is associated with poor health. Sleep is now a major component of our treatment and it has seriously changed how we approach memory disorders. We believe that more than 80% of our patients either have sleep apnea or some sort of sleep disorder, and although all of these cases are not cured overnight, with some adjustment and treatment of the sleep condition, major benefits can occur.

If you are not careful you may lose more than sleep.

 
You may realize that you do not feel like your mind is working at 100% capacity when you have not gotten a full nights sleep, but did you know that sleep disorders may actually cause dementia and cognitive decline? Recent observational studies indicate that individuals who are not getting a full, restful nights sleep are more prone to diseases of the brain such as Alzheimers Disease, as well as other cognition problems. Turns out hitting that snooze alarm one more time may be your brains way of letting you know that you need more (and better quality!) rest.

Benefits of Restful Sleep

 
A full, restful nights sleep is defined as anywhere between 6-9 hours depending on the individual, but sleeping longer does not necessarily mean you are sleeping better. Sleep quality is also a big concern with Americans today; the use of medications to alter sleep habits is on the rise. Around 4% of U.S. adults aged 20 and over are using sleep aids on a regular basis and up to 7% of older adults. Sleep plays an important role in memory and health, as well as our overall learning capacity as humans. Sleep is regulated in the body much in the same way that hunger and thirst are regulated, suggesting that sleep is another of our bodys critical functions to maintain health.

Types of Sleep Disorders

 
One of the most well-known sleep disorders is insomnia, which occurs when individuals have difficulty falling asleep, staying asleep and may have poor sleep quality or duration. A secondary grouping of sleep disorders are considered sleep related breathing disorders, or sleep apnea, and includes snoring, Upper Airway Resistance Syndrome (UARS), Obstructive Sleep Apnea (OSA) and Central Sleep Apnea (CSA). Circadian Rhythm Disorders, also known as shift work disorder, occur when your body feels out of phase with the cycles of day and night, which can cause insomnia or hypersomnia (excessive sleepiness) at odd hours of the day or night. Restless leg syndrome, where the nerves in your legs are unable to take a break for the night, can also cause a poor nights sleep.

Links between Poor Sleep and Cognitive Disorders

 
Recent studies with self-reporting (questionnaires) and using objective sleep measures (wrist actigraphy) show that the links between cognitive disorders and low quality sleep are not yet clear; however, it is thought that poor sleep quality is linked to many pivotal changes in your body, such as lower cerebrospinal fluid levels, inflammation, change in immune modulation (both peripherally and centrally), and even altered metabolism in the brain. It has definitely been linked to poor memory consolidation and difficulty forming long-term memories. Sleep-disordered breathing may decrease the clearance of amyloid beta, which is an aberrant protein strongly associated with Alzheimers disease, from the brain. These changes can be highly detrimental to the neurons, neural connections, and ultimately, memory cognition and overall brain health.  
While there is still much work to be done to concretely tie cognitive disorders to essential sleep patterns, the current work being done in the field is impressive enough to suggest that getting into a regular habit of healthy sleep may help ward off dementia, or at least significantly slow its advance.