AWAKENING FROM ALZHEIMER'S - THE AWAKENING BEGINS.

[Stavia]

Day 3
Dr Michael Breus
Sleep

very good interview. More directed towards management sleep disorders in AD and lots of very interesting information. Useful for everyone as it is generally applicable for improving sleep quality. He said if there is only one take home message it is that sleep needs to be consistent

Just one night of bad sleep results in defects of reaction time, emotionally irritable/over emotional, cognition decreased

Functions of sleep
every one has different sleep needs. just one hour less one night is not too bad, 2 hrs less starts having effects. What happens in sleep? probably multiple purposes. Not sure of mechanisms. Studies in the 1940s only started exploring sleep architecture so its a new field.

1.Sleep deprivation compounded over time : affects every organs system.
2. Immune function decreases dramatically. Flu shots given to sleep deprived people - less sero-convert. Cancer cells multiply faster.
3. Deep sleep: Growth hormone and bodily repair.
4. REM: information moves short term to long term memory.
5. Chronically poor sleep and the brain: If you have a genetic propensity, AD genes can be affected.

Sleep cycles
Sleep is a dance - stages cycling. Different things happen in each cycle - 80 to 120 min, average 90 mins. Average person has 5 cycles - 7 1/2 hours. 8 hours is a myth. (lol mine is exactly 7 1/2 hours). (Different during adolescence - another purpose of sleep is development and growth.)

All the cycles aren't the same - first part of night is deep sleep - growth hormone, cellular repair. In the last third of the night is REM sleep and mental restoration occurs. So if you wake early you cut off the REM sleep and its cognitive effects. So if you go to bed too late, you shift forward and miss the last sleep cycle and miss the last REM cycle. REM sleep deprivation results in poor memory eg cant find keys, walk into a room and forget why you are there etc.

Sundowning
People with cognitive decline - their amount of sleep shortens as a result of the cognitive decline. Almost as if they become a shift worker, also napping during the day. Sundowning is an interesting condition, melatonin production in the early evening in those with AD has a paradoxical reaction of agitation - they get sleepy as their melatonin accumulates and they are tired but they get cranky and disinhibited and more confused. . Here light therapy is of help. Commercially available on Amazon, 460 nanometers, not very expensive. Switches off melanopsin and melatonin in the early evening. Used in sundowning from 5pm to about 7 to 8 pm and reduces the agitation.

Medications and sleep
Some meds for AD (eg Donepezil/Aricept) or Parkinson's cause insomnia which or changes circadian rhythm and aggravates agitation and memory issues.

Melatonin in AD
Data equiviocal. Melatonin is a hormone. Beware of purity standards. Some are pharamecutical grade, others not. 95% are sold in overdosage format. Adult dose normally half to 1 mg. When one ages, about 58 to 60 years, melatonin production decreases. Start low dose, takes 90 mins before want to fall asleep. Check there are no drug interactions eg beta-blockers, cardiac drugs.

Magnesium
He likes magnesium. Bananas. Peel of magnesium 3x magnesium than fruit. Boil sliced banana with skin. Use water as tea with cinnamon or honey. (ugh)

Two drivers of sleep
1. Sleep drive: like hunger. Adenosine builds up during the brain. Same structure as caffeine, which blocks adenosine receptors.
2. Circadian rhythm - body temperature drop at night drives melatonin release. Routine critical. napping not good for circadian rhythm - try to keep active during the day. Light in the morning. Light boxes or sunlight. Exercise in the morning - improves quality of sleep.

Hydration
breathe out a litre of water when breathing thru the mouth while sleeping.

Daytime naps
Try and keep to normal bedtime or waking time even if one has had a disturbed night as a caretaker. Sleep needs to be consistent

sleep apnoea
Weight gain an important factor causation wise. Results in refractory hypertension. Difficult to use CPAP in AD. Can use oxygen cannula. Can use mouthguards that advance the mandible.

Restless leg syndrome and periodic limb movements.
1. Caused by lack of dopamine sometimes.
2. Iron deficiency often associated - ferritin should be more than 50 and this fixes the restless legs.
3. There are some meds available.

Food before bed
1. Alcohol not a good idea
2. Don't want an AD person to go to bed hungry - "hangry" makes them agitated. Insulin resistance?
3. GERD flared by spicy food will disrupt sleep
4. He admits he is not a nutritionist and doesn't know much about food and sleep

Prevention of AD
1. consistency of sleep - bed time and wake time. The latter is more important even if you go to bed late one night - always wake at the same time
2. Sunlight. Go out every morning and get 15 mins sunlight
3. If you find yourself forgetful in the day - look if you snore and get sleepy in the day- check for sleep apnoea.

thesleepdoctor.com

[slacker]

Magnesium
He likes magnesium. Bananas. Peel of magnesium 3x magnesium than fruit. Boil sliced banana with skin. Use water as tea with cinnamon or honey. (ugh)

did you try it? What to do with the fruit after boiling? Compost??

PS Thanks for the fantastic summaries; so very helpful...

[Stavia]

Magnesium
He likes magnesium. Bananas. Peel of magnesium 3x magnesium than fruit. Boil sliced banana with skin. Use water as tea with cinnamon or honey. (ugh)

did you try it? What to do with the fruit after boiling? Compost??

PS Thanks for the fantastic summaries; so very helpful...

cut the ends off. slice it in pieces with skin on. boil it few minutes. ? discard I guess?
dunno if the water has been actually tested for magnesium content. doesn't sound very scientific to me. ?woo?

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[NewRon]

http://www.doctoroz.com/recipe/banana-tea

It must be true...

[chrissyr]

Thank you Stavia! I don't get where you find the time. Your comments are extremely helpful. I especially appreciate commentary such as ugh to banana peel tea (primer inclusions of -bowties are cool, and your descriptions including things like sticky outy thingies made me know I was in the right place in the first place!)

[Jafa]

Thanks for the great summary Stavia. Very helpful

[raj]

amazing, something so very natural for sleep and hard to even think to say no to.

[circular]

I didn't mind the interview with Dr. Bruce much. I think it's worth sorting out which of his recommendations may be very useful. I liked hearing what may be approved and used in other countries. I haven't yet found anyone whom I felt was always giving out perfect recommendations. Turns out he teaches martial arts and is himself a black belt (I assume since he teaches other black belts). He's also very experienced with breath work and teaches it to stressed out refugees which I find amazing. It may be that his real gift relates more to these areas and their cognitive benefits and I would love to listen to him speak about that. This came up toward the end.

Really I think his overall perspective was good, which isn't to say all his recommendations are sound (I don't know what is and what isn't). While Cochrane may have found one to be ineffective (and if I recall right Dr. Isaacson said the gingko didn't have good science to back it up), he talked about how some things don't work in isolation but do work in concert. It made me wonder if anyone has checked all of Dr. Bredesen's supplements in Cochrane, but we'd still be left with whether any that don't survive the Cochrane test would work in conjunction with other inputs.

I would have liked more science too, but I think the the series needs to appeal to people at many levels to have the reach the hope for, for public service and monetary return reasons. I think the interviewer is excellent in bringing out the speakers. After so many podcasts where interviewers sometimes over assert themselves into the dialog, I find it refreshing. Ie, maybe there's a difference between discussion and interview?

Anyhow, the sleep one was excellent and I'm committing to consistency for starters so off I go! I also really appreciated some focus on how to handle the issues as caregivers. So very useful that!

[Stavia]

Thank you Stavia! I don't get where you find the time. Your comments are extremely helpful. I especially appreciate commentary such as ugh to banana peel tea [emoji38] (primer inclusions of -bowties are cool, and your descriptions including things like sticky outy thingies made me know I was in the right place in the first place!)

ha! Thanks. I've been a nerd before it was cool. Btw great there's finally a Dr Who in a female gender body. She was awesome in Broadchurch IMO.

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[chrissyr]

Me too and my husband and son helped me along that path Can't wait for Jodie Dr. Who!! We loved her in Broadchurch too