HJNO Jul/Aug 2021

HEALTHCARE JOURNAL OF NEW ORLEANS I  JUL / AUG 2021 47 Carrie A. Mercer Senior Director of Marketing Lambeth House about 30% more likely to develop demen- tia than those who slept seven hours. The increased risk persisted even when scien- tists accounted for physical and mental health, as well as genetic risk for Alzheim- er’s disease. Other studies have uncovered associa- tions between sleep problems and demen- tia, but the link has remained unclear. This report, published by French Institute of Health and Medical Research in Paris and at University College London, England, of- fers a unique advantage over earlier ones. Lead epidemiologist Séverine Sabia told AARP, “Most previous studies were based among individuals aged 65 or older. The novelty of this study is that its long follow- up period allowed us to assess the as- sociation of sleep duration at age 50 and dementia risk in later life.” What the re- searchers found was a “consistent associa- tion between persistent short sleep dura- tion between age 50 and 70 and increased risk of dementia.” Although scientists have long acknowl- edged the association between disturbed sleep and dementia, they haven’t been able to solve a crucial question: are sleep prob- lems contributing to the onset of dementia, or could they be an early sign that some- thing is different in the brain? While Sabia’s study doesn’t cover this conclusively, it does strongly suggest that persistent short sleep in midlife might be a key driver of dementia decades later, said Brendan Lucey, MD, associate professor of neurology at the Washington University School of Medicine and an expert in the re- lationship between sleep and Alzheimer’s disease in an interview with AARP. “They began monitoring sleep qual- ity many years before any symptoms and probably before much of the pathology was developing,” he explained. “It’s not a definitive study, but to me it does provide compelling evidence that short sleepers might be at an increased risk.” Sabia and her colleagues followed nearly 8,000 people in Britain for about 25 years and assessed their sleep patterns, start- ing at age 50. Participants reported their sleep duration and quality in real time at six points over the course of the study, and more than half of the subjects wore an ac- celerometer — a device that detects periods of motion and stillness — to record their sleep during the 2012-2013 reporting cycle. By the end of the study, 521 subjects had developed some type of dementia; the average age at diagnosis was 77. What’s more, those who reported short sleep had a significantly increased risk of developing some form of dementia. At age 50, com- pared to normal sleepers, short sleepers faced a 22% increased risk. At age 60, the increased risk was 37%, and at age 70, it was 24%. All of the associations remained strong even after the team took into ac- count physical and mental health, genetic risk for Alzheimer’s disease, and sociode- mographic factors. Sabia and her team also looked to see if changes in sleep patterns had any effect on developing dementia. Regardless of age, people who had persistent short sleep pat- terns were at the highest risk — 30% more likely to develop dementia than people with normal sleep. The Alzheimer’s Association says, “Sleep is one potential risk factor associated with dementia, but it’s not the only one.” A healthcare professional and individuals should not focus on just one key source. Instead, try to create a healthy lifestyle that might actually, truly help prevent demen- tia. A nutritious diet, physical activity and social engagement have also been linked to better brain health. Poor sleep is not necessarily a fact of getting older. Primary Care physicians or sleep medicine physicians should be able to diagnosis any problems and provide re- liable treatment. In the meantime, here are some tips for improving sleep. Rest well! n TIPS FOR IMPROVING SLEEP Control your environment. A comfortable bed in a cool, dark, quiet room is the most conducive setup for high-quality sleep. Limit screen time for an hour or two before bed. TV is full-spectrum light, and phones and tablets emit a lot of blue light, which can reset our circadian rhythm and delay sleep onset. Avoid alcohol for a few hours before bedtime. It’s a sedative, true, but a short- acting one that leaves you vulnerable to abrupt waking once the effect of the alcohol wears off. Exercise regularly, but earlier in the day rather than close to bedtime. Establish a routine that lets your brain know sleep is coming soon. Set a regular bedtime, and if you are vulnerable to insomnia, set a regular wake-up time. Talk to your doctor about cognitive behavioral therapy for insomnia (CBTI). This psychological intervention is part education and part behavior modification. Usually delivered by a trained professional, it can encompass sleep restriction initially while you learn to sleep efficiently again, as well as other techniques that have been demonstrated by years of research to help restore — and then maintain — healthy sleep.