Nighttime sign indicating increased dementia risk

Around 67,000 people lose their lives to dementia every year in the UK, the equivalent of a large capacity football stadium. This is a figure set to grow in the future as projections suggest one in three people born today will develop dementia in their lifetime. Since the patient cohort could rise so substantially, there is great impetus among the scientific community to develop treatments which can slow the spread of the disease. However, treatments may only be of use to patients of the far future; for those in the near future, the focus is on getting an early diagnosis so treatments can be administered. A new study published by Concordia University in Canada has found that early signs of dementia can appear when they’re asleep.

Publishing their data in the Sleep journal, the researchers said the sleep disorder insomnia was associated with increased risk of dementia. Their conclusion was based on data form more than 26,000 participants who formed part of the Canadian Longitudinal Study on Aging.

All of the participants were between the ages of 45 and 85 and completed self-reported evaluations of their sleep and memory alongside neurological testing over a three-year period.

It was found that those who had the lowest quality sleep during this three-year period were also more likely to report subjective memory decline.

Nathan Cross, postdoctoral fellow on the study, said: “We found that insomnia specifically was related to worse memory performance compared to those who have some insomnia symptoms alone or no sleep problems at all.”

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Cross added: “This deficit in memory was specific, as we also looked at other cognitive function domains such as attention span multi-tasking. We only found differences in memory.”

Furthermore, Cross said the study differed from previous projects on the matter in that it benefitted

For the purpose of the study, the participants were split into three categories. The first group was those who had no sleep problems at all when first assessed. The second group was those who had symptoms of insomnia and the third group had been diagnosed with probable insomnia.

Those with insomnia were more likely to report memory decline and have it diagnosed as such by their doctor. These participants were also more likely to develop anxiety, depression, daytime sleepiness, and have breathing interruptions whilst they slept.

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Alongside these sleep interruptions, participants were also more likely to have other risk factors for dementia, such as smoking and a raised body mass index (BMI).

Cross added in his report that insomnia is more than just being unable to fall asleep: “A diagnosis requires symptoms of difficulty falling asleep, staying asleep or waking too early, three nights a week, over a period of three months. Additionally, those with insomnia must report that this sleep problem causes them difficulty in the daytime.”

While the Concordia study may cause someone sleepless nights it is important to remember two factors; firstly that the Concordia study has a caveat – its observational nature.

Since it is an observational rather than a causational study, this means it cannot draw a conclusive link between insomnia and dementia, it can only observe a potential relation or link.

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Furthermore, sleep disorders, unlike dementia, can be effectively treated and sent into remission. Cross said: “This highlights the importance of properly diagnosing and managing insomnia as early as possible in older adults. Adequately treating insomnia disorder might become an important preventive measure for cognitive decline and mitigate the incidence of dementia in later life.”

However, before insomnia is treated, it must first be diagnosed. Symptoms listed by the NHS include:
• Finding it hard to go to sleep
• Waking up several times during the night
• Lying awake at night
• Waking up early and finding yourself unable to go back to sleep
• Still feeling tired after waking up
• Finding it hard to nap during the day despite the tiredness
• Feeling tired and irritable during the day
• Finding it hard to concentrate during the day.

The NHS add that insomnia is split into two types, short-term and long-term insomnia. Short-term insomnia lasts for less than three months while long-term insomnia lasts for longer than three months.

How much sleep does someone need?

How much sleep a person requires depends on their age. The NHS recommends:
• Seven to nine hours for an adult
• Nine to 13 hours for children
• 12 to 17 hours for toddlers and babies.

What is insomnia caused by?

Sleep disorders like insomnia can be caused by a range of factors. Sometimes it’s lifestyle factors and sometimes it’s a question of work life balance.

For example, the NHS lists shift work as one potential cause of insomnia due to the long or anti-social hours those jobs can sometimes entail. So too can the stress, anxiety, and depression, which can be brought on by work and other factors, be causes for insomnia.

In some cases, addressing the cause of insomnia can be the key to reversing the symptoms it causes and the risk factors associated with it.

As well as stress, insomnia can also be caused by a range of health conditions including the menopause, restless legs syndrome, and an overactive thyroid.

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