Sleep on the Brain: Why is Sleep so Important for Brain Health?

Everybody’s experienced a night of bad sleep. Ever wonder why your memory and mood seem to be affected after poor sleep especially after consecutive nights of little or poor sleep? I certainly remember my long stretches of little and poor quality sleep during my years of residency.

Ever wonder why you feel incredibly good and the world may seem to have a rosy glow after a good nights sleep but the world may seem exactly the opposite when you have had a crappy night of sleep?

Turns out that bad sleep can affect memory and mood because sleep is involving in clearing metabolic waste products from the brain that accumulate during wakefulness. Sleep restores the brain and clears it of waste products. Accumulation of waste products in the brain are associated with neurodegenerative diseases like Alzheimer’s Disease. Alzheimer’s Disease is associated with a buildup of beta-amyloid found in fluid surrounding brain cells. In disease like Alzheimer’s Disease, the metabolic waste products accumulate so much that they clumps together and form plaques. These plaques prevent neurons from communicating with each other and thus leads to impaired memory as well as damage to neurons over time.

A metabolic waste product that is a hallmark of Alzheimer’s Disease is called beta-amyloid. Beta-amyloid has been shown to accumulate in brain cells after sleep deprivation in mice studies.  Moreover, a recent studypublished by the National Institute on Alcohol Abuse and Alcoholism found that even short-term sleep deprivation is associated with increased amyloid levels in humans. They took 20 participants (ages 20-70) and deprived them of sleep for 31 hours. Then they placed them in a PET scanner and injected them with a radioactive nucleotide that binds to amyloid protein in the brain and scanned them. Beta amyloid increased by 5% in people who were sleep deprived. The brain regions which were particularly affected were the thalamus and the hippocampus – both regions in the brain which are particularly susceptible in Alzheimer’s Disease. The hippocampus plays a role in the formation of new memories. The thalamus plays a role in multiple different neurological functions such as sleep, memory, mood, and relaying information from the cortex (the outer layer of the brain) to the rest of the body via the brain stem and spinal cord.

When I was a neurology resident, I worked in the hospital day in and day out. I consistently experienced poor quality sleep especially during my weekend calls and night shift rotations.

For about two years after graduating residency, I experienced regular bouts of troubled and light sleeping (likely as a result of the awkward sleep patterns induced during residency). During these bouts, the subtle hum from the highway next to my home would keep me awake. I would have to wear earplugs at night and sometimes I would have to resort to my noise canceling headphones to block out any sound. I would wake up in the early morning with my heart racing and unable to fall asleep. I went through a period where I intermittently had to rely on sleeping pills – which ultimately did not lead to the most refreshing sleep.

As a result, my brain at the time did not function optimally. During my bad sleep phases, I felt cognitively slow, had difficulty learning new things, remembering things that my younger self would have remembered easily, and often experienced word finding difficulties.

While I still experience the occasional bad night of sleep, I have discovered a few strategies that have helped me tremendously.

3 Tips of Getting Better Sleep:

1. Incorporate new, challenging physical exercise

Since I was 13 years old, long distance running has been my main form of exercise. As I transitioned to my thirties, I wanted to try other exercises that were not as hard on my joints. I began to implement weight training and hot yoga (i.e., Bikram) to my exercise regimen, and realized that on the days that I performed those activities, my sleep quality was greater. I slept through the night without waking up. I woke up physically sore, but mentally calm and in a happier mood. Several studiessuggest that vigorous exercise significantly improves sleep in people with chronic insomnia. I’m not sure whether it was the muscle confusion of the new exercises or the specific type of exercise (weight lifting and yoga versus running) that helped me sleep better.

Yoga has been shown to improve mindfulness and calmness, which can help keep hyper-alertness (associated with stress and anxiety, and also associated with insomnia) in check so you can fall asleep and stay asleep.

2. Limit your alcohol intake

While alcohol can help you fall asleep, it can lead to early morning waking and decrease the amount of time spent in restorative sleep (REM sleep and slow wave sleep-the kind needed to feel recharged and refreshed). I personally experienced more early morning awakening and heart racing episodes after nights in which I drank alcohol. I now limit my alcohol intake to 1-2 drinks a month and have noticed a tremendous improvement in my sleep quality.

3. Sleeping with someone who snores? Implement a change (without changing your partner)  

Either get them help (sleep doctor, weight loss, ask them to limit their alcohol intake (can make snoring worse) and/or a CPAP machine)) or sleep separately. I know this sounds harsh, but think of it this way – would your partner rather be in the daytime presence of a refreshed happy you, or an angry resentful (perhaps irrational) and foggy you because you can’t get a good night’s sleep?

If your significant other tells you that you snore, get help! Sleep apnea (which causes snoring) can increase your risk of health problems like heart attacks, strokes, and high blood pressure.

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