Howard Gold's No-Nonsense Investing: Can lack of sleep lead to dementia?

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Getting a good night’s sleep becomes more difficult as we age, but it also becomes more important. Two-thirds of older adults report sleep-related problems, which can affect people’s health in many ways — and dementia is one of them.

For some time, scientists have observed a link between insomnia and dementia, but a recent paper by researchers from Brigham and Women’s Hospital in Boston and Harvard Medical School shows how tight the connection may be. The study, which covered some 6,300 people 65 and older, representing more than 30 million elderly Americans, found “a consistent, strong relationship between sleep difficulties and incident dementia over an eight-year follow-up” period.

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How strong is that relationship? “Self-reported difficulty with initiating sleep was associated with a 49% increased risk of incident dementia [while} risk of incident dementia was increased 39% in those who reported difficulty falling back asleep,” the study said. People who reported they had trouble both falling asleep and getting back to sleep showed a 58% higher risk of dementia over those who had normal sleep patterns.

And people who have insomnia of one kind or another also were more likely to die of other causes over the eight-year period the study covered: Those who had trouble getting to sleep had a 44% higher risk of mortality from all causes while those who struggled to get back to sleep had a 56% greater mortality risk. Those who had problems falling asleep and getting back to sleep had a whopping 80% greater risk of dying from any cause over the eight years than people who didn’t have sleep problems. Clearly that combination is a double whammy that can have far-reaching consequences on people’s health.

Sleep scientists consider seven to nine hours of sleep a night a healthy amount even for older people. According to the paper, roughly one in five seniors reported difficulty falling asleep, while 15% of their sample population had trouble getting back to sleep. The study was just published online by the peer-reviewed Journal of Sleep Research.

Why does this happen? There are several theories. When we sleep, fluids build up in the brain that wash away toxins associated with dementia. With insufficient sleep, that clearance is impaired and toxins may accumulate. Also, insomnia may reduce so-called “slow-wave sleep”—deep, dreamless sleep—and that’s associated with “higher levels of cerebral spinal fluid amyloid beta, which may lead to brain amyloid plague deposition that is toxic to neurons.”

Either way, lack of sleep is bad for your brain.

So, what should you do to get a good night’s sleep? I contacted Dr. Rebecca Robbins, the lead author on the study and associate scientist at the Division of Sleep and Circadian Disorders at B&W. She was kind enough to take my call while on maternity leave, and she actually put her baby boy to sleep during the interview, which makes her an official Sleep Wizard.

Older adults do face more difficulties sleeping, but “the good news is, there are evidence-based strategies that we can all do to improve our sleep, and particularly older adults. And those are what we call healthy sleep strategies or good sleep hygiene,” she told me.

Meditation is one of them. “Number one, learn relaxation strategies–meditation, mindfulness, visualization exercises, breathing exercises, progressive muscle relaxation,” Robbins said. “Get it in whenever you can. And if that’s five, 10 minutes before bedtime, God bless you.”

Second, make your bedroom more conducive to sleep. “You want to make sure you have a very dark environment. You also want to make sure that you’re sleeping in a cool environment,” she said. “Open the windows for some fresh air, turn down the air conditioning. That will help you fall asleep faster, into deeper sleep.”

Finally, she said, “try to eat your last meal of the day far away from bedtime. So, having an early dinner is actually really good, not only for your waistline, for your health, for your blood pressure, but also for your sleep. If you eat too close to bedtime, your body can be up and awake trying to digest your food as you’re trying to slip into sleep.”

How far away from bedtime? Three to four hours is ideal, she said, and avoid eating a big meal an hour to an hour and a half before going to bed. That makes the “early-bird special” an even better deal.

Most of us take sleep for granted or pay little attention to it. But research like this shows that especially as we age, getting a good night’s sleep may be the best single thing we can do for our bodies and minds.

Howard Gold is a MarketWatch columnist who writes regularly for Retirement Weekly.

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