As We See It: Sleep, Obesity, and Dementia

Those with impaired sleep suffer a tsunami of disorders, including higher dementia rates and unwanted weight gain.

In January 2022, I described data supporting a relationship between less-than-optimal sleep and obesity.¹

Throughout 2022-2023, similar reports linking sleep disorders with excess body fat^2-4 and cognitive defecits were published.^5-8

Sleep deprivation harms overall health and increases all-cause mortality.^9,10

Research published in 2023 reveals how lack of quality sleep can inflict structural brain damage.¹¹

The lead author of this study was quoted as saying that insufficient restorative sleep accelerated an indicator of brain aging by as much as 4.6 years!¹²

This 2023 study helps corroborate prior data linking decreased slow-wave sleep to cognitive decline and detrimental structural changes indicative of Alzheimer's.^13-15

The challenge is what to do if you are unable to readily fall or stay asleep.

Encouraging news has emerged of non-drug approaches that have been shown to provide substantial help to sleep-challenged people in randomized controlled trials.  

Widespread enhancements of restorative sleep would help reduce the epidemic burdens inflicted by aging, including excess fat accumulation, neurodegeneration, and cardiovascular disorders.

The media relentlessly reports on growing numbers of Americans not getting enough sleep hours.

One of every three American adults are sleep deprived.¹⁶

With aging, it's not just sleep quantity, but also sleep quality that matters.

Any intervention that improves restorative sleep can have major impacts on overall health and longevity. 

Rising Prevalence of Sleep Disorders

Official statistics claim that 50 to 70 million Americans are afflicted with a chronic or ongoing sleep disorders.¹⁶ About 9% to 15% of the U.S. adult population suffer insomnia.¹⁷

In older adults, however, the number suffering sleep disorders surges to between 40% and 70%.¹⁸

Inadequate sleep is not just about feeling miserable the next day. It significantly increases risks of lethal disorders.

Five-Fold Rise in Stroke Risk

Stroke continues to be a leading cause of long-term disability and death, striking 795,000 American each year.¹⁹

More than half of stroke survivors over age 64 suffer reduced mobility including paralysis.²⁰

A study published in April 2023 linked multiple sleep problems to a five-fold increase in odds of stroke.²¹ The nocturnal disorders included short, fragmented sleep, insufficient restful hours, and sleep apnea that impair the body’s ability to regulate metabolism, inflammation, and blood pressure.

These findings are consistent with prior research linking unhealthy sleep to chronic conditions leading to blood vessel impairments associated with stroke.²²

Increased Heart Disease Associated with Sleep Problems

A February 2022 study found that having more self-reported sleep problems was associated with a 54% increased risk of heart disease.²³

When a sleep monitoring device (actigraphy*) was added as part of a combination assessment, sleep problems were associated with a startling 141% higher risk of heart disease.²³

This data suggests that heart disease is correlated with sleep problems, including poor quality sleep. It helps identify sleep quality as an underappreciated risk factor associated with heart disease.²³

The Harvard Heart Letter reported on this study in August 2022.²⁴

Although additional studies are needed to confirm correlation and cause, this data suggests that cardiologists should inquire about patient sleep quality in addition to other cardiovascular risk factors.

* An actigraphic device looks like a wristwatch, and measures changes in movement which are correlated with sleep parameters

Sleep-Disordered Breathing

A May 2023 study published in the journal Neurology showed that severe sleep apnea markedly accelerates aging.¹¹

What surprised me is the impact of even small reductions in deep (slow wave) sleep. In an interview, the authors of this study said a mere 10% decline in deep (slow-wave) sleep is equivalent to 2.3 years of brain aging.²⁵

Sleep apnea is complete cessation of breathing.

Sleep disordered breathing refers to a wide spectrum of conditions including increased resistance to airflow in the upper airway, heavy snoring, and marked reduction in airflow.

A March 2023 article published by the American College of Cardiology describes "sleep-disordered breathing" as being linked together with obesity, type II diabetes, and premature death.²⁶

The researchers emphasize that this is a growing, but under-recognized crisis that provides an opportunity for physicians to reduce cardiovascular disease and improve quality of life by correcting sleep-breathing disorders.

Yale Researchers Concur

A report emanating from Yale University in March 2023 describes specific mechanisms by which poor sleep contributes to diabetes and obesity.²⁷

They point out that sleep deprivation creates an imbalance in hormones that regulate appetite (ghrelin and leptin).

Leptin helps induce satiety (feeling full) while ghrelin makes people hungry.

During sleep leptin typically rises. With insufficient sleep, leptin levels decrease, making one feel hungrier and more likely to excessively eat and gain weight.

Sleep disruptions of any kind can increase ghrelin, which makes people hungrier for more calories

This 2023 Yale report points out that people who are more sleep-deprived tend to gain weight and develop type II diabetes. They conclude by stating

"Sleep, obesity, and diabetes are all linked, and improvements to one aspect can benefit others. For example, significant weight loss can treat and, in some cases, eliminate sleep apnea, a disruptive sleep disorder in which breathing stops and starts at night."²⁷

Defying Conventional Wisdom

Traditional factors such as excess calorie intake and lack of physical activity do not fully explain today's high prevalence of unwanted body fat, metabolic syndrome, and obesity.

Insufficient sleep and poor-quality sleep promote weight gain and predispose people to metabolic disorders like type II diabetes.²⁸

A February 2023 report describes a growing recognition that insufficient sleep, misalignment of sleep/wake cycles, and altered feeding contributes to a constellation of factors behind today's obesity epidemic. The authors conclude that:

"Efforts are needed to highlight the importance of optimal sleep and circadian health in the maintenance of metabolic health and body weight regulation."²⁹

Sleep Well and Reduce Dementia Risk

People who slept six hours or less per night in mid-life are 30% more likely to develop dementia as they age. Those who sleep less than five hours have been shown to double their dementia risk in later life.³⁰

The adverse impact of sleep deprivation is no longer hidden. Numerous published studies show increased risks of:

• Alzheimer's^31-33
• Parkinson's^34,35
• Multiple sclerosis³⁶
• Stroke^21,22
• Frequency of Epileptic seizures^37,38
• Behavioral changes in Autism Spectrum Disorder^39,40
• Progression of Glioma⁴¹
• Pain (neuropathic)^42,43

The problem is that nearly 50% of older adults have some kind of sleep disturbance, and no single complete solution exists for many of them.⁴⁴

All validated lifestyle methods shown to improve sleep should be considered by those unable to achieve optimal quantity and quality nightly rest.

In this month’s issue…

Researchers isolated two plant extracts that have been shown to improve every measured component of the sleep cycle.

Compared to placebo, people taking one of these plant extract showed significant sleep enhancements at seven⁴⁵ and 60 days.⁴⁶

Two randomized controlled trials, one for each of these 2 ingredients, demonstrated improvements in the ability to fall asleep, stay asleep, and perhaps most important, improve overall sleep quality.^47,48

Page 46 of this month's issue describes the science behind this new botanical extract combination that may provide partial or substantial relief for those not attaining sufficient nightly rest.

You may note that most reports cited in this editorial are published this year (2023).

They provide near universal consensus that common disorders afflicting aging humans may be curtailed in response to healthier sleep patterns.

For longer life,

William Faloon, Co-Founder,
Life Extension®

References

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