What is the relationship between Alzheimer’s and sleep? | Drauzio Varella

Sleep disorders, such as apnea and insomnia, are more frequent in Alzheimer’s patients. Behavioral measures can help.

The diagnosis of Alzheimer’s brings a series of impacts to the life of the patient and their families. As the disease progresses, the person’s entire routine needs to be rethought and adjusted. And a frequent alteration in cases of Alzheimer’s is sleep.

First, it must be noted that the sleep deprivation seems to be related to cognitive decline and, consequently, a higher risk of having Alzheimer’s. According to Dr. Jerusa Smid, a neurologist and coordinator of the Scientific Department of Cognition at the Brazilian Academy of Neurology (ABN), some studies suggest that during sleep, a pathogenic protein is removed from the brain.

“This protein is called beta-amyloid and is one of the proteins deposited in the brain in Alzheimer’s disease (AD). Therefore, situations that lead to sleep deprivation cause this protein to accumulate in the brain. patients with obstructive sleep apnea syndrome (Saos)a common disease in the general population, are more likely to have cognitive decline and AD, for example”, he explains.

When we talk about patients diagnosed with Alzheimer’s, according to the neurologist, the sleep disorders, such as sleep apnea itself, are frequent. “In addition insomnia is a common symptom in AD, with higher prevalence in more advanced stages of the disease. Nocturnal behavior, with wandering and loss of sleep-wake cycle, are also frequent symptoms”, says the specialist.

See also: How to deal with Alzheimer’s patient?

Is Melatonin an Option?

The doctor explains that the secretion of melatonin – a hormone that aids in inducing sleep – appears to be reduced in Alzheimer’s disease. “Patients with moderate and severe stages of the disease present what we call the sunset phenomenon: agitation and behavior change at the beginning of the night, indicating a loss of the day-night chronobiological rhythm”, he says.

However, studies that have tried to establish melatonin replacement as a possible treatment for these changes show conflicting results. “The use of melatonin can be tried in patients with Alzheimer’s and sleep disorders, but without robust scientific evidence to support this indication”, adds Dr. Jerusalem.

Although melatonin has been released for sale in Brazil in the form of a food supplement without the need for a prescription, its use deserves caution. There are few conditions for which melatonin replacement has proven benefits.

See also: Melatonin helps regulate sleep, but does not treat insomnia

Measures to help sleep

To help the Alzheimer’s patient who is having trouble sleeping, the first step is to find the cause of it – for example, identifying whether the person is having trouble falling asleep or staying asleep.

According to the specialist, there are medications that can be used in various clinical situations. Therefore, it is important that family members or caregivers report complaints to professionals who follow the case to receive appropriate guidance.

In addition, it is essential to adopt behavioral measures that favor a good sleep routine (so-called sleep hygiene):

  • Avoid stimulating activities after 6 pm;
  • Avoid ingesting stimulant substances (such as coffee and other caffeinated drinks) after 6 pm;
  • Avoid naps throughout the day;
  • Keep the environment bright and lit during the day (open windows, let in light);
  • Practice physical activity during the day;
  • Maintain regular sleeping and waking times;
  • Avoid exposure to electronic screens close to bedtime.

The recommendation of the National Sleep Foundation, an entity in the United States that specializes in issues related to sleep, is that an elderly person should sleep, on average, 7 to 8 hours a night.

See also: Five tips for a good night’s sleep

Prevention and cognitive reserve

According to the neurologist, preventive measures to insanity and Alzheimer’s are those that increase the so-called cognitive reserve, and include encouraging the individual to have high schooling; fight and treat obesity, high blood pressure, diabetes, smoking, physical inactivity, depression, hearing loss, alcohol abuse; stimulate social interaction; prevent traumatic brain injury.

“Studies show that gaining new skills, such as learning a new language, playing a musical instrument, dancing, among others, also increases cognitive reserve”, adds the doctor.

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