Feature

Sleep, medication and Alzheimer’s

By Emily Spacek

A team of USU researchers find curious correlations

“The last few months of her life my dad would simply hug me and thank me for the visit. Words I exchanged with my mom soon were reduced to simple words I uttered: ‘It’s great to see you, mom,’ ‘You’re looking great,’ and, ‘I love you.’ She forgot who I was, did not recognize my voice or appearance. Her eyes were often vacant, staring into unknown faces, places or maybe they were distant places or faces. Despite the repetitive conversations, my corrections about who was who and the moments of silence near the end, I knew my mom was still my mom, and I still was her daughter. I knew that I would never forget the memories we built together though they were mine, now, to keep and share.”

 

Alzheimer’s disease is a progressive dementia disease that robs the afflicted of their memories and various cognitive functions. Currently, the disease devastates the lives of roughly 5.8 million Americans and their families—as it did to mine earlier this year when my mother (who writes above) lost her own mother and I, my grandmother.

Anyone who has witnessed a loved one struggle is all too familiar with the frustrating truth of how little is known about the disease. Its cause is still unknown, and we don’t know definitively how to prevent it, slow it or cure it.

Nonetheless, plates may be shifting. We are reaching the years where the first wave of the massive baby boomer generation is in their early 70s. Federal funding for dementia research is at an all-time high. With new findings published more and more frequently, hope might be on the horizon.

Breakthrough connections are being seen between Alzheimer’s and factors such as inflammation, the human microbiome and sleep.

Sleep, quite the scientific mystery in and of itself, is known to be extremely important for brain health and memory consolidation. New research over the past few years has shown a correlation between lack of quality sleep and risk for developing Alzheimer’s disease. It appears that during non-REM sleep, the brain flushes itself of toxins that, when left behind, may misshape or fold into the plaques and tangles that are commonly associated with Alzheimer’s.

Building on this hypothesis, a Utah State University-based cohort of scientists wanted to see how sleep medications, which affect the sleep cycle, further affected the risk of Alzheimer’s.

Elizabeth Vernon, a doctoral student on the research team, presented the new research findings this past July at the 2019 Alzheimer’s Association International Conference.

“Our hypothesis was that sleep medications affect Alzheimer’s development either by reducing risk because they help individuals get better sleep, or by increasing risk because they change the sleep stages. Because other studies linked sleep to Alzheimer’s disease, we chose to treat the sleep as the problem,” Vernon explains.

They studied a compilation of data that had been gathered 1995-2005. Cache County individuals without dementia aged 65 and over were asked to complete a lengthy survey. Questions included whether they took certain medications—benzodiazepines, tetra or tricyclics, antihistamines, antidepressants—and whether they experienced a sleep disturbance. For followup,their cognitive status was measured with exams in the third, seventh and 10th years. 3,656 (57% of whom were female) participated.

Vernon’s team found that women who self-reported experiencing sleep issues and who took any of the listed medications were at a 35% decreased risk of developing Alzheimer’s.

On the contrary, women who did not report sleep issues but who took any of the medications for other reasons were at a four times increased risk of developing Alzheimer’s. Men who took the meds, regardless of experiencing sleep issues or not, also had about a fourfold increased rate of developing the disease compared to men who did not use sleep medication.

Vernon stresses the associational nature of the study—that though the associations are strong, the causes for those associations are unknown. One reason her study has received so much attention is due to its surprisingly sharp difference in results between the sexes.

“There has been a growing understanding that there may be some differences between how men and women become susceptible to Alzheimer’s disease,” Vernon says.

Obviously much more study is needed to make the appropriate determinants. All Vernon can say for now is that there is an association between a group of drugs and risk for Alzheimer’s. “We also know there are behavioral techniques for sleep issues that may be worth exploring… Research, too, should continue to look into these other interventions for sleep to see how they may affect someone’s outcome in reducing their risk for the disease.”

 

Emily is a recent college graduate from California. Since August she has found home in Salt Lake City at CATALYST and as a junior high after-school teacher.

This article was originally published on December 1, 2019.