Improving sleep to reduce the risk and symptoms of dementia

I spent years doing yoga and breathing exercises in the middle of the night. Lonely hours with my legs up the wall. I am glad that I did not know how insomnia increased my risk of Alzheimer’s and Parkinson’s disease.  Now, the links between poor sleep and dementia are well established.  With increased knowledge, there are more suggestions, techniques and products designed to help us to sleep better. including our own. How can we improve our sleep quality, minimise our risk of developing dementia, and reduce existing dementia symptoms?

This is what we know:

Protein build up is the main contributor to Alzheimer’s disease  [1]

The link between lack of deep sleep and build up of amyloid and tau proteins is so clear that sleep quality is regarded as a biomarker for  the development of Alzheimer’s disease. [2]

Protein debris clears from the brain through channels in the brain (the “glymphatic system”) which open up when deep sleep [3] increases glymphatic flow [4]

Disruption of deep slow wave sleep causes amyloid plaque levels to rise by up to 30%.[1].

Apnoea sufferers have higher tau levels than people with no apnea. The research raises “the possibility that sleep apnea affects tau accumulation. But it’s also possible that higher levels of tau i..may predispose a person to sleep apnea”  [5]

Lack of deep sleep is a major risk factor for the development of Parkinson’s [5]

Alzheimer’s, Parkinson’s disease and vascular dementia exacerbate age-related sleep disorders [6] and interfere with the regulation of our circadian clocks

Poor sleep is a major reason for admission into care. If sleep becomes disrupted and disruptive, so that carers cannot cope, admission into care is more or less inevitable.

Sleeping pills inhibit deep sleep - taking more than five a month increases our risk of dementia by 43%.  [7]

People whose sleep deteriorates in their 50s and 60s have an increased risk of Alzheimer’s.  [8]

Understandably, sleep therapy (increasing deep sleep) is now being considered as a clinical approach to reducing the risk of Alzheimer’s disease. Professor Matthew Walker, author of “Why we sleep” says "If you struggle with sleep, you should see your doctor and find ways, such as CBT-I, that can help you improve your sleep. The goal here is to decrease your chances of Alzheimer's”

How can we improve the quality of sleep / increase deep sleep?

Sleeping Pills, Lifestyle and Diet

Sedatives (sleeping pills) suppress rather than enhance deep sleep. Reducing stress and anxiety e.g. through CBT-I helps.  Dietary changes can make a difference. Sugar lightens sleep and fibre deepens it.  Improving our gut biome increases serotonin and melatonin production and helps us to relax and sleep.

Tech – Sound, Electrostimulation, Transcranial Magnetic Stimulation (TCMS) and Resonance

Several devices use tech to influence sleep. Sound, played when our brain generates deep sleep brainwaves, can increase the power of that deep sleep, but that approach has no application for people who don’t already sleep deeply. Some devices use Electro stimulation, passing a current through the skull to a targeted area of the brain. Others create a magnetic field of sufficient strength to create electric currents within the brain. These devices (Philips Smart Sleep, Dreem, Alpha-Stim, Modius, NeoRhythm) generally deliver their signals through a headset. Unsurprisingly, I prefer our lower power approach which relies on under the pillow pulses intended to match those produced naturally by our neurons.

The Zeez Sleep Pebble and Zeez Sleep Pad

Our devices prompt deep sleep. They emit tiny pulses intended to match the alpha, theta and delta brainwaves of a good sleeper, at appropriate times in the sleep cycles. Around 80% people respond by adopting the same pattern.  We have been selling the Zeez Sleep Pebble since October 2018 to people aged 9 – 91. We have had quite a few users with Parkinson’s and a small (successful) case series study at Plymouth University hospital with people with Parkinson’s- related sleep disorders will be published later this year (2020).

We have had fascinating results with people with dementia and I hope that we can make a real difference.  The graphs below show “before and after” results of an NHS Dementia Assessment Unit using the Zeez with their worst-affected patient, a 62 your old lady with vascular dementia. She was often distressed and slept only 2-5 hours at night. She used the Zeez Sleep Pebble for six weeks and quickly began to sleep better. At the end of the period she was falling asleep faster, sleeping for 5-9 hours and waking up with energy. The overall quality of her sleep changed from ‘very poor’ to ’very good’.

Improving the sleep of people in care enhances their quality of life. It also reduces demands on staff, especially at nighttime.  Everyone benefits.

References

1. https://www.sciencedaily.com/releases/2019/03/190322093851.htm

2. httpsww.jneurosci.org/content/39/32/6315

3. http://stm.sciencemag.org/content/4/147/147ra111

4. http://advances.sciencemag.org/content/5/2/eaav5447

5. https://newatlas.com/sleep-apnea-alzheimers-dementia/58707/

6. www.thelancet.com/neurology Vol 14 January 2015  — retrospective analysis of 54,000 people

7. http://www.nature.com/articles/nn.4035.epdf?

8. https//www.medscape.com/viewarticle/915836  

9. https9//www.sciencedaily.com/releases/2019/06/190627114105.htm

10. https://newatlas.com/deep-slow-wave-sleep-brain-cleaning-alzheimers-dementia/58671/