Is there a relationship between sleep and Alzheimer's?

(The Herald Bulletin) The quality of sleep, already so mysterious, and how a poor night of snoozing is treated now might be linked to Alzheimer's disease.

Research by Hoosier Kathleen Vernon that she presented at a July 15 Alzheimer's Association International Conference in Los Angeles has landed in The London Times, a medical journal for Asian physicians and AARP.

When the 2007 Batesville High School graduate completed a master's degree in 2018 at Utah State University, Logan, her thesis focused on examining sleep disturbances and long-term sleep medication use in males and females with regards to the risk for developing Alzheimer's disease. A group of 3,656 adults 65 and older participated in the study that she authored.

The results varied by gender. Men who used sleeping aids were 3.6 times more likely to develop Alzheimer's disease.

Women's risk for the illness depended on whether they reported having a history of insomnia. When women did have that problem, taking a sleeping medication was associated with a 35 percent reduced risk of Alzheimer's disease. But Alzheimer's risk was nearly four times higher among women who didn't report having sleep disturbances and who took sleeping pills to, say, counter sleep loss associated with chronic pain or another condition.

Vernon, who is known professionally by her first name, Elizabeth, doesn't want people to leap to conclusions. She points out these varying statistics may stem from underlying health challenges, the type of sleeping aid used, hormonal differences, or variations in the sleep patterns of men and women.

The student was surprised females with sleep issues, like insomnia, and taking sleeping aids had a reduced risk. "These medications often have several negative side effects, especially among adults 65 and older, and I had anticipated that the results would have been similar to the findings in males."

More questions need to be answered. She advises, "Future research should examine the underlying mechanisms that may be associated with the differences in males and female’s risk of Alzheimer’s disease with sleep medication use. We have some research to suggest females tend to have more sleep complaints than men and that men and women appear to have differences in prescription rates of these classes of medications (benzodiazepines and antidepressants). It would be interesting to examine how these differences may impact risk as well as the underlying cause of the sleep disturbance. For example, pain might be associated with the cause of the sleep disturbance and those individuals may be taking a nonsteroidal anti-inflammatory drug, which in our Cache County sample has been associated with reduced risk for Alzheimer’s disease.

"In addition, it would be interesting to examine the specific medication class (i.e. benzodiazepine, antidepressant and antihistamines) and risk for Alzheimer’s disease. We were unable to examine this in our sample."

"The final product took approximately three years to complete. One of the reasons for this was I was taking a full courseload as well as doing clinical work. The other reason was needing to take statistical analysis courses that would allow me to understand and conduct my own analyses."

After graduating from Indiana University with a Bachelor of Arts degree, Vernon was employed at the Knight Alzheimer’s Disease Research Center at Washington University School of Medicine in St. Louis, where she worked as a psychometrist (a person who administers tests looking at memory and thinking abilities). "This experience started my career in the clinical field and allowed me to gain research experience. It was here that I started to enjoy clinical work."

One mentor discussed the versatility of a clinical psychology degree. She recalls, "I decided that this would be a good fit for me. It wasn’t until after my second year in the program at Utah State University that I realized how much I enjoyed clinical work and wanted to pursue a career primarily focused on clinical work rather than research."

She remains at the USU Psychology Department as a doctoral student in the combined clinical/counseling Ph.D. program and has been working in the Alzheimer's Disease and Cognitive Disorders Lab. The student has completed practicums at the Student Health Center and a psychology community clinic at the university.

She explains, "My main area of interest and my current clinical experiences have focused on neuropsychology. This looks at the brain, how it relates to behavior and focuses on cognitive functioning, emotional functioning and personality and how this is informed by environmental factors within the history of an individual. I work primarily with adults, older adults and adolescents and I tailor a battery of tests to examine their presenting concerns, such as anxiety, depression, ADHD, learning disabilities, cognitive decline, dementia and TBI (traumatic brain injury) with the help of my supervisor. I then make recommendations and next steps to help adjust or handle these difficulties or concerns.

Of earning a Ph.D., Vernon observes, "The beauty of this degree is the flexibility it allows me. I would be able to work in a research, clinical or private practice. I ideally would like to be able to do a little bit of everything. I would like to work in the field of neuropsychology either in a medical setting or private practice and conduct some research on the side."

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