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Deep Sleep May Help the Brain Clear Alzheimer's Toxins

355 points| spking | 6 years ago |npr.org | reply

213 comments

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[+] theli0nheart|6 years ago|reply
I've been dealing with a hormonal issue that's been negatively impacting my deep sleep for almost two years.

There was a week in early February this year, right after surgery, where I felt like a million bucks. Normally, I have a pretty low-grade chronic headache (yeah, it's as horrible as it sounds). However, that week, my head felt "clear". I don't know how else to explain it other than I felt like my brain had been washed. I was going to bed at 9-9:30pm, and waking up at 5am, and felt incredible. I reverted not long afterwards, and believe I recently figured out the root of the issue (fingers crossed!), but I 100% believe that you need deep sleep to function well. IMO, it's not sufficient to get light and REM sleep; deep sleep is when true brain recovery occurs. I feel like I should know; before I started treatment, I would go to bed at 9-9:30pm and sleep until 8 and still feel exhausted. You need quality sleep in addition to quantity.

Wrist-based sleep trackers are basically useless, FWIW. I've been using one pretty consistently since before my health issues started and they really can't discern the difference between light/REM/deep sleep phases. If there's anything which mirrors how I feel after waking up in the morning, it's HR dip, but even that isn't 100% reliable.

[+] newsbinator|6 years ago|reply
My watch says I get between 20 minutes and 70 minutes of deep sleep a night, out of 7 ~ 9 hours total.

I've tried Magnesium, Melatonin, turning off all devices hours before bed, turning off all lights hours before bed, sleeping in a cold room, etc.

I'm not overweight or unhealthy. I take in zero caffeine, zero alcohol/zero drugs. I do take a daily PPI.

I feel tired a lot, and I seem to feel more tired on days when my watch (Xiaomi Smart Band 3) reports the lowest deep sleep scores (I consider how I'm feeling first, then look at the sleep score to compare).

I want more deep sleep, but try as I might I don't know how to make it happen.

[+] etagobla|6 years ago|reply
One thing I want to try to eliminate stress is an internet detox. I think just surfing the web, even semi-intelligent stuff like Hacker News, might be really stressful. I ditched my computer and phone today while the sun was up and it was an uneasy feeling -- beyond the withdrawal, it seemed like the world I was seeing was actually a lot brighter and safer than what I'd read about online. People seemed more approachable or at least safer and happier when I took the time to look. I cleaned my room on the third hour because I wanted to, not because some stressed out blogger told me to. Right now I feel just relaxed.

This may sound stupid but it's the first time in a while that I ditched the internet in a place where I normally would have it. Now I'm wondering if our more primitive ancestors would have viewed it as a cesspool of negativity that not only freaks us out but distracts us from more obvious personal issues.

Anyway the connection to sleep is that stress obviously can mess with your sleep.

[+] hhanesand|6 years ago|reply
Prof. Matthew Walker says the accuracy of sleep trackers when it comes to per stage time is questionable. See Peter Attia podcasts w/ Walker.

Have you thought about going to a sleep lab to get some higher quality data? It’s near impossible to diagnose someone over the Internet, especially when the subject matter is so complex.

[+] sn41|6 years ago|reply
I will not trust a "smart" watch. However, your fatigue is not a good sign. You should get medical advice.

Perhaps you are not breathing right during your sleep. A possibility is sleep apnea. I do have allergies which make me tired after sleep, during some seasons. One of the ways I cope is to do breathing exercises before I sleep. This does help sometimes.

[+] jryan49|6 years ago|reply
Do you get good, exhausting exercise? I've found that's the magic formula for me.
[+] sjg007|6 years ago|reply
Go get a sleep study done. That will tell you. You may have sleep apnea. Also you may want to ask your doctor about a sleep aid such as ambien.
[+] agumonkey|6 years ago|reply
what about physical exercise ?

what about social / emotional life ?

these are the two most impactful factors I've experienced so far. Good physical exhaustion made me sleep like a baby. And a stress free job (min wage) made me sleep better too.. the simplest call for an IT job made me wake up in the middle of the night and thinking.

[+] tyingq|6 years ago|reply
Maybe undiagnosed sleep apnea? I love/hate my CPAP machine, but it helps me. There is a clear difference when I opt out.
[+] notjustanymike|6 years ago|reply
For me it was environmental. Turns out the air conditioning was dehydrating me to the point of waking up every night. Do you sleep better on vacation when you're away from home?
[+] runnig|6 years ago|reply
I had a similar problem. I was waking up in the middle of the night not able to get back to sleep for hours and then overslept in the morning feeling groggy for the rest of the day.

Here's what I did: 1. Sleep alone in a separate bed since your SO other might wake you up inadvertently - this helped me 2. Wim Hof method for a few weeks: deep breathing and cold showers in the morning.

I'm not sure which of these worked. I did these two things simultaneously and my sleep significantly improved over a couple of weeks. I'm fully recovered in the morning, feeling energized and can actually remember dreams which never happened before. I don't need Melatonin anymore and can even have an espresso in the morning. Good luck!

[+] CalRobert|6 years ago|reply
No idea if it works for you, but if I need to sleep _really_ well I wear ear plugs, even in a relatively quiet room. They need to fit right (rolled between your palms to squish them up, then they should barely fit inside your ear and expand to fill gaps).

The first time I did this it was revelatory. I woke up feeling like a new person. Sadly I don't much these days, because sleeping through a hungry/wet/scared infant isn't as acceptable (also I was a little disturbed what I could, in fact, sleep through, and whether that included smoke alarms)

[+] throwaway9d0291|6 years ago|reply
Your watch doesn't know what it's talking about.

I have a watch, an under-mattress tracker and a headband with a ton of sensors (including an EEG). Typically, none of these agree with each other (and I trust the headband to actually be accurate).

I'd strongly recommend consulting a sleep specialist.

One thing you haven't mentioned is cognitive behavioural therapy, which is often the first thing people will be recommended.

[+] ianai|6 years ago|reply
How were you taking melatonin? I got great benefit from it but only when I always took it at the exact same time every night, turned lights out, no screens, etc. it would still take about 3 hours to kick in. I’d take it and not shut off lights for about an hour and a half, fwiw.
[+] meremortals|6 years ago|reply
Fwiw I have the same habit and experience with my mi fit band 2. I try to gauge how much sleep I got based in how I feel, before looking to hopefully avoid placebo. I feel considerably better the nights I get 1.5-2 hours of deep sleep
[+] mark_l_watson|6 years ago|reply
Thanks for your comment, it just nudged me to install two additional heart and sleep monitoring Apple Watch/iPhone apps. I don’t wear my Apple Watch to bed, but I will start tonight and collect a few weeks of data. curiosity++
[+] timeattack|6 years ago|reply
I have exactly the same problem as you. I'm looking for a solution too and it seems that deep sleep length/continuity might be linked with serotonin levels. Did you take a blood test on serotonin?
[+] manmal|6 years ago|reply
Did you check CO2 levels in the bedroom, or at least take care that CO2 should theoretically exit the room? Just unlocking the window handle a little bit can create a bit of air circulation.
[+] hourislate|6 years ago|reply
You seem to be doing all the right things. The only thing I could suggest that might help you trying cold showers before bed as painful as that sounds. It apparently promotes more restful sleep.
[+] LegitShady|6 years ago|reply
If poor sleep is affecting your life and you can't understand why, see a doctor.

IF its just because your watch said so, don't worry about it.

[+] maloney|6 years ago|reply
How are your iron/ferritin levels? Low iron causes fatigue
[+] sova|6 years ago|reply
Body is just one half of the equation for Deep Sleep
[+] Zod666|6 years ago|reply
get a sleep study and find out if you have sleep apnea.
[+] Florin_Andrei|6 years ago|reply
Bring out the big guns. Time you get you started on Lunesta.
[+] swader999|6 years ago|reply
Shut off your wifi and put phone on airplane mode. Don't put a blue tooth sleep tracker right buy your head either.
[+] maxheadroom|6 years ago|reply
Surprised that this is the first comment about this on here but we really need a better turn-of-phrase than "toxins" because kind of language validates the fads going around that are harming people - like the "get skinny in two days!" diets or the anti-vax community.

Also, why do they use the term emphatically in the title of the article and then state, "...presumably removing toxins associated with Alzheimer's, researchers reported Thursday in the journal Science." That comes across as, "We don't actually know what this is doing but we're going to take a guess and just run with it."

In fact, from the abstract of the paper itself, "Sleep is also associated with increased interstitial fluid volume and clearance of metabolic waste products. It is unknown why these processes co-occur and how they are related."

I don't understand how metabolic waste products automatically equates to "Alzheimer's toxins" nor how they're reaching these conclusions if they don't understand their coincidence - whether accidental or intentional.

Can anyone help a stranger on the internets and connect these dots? =]

[+] megous|6 years ago|reply
I guess I can understand that moving fluid can at the very least dislodge other material around it, but:

- how do "the toxins" get out of the cerebro-spinal cavities

- if the flow is not unidirectional (with new fluid comming in), why would not the toxins just settle at slightly different place, after those fluid movements end

- how is the fluid itself cleaned

- what about the blood-brain barrier

[+] tentboy|6 years ago|reply
Anecdotal, but we have a family friend who has just been diagnosed with early onset Alzheimer's.

She was a brilliant colorectal surgeon and highly regarded and referred in the area but she also lived for her work, spending nights sleeping on the floor under her desk for two hours before pulling another full day of work.

I am sure this lifestyle for the better part of 30 years took a toll on the body and more and more I've been hearing about the lack of sleep being related to Alzheimers

[+] theNJR|6 years ago|reply
Interesting how there’s a lot of sleep trouble on HN. Here’s mine, curious if anyone has thoughts.

For over a year now I’ve been averaging around 5.9 hours of sleep. Usually I’m up at 5am and can’t fall back asleep. Compounding this, bad nights I wake at 2 and it takes an hour to get back to sleep. Even then I’m up before 6.

So, two problems: always wake up early and often wake in the middle of the night for an hour.

I can get my brain to spin up at a good level if I get six hours. If I get 5 hours the day is mostly ruined.

My Oura ring data doesn’t suggest sleep apnea and my wife says I don’t snore. I’m not waking up super fresh - so it’s not like I’m rested after six hours. I used to sleep just fine so I don’t think I have the genetic mutation that makes you not need 8 hours. I just can’t sleep much more than six hours lately.

I’ve tried all the usual things; last meal at 4:30, exercise in morning, consistent bed time of 10pm, no devices after 9, cool room, no alcohol, black out curtains, etc. I’ve tried every supplement you can think of. Phenibut will prevent 2am wake ups but even with phenibut I can’t get more than 6.5 hours. You also shouldn’t take that more than 2-3 times a week.

I’m not sure what to try next. I’d love to get back to 7-8 hours though.

[+] gwbas1c|6 years ago|reply
I sometimes have nights like that when my wife works overnight, and my toddler wakes frequently from teething.

What I do is I take a THC tablet 2-3 hours before bed. Specifically, 5mg of delta-9 THC and 5 mg of TAC. It makes me sleepy enough that when I have to wake up for my toddler, I can quickly fall back into a deep sleep.

(I live in a state where pot is legal without a prescription.)

Many people don't realize this, but pot's effects vary widely with the strain. I suspect that the combination of THC and TAC makes the tablet very similar to an indica strain.

[+] Jagerbizzle|6 years ago|reply
How vigorous is said exercise?

I go through this exact same pattern if I don't get enough exercise. If I do 60-90 minutes of treadmill/elliptical/rowing in the morning then I sleep like a baby for 7-8 hours and wake up feeling fresh. On the other hand if I do less than 30 minutes of cardio or skip the gym on a given morning I start regressing into the pattern you describe.

Compared to other healthier-living choices I can make (healthier eating, less drinking, etc), exercise seems to provide by far the most consistent and tangible results.

Best of luck, I hope you figure out something that works.

[+] joveian|6 years ago|reply
Have you seen a doctor about it? Doctors are usually useless about sleep issues, but a sudden change is more likely to have a cause that can be pinpointed (e.g. pituitary issues as mentioned elsewhere, maybe adrenal issue). Also, seizures that only happen at night are apparently somewhat common and can disrupt sleep. Even narcolepsy of all things can appear as sleep disruption. If you did try to see a doctor and got brushed off, maybe try again.

In my experience phenibut is the strongest medication easily available for staying asleep at night, although I switched to 10mg baclofen that is somewhat less effective than 600mg phenibut for me but I feel more confident about the safety and it is less addictive. At one point I took 600mg phenibut one day, 10mg baclofen the next, and nothing the third then repeat and that seems to work well for at least a month (I also recently tried taking baclofen for a few weeks at a time and while it didn't do much after a few days I'm fairly sure it did still do something, although I worry about using anticholinergic medication so frequently). Magnesium (600mg before bed) helps me as much as phenibut but wipes me out even more than usual the next day. I also use 150mg uridine monophosphate sublingually a few hours before bed, which doesn't help much with staying asleep but helps me feel more rested (nootropics depot is the highest quality source of the powder I have been able to find). That works best taking a few days off every month and a few weeks off every year. But I think in your case trying to figure out the cause is likely to be the most effective thing to try at this point.

[+] thewhitetulip|6 years ago|reply
I had also issues, yoga + meditation + pranayam has workws wonders.

The effects went away when I had taken a pause from the the activities and Normal sleep returned when I resumed them

[+] gibrown|6 years ago|reply
Have you tried slow release melatonin? My sleep medicine doc suggested it and I take 6mg a night. Helped a lot with waking up in the middle of the night.

The other pieces you may consider is some form of restless legs. Sleep docs diagnose a lot more than apnea. Best of luck.

[+] jmpman|6 years ago|reply
Every night (takes 6 weeks before I notice a big change)

Magnesium Glycinate

EPA fish oil

If I stop the above regiment, and my insomnia flares up again, I find the following to help break the cycle until the magnesium and fish oil ramp back up.

Take an Aleve

Eat a half bunch of celery an hour or two before bedtime.

[+] bvinc|6 years ago|reply
I have always traditionally been someone who would stay up until 2am a few times a week, and always been lacking in sleep. I've turned that around, along with a lot of other healthy changes I've been making, along with diet, exercise, and sauna use.

But the thing that's been an absolute game changer with sleep has been red glasses. So the idea is that blue light and to a lesser extent green light, both interfere with your brain's melatonin production. Everyone tells you to avoid looking at screens or your phones after dark, but who actually manages to do that? Also, these "night light" programs like flux just tone down the blue light, they don't eliminate it. These glasses block almost all blue and green light. They also have a barrier on the side so no light comes in through the side.

Sure, these glasses make you look like a dork, but they're great. If I'm in any state of lacking sleep, I find everything much less stimulating, and I get tired really fast. But even better, I sleep like I went into a coma, and I feel like I've been dreaming a lot more than usual.

There are tons of tips for sleeping better that I think all work, but from my experimentation, the unnatural blue and green light after sun down is by far the biggest problem that we all have.

Here are some examples of what I'm talking about.

https://www.amazon.com/Sleep-Savior-Ultra-Disruptive-Melaton...

https://www.amazon.com/gp/product/B07H44C8DT/

[+] milesvp|6 years ago|reply
I havn’t been keeping references, but this isn’t the first paper I’ve seen suggesting part of REM cycle is used to flush fluid build up in parts of the brain, and that this flushing is necessary for high cognitive utilization. Also, this flushing seems to be difficult or impossible without REM (though I suspect vigorous exercise helps).

I wouldn’t be surprised if lack of sleep could help contribute to Alzheimer symptoms, if not the actual disease side effects of brain structure deterioration.

[+] tluyben2|6 years ago|reply
I do not sleep very long (when I wake up, that it is; usually dingdong after 7 hrs) but when I sleep I sleep very deep. I had fitbit saying 80% deep sleep and my doctor told me to get tested for sleep apnea and other stuff but I just sleep very deep; they found nothing. I also remember dreams (I can lucid dream whenever I want; I spent a year training that when I was 18 and it is like riding a bicycle) very vividly.

I am wondering if the lucid dream training I did made my sleeppatterns like this; lucid dreaming is so much better than lsd or shrooms or games; it is free, does not harm anything and you can do anything you want (fly, infinite strength, immortal, ...) so I cannot wait to go to sleep every night.

[+] dzhiurgis|6 years ago|reply
Is there any link between cannabis use and deep sleep?

I find cannabis completely removes dreams from my sleep which come back very vivid after stopping use. Many people online report the same.

[+] pontusrehula|6 years ago|reply
I have a practical kind of question about this kind of research. How do you put a sleeping person in to an MRI machine without waking him/her up?
[+] tempsy|6 years ago|reply
I have read benefits of fasting on Alheimers as well
[+] michaelborromeo|6 years ago|reply
Sleep on an incline - use bed risers that raise the head of the bed 4-6 inches.

You’ll sleep better.

[+] aitchnyu|6 years ago|reply
I have dust mite allergy and had infection-prone sinuses for years and lived with a chronic feverish feeling. I recently had FESS, using endoscope blades to clear passages. I slept great for a few weeks and then allergic symptoms came back again giving me muscle aches and a racing heart. So I wake up unrested. My Huawei band says I get recommended amount of deep sleep but deep sleep continuity is lower than recommended. I am waiting for the dust mite SLIT vaccine to kick in, it could take a year more. Till then I'm trying to isolate the mites in bed.
[+] L-four|6 years ago|reply
Toxins. a poison of plant or animal origin, especially one produced by or derived from microorganisms and acting as an antigen in the body.

If you've got toxins in the brain you've got bigger problems.