‘Poor sleep leads to a higher risk of dementia’

1. You are researching the link between dementia and sleeping problems. What’s new about this research?

“The relationship between dementia and sleep has only been known for a few years. A study found that people who slept poorly seemed to have a higher risk of dementia.

A few years ago it was not at all clear what caused people to develop dementia. Subsequently, a number of risk factors were gradually discovered. There were also a number of well-known ones, such as high blood pressure, smoking and alcohol use. Sleep was therefore only discovered about four to five years ago, but in the research world it is still recent. What’s new is that there is new evidence that continues to confirm that sleep also plays a role.”

2. What are the main findings?

“Repeat research has shown that poor sleep leads to a higher risk of dementia many years later. You will not find this in one population group or research group, but it appears in several studies in several countries. Then it becomes increasingly plausible that there really is something.

Several research groups have now taken some steps in which you can see, for example, that poor sleep affects the Alzheimer’s protein (amyloid), whereby poor sleep often leads to an increase in amyloid in the brain. That could fit well with a higher risk of Alzheimer’s. The theory is that the amount of protein leads to dementia. The latter has yet to be investigated, but it is already known that people with Alzheimer’s have too much of that protein.”

3. How does sleep affect the risk of dementia?

“If you could improve your sleep, then you have a chance of an improvement in functioning in the short term. Because if you don’t sleep well one night, you function less the next day, so do healthy people. Someone who already has dementia and If you don’t sleep well one night, you will function even worse the next day than it would the day after, and it is possible that poor sleep can also cause additional damage, which means protein accumulation and further deterioration.

There is also strong evidence that prolonged poor sleep increases the risk of cardiovascular disease. You could also consider that poor sleep leads to high blood pressure, cerebral infarction and thus further aggravates dementia. That also means that you can expect health effects from better sleep, which may cause people with dementia to deteriorate less if they sleep better. So all of that still needs to be investigated.”

4. How can dementia patients with sleeping problems be treated?

“People who have dementia tend to become less active, so they start doing less during the day. They also tend to doze off when they are not activated. As a result, they have short naps during the day, which do not help enough to In the evening they are not tired enough and they sleep badly, so you can improve sleep quite simply by keeping people more active during the day through more exercise, which means they sleep better at night.

What is also a simple measure: make sure that there is sufficient exposure to daylight during the day and that it is sufficiently dark at night. If people sit in a dim room during the day, their sleep-wake rhythm is disrupted and that doesn’t help either.”

5. How much minimum do you need to sleep to reduce the risk of dementia?

“For the average person it seems that you have to sleep at least seven hours. There is also an upper limit: that it is also not good if people lie in bed for a long time. That is probably also an expression of health risks “If you sleep more than nine hours, which is abnormally much, that’s not good either. There’s an optimum somewhere, which is somewhere around seven to eight hours.”

6. From what age is sufficient sleep important to prevent dementia?

“You should definitely start watching this from middle age, maybe even earlier. If you’ve been sleeping badly all your life, then in theory it could already cause damage. So you shouldn’t be too careful. “starting on the sixtieth or seventieth. That is also apparent from the studies that see these connections. They really see ten, twenty or even thirty years before the dementia develops, that people have already indicated that they sleep badly.”

7. Does the quality of sleep also play a role?

“There are all kinds of sleep phases, so the question is: is one sleep phase more important than the other? There is a lot of evidence that deep sleep is the phase that is the most important, because this phase gives the most rest and recovery capacity to your brain There may also be other sleep stages, but regardless of which one it is, they do say something about sleep quality.

What poor sleep quality does is that you often wake up briefly or have a very light, shallow sleep, and it is certain that light, shallow sleep offers no protection.

It has been shown that if you do have that deep sleep phase, you get less of the Alzheimer’s protein and if you don’t have it, you get more of that protein. If you sleep lighter, you see an increase in that protein in that brain, while if you have a lot of that deep sleep in one night, you even see a decrease in that protein.”

8. How many days a week do you need to be able to sleep well to prevent dementia?

“What we think, which is not yet entirely certain, is that if you get a good night’s sleep again, that protein will be removed again. I personally think that you would have to sleep badly for more than half of your sleeping nights if it really had an effect. If you have a bad night’s sleep one night and you do the following nights, then you probably have sufficient recovery capacity.

If your brain does not get any compensatory capacity for a week, you build up waste products. There has to be a balance somewhere between disruption and the chance of recovery. Where it is exactly is yet to be determined.”

9. What else can you use to prevent dementia?

“Sleep is a factor that plays more of a role in some people than others. It’s probably a combination of risk factors: high blood pressure is one that has been known for a while and that probably plays a very large role. Now it is not that everyone with high blood pressure will get dementia per se, but there are a lot of people with high blood pressure in the world, some of whom have a higher risk of dementia, which means that if you can prevent high blood pressure, you can Many cases of dementia can be prevented.In addition to high blood pressure, other cardiovascular diseases probably also play a role, for example people who have high cholesterol and heart attacks.Everything you can prevent about this probably reduces the risk of dementia.

Furthermore, a number of lifestyle factors have been discovered: things that influence your health, such as your diet, weight, smoking and all those things that we know are bad for the heart and blood vessels, also appear to be bad for dementia. In research you can look very closely at who eventually gets dementia and then you can look back at which people turned out to have more risk and which less. And then you come up with all these kinds of factors. People who live a healthy life, do not smoke, exercise a lot and have a good education have less chance of dementia.”