Sleeping and your brain: Associate Professor Rosie Gibson

Q. Why is getting a good sleep important for brain health?

A. We know that sleep is really important for all of our waking wellbeing and for our physical, cardiovascular health, metabolism – but also brain health. And scientific research shows that, while we’re sleeping, there’s all sorts of activity going on in the brain and that sleep plays a really important role for things like memory consolidation, our emotional regulation, and cognitive functioning. So we know that during certain stages of sleep, the brain’s doing sort of work behind the scenes to strengthen those connections that are really important and to kind of ‘wash away’ or ‘delete’ the stuff that’s not so important. So, it really helps to strengthen our brain health as well as physically restore the body.

Q. Why is this particularly important for people living with dementia mate ware ware?

A. Yeah, good question. Research shows that as we grow older, the parts of the brain that are really important for regulating sleep and keeping us in nice deep sleep and REM sleep start to degenerate. So, it is common to experience more fragmented of dissatisfactory sleep with ageing. Unfortunately, for people with Alzheimers disease or dementia mate wareware, we tend to see an earlier and exacerbated rate of degeneration of those areas of the brain. This means that issues with fragmented sleep, confused awakenings, and daytime sleepiness can become more common with dementia. Also, we know that when we don’t sleep well, this has real implications for how we feel and behave during the day. Many of us can relate with how one or two bad night’s sleep affects our waking life. For example, we might feel more irritable, be less able to pay attention, and more likely to make mistakes. So, for those of us with a condition like dementia, sleep loss can compound on those cognitive impairments and be exacerbating some of those waking symptoms. Therefore, if we can look after sleep, we can help to support some of those waking symptoms and overall wellbeing for those with dementia as well as family whānau carers.

Q. Why do so many people struggle with sleeping?

A. Around 20 to 30 percent of New Zealanders experience what we call a ‘primary sleep disorder’. So that might be chronic insomnia or a breathing-related sleep disorder (like snoring or sleep apnoea). There are things like restless leg syndrome and other, less common, disorders like narcolepsy and parasomnias. And these rates have been noted to rise with dementia-related diseases. Furthermore, our general sleep health is influenced by so much else (causing secondary sleep problems). For example, we know that good sleep helps to regulate our mood; but mood disorders also affect our ability to sleep. Similarly, painful arthritis can make it difficult to sleep; but sleep loss also increases our sensitivity to pain.

Sleep is also affected by our environments and our social lives. For example, the temperature and lighting of the bedroom; who we share a room or bed with (and what their routines or sleep disturbances are like); stormy weather, and social and political events outside of our control (like the COVID pandemic). So, there’s many individual and mediating as well as social elements that an influence sleep. That is why we also see sleep disturbances rise at busy times of life such as transitioning into retirement, caring for someone with dementia, and grief. So, it is important to consider the sleep health of the whole family.

Q. How can people living with dementia mate wareware get a good night’s sleep?

A. This is tricky because so much does affect sleep. So, it is important to the environment that we’re sleeping in, our behaviours leading up to bedtime and the sleep of others, but also being aware that some of the physiological generation that comes with ageing and dementia mate wareware will likely contribute to sleep issues. As well as those increased risk for things like sleep disordered breathing, due to changes to muscle patency as well as neurophysiological processes. So, for some people with dementia, it might be a case of having an assessment for sleep apnoea and seeking treatment for that early. Or it might be thinking about, okay, we know that there’s some compromising around the circadian system (that helps regulate sleep timing). For example, declines in the production and synthesis of the hormone melatonin, which acts like a time cue for sleep and wake. And so we can try to support this by doing things activities in bright light around that early or mid-morning time,  to help  boost the circadian system and give it a kind of a marker that this is daytime and it gives a little bit of a peak physiologically, supporting a trough later in the day when the light is dimmer.. If people have had disruptive nights, then actually having a planned nap can be really useful. A lot of the caregivers that we talk to talk about how their partner falls asleep a lot during the day because they have disruptive nights. So it’s trying to work in maybe a planned nap after lunchtime, rather than drifting in and out throughout the day or falling asleep too close to that evening bedtime. We need to build up what we call a ‘sleep pressure’ through the day. So, the longer you’ve been awake, the more tired you feel and the easier it is to fall asleep. This means that when we unintentionally fall asleep late in the afternoon or into the evening, then that can exacerbate issues around falling asleep and staying asleep overnight. Other things to consider are things like avoiding caffeine consumption too late in the day, alcohol too close to bedtime, and other more individualised techniques around, for example, technology use and mindfulness activities. Sleeping tablets is something that you need to obviously talk to a doctor around and we don’t typically recommend using for long periods of time, especially if there are these other health conditions or environmental or contextual things that can be addressed.

More on brain health

• Brain health and poverty: Dr Etu Ma’u