Insomnia medication can be over-prescribed

Aging, Restorative Sleep, and Sleeping Pills

Changes in sleep are part of the aging process.  Suddenly, we find ourselves waking up several times a night for bathroom breaks, pain, or other nuisance that prevents deep, restorative sleep that was easily obtained in youth.  The question is whether older people need more sleep, or if there is perhaps another solution.

Researchers from UC Berkeley published an argument in the April issue of the journal, Neuron, stating that poor quality sleep in the elderly contributes to their higher risk of memory loss, cognitive dysfunction, and a number of mental and physical disorders.

Senior author of the article, Matthew Walker, noted that every disease found in the elderly is linked to loss or lack of sleep.  Dr. Walker is a professor of psychology and neuroscience at UC Berkeley.  In the article, he stated that the medical field has made significant advancements that have extended our life span, but unfortunately, they have yet to extend our health span.  It is now clear to those in the industry that improving sleep is a way to fix that issue.

Sleep loss as we age

Loss of sleep is not like other, more obvious, signs of aging, such as wrinkles and gray hairs.  Instead, sleep deterioration is linked to heart disease, Alzheimer’s disease, diabetes, stroke, and obesity, and it is a problem that lurks in the background, getting worse more slowly so as not to be noticeable until much later.

Changes in sleep patterns can start as early as one’s 30’s, which is plenty of time for sleep-related cognitive and physical conditions to surface and wreak havoc.

Risk of Sleeping Pills

Dr. Walker warns that the overuse of pharmaceuticals for insomnia are not a good substitute for natural sleep cycles.  The brain physiologically needs that natural, restorative sleep to function properly.  Sedation is not the same thing as sleep, he notes.

Researchers out of UC Berkeley took data from some of their own studies, as well as other international papers and found that the aging brain cannot generate slow brain waves needed for deep, restorative sleep.  Furthermore, they are unable to produce adequate amounts of the neurochemicals that help us go from sleep to wakefulness.

Unfortunately, it appears that the first part of the brain to suffer from the aging process is the same region that allows for deep sleep.  Deep non-REM sleep, or slow-wave sleep, is known to decline as one gets older.  This type of sleep includes both slow waves and the bursts of waves known as sleep spindles.

Normal or healthy slow waves and spindles help with memory consolidation, which is the process of taking the input from the part of the brain that stores short-term memory and sending it to the part of the brain that consolidates the information and preps it for long-term storage.

Sleep disturbances exacerbate dysfunction in Alzheimer's

Unfortunately, both types of brain waves get significantly less during the aging process, and science has now discovered that sleep loss is directly related to memory loss in later years.

Furthermore, the neurochemicals that help us keep a regular sleep pattern and allow us to go from deep sleep to wakefulness are not as regulated as in a youthful brain.  These chemicals include orexin, which helps us wake up, and galanin, which helps us sleep.  Older adults who report a disrupted sleep-wake cycle also report daytime fatigue and restless nights.

It is notable that not all older adults suffer from sleep changes.  Some people seem to age more successfully than others, and some people seem to sleep better as they get older.  That is another topic of research the team at Berkeley is considering.

In recent years, people have started to move away from pharmaceutical help for sleep.  They are leaning more toward alternative and natural measures to improve sleep quality, like taking melatonin and using electrical stimulation to amplify brain waves.  They do the latter with the use of acoustic tones on a metronome to slow wave rhythms.

Researchers warn that advertising alternatives over prescriptions can be quite the challenge, since millions are made every year on sleep-related drugs.

Dr. Walker does note, however, that the American College of Physicians does not recommend taking sleeping pills for a long time.  These drugs should not be the knee-jerk reaction to sleep problems.  Sleep pills are designed to sedate the mind rather than help naturally induce sleep, so there must be better options for restoring sleep in the elderly.

The goal for the researchers at Berkeley is to change the culture of sleep, and to do that we must understand the difference between quantity and quality sleep.  The conversations in the past have been focused on the number of hours that are needed; however, you can sleep for a dozen hours and still wake up exhausted and groggy.  Further studies will follow.

 Reference:  https://www.eurekalert.org/pub_releases/2017-04/uoc–dsm040517.php

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