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Deep sleep, memory formation go hand-in-hand. Scientists are also finding links to dementia | RCI

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Study found decrease in deep sleep associated with higher risk of dementia in people aged 60 and up

Shift workers sleeping at erratic hours. Students pulling all-nighters. Menopausal women tossing and turning in bed from hot flashes.

There are a host of reasons why people have periods of poor sleep. And anyone who’s endured back-to-back nights of sub-par slumber likely knows the result: Feelings of brain fog, grogginess or even memory issues.

In the short-term, those cognitive hiccups are usually manageable. Take new parents for instance, says a sleep scientist affiliated with the Canadian Institutes of Health Research.

It can be a couple of years of pretty serious sleep loss, and they still push through, said John Peever. But whether or not they could sustain that over many years, I think the answer to that question would be no.

A growing body of research points to clear links between deep sleep and memory formation and, on the flip side, the possibility of dire consequences when someone’s sleep quality erodes over time.

A new paper published in JAMA Neurology (new window) found even a one per cent reduction in deep sleep each year in individuals aged 60 and up was associated with a significantly higher risk of developing dementia.

The scientists looked at roughly 350 participants enrolled in the Framingham Heart Study (new window) — a long-term, multigenerational American research project — who completed two overnight sleep studies as part of the research.

During nearly two decades of follow-up, the team identified 52 cases of dementia among the participants. The researchers adjusted for other factors such as age, sex and sleeping medication use, and still found each percentage decrease in deep sleep per year was linked to a 27 per cent higher dementia risk.

That data couldn’t say whether the sleep decline caused the dementia — or which came first — but we do know sleep matters for our mental functioning.

Good sleep seems to be involved in so many things that are important for a healthy and well-functioning brain, noted lead researcher Matthew Pase, a sleep scientist from the Monash School of Psychological Sciences and the Turner Institute for Brain and Mental Health in Melbourne, Australia.

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How lack of sleep could be affecting your memory | In-Depth

Back in 2005, Canadians averaged about eight hours of sleep a night. By 2013, that dropped to seven. Now about 40 per cent of Canadians are dealing with some kind of sleep disorder. Something about sleep keeps our bodies and minds from falling apart. The lack of it has been linked to obesity, heart disease, stroke, diabetes and depression. Researchers are now discovering some fascinating things about how important sleep is to the way our brains store memories and learn things.

Research suggests poor sleep impacts cognition

The link between sleep and memory is a thread scientists have tugged on for centuries.

As far back as the mid-1700s, English philosopher David Hartley speculated (new window) that dream-filled sleep could be tied to the formation of memories inside the human brain. By the 1900s, modern researchers began to prove him right, showing how distinct sleep stages impact the process of memory development.

Evidence now suggests that sleep is important in the processing of newly acquired information and for the long-term storage of memory, neuroscientist and sleep researcher Matthew Walker wrote in 2009.

That evidence includes research from the last two decades suggesting just a day and a half without sleep is enough to disrupt someone’s ability to play a basic memory game (new window), or slow down their reaction times (new window)Another study (new window) involving American nurses found people who both under- or overslept — either five hours or less a night, or nine hours or more — showed worse performance on cognitive tests. The researchers estimated those groups were mentally two years older than their counterparts getting seven or eight hours of sleep each night.

Some research even suggests sleep deprivation mimics the feeling of being drunk, with one Australian research team (new window) likening a single day of sleep deprivation with the mental impairment of a blood alcohol concentration of 0.10 per cent.

By 2013, the U.S. Centers for Disease Control and Prevention declared (new window) that insufficient sleep was a public health epidemic.

Yet the conversation around what constitutes a good night’s sleep — and how sleep impacts memory loss and formation — continues to shift.

While most people still get hung up on the total hours of shut-eye, modern sleep scientists say there’s growing consensus that the quality of your sleep matters even more.

Impact of ‘slow-wave sleep’

Whether you typically sleep for six hours a night, or need nine hours of shut-eye, everyone’s body goes through a cycle of sleep stages. Once you doze off, your body enters a light sleep, which usually only lasts a few minutes. Then your heart rate and body temperature drop as you head into deeper sleep.

Eventually, you hit the restorative period that scientists call slow-wave sleep.

That’s the specific sleep stage Pase’s team studied where people fall into the deepest slumber. It’s also thought to be a period when the brain repairs itself.

Dr. Brian Murray, a professor of neurology at the University of Toronto and head of the neurology division at Sunnybrook Health Sciences Centre, said it’s a bit like rebooting a computer — giving it a chance to clear out stray signals. In the case of the human brain, that can mean removing misfolded protein garbage that builds up during waking hours.

<q data-attributes=””lang”:”value”:”fr”,”label”:”Français”,”value”:”html”:”This is critically important for neurodegenerative diseases, like Alzheimer’s [and]Parkinson’s,”,”text”:”This is critically important for neurodegenerative diseases, like Alzheimer’s [and]Parkinson’s,””>This is critically important for neurodegenerative diseases, like Alzheimer’s [and] Parkinson’s, he said.

The connection between good quality sleep and that junk removal process has only recently been identified, added Murray.

The latest findings from Pase and his team build on that, suggesting slow-wave sleep loss may be a dementia risk factor that people can actually try to mitigate. But Pase stressed his research doesn’t prove getting less slow-wave sleep can cause dementia.

Aging and memory loss also go hand-in-hand with comorbidities — which can disrupt sleep — and might result in someone living long-term in environments that aren’t conducive to quality slumber like brightly-lit hospitals or care homes, he noted.

The question becomes: Is altered sleep the side effect of dementia itself? Or is altered sleep facilitating dementia? echoed Peever, the Canadian sleep scientist. <q data-attributes=””lang”:”value”:”fr”,”label”:”Français”,”value”:”html”:”Soa ‘chicken and the egg’ story that is always almost impossible to unravel.”,”text”:”Soa ‘chicken and the egg’ story that is always almost impossible to unravel.””>So a ‘chicken and the egg’ story that is always almost impossible to unravel.

Still, Peever said the paper offers another piece of the evolving puzzle.

What they’ve shown is, if you take all patients across time — those with dementia, and those without incident dementia — there is a decline in how much slow-wave sleep they experience, he said. But the decline in dementia patients was significantly greater.

Dr. Eric Zhou, an assistant professor in the division of sleep medicine at Harvard Medical School, agreed the study was rigorous and compelling. The findings also fit into broader research linking poor sleep quality to an array of health issues, from stroke to cancer to mental health conditions.

You name the health problem, Zhou said, and chronically not getting enough sleep — or chronically not sleeping well — will accelerate your risk of developing it, or exacerbate the condition if you have it already.

Melatonin won’t help everyone’s sleep issues, experts say

The use of melatonin as a sleep aid has significantly increased over the past two decades, but experts say it isn’t a cure-all, and taking too much can cause health problems.

Challenges of studying sleep

Yet researching sleep, and showing clear cause-and-effect on various health issues, remains a distinct challenge. Sleep studies are notoriously difficult to run, time-consuming and often prohibitively expensive, Zhou noted. Ethically, scientists can’t randomly assign healthy adults to getting really miserable sleep, he said. Sleep studies also require a cumbersome step for participants: Staying in a lab overnight.

It’s not a blood draw, Zhou continued. It’s not one check of their pulse.

To really figure out the impacts of sleep on long-term memory loss, scientists also need a massive pool of people, and it’s almost impossible to gain funding to do complex sleep studies at a population level, Zhou said. Even decades-worth of data from hundreds of participants only gave Pase’s research team 52 dementia cases to analyze, he noted.

Pase himself agreed, and said the dual nature of his research presented an additional challenge.

The thing about dementia is, although it’s common in a population, everyone’s chance of getting it at any given time is kind of low. So, it’s a difficult thing to study.

The bottom line is that emerging research linking sleep and memory loss may be persuasive, but it’s not conclusive, Peever stressed. It’s worth striving for better sleep, he added, but there’s also no reason to panic: The vast majority of the population experiences a deterioration in sleep quality over time for reasons scientists don’t fully understand.

So clearly, sleep quality — as it declines with age — is not causing dementia in everybody.

 

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Whooping cough is at a decade-high level in US

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MILWAUKEE (AP) — Whooping cough is at its highest level in a decade for this time of year, U.S. health officials reported Thursday.

There have been 18,506 cases of whooping cough reported so far, the Centers for Disease Control and Prevention said. That’s the most at this point in the year since 2014, when cases topped 21,800.

The increase is not unexpected — whooping cough peaks every three to five years, health experts said. And the numbers indicate a return to levels before the coronavirus pandemic, when whooping cough and other contagious illnesses plummeted.

Still, the tally has some state health officials concerned, including those in Wisconsin, where there have been about 1,000 cases so far this year, compared to a total of 51 last year.

Nationwide, CDC has reported that kindergarten vaccination rates dipped last year and vaccine exemptions are at an all-time high. Thursday, it released state figures, showing that about 86% of kindergartners in Wisconsin got the whooping cough vaccine, compared to more than 92% nationally.

Whooping cough, also called pertussis, usually starts out like a cold, with a runny nose and other common symptoms, before turning into a prolonged cough. It is treated with antibiotics. Whooping cough used to be very common until a vaccine was introduced in the 1950s, which is now part of routine childhood vaccinations. It is in a shot along with tetanus and diphtheria vaccines. The combo shot is recommended for adults every 10 years.

“They used to call it the 100-day cough because it literally lasts for 100 days,” said Joyce Knestrick, a family nurse practitioner in Wheeling, West Virginia.

Whooping cough is usually seen mostly in infants and young children, who can develop serious complications. That’s why the vaccine is recommended during pregnancy, to pass along protection to the newborn, and for those who spend a lot of time with infants.

But public health workers say outbreaks this year are hitting older kids and teens. In Pennsylvania, most outbreaks have been in middle school, high school and college settings, an official said. Nearly all the cases in Douglas County, Nebraska, are schoolkids and teens, said Justin Frederick, deputy director of the health department.

That includes his own teenage daughter.

“It’s a horrible disease. She still wakes up — after being treated with her antibiotics — in a panic because she’s coughing so much she can’t breathe,” he said.

It’s important to get tested and treated with antibiotics early, said Dr. Kris Bryant, who specializes in pediatric infectious diseases at Norton Children’s in Louisville, Kentucky. People exposed to the bacteria can also take antibiotics to stop the spread.

“Pertussis is worth preventing,” Bryant said. “The good news is that we have safe and effective vaccines.”

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AP data journalist Kasturi Pananjady contributed to this report.

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The Associated Press Health and Science Department receives support from the Robert Wood Johnson Foundation. The AP is solely responsible for all content.

The Canadian Press. All rights reserved.

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Scientists show how sperm and egg come together like a key in a lock

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How a sperm and egg fuse together has long been a mystery.

New research by scientists in Austria provides tantalizing clues, showing fertilization works like a lock and key across the animal kingdom, from fish to people.

“We discovered this mechanism that’s really fundamental across all vertebrates as far as we can tell,” said co-author Andrea Pauli at the Research Institute of Molecular Pathology in Vienna.

The team found that three proteins on the sperm join to form a sort of key that unlocks the egg, allowing the sperm to attach. Their findings, drawn from studies in zebrafish, mice, and human cells, show how this process has persisted over millions of years of evolution. Results were published Thursday in the journal Cell.

Scientists had previously known about two proteins, one on the surface of the sperm and another on the egg’s membrane. Working with international collaborators, Pauli’s lab used Google DeepMind’s artificial intelligence tool AlphaFold — whose developers were awarded a Nobel Prize earlier this month — to help them identify a new protein that allows the first molecular connection between sperm and egg. They also demonstrated how it functions in living things.

It wasn’t previously known how the proteins “worked together as a team in order to allow sperm and egg to recognize each other,” Pauli said.

Scientists still don’t know how the sperm actually gets inside the egg after it attaches and hope to delve into that next.

Eventually, Pauli said, such work could help other scientists understand infertility better or develop new birth control methods.

The work provides targets for the development of male contraceptives in particular, said David Greenstein, a genetics and cell biology expert at the University of Minnesota who was not involved in the study.

The latest study “also underscores the importance of this year’s Nobel Prize in chemistry,” he said in an email.

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The Associated Press Health and Science Department receives support from the Howard Hughes Medical Institute’s Science and Educational Media Group. The AP is solely responsible for all content.

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Older patients, non-English speakers more likely to be harmed in hospital: report

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Patients who are older, don’t speak English, and don’t have a high school education are more likely to experience harm during a hospital stay in Canada, according to new research.

The Canadian Institute for Health Information measured preventableharmful events from 2023 to 2024, such as bed sores and medication errors,experienced by patients who received acute care in hospital.

The research published Thursday shows patients who don’t speak English or French are 30 per cent more likely to experience harm. Patients without a high school education are 20 per cent more likely to endure harm compared to those with higher education levels.

The report also found that patients 85 and older are five times more likely to experience harm during a hospital stay compared to those under 20.

“The goal of this report is to get folks thinking about equity as being a key dimension of the patient safety effort within a hospital,” says Dana Riley, an author of the report and a program lead on CIHI’s population health team.

When a health-care provider and a patient don’t speak the same language, that can result in the administration of a wrong test or procedure, research shows. Similarly, Riley says a lower level of education is associated with a lower level of health literacy, which can result in increased vulnerability to communication errors.

“It’s fairly costly to the patient and it’s costly to the system,” says Riley, noting the average hospital stay for a patient who experiences harm is four times more expensive than the cost of a hospital stay without a harmful event – $42,558 compared to $9,072.

“I think there are a variety of different reasons why we might start to think about patient safety, think about equity, as key interconnected dimensions of health-care quality,” says Riley.

The analysis doesn’t include data on racialized patients because Riley says pan-Canadian data was not available for their research. Data from Quebec and some mental health patients was also excluded due to differences in data collection.

Efforts to reduce patient injuries at one Ontario hospital network appears to have resulted in less harm. Patient falls at Mackenzie Health causing injury are down 40 per cent, pressure injuries have decreased 51 per cent, and central line-associated bloodstream infections, such as IV therapy, have been reduced 34 per cent.

The hospital created a “zero harm” plan in 2019 to reduce errors after a hospital survey revealed low safety scores. They integrated principles used in aviation and nuclear industries, which prioritize safety in complex high-risk environments.

“The premise is first driven by a cultural shift where people feel comfortable actually calling out these events,” says Mackenzie Health President and Chief Executive Officer Altaf Stationwala.

They introduced harm reduction training and daily meetings to discuss risks in the hospital. Mackenzie partnered with virtual interpreters that speak 240 languages and understand medical jargon. Geriatric care nurses serve the nearly 70 per cent of patients over the age of 75, and staff are encouraged to communicate as frequently as possible, and in plain language, says Stationwala.

“What we do in health care is we take control away from patients and families, and what we know is we need to empower patients and families and that ultimately results in better health care.”

This report by The Canadian Press was first published Oct. 17, 2024.

Canadian Press health coverage receives support through a partnership with the Canadian Medical Association. CP is solely responsible for this content.

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