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Sleepless Nights and/or the Medications Used as a Fix Could Lead to Alzheimer's Disease

 By Susan B. Geffen  

Have you ever had problems concentrating after a bad night's sleep? What if one bad night's sleep turned into another and another? 

Could that inability to concentrate actually be the beginning of something more serious? The thing we fear the most? Sleepless nights don't just affect your memory the next day. They could raise your odds of developing Alzheimer's disease.  

According to a recent study by scientists at Berkeley, it appears that poor sleep allows beta-amyloid, a memory-robbing toxic protein to build up in the brain. 

In a vicious cycle, this protein build-up disrupts sleep and significantly raises the risk of disease onset. Writing in the journal Nature Neuroscience, the researchers said they will now study whether it is the lack of sleep or the build-up of beta-amyloid that kick-starts the whole process.

A Johns Hopkins Bloomberg School of Public Health study found a similar link. The researchers studied 70 older adults, average age 76, who were part of the ongoing Baltimore Longitudinal Study of Aging. 

Using brain scans, they found that those who said they got the least sleep, under five hours a night, or who slept fitfully had higher levels of beta-amyloid in the brain than those who slept over seven hours a night. 

The findings appeared in the journal JAMA Neurology. Additional research suggests that one reason why poor sleep may be linked to Alzheimer's is that sleep may help to clear toxic molecules from the brain.

Researchers at the University of Rochester Medical School found that when mice slept, the cells in their brains literally shrank, making more room for the flow of fluids through the brain. 

This increased flow of fluid acted something like the jet sprays in a dishwasher, flushing away harmful waste products like beta-amyloid. In yet another study, scientists at the University of Toronto found that sound sleep seemed to mediate the effects of APOE-E4, a gene that predisposes to the development of Alzheimer's disease. 

In this six year study, the researchers found that in those who carried the APOE-E4 gene, those who slept most soundly showed the greatest preservation of memory and thinking skills. Among study participants who died, the poor sleepers were more likely to exhibit the characteristic brain plaques and tangles of Alzheimer's disease. 

Logically, sleep therapies could help delay the onset of the disease, as well as slow its progression in those who already have it.  However, be careful not to include benzodiazepines in that bag of sleep therapies. 

Up to 43 percent of older adults use benzodiazepines (Valium, Xanax, Ativan, to name a few) for anxiety and insomnia, often chronically, even though their long-term effectiveness and safety remain unproven. 

International guidelines recommend short-term use of benzodiazepines, because they cause withdrawal symptoms that make discontinuation problematic. Despite this, many seniors take them for years instead of a few weeks, as is recommended.

A new study in the British Medical Journal (BMJ) reported that people who had used benzodiazepines for more than three months had almost a 50% higher risk of Alzheimer's disease over the following six years, an association that has been reported in previous publications as well.  

Short-term use of benzodiazepines (less than 91 daily doses) did not raise the risk for Alzheimer's but, beyond that point, with longer use came greater risk.  The associated risk was observed even in people who had previously used a benzodiazepine for at least six months but had stopped using it at least a year before their diagnosis of dementia.  

Whether benzodiazepines raise the risk of Alzheimer's disease or not, this study reinforces what most clinicians already know. Benzodiazepines should not be the first line of treatment.  When they are used, they should be used in the short-term only.  All sleep medication, including zolpidem (Ambien™) can cause cognitive impairment including amnesia and should be used with caution in the elderly. That study concluded:

 "Benzodiazepine use is associated with an increased risk of Alzheimer's disease. The stronger association observed for long term exposures reinforces the suspicion of a possible direct association, even if benzodiazepine use might also be an early marker of a condition associated with an increased risk of dementia. Unwarranted long term use of these drugs should be considered as a public health concern."

The full scientific article is freely available from the BMJ and can be found here. 

There are plenty of ways to ensure that you get your Z's. I myself just violated a cardinal rule; do not work on your computer while in bed or within an hour of bedtime. 

So, I will put down my computer and now rest so that I can continue to use this brain of mine (for which I am ever so grateful) in the morning and hopefully well into the future.

Good night, sweet dreams, and I hopes to see you at my seminar next Saturday, July 18 at the Torrance Doubletree Hotel. (Click on the link to register)

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