The journalist, critic, and polemicist Christopher Hitchens, who amazed his friends by staying up until the wee hours of the night and then waking a few hours later to write pitch-perfect prose, said that he knew he burned the candle at both ends, “finding that it often gives a lovely light.” The problem is that, for most people, not sleeping can impair cognitive functions. Most of us can barely brew a pot of coffee without a solid six hours, much less write an essay on Proust. We all know that there is short-term damage done to our brains from lack of sleep, but recent studies have shown it could be far more damaging than that: lack of quality sleep might be a hidden cause of Alzheimer’s Disease and other forms of dementia.
This is a problem that can start in youth and then accelerate for older adults. When looking at ways to slow, or even prevent, the onset of Alzheimer’s, it is increasingly clear that restful and productive sleep is one of the main things that you can actually do. For caregivers, it is important to encourage solid sleep for our aging loved ones and to make sure you can create the right conditions for rest. Remember that the mind is what the brain does and, in order for the brain to function right, it needs sleep.
The Science Behind Sleep Deprivation and Alzheimer’s Disease
It’s hard to define feeling rested without eventually lapsing into tautology. You can say you have energy, or vitality, or that you don’t feel tired, but at the end, everyone knows what it means to “feel rested.” We just feel more clear. As we’re finding out, “feeling clear” is the literal definition.
As two different studies at UC-Berkeley and the Oregon Health and Science University in Portland revealed, one essential function of sleep is to clear out dangerous toxins in the brain. These toxins are known as amyloid plaques—a known cause of Alzheimer’s.
Think of amyloid plaques as the bacteria that grows in your mouth when you sleep, leading to morning breath. When you wake up, you rinse out your mouth to prevent buildup. Well, through a process that is just beginning to be understood, the brain does the same thing to amyloid plaques. Remarkably, cerebrospinal fluid, which is normally on the outside of the brain, “actually begins to recirculate back into and through the brain along the outsides of blood vessels,” according to Dr. Steven Iliff, of OHSU. This fluid flushes out the amyloids, but only seems to do so during sleep.
It has to be a good, deep sleep to let the body flush out dangerous toxins. That doesn’t mean cat naps, or light sleep, or the kind of restless, tossing and turning and clock-staring half-sleep that so many of us get. That’s why a good night’s sleep is so important, especially for older adults.
Cause and Effect
And, it must be said, all this doesn’t mean that people who don’t get deep sleep are going to inevitably get Alzheimer’s. There are a number of reasons that amyloids can build up—and scientists still aren’t sure that is the only cause of dementia. What it does mean, though, is that if you are at risk, especially if you are an older adult, it is important to get sleep.
In the past, we’ve seen a lack of sleep as a symptom of dementia, assuming that the parts of the brain which regulate sleep are being damaged, but the causation may in fact be the other way around. As a caregiver, if an older loved one is beginning to demonstrate signs of mental illness, you shouldn’t accept less sleep as an unavoidable result of that. It should spur you to encourage more sleep and to make their living space sleep-friendly.
Tips for Encouraging More Sleep in Seniors
There are several ways to help encourage the older adult in your life to sleep more. If you are worried about dementia, we encourage you to try these suggestions.
- Maintain a nighttime routine. This is good at any age—balanced circadian rhythms help establish good sleep patterns. For older adults, this is especially important since so much else is changing around them. Finding a pattern, and sticking to it, encourages healthy sleep.
- Beware of sleep apnea. Sleep apnea is an underdiagnosed problem among older adults, but it is one that could have them waking up as many as 30 times an hour. If you observe the symptoms of sleep apnea in an older adult in your life, get it diagnosed, and get the right equipment to help them.
- Avoid sleeping too much during the day. It’s easier for an older adult to get tired during the day, and naps can be essential. But naps generally don’t provide the deep sleep needed to cleanse the brain, and too many of them can hurt sleeping at night. As a caregiver, you may encourage a regular naptime in order to get a break, but make sure it doesn’t take away from healthy nighttime sleep.
- Check medications. Medications are prescribed for very specific reasons and they might have unexpected side effects in other areas. The AARP has a list of 10 medications that are known to cause insomnia. This is a case where you need to talk to your loved one and their doctor to find out if lack of sleep is better or worse than the illness the medication purports to treat.
A caregiver might feel that they have a break when their loved one is sleeping, and that is true. But it is also important to make sure that the aging adult in your life is sleeping well. We’re still a long way from definitively determining the many causes behind Alzheimer’s disease—and even further away from finding a cure. But we do know that a good night’s sleep may be able to help prevent some of its causes. That’s important for us, no matter what age.
At Institute of Aging, we help caregivers and families take care of their aging loved ones, both waking and sleeping, so that they can enjoy peace, independence, and dignity as they get older. Connect with us today to learn more.