If there is one health worry that seems to eclipse all others when it comes to getting older, it is the thought of falling prey to Dementia; a condition that instils the ‘fear factor’ in us all. Indeed, a study conducted by Alzheimer’s Research UK has shown that Dementia is in fact the public’s number one fear ahead of cancer. But does this need to be the case?

With over 30 years spent researching Alzheimer’s disease and over 200 published peer-reviewed papers, Professor Dale Bredesen, Augustus Rose Professor at UCLA and Founding President of the Buck Institute for Research on Aging, has developed The Bredesen Protocol™, a multi-factorial approach that includes diet and lifestyle changes, and that has so far successfully and sustainably reversed early Alzheimer’s disease in 90% of 110 people.

The Bredesen Protocol™ uses Western medicine for diagnostics and Eastern medicine as the framework for the components that are going to make us well. These include a plethora of lifestyle and nutrition related changes to day to day life and today we look at just one of these; sleep.

It’s long been known that people with Alzheimer’s disease don't tend to sleep well and spend more time awake at night. However there has been much uncertainty as to whether poor sleep actually contributes to the onset of Alzheimer’s. In this blog we look at the scientific mechanisms by which poor sleep may contribute to the early onset of Alzheimer’s and what we can do to improve our nightly sleep pattern.

The Bredesen Protocol™ – A quick recap

The Bredesen Protocol™ targets the multiple underlying causes of Alzheimer’s disease, with a goal to improve cognitive function.  The list below outlines the targets of the programme and the physiological biomarkers that it aims to change to improve cognition. It simultaneously addresses:

• Insoluble and soluble beta-amyloid
• Tau and tau tangles
• Metabolic issues
• Inflammation
• Toxicity
• Insufficiency of trophic factors
• Hormone imbalance
• Gut health
• Genetic errors
• Nutrient deficiencies
• Cognitive stimulationLifestyle factors that contribute to the pathology such as poor sleep; stress; lack of exercise; poor diet high in sugar

In light of this collaboration, Professor Bredesen will be visiting the UK this Autumn to provide a talk surrounding the ongoing work concerned with The Bredesen Protocol™.

To find out more about this event please follow the link.

 Sleep and Alzheimer’s

8 hours of uninterrupted sleep is probably a dream for most of us. But sleep is a vital part of The Bredesen Protocol™ and indeed in attempting to reverse and prevent Alzheimer’s disease.

Why?

During sleep our body cells detoxify and cleanse, and our brain cells are no exception to this. When we are in darkness the pineal gland releases a hormone called melatonin (we have written a blog on the hormone 'melatonin' - please follow this link to read more) which among other things is responsible for restful sleep.

Recent evidence from a study published in the Frontiers of Science has found a significant role for melatonin in neurodegenerative disorders. It is protective against:

• Alzheimer’s disease
• Parkinson’s disease
• Huntingdon’s disease
• Amyotrophic lateral sclerosis
• Multiple sclerosis

Melatonin is a natural hormone produced by the pineal gland – a ‘pea sized’ gland located just above the middle of the brain. It is the hormone responsible for the regulation of our internal body clock which is also referred to as the “circadian rhythm”.

The production of melatonin is influenced by the amount of light in the external environment. Darkness stimulates the production of melatonin while brightness produces the opposite effect. The presence of light – whether it be artificial or natural – inhibits the production of melatonin.

The precursor to melatonin is serotonin, a neurotransmitter that is derived from the amino acid tryptophan. Within the pineal gland, serotonin is acetylated and then methylated to yield melatonin.

Melatonin:

• Up-regulates antioxidant defence systems
• Helps reverse inflammatory processes
• Aids the breakdown of beta amyloid plaque
• Protects brain mitochondria from free radical attack
• Inhibits tau tangles from forming
• Helps promote Brain Derived Neurotrophic Growth Factors for the development of new healthy neurons

Amyloid Plaques

During sleep, metabolic activity is switched off and catabolic activity is initiated which places our bodies into a state of autophagy; a process which allows the degradation and recycling of cells all around the body.

One of the most important phases of autophagy is the breakdown of abnormal proteins such as amyloid plaques – the build-up of which, as mentioned above, is largely associated with the pathology of Alzheimer’s disease.

Indeed, research cited on the National Institute of Aging Website backs up this claim:

“Studies in laboratory animals show a direct link between sleep and Alzheimer’s disease. One study in mice, led by researchers at Washington University, St. Louis, showed that beta-amyloid levels naturally rose during wakefulness and fell during sleep (Kang et al., 2009). Mice deprived of sleep for 21 days showed significantly greater beta-amyloid plaques than those that slept normally. Increasing sleep had the opposite effect—it reduced the amyloid load.”

Free radicals

The process by which neurodegenerative diseases occur is extremely complex and multifactorial; there is very rarely one cause. However, one known factor is the action of ‘free radicals’ that cause oxidative stress and inflammation in the body. When an imbalance between free radicals and antioxidants occurs in the body this causes oxidative injury – a known precursor to neurodegenerative disease.

Free radicals cause the destruction of cells, particularly in the brain where the neurons are so exposed.

Research has suggested that “melatonin exerts an important protective role against free radical injury by stimulating gene expression for antioxidant enzymes and it may be considered as a potential therapeutic agent in some age-related neurodegenerative diseases.”

Scientists have also considered that the high incidence of neurodegenerative disease increases with age because of the inefficiency of antioxidant defences and the increase of mitochondrial dysfunction. Because melatonin can efficiently cross the blood-brain barrier and has a low toxicity, scientists consider that it could be useful as part of a treatment for the prevention of Alzheimer’s disease.

Mild Cognitive Impairment

Research has also suggested that subjects with Mild Cognitive Impairment – a common precursor to Alzheimer’s disease – showed significant cognitive improvement when supplementing with melatonin:

“A recent human study assessed the benefit of melatonin in 50 sufferers of mild cognitive impairment (MCI), a collection of conditions that precedes dementia and Alzheimer’s disease. After giving melatonin 3-9 mg daily at bedtime for 9-18 months to half of the study group, researchers found that the supplemented patients had significantly better performance on a host of neuropsychological tests while experiencing improvements in sleep quality and wakefulness.”

Melatonin is only available on prescription in the UK in doses of over 1mg. Doses vary from 2-4mg at bedtime. However, new research shows we need much less melatonin than was previously thought – 100ug/day women and 150ug/day for men and at that level it is safe to be used ongoing.

 Tips for ensuring a good night’s sleep

Keep a regular sleep cycle

• Set a regular bedtime – go to bed at the same time each night. Choose a time when you generally feel tired so you are ready for sleep and try not to break the routine.
• Wake up at the same time each day, even at weekends. If you are getting enough sleep you should naturally wake up without an alarm clock.
• Nap to make up for lost sleep during the day if you can, rather than disturb your normal sleep/wake cycle.
• Fight ‘after dinner drowsiness’ otherwise you will find yourself waking through the night

• Melatonin is a naturally occurring hormone that is controlled by light exposure that helps regulate your sleep-wake cycle. Melatonin is secreted in times of darkness and makes you feel sleepy. But many aspects of modern life can disrupt your body’s natural production of melatonin and with it your sleep/wake cycle.
• Spending long days in an office away from natural light, for example can impact your daytime wakefulness and make your brain feel sleepy. The bright lights at night from appliances such as TV’s and computers can suppress the natural production of melatonin and make it a lot harder to sleep.

• Ensuring daytime full light exposure ie getting outside during daylight hours everyday
• Having time before bedtime in naturally dimming light away from bright screens (such as the aforementioned TV’s, computers and mobile phones).
• It is essential to sleep in quiet and darkness and if you wake during the night don’t put on bright lights, use a low wattage bulb.
• Some people do not convert serotonin to melatonin effectively. The conversion can be supported by providing substrate and cofactors for melatonin synthesis eg 5-HTP, B6 and magnesium. Methylation is also involved in melatonin synthesis so adequate folate and B12 are also important.

• If you make a consistent effort to relax and unwind before bed you will sleep easier and more deeply. A peaceful bedtime routine sends powerful signals to your brain that it is time to wind down and let go of the day’s stresses.
• Keep noises down. Earplugs might also help.
• Keep your room cool. Most people sleep best at around 18 degrees celcius with adequate ventilation.
• Make sure that your bed is comfortable. If you often wake up with a sore back or neck you might need to change your mattress or pillow.

• Try to make dinnertime early in the evening and at least 3 hours before bedtime. Fatty and spicy or rich foods are best to avoid in the evening. Raised insulin from late night eating can suppress melatonin.
• Avoid alcohol before bed.
• Cut down on caffeine – some people take 12 hours to metabolise caffeine.
• Avoid drinking too many liquids in the evening as it will cause you to wake in the night.
• Quit smoking. Smoking causes many sleep problems in numerous ways. Nicotine is a stimulant, plus smokers experience nicotine withdrawal during the night making it much harder to sleep.

Biofood Magnesium – a co-factor in the synthesis of serotonin from melatonin.

5-HTP Plus – 5-HTP is a precursor to serotonin and melatonin. Also containing B6 and magnesium that are cofactors for serotonin.

Cyto-Night – Montmorency cherry, a natural source of melatonin with glycine, magnesium and hops.

Vitamin B6 – An important cofactor for serotonin / melatonin synthesis

Cautions:

Magnesium – may amplify the effects of anti-hypertensive, anti-angina, anti-arrhythmic and anti-coagulant drugs.

5-HTP – may have an additive effect with anti-depressants increasing the risk of serotonin syndrome. If you are on anti-depressant medication consult a doctor before use.

Cyto-Night – ask your doctor before taking if you are currently taking any other medications to help with sleep.

A Cytoplan Education Event – Thursday 8th September, 10.00am – 5.00pm.

Cavendish Conference Centre, 22 Duchess Mews, London, W1G 9DT

Professor Bredesen will be speaking at our Cytoplan Education Event on 8th September on the scientific basis and unprecedented clinical results of The Bredesen Protocol™.

Dr Rangan Chatterjee (well-known for his ‘prime time’ BBC series ‘Doctor in the House’)  will speak about his role as lead clinician for The Bredesen Protocol™ in the UK, heading a team of doctors, nutritional and lifestyle therapists and the pre-clinical research. 

To find out more, and to book your place, please click here.

If you have any questions regarding the health topics raised in this article then please do get in touch via phone (01684 310099) or e-mail (amanda@cytoplan.co.uk)

Amanda Williams & The Cytoplan Editorial Team: Joseph Forsyth, Clare Daley and Simon Holdcroft