The Real Reason Why You Can't Sleep at Night

Another night spent tossing and turning...

It's an all-too-familiar feeling. You feel exhausted, but as you lie in bed, you can't relax enough to fall asleep. You watch the clock tick away the minutes, then the hours. The little sleep you finally manage to get is fitful and you wake up groggy and irritable.

For millions of Americans, insomnia is a part of life. If you live with this problem, you're not just waking up feeling tired... you're also waking up with an increased risk of dementia.

Insomnia has a number of causes...

  • Back pain
  • Reflux and heartburn
  • Allergies and hay fever
  • Too much caffeine close to bedtime
  • Too much blue light exposure at night
  • Shift work

And more...

But there's one significant underlying cause that many folks, particularly older folks, shrug off: Anxiety.

Many people dismiss anxiety as a typical sign of aging.

You've probably done it. Think about the last time you visited your parents or another loved one in a senior living community. Did you notice changes in appetite, poor sleep, or trouble concentrating? Did they hoard food or avoid participating in any social activities?

It turns out, these are all markers for generalized anxiety disorder ("GAD") – the most common of all anxiety disorders.

We're seeing diagnoses of GAD spike in the U.S. As many as 40 million Americans have a type of anxiety disorder. And many more don't even have a diagnosis. That's due to increased stress from daily life – something we've discussed before.

In fact, we told you about an unconventional indicator on the state of our health in 2017. Bookseller Barnes & Noble reported that in 2017, sales of books about anxiety jumped more than 25%. A 2016 study backs this increase up – it found higher-income countries like the U.S. had much higher rates of anxiety than in previous years.

But despite all of the folks buying books about anxiety, there are plenty more suffering from symptoms without a diagnosis. Worse, people 65 and older are more likely to suffer from it, often without help.

For years, we assumed that anxiety was a by-product of diseases like Alzheimer's. But as we wrote in 2018, we now know that anxiety is also a precursor.

A study out of the Washington University School of Medicine looked at the connection between high stress levels and Alzheimer's.

They found that high stress triggers the release of a signaling chemical in the brain called corticotropin-releasing factor ("CRF"). CRF releases compounds called amyloid-beta peptides, which form those plaques we see in Alzheimer's.

A study from Brigham and Women's Hospital in Boston took this idea further...

Researchers looked at 270 adults aged from 62 to 90. Participants had brain scans every year for five years to measure levels of those compounds. Researchers also tracked anxiety and depression.

What they saw was that participants who had higher levels of anxiety over those five years also had more amyloid beta in their brains.

What's more, the researchers believe that testing folks for anxiety early on may help them catch Alzheimer's sooner... which means starting treatment sooner.

Even better, given the role of CRF and its relation to stress, treating anxiety early might also help slow Alzheimer's. It's a novel idea to treat anxiety as a way to alleviate and possibly prevent dementia symptoms.

But there's another link we need to understand: Untreated anxiety increases insomnia... and insomnia is a likely culprit behind Alzheimer's, too.

Researchers suspect that Alzheimer's results from the brain not being able to filter out debris and damaged proteins. That can lead to things like plaques. Plaques are clumps of proteins that stick to the brain's nerve cells and damage them.

Healthy brains get rid of this debris as we sleep through the glymphatic system. It's like a trash-disposal system that uses fluid to clear out our cells.

Lately, we've seen more studies illustrating how interrupted sleep or insomnia disturb this system. That means you're at a higher risk of debris piling up and causing damage.

In fact, a Taiwanese study found that in folks under 40, those with insomnia had a significantly higher risk of later developing dementia.

If you find yourself struggling with sleep this winter, take steps to deal with any stress and anxiety you may face. Remember, seasonal affective disorder ("SAD") hits folks this time of year due to the lack of sunlight. It causes symptoms of depression, one of which is heightened anxiety.

A good fix: Get plenty of sunlight. Sun benefits our health by triggering our bodies to produce vitamin D isomers (different versions of the basic chemical). Studies show that having adequate amounts of vitamin D reduces the risk of Alzheimer's, lessens symptoms of mild depression, and helps our bodies regulate calcium absorption, which keeps our bones strong.

Simply exposing your skin to sunlight for 20 minutes or so a day can be enough to fight winter depression. I try to take a walk or two during the day when I'm at my office in Baltimore... even if it's just to go get lunch. I also keep the shutters on my windows open to let in as much light as possible while I sit at my desk.

To help beat stress, sleep better, and stave off dementia, I recommend the following:

  • Enjoy scents like rose and lavender (I travel with a vial of rose oil and put it on my pillow before bed)
  • Meditate
  • Eat foods from the Mediterranean diet
  • Practice good sleep habits
  • Listen to music
  • Exercise

No matter which stress-reduction tactic you start, make sure to take time for your mental health. Too often folks overlook problems like anxiety. But with new insight into how it relates to dementia, you can't afford to let it go unchecked.

Here's to our health, wealth, and a great retirement,

Dr. David Eifrig and the Health & Wealth Bulletin Research Team
December 29, 2021