Many veterans suffer from disturbances of sleep. Many mental disorders such as anxiety, PTSD, and depression can cause insomnia, nightmares, frequent or early awakenings. Many veterans also suffer from physical disabilities that affect sleep, such as obstructive sleep apnea. I’ve written before about the link between mental illness and sleep apnea, and the one-two punch of these disorders can have a devastating effect on sleep patterns and quality. In addition, many veterans suffer from chronic pain, which affects the quality and length of sleep.
Research shows a clear link between the quality of sleep and the development of degenerative neurological diseases such as Alzheimer’s disease. For many years, doctors noticed that those suffering from Alzheimer’s disease tended to sleep poorly and less than other patients. They believed that AD was causing these sleep disturbances. However, recent research is beginning to show that poor sleep may actually be a causal factor in the development of Alzheimer’s. One study in 2014 found that men with sleep disturbances had a 1.5 times higher risk of developing Alzheimer’s than those with healthy sleep patterns!
So how exactly could sleep problems increase a veteran’s risk of Alzheimer’s? The answer is very complex. One of the major known causes of Alzheimer’s is a gene (APOE-E4) that predisposes some people to the development of AD. One study in 2013 found that in patients who carried this gene, those with better quality sleep were less likely to display Alzheimer’s symptoms, and presented with less severe symptoms. Sleep seems to have a protective effect on the brain. This actually makes a lot of sense, as one of the major signs of Alzheimer’s is a buildup of a chemical called amyloid-beta in the brain. We’ve discovered recently that as we sleep, the fluid from our spines actually enters the brain, and “washes” amyloid-beta and other chemicals that are built up in the “crevices” of our brain each day. When our sleep quality is poor, it may be that this doesn’t take place, and amyloid-beta builds up to levels that can trigger AD symptoms.
Another possible cause is medication. Studies have shown an increase in Alzheimer’s in patients who take certain medications to help them sleep, such as Benadryl, Nytol, or several over-the counter medications. In addition, some antidepressants such as doxepin have been linked to AD. One of the clearest links to Alzheimer’s disease from medication are from anti-anxiety drugs such as Ativan, Xanax, Valium, and Klonopin, and closely-related sleep medications such as Ambien and Lunesta. It is interesting that all of these medication have some effect on sleep. It may be that the sleep that results from these medications somehow interferes with the brain’s ability to clean itself.
While we do not have a completely clear picture as to the role of sleep in the development of Alzheimer’s disease, a picture is beginning to form, and it looks like sleep may be even more important to our health than previously thought.