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June is Alzheimer's and Brain Awareness Month! Each week, the Memory and Brain Wellness Center team will share information on brain health! These important, evidence-based tips involve nutrition, sleep, nature exposure, stress reduction, physical activity, and social engagement, and cognitive stimulation. This week, we are sharing evidence-based information about improving sleep habits for brain health and wellness.
Quick tip:
Sleep that knits up the ravell’d sleave of care, The death of each day’s life, sore labour’s bath, Balm of hurt minds, great nature’s second course, Chief nourisher in life’s feast. - Shakespeare, Macbeth
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As Shakespeare captured, a good night’s sleep helps us recover and recharge for the day ahead. During sleep, our brains are busy storing memories and new knowledge, healing from injury, and boosting immune response. The brain also turns on its “wash cycle” in deep sleep in a clearance process governed by the glymphatic system. Since 2008, researchers have known that sleep gives the brain a chance to flush out the waste products that accumulate during the day. Impairments in the glymphatic system may increase the risk for Alzheimer’s disease.
This research shows how important it is to sleep well. But we all know how it feels to sleep poorly or get much less sleep than we need to feel our best. Lack of sleep affects your aspects of your mental function, such as decision making, memory, and attention. In fact, research shows that mid-life sleep disruption predicts cognitive decline later in life. "If people know that how they sleep when they are in their 30s, 40s, and 50s is going to influence the way their brain functions in their 60s, 70s, and 80s, they might pay more attention to getting the recommended 7 - 9 hours per night,” says Jeff Iliff, Professor, UW Department of Psychiatry and Behavioral Sciences. “Many of us are starting to view sleep as a potentially modifiable risk factor, like high blood pressure or smoking, for the development of dementia later in life.” Here are some evidence-based tips from medical professionals at the UW Memory and Brain Wellness Center and UW sleep experts that everyone can use to support better sleep.
- Have a routine and stick to a consistent sleep schedule. Try not to alter your bedtime by much day to day or from the week to the weekend. "Try to make every effort to make your sleep schedule consistent with your body. Everybody has a different body clock, so try to align your sleep schedule with your daytime activity so that you can have a regular sleep and wake time." - Yeilim Cho, MD, sleep physician and MIRECC Fellow in the Iliff Lab
- Talk to your doctor if you think you may have sleep apnea or trouble breathing at night. Sleep apnea contributes to long-term brain health risks, but this condition is treatable. “Common symptoms of sleep apnea include heavy snorning and waking up gasping. If that sounds like you, consider reaching out to your physician.” – Jeff Iliff, Professor, UW Department of Psychiatry and Behavioral Sciences in a Wired Q&A. "Make sure that any environmental or medical conditions affecting sleep are being addressed. We like to remind patients that the consistent use of CPAP (continuous positive airway pressure) machines has been shown to make a significant difference in cognitive outcomes for people diagnosed with sleep apnea." - Micheal Persenaire, MD, Neurologist, UW School of Medicine
- Create a light-dark cycle in your bedroom. “In our dark winter months, turn on bright lights in the morning and similarly, have dark curtains in the bedroom for early summer mornings.” Pamela Dean, PhD, Assistant Professor, UW Department of Psychiatry and Behavioral Sciences, in a MBWC wellness presentation on sleep (View slides).
- Do something physically active or mentally challenging every day. "Stimulate your brain with activities like reading a book, so that you get really tired and build up the sleep power to sleep at least three or four hours in a chunk at nighttime." – Yeilim Cho, sleep physician and MIRECC Fellow in the Iliff Lab
- Try to curb the caffeinated beverages around 2 or 3 o’clock in the afternoon. "Coffee takes about a half of a day to clear out of the body, so if you don’t want coffee to affect your sleep, stop drinking in the afternoon. Caffeine keeps your brain in light sleep, preventing you from going into the deep phases of sleep." -Jeff Iliff, Professor, UW Department of Psychiatry and Behavioral Sciences."Avoid or decrease substances that are clearly harmful for sleep, such as stimulants, caffeine, tobacco, and alcohol.” - Micheal Persenaire, MD, Neurologist, UW School of Medicine
- Avoid TV, electronic readers, and tablets/smartphones right before bed. "These devices will send activating light to the eye and brain, which confuses our bodies. Some devices have settings to reduce brightness/blue light–if you don’t have this option, opt for a printed material or soothing music." – Pamela Dean, PhD, Assistant Professor, UW Department of Psychiatry and Behavioral Sciences.
- For chronic sleeping problems linked to anxiety, talk to your doctor about cognitive behavioral therapy, a common form of talk therapy. "Cognitive behavioral therapy has been shown to be particularly effective in treating insomnia.” -Micheal Persenaire, MD, Neurologist, UW School of Medicine
Sources
Eide PK et al. Delayed clearance of cerebrospinal fluid tracer from entorhinal cortex in idiopathic normal pressure hydrocephalus: A glymphatic magnetic resonance imaging study. J Cereb Blood Flow Metab. 2019 Jul;39(7):1355-1368.
Iliff JJ et al. A paravascular pathway facilitates CSF flow through the brain parenchyma and the clearance of interstitial solutes, including amyloid β. Sci Transl Med. 2012 Aug 15;4(147):147ra111.
Iliff JJ et al. Impairment of glymphatic pathway function promotes tau pathology after traumatic brain injury. J Neurosci. 2014 Dec 3;34(49):16180-93.
Kress BT et al. Impairment of paravascular clearance pathways in the aging brain. Ann Neurol. 2014 Dec;76(6):845-61.
Li J et al. Assessment of the Mid-Life Demographic and Lifestyle Risk Factors of Dementia: Using Data from the Framingham Heart Study Offspring Cohort. J Alzheimers Dis. 2018;63(3):1119-1127.
Lutsey PL et al. Sleep characteristics and risk of dementia and Alzheimer's disease: The Atherosclerosis Risk in Communities Study. Alzheimers Dement. 2018 Feb;14(2):157-166.
Mawuenyega KG et al. Decreased clearance of CNS beta-amyloid in Alzheimer's disease. Science. 2010 Dec 24;330(6012):1774.
Potter R et al. Increased in Vivo Amyloid-β42 Production, Exchange, and Loss in Presenilin Mutation Carriers. Science Translational Medicine. 12 Jun 2013: Vol. 5, Issue 189, pp. 189ra77.
Wang M et al. Focal Solute Trapping and Global Glymphatic Pathway Impairment in a Murine Model of Multiple Microinfarcts. J Neurosci. 2017 Mar 15;37(11):2870-2877.
Xie L et al. Sleep drives metabolite clearance from the adult brain. Science. 2013 Oct 18; 342(6156): 373-7.
