A common sleeping medication, once only known for aiding insomnia, now shows surprising potential to reduce proteins linked to Alzheimer’s disease development, giving hope to millions concerned about cognitive decline.
At a Glance
- Suvorexant, a dual orexin receptor antagonist used for insomnia, may reduce levels of amyloid beta and tau proteins associated with Alzheimer’s disease
- Sleep disturbances are both an early sign of Alzheimer’s and can accelerate brain changes linked to the disease
- Research shows high doses of suvorexant led to a 10%-20% drop in amyloid levels and a 10%-15% drop in tau protein levels
- Scientists caution it’s premature for people to take the medication solely for Alzheimer’s prevention
- Sleep is critical for brain waste removal through the glymphatic system, which clears proteins linked to neurodegenerative diseases
The Dual Promise of a Common Sleep Aid
The relationship between sleep and Alzheimer’s disease has gained significant attention in recent years. Sleep disturbances affect up to 50% of individuals with moderate to severe Alzheimer’s disease, and growing evidence suggests poor sleep may not just be a symptom but also a contributing factor to disease progression. Now, an FDA-approved medication for insomnia may offer unexpected benefits against the disease itself, potentially addressing both problems simultaneously.
Researchers have discovered that suvorexant, marketed under the brand name Belsomra, appears to reduce levels of proteins associated with Alzheimer’s disease. In a proof-of-concept study, high doses of the medication led to measurable decreases in both amyloid beta and hyperphosphorylated tau proteins in the brain—key markers of Alzheimer’s disease pathology.
— Kamil Banc (@kamilbanc) August 29, 2024
How Sleep Affects Brain Health
Sleep plays a crucial role in brain maintenance through a recently discovered waste-clearance pathway called the glymphatic system. During sleep, especially deep non-REM sleep, the brain engages in a cleaning process that removes protein waste, including amyloid and tau. This cleaning process appears to be facilitated by slow-wave activity, micro-arousals, and fluctuations in the neurotransmitter norepinephrine, creating optimal conditions for waste removal.
Poor sleep means this cleaning process doesn’t function optimally, potentially allowing harmful proteins to accumulate over time. Sleep problems increase with age, just as Alzheimer’s risk does, creating a concerning overlap. Notably, sleep disturbances often precede other symptoms of Alzheimer’s disease, sometimes appearing years before memory problems become evident.
Conflicting Evidence on Sleep Medications
While the news about suvorexant is promising, the relationship between sleeping medications and dementia risk shows concerning contradictions. Some research indicates frequent use of certain prescription sleeping pills is linked to an increased risk of developing dementia in older adults. A study found white adults who frequently used sleeping medications had a 79% higher risk of developing dementia compared to those who rarely or never used them.
The difference appears to be in how various sleep medications work. Some, like zolpidem (Ambien), might suppress the glymphatic system’s cleaning function. Suvorexant works differently, targeting the orexin system that regulates wakefulness without the same apparent negative effects on brain cleaning mechanisms. This distinction could explain the contradictory findings regarding sleep aids and brain health.
Caution Against Premature Use
Despite the encouraging findings, researchers strongly caution against using suvorexant solely for Alzheimer’s prevention at this time. The medication has potential side effects, including depressant effects and daytime impairment, and it’s not currently approved for treating or preventing Alzheimer’s disease. Long-term studies are still needed to determine if the reductions in harmful proteins translate to meaningful protection against cognitive decline.
For those concerned about brain health and sleep, experts recommend first addressing sleep hygiene and treating underlying sleep disorders like sleep apnea. Cognitive behavioral therapy for insomnia remains the first-line treatment for chronic sleep problems. The hope is that ongoing research will eventually lead to medications specifically designed to enhance sleep quality while protecting brain health, potentially offering a powerful tool against Alzheimer’s disease.
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