Sleep Disturbances by Alzheimer's Disease

SUSHRUT -A Magazine of Pharmaceutical Sciences

Volume 1, Issue 1, August 2024, Pages 11-13

Sleep Disturbances by Alzheimer's Disease

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August, 2024 ➧ A MAGAZINE OF PHARMACEUTICAL SCIENCES ➧ ¹ Institute of Pharmaceutical Sciences, RKDF University, Ranchi, Jharkhand-834004, India ➧ Volume 1

Sleep disturbances, as well as sleep-wake rhythm disturbances, are typical symptoms of Alzheimer's disease (AD) that may precede the other clinical signs of this neurodegenerative disease. Typical disturbances of the neurophysiological sleep architecture in the course of the AD include deep sleep and paradoxical sleep deprivation. Factors that might contribute to sleep disturbances and sundowning include mental and physical exhaustion at the end of the day. Many people with Alzheimer's wake up more often and stay awake longer during the night. It is quite common for a person, especially in the later stages, to spend a lot of their time sleeping both during the day and night. This can sometimes be distressing for the person's family and friends, as they may worry that something is wrong... Read More

: Alzheimer's disease, Sleep disturbances, Insomnia

Introduction

Alzheimer's disease, it is a devastating neurodegenerative condition, that affects millions of people worldwide. While genetics and age are well-known risk factors, recent research has highlighted the significant role that sleep plays in the development and progression of Alzheimer's disease. The connection between sleep and Alzheimer's is crucial for developing preventive strategies and improving the quality of life for those at risk. Among sleep disorders occurring in patients with AD, the most frequent disorders are sleep breathing disorders and restless legs syndrome. Sleep disorders may influence circadian fluctuations of the concentrations of amyloid-β in the interstitial brain fluid and in the cerebrovascular fluid related to the glymphatic brain system and production of the amyloidβ [1].

The Importance of Sleep for Brain Health

Sleep is essential for overall health and well-being, particularly for brain function. During sleep, the brain undergoes vital processes such as memory consolidation, waste clearance, and the regulation of various cognitive functions. Adequate and high-quality sleep is necessary for maintaining these processes and ensuring optimal brain health.

Sleep and Amyloid-Beta Clearance

One of the hallmark features of Alzheimer's disease is the accumulation of amyloid-beta plaques in the brain. These toxic protein aggregates disrupt neural communication and contribute to cognitive decline. Studies have shown that sleep plays a critical role in the clearance of amyloid-beta from the brain. During deep sleep, the brain's glymphatic system becomes more active, facilitating the removal of waste products, including amyloid-beta. Conversely, poor sleep or sleep disorders can impair this clearance mechanism, leading to the buildup of amyloid-beta and increasing the risk of Alzheimer's disease [1],[3]. 

The Impact of Sleep Disorders on Alzheimer's Risk

Sleep Apnea

Sleep apnea, a condition characterized by repeated interruptions in breathing during sleep, is associated with an increased risk of Alzheimer's disease. The intermittent hypoxia (lack of oxygen) and sleep fragmentation caused by sleep apnea can lead to inflammation, oxidative stress, and neuronal damage, all of which contribute to cognitive decline. Effective treatment of sleep apnea, such as continuous positive airway pressure (CPAP) therapy, can improve sleep quality and potentially reduce Alzheimer's risk.

Insomnia

Insomnia, a common sleep disorder characterized by difficulty falling asleep or staying asleep, is also linked to an increased risk of Alzheimer's disease. Chronic insomnia can lead to prolonged periods of sleep deprivation, which negatively impacts cognitive function and accelerates the accumulation of amyloid-beta. Implementing good sleep hygiene practices, cognitive-behavioral therapy for insomnia (CBT-I), and, in some cases, medication can help manage insomnia and improve sleep quality.

Sleep Quality and Cognitive Function

Even in the absence of sleep disorders, poor sleep quality can adversely affect cognitive function. Fragmented sleep, frequent awakenings, and reduced time spent in deep sleep stages can impair memory, attention, and executive function. These cognitive impairments can increase the susceptibility to Alzheimer's disease. Prioritizing healthy sleep habits, such as maintaining a consistent sleep schedule, creating a restful sleep environment, and avoiding stimulants before bedtime, can support better sleep quality and cognitive health [2],[3].

Strategies for Improving Sleep and Reducing Alzheimer's Risk

Establishing a Sleep Routine

Creating and maintaining a consistent sleep routine is crucial for promoting healthy sleep patterns. Going to bed and waking up at the same time each day helps regulate the body's internal clock and improve sleep quality. Establishing a calming pre-sleep routine, such as reading or taking a warm bath, can signal to the body that it is time to wind down and prepare for sleep.

Creating a Sleep-Conducive Environment

The sleep environment plays a significant role in sleep quality. Ensuring a cool, dark, and quiet bedroom can promote better sleep. Investing in a comfortable mattress and pillows, as well as minimizing electronic device use before bedtime, can also enhance sleep quality.

Managing Stress and Anxiety

Chronic stress and anxiety can disrupt sleep and negatively impact cognitive health. Incorporating stress management techniques, such as mindfulness meditation, deep breathing exercises, and regular physical activity, can help reduce stress levels and improve sleep quality. Seeking professional support, such as therapy or counseling, may also be beneficial for managing stress and anxiety [2],[3].

Conclusion

The link between sleep and Alzheimer's disease underscores the importance of prioritizing good sleep habits for maintaining cognitive health. By understanding the mechanisms through which sleep affects brain function and implementing strategies to improve sleep quality, individuals can take proactive steps to reduce their risk of Alzheimer's disease. As research continues to uncover the intricate relationship between sleep and neuron degeneration, promoting healthy sleep practices will remain a key component of Alzheimer's prevention and overall brain health.

References and Bibliography

1. Brzecka A, Leszek J, Ashraf GM, et al. sleep disorders associated with Alzheimer's disease: A perspective. Front Neurosci. 2018 May 31; 12:330. doi: 10.3389/fnins.2018.00330. PMID: 29904334; PMCID: PMC5990625.
2. Ancoli-Israel S, Kripke DF, Klauber MR. et al. Sleep-disordered breathing in community-dwelling elderly. Sleep 1991;14, 486–495. 10.1093/sleep/14.6.486 
3. Ancoli-Israel S., Clopton P., Klauber M. R., Fell R., Mason W. Use of wrist activity for monitoring sleep/wake in demented nursing-home patients. Sleep 1997; 20: 24– 27.