senior man smiling and leaning on his caneStudies have shown that insufficient or decreased sleep quality is associated with poor cognitive function.  In addition, sleep disturbances are associated with a 1.5-fold increased risk in developing Alzheimer’s disease (AD).

This article suggests a relationship between sleep and Amyloid B, which is a key molecule involved in Alzheimer’s pathogenesis.  Until recently, amyloid formation was considered to be a slow process of deposition of an abnormal protein due to genetic abnormalities, however recent data suggests that the process of amyloidogenesis may be much more rapid than previously thought.  Amyloid deposition is one of the central neuropathological abnormalities in Alzheimer disease (AD).

Symptoms of AD develop slowly, often making it harder to detect.  Keep in mind that the pathological changes underlying AD can begin 10-20 years before any cognitive symptoms appear.  AD affects an estimated 4.5 million Americans, according to NIH.  Alzheimer’s disease is not a normal part of aging, but the risk of developing it increases with age. It usually begins after age 60 and the risk nearly doubles with every 5 years of age after age 60.  AD begins with short-term memory problems.  As time goes on, patients gradually lose more of their mental faculties.  We all tend to forget names from time to time, or we cannot always remember specific dates, but we need to be on alert when things get more serious.  AD patients typically cannot think or speak clearly, they forget to do routine things like bathing or cleaning, and they may not recognize family and friends.   Many people with Alzheimer’s start experiencing changes in their sleep patterns.  Scientists are not totally clear why this happens.  As with changes in memory and behavior, sleep changes somehow result from the impact of Alzheimer’s on the brain.  Those who cannot sleep may develop other comorbidities such as restless leg syndrome, sleepwalking, or they may yell out in their sleep.  This leads to daytime sleepiness, fatigue, agitation, memory loss, and inability to focus.  “Sundowning” is a common term you may hear associated with this.  Because of this, napping often occurs once a day to several times per day, which also creates difficulty falling asleep again at night when their body is supposed to be resting.

Experts estimate that in late stages of Alzheimer’s, individuals spend about 40 percent of their time in bed at night awake and a significant part of their daytime sleeping.  In extreme cases, people may have a complete reversal of the usual daytime wakefulness-nighttime sleep pattern.

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