ST. LOUIS — Poor sleep can be an early sign that Alzheimer’s is in your future. However, a new study finds that taking sleeping pills could prevent the disease from ever developing later in life. Researchers from Washington University School of Medicine in St. Louis found that older adults taking a sleeping aid called suvorexant before bed lowered their levels of two key proteins linked to Alzheimer’s onset. While scientists still need to confirm these results, it appears that the best way to avoid dementia is to cure a patient’s insomnia first.
In this study, the team conducted a two-night experiment with a group of 38 people between the ages of 45 and 65. These participants either took a low-dose (10 mg) or high-dose (20 mg) of suvorexant or a placebo before going to sleep. The team then took samples of their cerebrospinal fluid every two hours for 36 hours. Results show that volunteers taking a high dose of the sleeping aid saw a significant drop in both Alzheimer’s-related proteins — amyloid beta and tau.
“This is a small, proof-of-concept study. It would be premature for people who are worried about developing Alzheimer’s to interpret it as a reason to start taking suvorexant every night,” says senior author Brendan Lucey, MD, an associate professor of neurology and director of Washington University’s Sleep Medicine Center, in a media release.
“We don’t yet know whether long-term use is effective in staving off cognitive decline, and if it is, at what dose and for whom. Still, these results are very encouraging. This drug is already available and proven safe, and now we have evidence that it affects the levels of proteins that are critical for driving Alzheimer’s disease.”
What are sleeping pills?
Sleeping pills, also known as hypnotics, work by increasing the activity of a neurotransmitter called gamma-aminobutyric acid (GABA) in the brain. GABA is a naturally occurring chemical in the brain that helps to slow down or calm down the activity of nerve cells. By increasing GABA activity, sleeping pills can cause a sedative effect, which can help people fall asleep faster and stay asleep longer.
There are several types of sleeping pills, including benzodiazepines, non-benzodiazepines, and sedating antidepressants. Benzodiazepines, such as Valium and Xanax, work by enhancing the effects of GABA on nerve cells. They can cause drowsiness, muscle relaxation, and a decrease in anxiety. Non-benzodiazepines, such as Ambien and Lunesta, work in a similar way but are less likely to cause daytime drowsiness. Sedating antidepressants, such as trazodone and doxepin, also increase GABA activity but are primarily a treatment for depression, not sleep.
It is important to note that sleeping pills can be habit-forming and should only be used under the guidance of a healthcare professional. They can also cause side-effects such as dizziness, headache, and nausea, and can interact with other medications. Additionally, sleeping pills may not address the underlying causes of sleep problems and may only provide temporary relief. Therefore, it is important to address any underlying medical or psychological issues that may be contributing to sleep problems.
Here’s what you need to know about suvorexant
Suvorexant belongs to a class of insomnia drugs called dual orexin receptor antagonists. Orexin is a natural biomolecule that promotes wakefulness. When medications block orexin, people fall asleep. The U.S. Food and Drug Administration has approved three orexin inhibitors for use and researchers say more are on the way.
Suvorexant is a prescription medication available under the brand name Belsomra. Like other sleeping medications, it comes in tablet form. Doctors typically prescribe it for short-term use, and its dosage should be individualized based on the patient’s needs and response to the medication. As with any medication, suvorexant may cause side-effects, and it is essential to consult a healthcare professional before starting the treatment.
What is Alzheimer’s disease?
Alzheimer’s disease is a chronic and progressive brain disorder that affects memory, thinking, and behavior. It is the most common form of dementia, a condition characterized by a decline in cognitive function and memory loss.
The disease usually begins with mild symptoms, such as forgetfulness, difficulty remembering recent events, and problems with language. As the disease progresses, the symptoms become more severe, and individuals may experience changes in personality and behavior, confusion, difficulty with communication, and eventually, loss of independence.
Alzheimer’s disease is the result of a buildup of abnormal proteins in the brain, including beta-amyloid and tau proteins. These proteins form plaques and tangles, which disrupt the normal communication between brain cells, leading to the death of brain cells and the shrinking of the brain.
Although there is no cure for Alzheimer’s disease, there are treatments available that can help to manage the symptoms and improve quality of life for individuals with the disease. These treatments include medications to help manage symptoms such as memory loss and behavioral changes, as well as lifestyle changes such as regular exercise, a healthy diet, and social engagement. Additionally, research is ongoing to develop new treatments that can slow or stop the progression of the disease.
Lucey’s team is one of the first to show that poor sleep has a connection to higher levels of both amyloid and tau in the brain. However, there are still questions as to whether improving sleep quality can effectively lower these proteins and stop the disease.
How well did sleeping pills work?
Results of the two-night study show amyloid levels fell by 10 percent (down to 20%) in the cerebrospinal fluid of participants taking the higher dose of suvorexant — compared to those taking a placebo. Levels of a key form of tau (called hyperphosphorylated tau) also dropped by 10 percent (down to 15%). Researchers say both of these changes are significant, however, using the lower dose of suvorexant did not produce results that were significantly different from taking a placebo.
Additionally, hyperphosphorylated tau levels began to rise again 24 hours after the high-dose group took their first pill. taking a second dose on night two sent levels of both Alzheimer’s protein down again for the group taking 20 mg of suvorexant.
“If we can lower amyloid every day, we think the accumulation of amyloid plaques in the brain will decrease over time,” Lucey says. “And hyperphosphorylated tau is very important in the development of Alzheimer’s disease, because it’s associated with forming tau tangles that kill neurons. If you can reduce tau phosphorylation, potentially there would be less tangle formation and less neuronal death.”
“Future studies need to have people taking these drugs for months, at least, and measuring the effect on amyloid and tau over time,” the researcher continues. “We’re also going to be studying participants who are older and may still be cognitively healthy, but who already have some amyloid plaques in their brains. This study involved healthy middle-aged participants; the results may be different in an older population.”
“We’re not quite there yet. At this point, the best advice I can give is to get a good night’s sleep if you can, and if you can’t, to see a sleep specialist and get your sleep problems treated.”
The new study is published in the Annals of Neurology.
7 simple habits can cut Alzheimer’s risk in half
Aside from using sleeping pills as a possible preventative medication for Alzheimer’s, a previous study mapped out seven simple habits that cut the risk of disease onset in half.
These simple tips include being active, eating better, losing weight, and maintaining normal blood pressure. Controlling cholesterol, not smoking, and reducing blood sugar are also part of that the team calls “Life’s Simple 7” — which also protect against cardiovascular disease.
“These healthy habits in the Life’s Simple 7 have been linked to a lower risk of dementia overall,” lead author Professor Adrienne Tin from the University of Mississippi says in a statement. “But it is uncertain whether the same applies to people with a high genetic risk.”
“The good news is even for people who are at the highest genetic risk, living by this same healthier lifestyle are likely to have a lower risk of dementia,” Prof. Tin adds.
Researchers tracked 11,561 older people for 30 years, including 8,823 of European ancestry and 2,738 of African ancestry. Among Europeans, those who achieved high lifestyle scores were 43 percent less likely to develop dementia. Those with an intermediate lifestyle score had a 30-percent lower risk. Among those of African ancestry, the number of cases fell by 17 and six percent, respectively.
Participants reported their levels in all seven health factors during the study. Scores ranged from 0 to 14, representing the most unhealthy and healthiest, respectively. The average score for Europeans was 8.3, while Africans had an average score of 6.6. For each one-point increase, there was a nine percent lower dementia risk.
Estimates project the number of Alzheimer’s cases worldwide will triple to more than 150 million by 2050. With no cure in sight, there is an increasing focus on potentially protective lifestyle changes.
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