Having Trouble Falling Asleep Predicts Cognitive Impairment in Later Life

A study of nearly 2,500 adults found that having trouble falling asleep, as compared to other patterns of insomnia, was the main insomnia symptom that predicted cognitive impairment 14 years later.

Results show that having trouble falling asleep in 2002 was associated with cognitive impairment in 2016. Specifically, more frequent trouble falling asleep predicted poorer episodic memory, executive function, language, processing speed, and visuospatial performance. Further analysis found that associations between sleep initiation and later cognition were partially explained by both depressive symptoms and vascular diseases in 2014 for all domains except episodic memory, which was only partially explained by depressive symptoms.

“While there is growing evidence for a link between insomnia and cognitive impairment in older adults, it has been difficult to interpret the nature of these associations given how differently both insomnia and cognitive impairment can present across individuals,” said lead author Afsara Zaheed, a graduate student in clinical science within the department of psychology at the University of Michigan. “By investigating associations between specific insomnia complaints and cognition over time using strong measures of cognitive ability, we hoped to gain additional clarity on whether and how these different sleep problems may lead to poor cognitive outcomes.”

Insomnia involves difficulty falling asleep or staying asleep, or regularly waking up earlier than desired, despite allowing enough time in bed for sleep. Daytime symptoms include fatigue or sleepiness; feeling dissatisfied with sleep; having trouble concentrating; feeling depressed, anxious, or irritable; and having low motivation or energy.

The study analyzed data from the Health and Retirement Study, which involved 2,496 adults who were at least 51 years of age. In 2002 they reported the frequency of experiencing insomnia symptoms. In 2016 the participants’ cognition was assessed as part of the Harmonized Cognitive Assessment Protocol and operationalized with a comprehensive neuropsychological battery tapping episodic memory, executive function, language, visuoconstruction, and processing speed. Analyses controlled for sociodemographics and baseline global cognitive performance.

“These results are important given the lack of currently available treatments for late-life cognitive disorders, like Alzheimer’s disease and other dementias,” said Zaheed. “Sleep health and sleep behaviors are often modifiable. These results suggest that regular screening for insomnia symptoms may help with tracking and identifying people with trouble falling asleep in mid-to-late life who might be at risk for developing cognitive impairments later in life. Additional intervention research is needed to determine whether intervening on insomnia symptoms can help prevent or slow the progression of cognitive impairments in later life.”

The research abstract was published recently in an online supplement of the journal Sleep and will be presented as a poster beginning June 9 during Virtual SLEEP 2021. SLEEP is the annual meeting of the Associated Professional Sleep Societies, a joint venture of the American Academy of Sleep Medicine and the Sleep Research Society.

Source: Sleep 2021

Researcher Finds “Earworms” After Listening to Music Near Bedtime Continue During Sleep

Most people listen to music throughout their day and often near bedtime to wind down. But can that actually cause your sleep to suffer? When sleep researcher Michael Scullin, Ph.D., associate professor of psychology and neuroscience at Baylor University, realized he was waking in the middle of the night with a song stuck in his head, he saw an opportunity to study how music — and particularly stuck songs — might affect sleep patterns.

Scullin’s recent study, published in Psychological Science, investigated the relationship between music listening and sleep, focusing on a rarely-explored mechanism: involuntary musical imagery, or “earworms,” when a song or tune replays over and over in a person’s mind. These commonly happen while awake, but Scullin found that they also can happen while trying to sleep.

“Our brains continue to process music even when none is playing, including apparently while we are asleep,” Scullin said. “Everyone knows that music listening feels good. Adolescents and young adults routinely listen to music near bedtime. But sometimes you can have too much of a good thing. The more you listen to music, the more likely you are to catch an earworm that won’t go away at bedtime. When that happens, chances are your sleep is going to suffer.”

People who experience earworms regularly at night — one or more times per week — are six times as likely to have poor sleep quality compared to people who rarely experience earworms. Surprisingly, the study found that some instrumental music is more likely to lead to earworms and disrupt sleep quality than lyrical music.

The study involved a survey and a laboratory experiment. The survey involved 209 participants who completed a series of surveys on sleep quality, music listening habits and earworm frequency, including how often they experienced an earworm while trying to fall asleep, waking up in the middle of the night and immediately upon waking in the morning.

In the experimental study, 50 participants were brought into Scullin’s Sleep Neuroscience and Cognition Laboratory at Baylor, where the research team attempted to induce earworms to determine how it affected sleep quality. Polysomnography — a comprehensive test and the gold standard measurement for sleep — was used to record the participants’ brain waves, heart rate, breathing and more while they slept.

“Before bedtime, we played three popular and catchy songs — Taylor Swift’s ‘Shake It Off,’ Carly Rae Jepsen’s ‘Call Me Maybe’ and Journey’s ‘Don’t Stop Believin’,” Scullin said. “We randomly assigned participants to listen to the original versions of those songs or the de-lyricized instrumental versions of the songs. Participants responded whether and when they experienced an earworm. Then we analyzed whether that impacted their nighttime sleep physiology. People who caught an earworm had greater difficulty falling asleep, more nighttime awakenings, and spent more time in light stages of sleep.”

Additionally, EEG readings — records of electrical activity in the brain — from the experimental study were quantitatively analyzed to examine physiological markers of sleep-dependent memory consolidation. Memory consolidation is the process by which temporary memories are spontaneously reactived during sleep and transformed into a more long-term form.

“We thought that people would have earworms at bedtime when they were trying to fall asleep, but we certainly didn’t know that people would report regularly waking up from sleep with an earworm. But we saw that in both the survey and experimental study,” he said.

Participants who had a sleep earworm showed more slow oscillations during sleep, a marker of memory reactivation. The increase in slow oscillations was dominant over the region corresponding to the primary auditory cortex which is implicated in earworm processing when people are awake.

“Almost everyone thought music improves their sleep, but we found those who listened to more music slept worse,” Scullin said. “What was really surprising was that instrumental music led to worse sleep quality — instrumental music leads to about twice as many earworms.”

The study found that individuals with greater music listening habits experienced persistent earworms and a decline in sleep quality. These results are contrary to the idea of music as a hypnotic that might help sleep. Health organizations commonly recommend listening to quiet music before bedtime — recommendations that largely arise from self-reported studies. Instead, Scullin has objectively measured that the sleeping brain continues to process music for several hours, even after the music stops.

Knowing that earworms negatively affect sleep, Scullin recommends first trying to moderate music listening or taking occasional breaks if bothered by earworms. Timing of music also is important — try to avoid it before bed.

“If you commonly pair listening to music while being in bed, then you’ll have that association where being in that context might trigger an earworm even when you’re not listening to music, such as when you’re trying to fall asleep,” he said.

Another way to get rid of an earworm is to engage in cognitive activity — fully focusing on a task, problem or activity helps to distract your brain from earworms. A previous study by Scullin — partially funded by a National Institutes of Health grant and the Sleep Research Society Foundation — found that participants who took five minutes to write down upcoming tasks before bed helped “offload” those worrying thoughts about the future and led to faster sleep.

Source: Baylor University

People Who Have Trouble Sleeping Are at a Higher Risk of Dying – Especially People with Diabetes

In a paper published by the Journal of Sleep Research, researchers reveal how they examined data* from half a million middle-aged UK participants asked if they had trouble falling asleep at night or woke up in the middle of the night.

The report found that people with frequent sleep problems are at a higher risk of dying than those without sleep problems. This grave outcome was more pronounced for people with Type-2 diabetes: during the nine years of the research, the study found that they were 87 per cent more likely to die of any cause than people without diabetes or sleep disturbances.

The study also found that people with diabetes and sleep problems were 12 per cent more likely to die over this period than those who had diabetes but not frequent sleep disturbances.

Malcolm von Schantz, the first author of the study and Professor of Chronobiology from the University of Surrey, said:

“Although we already knew that there is a strong link between poor sleep and poor health, this illustrates the problem starkly.”

“The question asked when the participants enrolled does not necessarily distinguish between insomnia and other sleep disorders, such as sleep apnoea. Still, from a practical point of view it doesn’t matter. Doctors should take sleep problems as seriously as other risk factors and work with their patients on reducing and mitigating their overall risk.”

Professor Kristen Knutson of Northwestern University, the senior co-author of the study, said:

“Diabetes alone was associated with a 67 per cent increased risk of mortality. However, the mortality for participants with diabetes combined with frequent sleep problems was increased to 87 per cent. In order words, it is particularly important for doctors treating people with diabetes to also investigate sleep disorders and consider treatments where appropriate.”

Source: University of Surrey

Does Listening to Calming Music at Bedtime Actually Help You Sleep?

A new study published in the Journal of the American Geriatrics Society has found that listening to music can help older adults sleep better.

Researchers from the National Cheng Kung University Hospital in Taiwan combined the results of past studies to understand the effect that listening to music can have on the quality of older adults’ sleep. Their work suggests that:

  • Older adults (ages 60 and up) living at home sleep better when they listen to music for 30 minutes to one hour at bedtime.
  • Calm music improves older adults’ sleep quality better than rhythmic music does.
  • Older adults should listen to music for more than four weeks to see the most benefit from listening to music.

Why Older Adults Have Trouble Getting a Good Night’s Sleep

As we age, our sleep cycles change and make a good night’s sleep harder to achieve. What does it really mean to get a good night’s sleep? If you wake up rested and ready to start your day, you probably slept deeply the night before. But if you’re tired during the day, need coffee to keep you going, or wake up several times during the night, you may not be getting the deep sleep you need. According to the National Institute on Aging, older adults need seven to nine hours of sleep each night.

But studies have shown that 40 to 70 percent of older adults have sleep problems and over 40 percent have insomnia, meaning they wake up often during the night or too early in the morning. Sleep problems can make you feel irritable and depressed, can cause memory problems, and can even lead to falls or accidents.

How the Researchers Studied the Effect of Music on Older Adults’ Quality of Sleep

For their study, the researchers searched for past studies that tested the effect of listening to music on older adults with sleep problems who live at home. They looked at five studies with 288 participants. Half of these people listened to music; the other half got the usual or no treatment for their sleep problems. People who were treated with music listened to either calming or rhythmic music for 30 minutes to one hour, over a period ranging from two days to three months. (Calming music has slow tempo of 60 to 80 beats per minute and a smooth melody, while rhythmic music is faster and louder.) All participants answered questions about how well they thought they were sleeping. Each participant ended up with a score between 0 and 21 for the quality of their sleep.

The researchers looked at the difference in average scores for:

  • people who listened to music compared to people who did not listen to music;
  • people who listened to calm music compared to people who listened to rhythmic music;
  • and people who listened to music for less than four weeks compared to people who listened to music for more than four weeks.

What the Researchers Learned

Listening to calming music at bedtime improved sleep quality in older adults, and calming music was much better at improving sleep quality than rhythmic music. The researchers said that calming music may improve sleep by slowing your heart rate and breathing, and lowering your blood pressure.[3] This, in turn helps lower your levels of stress and anxiety.

Researchers also learned that listening to music for longer than four weeks is better at improving sleep quality than listening to music for a shorter length of time.

Limits of the Study

  • Researchers only looked at studies published in English and Chinese, meaning they may have missed studies in other languages on the effect of listening to music on sleep in older adults.
  • Results may not apply to older adults with Alzheimer’s disease or Parkinson’s disease.
  • In the studies researchers used, people who listened to music received more attention from researchers than did people who got standard or no treatment for their sleep problems. This means that sleep improvements in the music therapy group could be due to that extra attention.
  • Since the different studies used different kinds of music, researchers could not single out which type of calming music improved sleep the most.
  • All of the people in the study had similar kinds of sleep problems. This means listening to music may not help people with other kinds of sleep problems.

What this Study Means for You

If you’re having trouble sleeping, listening to music can be a safe, effective, and easy way to help you fall and stay asleep. It may also reduce your need for medication to help you sleep.

Source: Health in Aging

Being a ‘Night Owl’ Raises Odds for Diabetes If You’re Obese

Alan Mozes wrote . . . . . . . . .

Though obesity by itself can drive up heart disease risk, new research suggests diabetes and heart disease risk is especially high when combined with a tendency to stay up late at night.

The finding stems from a comparison of sleep patterns and disease in 172 middle-aged people as part of an ongoing obesity prevention study in Italy.

“The sleep-wake cycle is one of the most important behavioral rhythms in humans,” said lead researcher Dr. Giovanna Muscogiuri. She is an assistant professor in the endocrinology unit of the University of Naples Federico II, in Italy.

For the study, her team grouped participants according to their sleep patterns.

Nearly six in 10 were early risers — the so-called “morning larks.” These folks tend to wake up and be most active early in the day.

About 13% were “night owls.” They tended to wake up late and be most active during late afternoon or evening.

The rest — about three in 10 — fell somewhere in between (the “intermediate-type”).

Though study participants in all three groups had similar BMIs, night owls were more likely to eat big dinners and have other unhealthy habits, such as tobacco use and lack of exercise. (BMI, or body mass index, is an estimate of body fat based on height and weight.)

And all that put them at higher risk for health problems.

While 30% of morning larks had heart disease, that figure hit nearly 55% among night owls, the study found.

The risk of type 2 diabetes, meanwhile, was about 9% among morning people, and almost 37% among night owls. There was no difference between morning people and participants who were in the intermediate-type category.

Muscogiuri noted that prior studies have estimated that late risers have 1.3 times the risk of high blood pressure and high cholesterol, compared with early risers. They are also less likely to follow a heart-healthy Mediterranean diet, which is heavy on fruits, vegetables and fish.

Taken together, she said, all these features leave night owls at higher risk for heart disease and type 2 diabetes.

As to the best way to combat it, Muscogiuri suggested that efforts to get obesity under control might be more successful if sleep patterns were taken into account.

So the idea, she explained, would be to help obese patients develop better sleep-wake habits based on earlier rising, because earlier rising patterns might help such patients develop better dietary and activity habits, and thereby “increase their chance of success for weight loss.”

Unfortunately, getting people to change their sleep, eating and activity routines won’t be easy, warned cardiologist Dr. Kenneth Ellenbogen, of the Medical College of Virginia, in Richmond.

“We know how hard it can be to reset an individual’s biological clock or activity habits,” he said. “And while this is certainly fascinating work, it’s really hard to know what’s really going on from one observational study involving a relatively small number of patients.”

Ellenbogen noted, for example, that it’s unclear whether “sleeping in” is a direct cause of the increased risk for type 2 diabetes or heart disease, or whether it’s the lifestyle associated with sleeping in that indirectly raises risk.

“It’s not at all obvious to me what the answer is,” he said after reviewing the findings. “And I certainly wouldn’t say this study proves anything like cause and effect.”

Ellenbogen suggested that the research should be regarded as the start of an ongoing effort to explore links between sleep patterns and heart function.

Muscogiuri’s team presented the findings at a virtual meeting of the European Congress on Obesity. Research presented at meetings should be considered preliminary until published in a peer-reviewed journal.

Source: HealthDay