Addressing insomnia isn’t just a fight against tomorrow’s midafternoon fatigue –– it could help protect against brain aging in the future, new research suggests.
Sleep difficulties are common, with 12% of Americans saying they have been diagnosed with chronic insomnia, according to theAmerican Academy of Sleep Medicine.
Unlike genetic and other factors that go into cognitive health that are not under your control, insomnia may be one condition you can do something about, according to a study published Wednesday inthe journal Neurology.
“The main takeaway for this study is that chronic insomnia may be a modifiable risk factor for cognitive decline,” said lead study author Dr. Diego Carvalho, assistant professor of neurology and sleep specialist at the Mayo Clinic Center forSleep Medicine in Rochester, Minnesota.
For this research, 2,750 people underwent about five years of annual neurological assessments and brain imaging along with evaluations of sleep habits to investigate the association between insomnia and brain changes.
Insomnia was found to be linked to a 40% increased risk of cognitive impairment, according to the data. People who had insomnia but increased their sleep time or utilized medication did not experience the same detriment to their cognitive health.
“We can’t say for sure that treating insomnia will necessarily reduce those risks, because we lack that data … but I think there is a growing interest in that potential venue,” Carvalho said.
How insomnia hurts brain health
Insomnia is the most common sleep disorder Dr. Rachel Salas sees in the Johns Hopkins Center for Sleep and Wellness –– and the condition involves more than just having trouble falling asleep, she said.
“It can encompass problems with sleep maintenance and quality, which can affect daily functioning and overall health. Chronic insomnia is associated with an increased risk of various cognitive disorders,” said Salas, professor of neurology at the Johns Hopkins University School of Medicine in Baltimore. She was not involved in the research.
Good sleep is vital for good brain health in many ways. Sleep helps clear the synapses you don’t need, so that your brain isn’t overloaded. Research also suggests that as the day goes on, waste accumulates in the brain that sleep helps clear out, Carvalho said.
The accumulation of some of those proteins are markers for Alzheimer’s disease, he added.
Sleep is also essential for memory consolidation, emotional regulation and overall brain recovery, Salas said. “Inadequate or poor-quality sleep can lead to increased neuroinflammation and impaired synaptic plasticity, factors that contribute to cognitive decline,” she added.
Not enough treatment
Insomnia is common, but it doesn’t always get the attention it deserves.
People older than age 65 are much more likely to have a sleep disorder, Salas said. However, older people are more likely to perceive poor sleep as a normal part of aging, Carvalho added.
While it is true that age is associated with some changes in sleep, insomnia goes beyond that, he said. Problems with initiating sleep, maintaining it, impairments during the day, fatigue, moodiness, cognitive issues and problems thinking are not what should be expected as you get older, Carvalho said.
For many demographics, insomnia tends to be underreported by patients, under-recognized and, as a result, undertreated, he added.
How to get to sleep
The hope is that treating insomnia more will both improve people’s quality of life as well as protect their brain aging as they get older, Carvalho said.
Fortunately, simple interventions can effectively address insomnia, he added.
The primary mode of treatment is cognitive behavioral therapy for insomnia, or CBTI. It’s not talk therapy around previous experiences. Instead, CBTI is a set of principles, tools and guidance targeting issues that lead to or perpetuate insomnia, Carvalho said.
Establishing a consistent sleep schedule and practicing relaxation techniques before bed can be helpful, Salas said. The right environment is also important, she added.
“Make your room like a cave,” said Dr. Cheri D. Mah, a sleep physician specializing in the sleep and performance of elite athletes, ina previous story. Mah was not involved in the research. “You want it to be really dark, quiet and cool — as well as comfortable.”
Limiting screen time before bed, limiting caffeine and alcohol, not spending too much time in bed while awake, and getting exercise can all help set you up for success at bedtime, Carvalho said.
If you continue to struggle with insomnia after making some behavioral changes, consult with a doctor or sleep specialist, Salas said.
“Everyone is looking for a single pill that improves their sleep, and it’s true that some patients may need medication as well if the strategies do not work for them. But even for the patients that go into medication route, they still need to be cautious about their behaviors,” he said.
“The whole treatment of insomnia has to be comprehensive.”
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