The Link Between Sleep and Alzheimer’s in the Elderly


Alzheimer’s disease is the most common form of dementia, according to the World Health Organization. Alzheimer’s is defined as “a brain disorder that slowly destroys memory and thinking skills and, eventually, the ability to carry out tasks[1]” and “a progressive neurologic disorder that causes the brain to shrink (atrophy) and brain cells to die.[2]” The Mayo Clinic states that nearly 6 million seniors in the United States have Alzheimer’s, and the vast majority of them – about 80% - are over the age of 75.

Unfortunately, there is no cure and no truly promising treatments that might slow the progression of the disease. But while we don’t know exactly how to prevent or slow the disease, we do know that there are certain factors that can increase your risk of developing it.

Risk Factors for Alzheimer’s Disease

As with most diseases, there are two types of risk factors: Those that can be changed and those that can’t. According to the Alzheimer’s Association, those risk factors for Alzheimer’s that can’t be changed include:

·         Age. Those who are 65 and older see their risk of Alzheimer’s double every five years, and from the age of 85, the risk increases by a third.

·         Family history. Those who have a parent or sibling who had Alzheimer’s are more likely to develop it themselves.

·         Genetics. Some people have genes that heighten their risk, while only 1% have what’s known as deterministic genes, or genes that actually cause the disease.

Risk factors that can be controlled include:

·         Certain medical conditions. Some medical issues that affect the heart can also affect the brain and lead to a higher risk of Alzheimer’s. These include high blood pressure, high cholesterol, diabetes, and heart disease. Keeping these conditions under control can help you avoid a greater risk of dementia later in life.

·         Brain injuries. A traumatic brain injury, such as one suffered when you hit your head during a fall, can lead to a greater risk of Alzheimer’s later in life. Getting immediate help can improve your odds of overcoming a traumatic brain injury, so consider keeping a medical alert pendant with fall detection handy. Being able to press the button and summon help as soon as an accident happens can ensure you get the prompt medical attention you need for a better outcome.

·         Lifestyle patterns. Living as healthy as possible can help reduce your risk of Alzheimer’s. This includes your diet, avoiding excess alcohol, not smoking, getting exercise, staying socially active, exercising the mind, and getting plenty of sleep.

The Sleep Connection

As we get older, our sleep patterns change. This is entirely normal and not necessarily a sign that Alzheimer’s is imminent. Many seniors wake up more frequently during the night, get up earlier in the morning and as a result, go to bed earlier in the evening. They also tend to be lighter sleepers than they were when they were younger[3].

Sleep provides us with much-needed benefits. Everything in our bodies is affected by sleep, including appetite, blood pressure, the immune system, cardiovascular health, energy, hormones, and our brains – everything from cognitive function to mood[4]. For some people, six hours of sleep feels like enough to keep them on an even keel. For others, eight hours or more is their minimum to feel rested and alert during the day.

The amount of sleep necessary depends on the individual, but studies have found that less than six hours of sleep each night can be risky for senior adults. A study from the National Institute on Aging found that those who slept six hours or less each night while in their 50s and 60s were more prone to developing dementia later in life than those who got “normal sleep,” which the study defined as seven hours of sleep each night. Those with less sleep were 30% more likely to be diagnosed with dementia in their later years[5].

But what if you are one of the many seniors who suffers from sleep problems? You might think it’s a good idea to reach for a sleep aid to help you get in that minimum of six hours every night to greatly reduce your risk of developing Alzheimer’s. But it gets complicated: a study presented at the 2019 Alzheimer’s Association International Conference found that those aged 70 to 79 who reported “often” or “always” using a sleep aid were 43% more likely to develop dementia than those who didn’t use a sleep aid.

There was another interesting wrinkle in the study-- the increase in dementia risk only applied to white participants. Black participants showed no link between their use of a sleep aid and their risk of dementia as they grew older[6]. There were also differences in men and women in the study, with women who had a history of insomnia actually showing a 35% reduced risk of Alzheimer’s if they took sleep aids to help them get some shut-eye. Women with no history of insomnia showed results similar to men[7].

That suggests that it’s not the sleep aid, but rather the sleeplessness itself, that can lead to problems with cognitive decline.

Other studies back that up, such as one from Harvard Medical School, which found that those over the age of 65 who got five hours of sleep or less per night were twice as likely to develop dementia five years later. They were also twice as likely to die compared to those who slept between six and eight hours each night.

But why?  

Scientists don’t really know why the lack of sleep can increase the risk of dementia, but they have some strong theories. One of these involves a protein called beta amyloid, which is associated with Alzheimer’s. This protein builds up in the brain and clumps together to form the plaques that are a hallmark of those with Alzheimer’s disease[8].

We all make this protein during the day. But when we sleep, something called the glymphatic system kicks in. Our brain cells and their connections shrink slightly during sleep, opening up more space between them for the glymphatic system to flush out the things that accumulate during the day, including beta amyloid. The longer you sleep, the more time that system has to get rid of the protein associated with Alzheimer’s[9].

How to Get Better Sleep

Study after study makes it obvious that sleep has a strong connection to the development of Alzheimer’s. So what can you do about it? Getting better sleep, no matter your age, can help you reduce your risk. Kaiser Permanente suggests the following to make sure you get good shut-eye each night:

·         Do you snore? That might be a sign of sleep apnea, a condition that affects about 30 million people in the U.S. Not only does it affect the quality of your sleep, in severe cases it can be life-threatening[10]. If you snore, talk to your doctor.

·         Slowing your mind down before sleep can help you get into deeper sleep cycles. Put away your phone or laptop and focus on things that are calming, such as listening to soft music or reading. Don’t watch television and don’t get into invigorating conversations.

·         Routines can be soothing, especially at bedtime. Choose one that works for you. It might mean a cup of hot tea right before bed (make sure it’s decaf) or taking a warm bath or shower. Finding a routine, including going to bed at the same time every night, can improve your sleep.

·         Think about your mattress and pillows. Just how comfortable and supportive are they? Mattresses break down over the years and need to be replaced for proper sleep and overall physical health. Use pillows to bolster your body if you suffer from aches and pains – for instance, a pillow between the knees or against your lower back can help ease back or hip pain.

·         Think about light, temperature, and noise. Experiment with what helps you sleep best. Some seniors might need a totally dark room while others need some ambient light. Some might like it very cool in the room while others need it warm and toasty. A white noise machine or a fan is a must for some, while others can’t stand to have any sound in the room at all. Try to implement what works for you.

·         Reduce your stress levels. Stress can keep our minds hopping, and that can make it impossible to fall asleep, or lead to fractured sleep when you do manage to drift off. Try to get rid of those worries in your head. Write them down in a journal, focus on pleasant thoughts, or even distract yourself with a book before bed. Consider what you can do during the day to reduce stress levels, including exercise and counseling, if necessary. Improve your peace of mind about your health with medical alert devices, aging in place solutions, a solid exercise routine, and planning out healthy meals.

Getting enough sleep is important to lower your risk of Alzheimer’s later in life. It’s also important for the day-to-day issues, such as being rested enough to get around the house without falling, having the sharp cognitive ability to handle your responsibilities, and generally being able to function in the best way possible. If you aren’t getting enough sleep, it’s vital that you have a safety net of some kind, like a medical alert system with fall detection. Though nothing can substitute sleep, an Alert1 Medical Alert can provide the peace of mind you need on those days when you didn’t get enough and you aren’t quite feeling like yourself. Being able to reach out for help at a moment’s notice can make all the difference and help lead to a better outcome in the event of emergency.