New Studies Link Sleep Quality and Diabetes Drugs to Alzheimer’s Risk Lisa Skinner

Are you caring for a loved one with dementia? You don't have to figure this out all on your own. Welcome to Truth, Lies Alzheimer's, the show that helps you reimagine a new relationship with your loved one, a relationship a little more free of stress and anxiety. Join host Lisa Skinner and her 30+ years of experience as she guides you on a new path to a better relationship with those you care for. Here's Lisa.

Hello everybody, this is Lisa Skinner, your host of the Truth, Lies Alzheimer's Show. And as promised, I'm back with another brand new episode for you today. Now, as we all know, One of the risk factors based on scientific research that I have talked about many times on this show is that— and one that increases a person's risk of developing Alzheimer's disease is poor quality sleep or having sleep apnea. Sleep apnea. This also inhibits people from getting quality sleep. So, I wanted to talk about that again today because I found an article that I think you would all be really interested in that supports this, explains to us why. It's one of the risk factors for developing Alzheimer's disease by not getting good quality sleep. I don't think I've ever been able to do that for you before, is actually explain why. In this article that I found really does a deep dive into it, so I want to share this with you. I found this on CNN Health. The title is Alzheimer's risk Rises when amount of deep sleep falls. And this is based on a new study and the outcome of that study. This was published on Tuesday, April 8th, which was very recently, and it's written by Sandy Lamont of CNN. So she starts off by saying, do we need another reason to prioritize our sleep? Well, of course we do. Not spending enough time in the two deep stages of sleep—slow wave is one of them, and rapid eye movement, also known as REM sleep—may hasten the deterioration of parts of the brain associated with Alzheimer's disease. And this is what this study found to be true. This gentleman by the name of Cho, who's a postdoctoral associate in internal medicine at the Yale School of Medicine in New Haven, Connecticut, He says, we found the volume of a part of the brain called the inferior parietal region shrunk in people with inadequate slow and REM sleep. He also says that part of the brain synthesizes sensory information, including visuospatial information, so it makes sense sense that it shows neurodegeneration early in the disease. Then preventive neurologist Dr. Richard Isaacson, who established one of the first Alzheimer's prevention clinics in the US, said in an email that his clinical experience treating adults at risk for Alzheimer's also supports this study's findings. They also found sleep metrics on deeper sleep predicted cognitive function. So between that plus brain volumes, it's a real thing. So what happens in the brain during deep sleep? During deep sleep, the brain sweeps out toxins and dead cells while also repairing and restoring the body for the next day. While we dream during REM sleep, the brain is busy processing our emotions, consolidating our memories, and absorbing new information. So, that said, it makes perfect sense that getting quality sleep not just REM sleep, but quality deep sleep is key to our ability to function. Adults need about 7 to 8 hours of sleep to be healthy, while teens and younger children need much more. However, data shows that more than 1 in 3 American adults don't get enough sleep, and this is according to the US Centers for Disease Control and Prevention. Experts also say that most adults should spend between 20% and 25% of their night in deep sleep, and the same goes for REM sleep. Those are two different things. Older adults require less while babies need much more. In fact, infants can spend about 50% of their sleep in REM. And then to make matters worse, deeper stages of sleep decrease as we age, Cho says. So, can we get more deep sleep? I don't know. Let's see what they have to say. Deep sleep tends to come soon after we fall asleep, while REM sleep appears later in the night toward morning. Therefore, if you go to bed late and get up early, Guess what? You are actually cutting your chances of spending enough time in one or both of these stages. The more time you are in bed, the more a person sleeps, and generally speaking, the longer a person sleeps, the more REM and deep sleep they will get, Isaacson tells us. However, You have to do more than just lie in bed longer. You also need to have an uninterrupted restful night's sleep on a regular basis. If you do that, there's an additional payoff. A February 2023 study found that good sleep habits actually added nearly 5 years to a man's life expectancy and almost 2.5 years to a woman's life. That's amazing. The article goes on to say that to accomplish this, however, you can't wake up during the night or have trouble falling asleep more than 2 times in a week. This is what the study found to be true. You also have to feel well-rested at least 5 days a week when you wake up. And finally, you can't be using sleep medications to achieve your good slumber. But don't lose hope. The good news is that you can easily train your brain to better sleep by following what they're calling sleep hygiene. It's important to go to bed at the same time on most nights and get up the same time most mornings, even on weekends and holidays, it's recommending. So make sure your sleeping environment is optimal. Cooler and darker is better. And block noise or try a sound machine, they're recommending. They're also telling us to avoid booze before bed. It may seem like you're falling asleep more easily, but when your liver finishes metabolizing the alcohol at 3 o'clock in the morning, your body will wake up Experts say so. The bottom line is they're recommending set up a sleep routine, stick to it, no blue lights or distractions at least an hour before bedtime, and try meditation, yoga, tai chi, warm baths. Or anything that relaxes you is great to achieve the optimal stages of sleep. So, wow, that's, that's pretty great. Now we understand the correlation between poor quality sleep, which is one of the known risk factors that does increase a person's risk of developing Alzheimer's disease. So if we can manage that, then we can remove that off our risk factor list that may apply to any one of us. The second article that I want to share with you is new. It's very Interesting. So, and it also has to do with what they've learned about drugs that could minimize or reduce our risk of developing Alzheimer's disease, because diabetes is a known risk factor that does increase our risk of developing Alzheimer's disease. This was written by Tim Newman in Medical News Today, and it was published on April 9th of this year, so like a couple weeks ago. The title of this article is "Diabetes drugs, like Alzheimer's and Jardiance, may slash a person's Alzheimer's risk. A new study investigates the relationship between Specific diabetes drugs and dementia. They use data from more than 92,000 people with Type 2 diabetes. The scientists found that 2 medications significantly reduce the risk of developing dementia in life. And this was based on a new study that was published in JAMA Neurology, which is a publication, and it found that people with type 2 diabetes who take these two new common anti-diabetic diabetes medications had a reduced risk of Alzheimer's and associated dementia. Specifically, the GLP-1RA which is Ozempic, was linked to a 33% lower risk of dementia. And then the SGLT2i, which is the Jardians, was linked to a 43% lower risk. Other diabetes medications, however, were not associated with a change in the risk. So how are dementia and diabetes linked? This is important for us to know. As the average age of the population steadily rises, the number of dementia cases also rises in step. Despite decades of intensive research, a cure still remains elusive. Although some treatments can slow the progress, we are far from a breakthrough. Adding to these challenges, if an effective drug were found, it would take many years to build up a sufficient evidence base and millions of dollars to then bring it to market. For these reasons, some researchers are focusing on existing drugs. If they can identify a drug that is already widely used and helps lower the risk of dementia, well, obviously this would be a much shorter road to wider availability. So some recent research has suggested that type 2 diabetes and dementia may share some physiological similarities, including inflammation, and impaired insulin signaling in the brain. People with diabetes also have a higher risk of developing dementia. This we know. So drugs like Ozempic have been linked through this study to 33% lower dementia risk. That's pretty compelling. So this is the history of the study. To investigate this theory, scientists accessed data from Florida, Georgia, and Alabama. In total, this amounted to 92,160 people aged 50 or older with type 2 diabetes. That's quite a sample. Participants were followed until they died and/or developed dementia, including Alzheimer's, vascular dementia, frontotemporal dementia, and Lewy body dementia. They focused on 3 comparisons: the GLP-1 RA versus other second-line glucose lowering drugs. Now that's your Ozempic. The SGLT2i versus other second-line glucose-lowering drugs, that's the Jardians, and a GLP-1 RA versus the SGLT2i. So they compared both the Ozempic with the Jardians. And this is what they concluded, that the GLP-1 RAs and the SGLT2 were associated with a reduced risk of developing dementia compared with second-line diabetes drugs. So the Ozempic use was associated with a 33% lower risk of developing dementia, and the Jardians use was associated with a 43% lower risk compared with other glucose-lowering drugs. Medical News Today contacted Dr. William Knapp, who's a longevity expert and CEO of the company Fountain Life. He was not involved in this study, but they interviewed him, and this was his response to the findings of this study. He says, "The results actually did not shock me, but they gave— but they did give more credence to what we've been observing. Brain and body don't age separately. Metabolic problems such as insulin resistance are linked to inflammation, oxidative stress, and altered blood flow, all known to impact our brain health. So how do these drugs reduce dementia risk? Although scientists do not know for sure how they reduce our dementia risk, they may reduce dementia risk in people with type 2 diabetes, um, the authors suggest some potential mechanisms. For instance, the Ozempic drug has been shown to reduce neuroinflammation, improve insulin signaling in our brain, and promote the growth of new nerve cells, which is called neurogenesis. Now, the Jardiance drug, which is the SGLT2, may protect the brain by improving cerebral blood flow, reducing oxidative stress, and enhancing mitochondrial activity. The scientists also explained that both drugs are associated with improved metabolic and vascular health, both of which may support healthy brain function. Additionally, there is some evidence that these drugs can reduce levels of amyloid beta and tau proteins in the brain, which are the hallmarks of Alzheimer's disease. Now, there's a medical school in the UK similarly not involved in the study that also explained the GLP-1 receptor antagonist and the SGLT2 inhibitors, our Ozempic and our Jardiance, have been demonstrated to control the sugar and also reduce the inflammation, which is a key driver of Alzheimer's disease. And reduce vascular risk, which is a key driver of vascular dementia, more than would be expected by sugar control alone. It is therefore no surprise that these data show a lower risk of dementia in people who receive them as part of their routine care. Okay, the bottom line question: is there enough data to draw strong conclusions? And this is how they respond to that. This study, which analyzed data from almost 100,000 people, is supported by a number of previous studies. However, a paper published in the same journal and on the same day casts a small portion of doubt on the results of the study that I just referred to. The paper in question, which was also published in JAMA Neurology, is a systematic review and meta-analysis of 26 clinical trials, including data from 164,531 participants. According to its authors, glucose-lowering therapy with drugs like Ozempic, but not Jardiance, was associated with a statistically significant reduction in dementia or cognitive impairment. So their findings do draw a strong correlation to Ozempic, but they're saying not to Jardiance. So their conclusion on the Ozempic drug mirror those from the original paper, but they did not find the same effect for the Jardiance, which is the SGLT2. This may be partly due to the short duration or follow-up. The average study follow-up in the meta-analysis and the follow-up in the original study were under 5 years. And they're saying, well, it's still early and we're not seeing all the long-term data, but what we're seeing is that regulating insulin and inflammation might also slow down some of the changes in the brain that are tied to dementia. The inevitable next question is, will these drugs reduce dementia risk in people without diabetes? And they tell us, if the benefit is from reducing insulin resistance or inflammation, It's possible that these drugs could be good for people without diabetes also. Just because something is good for one group doesn't mean it is for others, and there are always risks to long-term use. For now, the jury is, or at least part, out. We may have to wait for longer studies before we can draw solid conclusions. Still, it is looking increasingly likely that GLP-1 RAs, Ozempic, might reduce the risk of dementia for people with type 2 diabetes, which is certainly a positive finding. I would say so. And I am actually read information on this very topic before, but I like this article because it really does a deep dive into explaining why, what they found in this study, and I think it's very promising. So I hope you enjoyed me bringing these two articles to your attention today. I think they're both very valuable pieces of information that could apply to helping a lot of us filter through what increases our risk of developing Alzheimer's disease versus what can reduce or minimize our risk. Because as you know, there are so many that play a role. In that scenario. So that'll do it for today's episode of the Truth, Lies Alzheimer's Show. I'm Lisa Skinner, your host. As always, I appreciate you spending part of your day with us to bring you this information to hopefully help set you up for a dementia-free life. And I hope all of you have a happy, healthy rest of your week, and I will be back next week with another new episode of The Truth, Lies Alzheimer's. Take care for now. See y'all next week. Bye-bye.

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