Demented: The Link Between Insomnia and Dementia

The last thing an insomniac wants to hear is all the extra health problems caused by lack of sleep. Let’s face it – if we could sleep, we would sleep. But there’s no denying the fact that sleepless nights are more than just an inconvenience.

While my adult children gently jest about Alzheimer’s if I lose my car keys, the reality of dementia in older populations is – quite frankly – terrifying. So, it’s nerve-wracking to learn of links between sleep deprivation and dementia.

How common is dementia?

Globally, there are 50 million people living with dementia and 10 million new cases each year – it’s one of the leading causes of disability and dependency in the elderly population. According to the World Health Organisation, “In 2015, the total global societal cost of dementia was estimated to be US$818 billion, equivalent to 1.1 percent of global gross domestic product (GDP).”¹

In the last decade, mortality for cardiovascular disease decreased by 7.3 percent, while deaths due to Alzheimer’s increased 145 percent. Dementia kills more people than breast cancer and prostate cancer combined.²

I don’t know about you, but I find all these statistics quite alarming.

What is dementia?

Cognitive decline is a normal part of the aging process, but dementia is not. For those affected, brain cells function incorrectly and die more quickly than in healthy adults. Dementia symptoms include difficulties with memory loss and problem-solving, trouble understanding visual images and spatial relationships, unusual problems with spoken and written words, confusion, poor judgment, withdrawal from activities, and changes in mood and personality.

All in all, dementia is something most of us want to avoid if at all possible.

[A] longitudinal study of nearly 8,000 participants with repeat data on sleep duration and a long follow-up for dementia suggests short sleep duration in midlife to be associated with the increased risk of incident dementia.³

Lifestyle impacts and sleep hygiene

Genetics is a big risk factor for dementia, but lifestyle also has an impact. Sleep is considered by many to be a lifestyle factor – like smoking, eating behaviours, and physical exercise – something we can control and modify at will. But as many of those reading this article can attest, it isn’t that simple. What do you DO when you consistently can’t sleep?

Most of us don’t want to hear it again, but the basics of good sleep hygiene are always a good first step if insomnia strikes:

• Avoid late-night munchies
• Reduce or eliminate caffeine, alcohol and smoking
• Reduce or eliminate napping
• Exercise regularly but not too close to bedtime
• Catch some natural light throughout the day
• Invest in a comfy mattress, pillows and bed linen
• Keep the bedroom quiet, cool and dark, and only for sleep and sex
• Create a regular bedtime routine then get up at the same time each day

Controlling the things within our control

When these things are beyond our control, it’s important to work extra hard at those things we can control. Shift workers may struggle with regular sleeping patterns, but it’s still important to exercise, eat well, and create some kind of bedtime rituals.

People with chronic pain may struggle with exercise and avoiding napping, but alcohol and caffeine can still be reduced and late-night munchies are bad for all of us. If you haven’t considered sleep hygiene for a little while, perhaps now is a good time to revisit some of those habits we can all slip into.

Calming an overly busy brain

Hyperarousal is also a big issue for some people. Increased physical and psychological responses to the environment can lead to higher levels of anxiety with elevated heart rate and respiration. All of which is not conducive to a good night’s sleep.

An overly busy brain that just won’t switch off has kept me awake many a night. Psychological therapies over several years have taught me to calm my mind. Without that therapy, I might have been awake for the past 5 years.

Sleep deprivation, insomnia, and risk of dementia

The link between sleep deprivation and dementia isn’t fully understood, but one theory is a buildup of beta-amyloid, a protein that forms Alzheimer’s plaques. When we sleep, beta-amyloid and other substances are flushed away. With insomnia, beta-amyloid can accumulate and theoretically lead to an increased risk of dementia.⁴

Knowing when it is time to seek help

Sometimes all the sleep hygiene and psychological therapy in the world still doesn’t lead to consistently good sleep. So, what then? If insomnia persists more than 3 nights a week for more than 3 months, it’s considered chronic. And it’s around about now that a visit to a healthcare professional is highly recommended. I was fortunate to find very good healthcare providers because, at the end of the day, without pharmacological assistance, I don’t sleep.

Drugs are never a good first port of call, but for some of us, they’re necessary and I no longer feel the need to apologise for requiring assistance. Crippling insomnia decimated my mental health and brought me to my knees. I don’t know what the long-term effects of my sleepless years will be, but the old serenity prayer does come to mind.

Grant me the serenity to accept the things I cannot change, the courage to change the things I can, and the wisdom to know the difference.

I cannot control history or genetics, but I can make choices today that will lead to a better tomorrow. One of those choices is to prioritise my sleep.