A new study linking disrupted sleep patterns to changes in brain regions associated with Alzheimer’s disease is renewing attention about the importance of healthy sleep habits.

Research published in the Journal of the Alzheimer’s Association suggests that fragmented circadian rhythms, irregular sleep and wake cycles, may be linked to shrinkage in areas of the brain tied to memory and cognition. While experts caution that the findings are still preliminary, they say the study adds to growing evidence that poor sleep can have serious long-term health consequences.

“So it’s not a direct linkage that says, you know, if you have fragmented sleep, or if you sleep too much during the day, that you’re obviously going to get dementia,” says Bradley Gleason, MD, internal clinical director, OSF Sleep Lab in Peoria, Illinois. “But the linkage is strong enough, and it points to needing more studies and more data down the road that there could be a significant link so obviously it’s very important to clean up your sleep disorders so that the risk of dementia and Alzheimer’s potentially is lowered.”

Researchers have long known that sleep affects multiple systems throughout the body, including cardiovascular health, immune function and mental performance. The latest findings raise concerns that chronic sleep disruption could also contribute to neurodegenerative diseases over time.

Don’t ignore sleep issues

Dr. Gleason says many people still underestimate the importance of sleep, often delaying treatment for sleep disorders such as insomnia or obstructive sleep apnea.

“We have lots of other data about cardiovascular health and high blood pressure and stroke and all that we know is linked to poor quality sleep and not getting enough sleep,” Dr. Gleason shares. “So absolutely, yeah, you want to take this seriously. I’m obviously biased but we want to attack your sleep problems head on as early as we can.”

The growing role of wearable devices such as smart watches and sleep trackers in monitoring sleep habits can be helpful. But Dr. Gleason stresses that while those tools can provide useful information, they are not always reliable enough to replace formal sleep evaluations.

At the study’s conclusion, researchers found that participants with more consistent daily sleep-wake patterns had larger volumes in the memory-associated brain areas – the hippocampus and parahippocampus – and less shrinkage of the amygdala, a region vital to emotional processing.

When sleep is fragmented, the body becomes stressed according to Dr. Gleason.

Bad sleep impacts your immune system

“So, you’re not sleeping well and therefore you’re going to have the immune-related ways your body kind of fixes itself is not happening and so your cells are dying off and that could lead to some of the study results that now you’re getting atrophy in some of those important brain areas. So that’s what I would say ‘I need to try to fix why are you having these troubles so we can address it now.’”

According to Dr. Gleason, future research will be needed to determine whether poor sleep directly contributes to dementia risk or whether early brain changes themselves disrupt sleep. In the meantime, the message is straightforward: addressing sleep problems early may help protect long-term health.

“There is a link potentially between poor quality sleep and potentially long-term bad outcomes, including memory problems and/or Alzheimer’s disease. It just points to the importance of sleep quality now to avoid those problems later.”

Here are some tips for getting good sleep to potentially help brain health as you age:

• Waking up at about the same time every day
• Getting bright light exposure in the morning
• Staying physically active during the day
• Keeping meals and bedtime consistent
• Limiting long or late naps
• Avoiding caffeine or alcohol too close to bedtime

If you are having trouble getting to sleep or staying asleep, start by talking to your primary care provider. They might also refer you to a sleep specialist at an OSF Sleep Clinic.

Dr. Bradley Gleason

B-roll-Poor sleep and brain issues

It’s no great surprise to read that men and women both benefit from working out.

But women may receive greater benefits from regular exercise than men, according to a study published in the Journal of the American College of Cardiology.

The study centered on the importance of exercise as a way to avoid dying prematurely. The researchers studied data from 400,000 people and found that women who exercised were 24% less likely to die early from any cause. Men who exercised, however, were 15% less likely to die early.

The study also revealed that the women who exercise had a 36% lower risk of dying from a cardiovascular event, compared to men at 14%. That’s important because women have twice the risk of dying from a heart attack than a man.

Mary O’Meara is a nurse practitioner with OSF HealthCare. She says society still views heart attacks more as a man’s disease. That’s simply not true.

“Usually, a male is feeling this really bad chest pressure, chest pain going in the left arm into the jaw, very pale. Women, very often, will just complain of fatigue, nausea or heartburn. ‘I feel wiped out. I just can't walk across the room. I need to sit down,’” explains O’Meara. “Unfortunately, that can be a sign of a heart attack in a female, and it gets missed quite often.”

While any movement is good, O’Meara stresses the importance of women incorporating strength and/or resistance training, such as lifting weights. Frequency and the amount of weight depend on the person and their situation.

“For a long time, women were encouraged to do more aerobics-calisthenics. We were always thought of as the weaker sex, I guess you can say, and we weren't really encouraged to do any weight bearing exercise,” says O’Meara. “A lot of research has come back that states that women should be focusing on weight bearing exercises for several different reasons.”

Strength training can also help women as menopause becomes an issue. According to O’Meara, hormones start changing between the ages of 40 and 50 – a time when women start losing muscle and see an increase in body fat. Strength training can help with that change, along with other health issues.

“We found that weight bearing exercise can reduce our risk of dementia and Alzheimer's, and also reduce our risk of osteoporosis, which is a big one,” says O’Meara.

O’Meara also has a nutrition tip for her patients. Protein, she says, is important for women to prevent muscle loss, especially during menopause. O’Meara recommends 30 grams of protein before and 15 grams after a workout, to help rebuild muscle that has been naturally broken-down during exercise.

Additionally, O'Meara is a proponent of healthy fats. She encourages patients to incorporate grape seed oils, olive oils, fish oils, flax seed oils, nuts and avocados into their diets.  Her philosophy is that good fats battle bad fats, and good fats protect our heart.

O’Meara stresses that it's never too late for women to start exercising. Even a short walk or work around the home, for instance, can go a long way to a healthier future.

“You read many testimonials from people who were couch potatoes and never exercised,” she says. “And then, they go into these exercises and do wonderful things that have really made a difference.”

For more information on women’s health, visit the OSF HealthCare website.

Interview Clips 

“Mom! I have to go!”

“Hold it!”

It's an exchange you probably had as a kid on long car rides. But Uwais Zaid, MD, says it’s not just a funny vacation story. A person of any age or profession can find themselves holding their urine for a long time.

“In the medical field, we see this all the time,” says Dr. Zaid, a urologist who sees patients at OSF HealthCare. “When you’re rushing from patient to patient, doctors, nurses and technicians might not go to the bathroom as much as they should. They hold their urine the whole day.”

Dr. Zaid is sharing his playbook: why this phenomenon happens, how to fix it and what can happen if you don’t.

Why do we hold our pee?

Dr. Zaid says some people hold their urine simply based on the situation. They’re on a long car ride, and stopping will make them late. Or they might be at a dinner party and don’t want to seem rude by leaving the table.

“Then there’s another subset of people who just don’t have the desire to urinate. There’s something medically wrong,” Dr. Zaid explains. “As we get older, we can get dementia and be forgetful. So sometimes people just forget they need to urinate. Sometimes, you can have lack of bladder sensation from neurological conditions like multiple sclerosis. Or they might have had their bladder stretched for so long due to things like an enlarged prostate or scar tissue in the urethra.”

The consequences

In the short term, holding your pee will make you feel uncomfortable and antsy. We all know the feeling. Dr. Zaid has even heard from patients, “The feeling doesn’t bother me that much. What’s the problem?”

A few problems, the doctor says.

“It does increase your risk of urinary tract infections [UTIs]. Your bladder is almost like a swamp instead of flowing like a river. You have stagnation of urine,” Dr. Zaid says. “It can increase the risk of bladder stones. Also, the bladder is connected to the kidneys. It’s one fluid column. So if your bladder gets really distended, it can back up and hurt your kidneys. You can get kidney swelling.

“And when the bladder is chronically distended, you can get pouches called bladder diverticuli. Those pockets can hold on to urine and be sources for infection,” Dr. Zaid adds. Over time, these pouches can also lead to worse urinary control and even the inability to pass urine.

If holding your urine and not getting treatment for it lead to, for example, the kidney issues Dr. Zaid outlined, serious health problems and, rarely, even death are possible. Dr. Zaid says that shouldn’t scare people into drastically altering their bathroom habits. But it is something to be aware of.

Prevention and treatment

So what should be the best practices when we start thinking about the toilet?

• Before you even head for the bathroom, Dr. Zaid urges you to take care of your bladder and kidneys by staying hydrated. The U.S. Centers for Disease Control and Prevention (CDC) says daily water intake recommendations vary by person. So it’s a conversation you should have with your primary care provider. But, the CDC has general tips about staying hydrated and the dangers of drinking sugary or caffeinated drinks often.
   
• Plan ahead. For example, if you have a long commute, leave early to make time for rest stop breaks, and avoid drinks like soda. If you have a busy day at work, make a promise to yourself that you’ll take breaks to use the restroom. You can set a reminder alarm on your phone to nudge you.
   
• Try the “double void.”
  
  “You get to the toilet. You get done peeing. Wait 30 seconds, and then try to get a little more out,” Dr. Zaid suggests. “But don’t bear down and push because that creates trauma for your pelvic floor.”
   
• For older adults who might simply forget to use the bathroom, make sure they have someone checking in on them. Make sure they are empowered to speak up about their health. Setting an alarm reminder and having a clear path to the toilet can also help.

If someone consistently avoids or forgets to urinate or experiences symptoms like frequent UTIs, discomfort or difficulty emptying the bladder, it’s time to see a doctor.

Dr. Zaid says the first thing a urologist would do is look for anything blocking the urine. For men, this could be an enlarged prostate, scar tissue in the urethra, a bladder stone or tumor or trauma to the bladder area. For women, it could be a prolapse, when the bladder falls through the vagina.

“We can look inside the bladder with a camera. We can do a urodynamic study, which tells us about bladder function,” Dr. Zaid says.

Doctors would then form a treatment plan depending on what’s found. For example, bladder stones could be a “wait and see” situation. Or, a doctor could perform a procedure to remove the stones or break them apart and allow them to pass. Dr. Zaid says this is sometimes done with a laser in a minimally invasive procedure.

Dr. Zaid says in some more serious cases, the bladder stops working entirely.

“It’s something we can’t often fix. It’s really frustrating,” Dr. Zaid says.

Those people, he says, would need a catheter. It could be a short-term one to help drain the bladder or a long-term one to help correct the problem for a while.

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Tiffani Franada, DO, is a neurologist with OSF HealthCare who specializes in Multiple Sclerosis. Part of her passion is working with patients choosing brain-healthy diets and lifestyle, which prevents neurological diseases like Alzheimer’s, Parkinson’s and Multiple Sclerosis.

The MIND diet

"The MIND diet is a combination of the Mediterranean diet, which is healthy fats, olive oils, fish, fruits and vegetables. And the DASH diet, which is a low-sodium diet,” Dr. Franada says. “It's particularly helpful for patients who live with hypertension (high blood pressure). The two of those combined seem to be very effective at preventing the development of Alzheimer's."

Patients on the Mediterranean diet often have lower levels of inflammatory markers in their spinal fluid. Higher levels are suggestive of Alzheimer's. Patients also perform better on cognitive testing, Dr. Franada adds.

Fiber-rich foods

"In regard to carbs, whole grains are probably best, and they have really good fiber in them. As well as things like legumes and beans which have good fiber levels, which make you feel full for longer," Dr. Franada says. 

The National Cancer Institute (NCI) lists many high-fiber foods here. Lentils, vegetable soups, whole-wheat bread and pasta make the list. As well as fruits and vegetables like apples, apricots, broccoli and Brussels sprouts.

Berries and antioxidant production

"Blueberries are great, really berries of all kinds. They really help that antioxidant production," Dr. Franada says. "For vegetables, leafy greens are really helpful. They have a good amount of folic acid, which helps to reduce homocysteine (amino acid) in the brain. Homocysteine promotes inflammation and shrinkage in the brain, and we want to reduce that."

“Fats are not the enemy”

The word “fat” oftentimes has a negative connotation to it. Dr. Franada says there are healthy fats out there that offer benefits to brain health.

"Fats are not the enemy. Healthy fats are good for the brain. Your brain requires them, like fatty fish (salmon), which have good Omega-3s in them. If you don't eat fish, flax seed is a great alternative," Dr. Franada says. "Walnuts also have great, healthy fat in them. As well as olive oil, which has monounsaturated fatty acids which protects against inflammation in the brain." 

Lean meats, like chicken and turkey, can be good for brain health because there’s healthy amounts of protein and fiber in them, Dr. Franada says.

Don’t dismiss dark chocolate!

"Dark chocolate is great. Dark chocolate has good amounts of antioxidants. Of course, all things in moderation. But a dark chocolate square once a night, not a bad thing," Dr. Franada says. "Also, caffeine! Believe it or not, a cup of caffeine, like coffee or tea, can help with focus, attention and is helpful for the brain."

Dr. Franada recommends having your caffeinated drink of choice early in the morning, right when you wake up, instead of later in the day. Having it later in the day can give you a lot of energy, which leads to you not sleeping well at night. Sleep is also extremely important for brain health.

Foods to avoid

Ultra-processed foods have been trending lately, with health experts giving them more attention than usual because of their negative effects on people’s health. High sodium, added sugars and excessive amounts of bad fat headline are the reasons why we should avoid them, with these elements being linked to diabetes, obesity and cancer.

Obesity is typically part of a metabolic syndrome, where a person has elevated blood sugars, blood pressure and cholesterol. This puts patients at risk for stroke, sleep apnea, Alzheimer's and many other health issues. Those risk factors can put someone at risk for neurological disease. 

"Heavily processed foods are not great for the brain or the heart. Excess sugars, like added sugars, should be avoided as well. If you're going to have sugar, have something with natural sugar in it," Dr. Franada says. "Berries are much preferred to things with added sugars. Also, white bread and processed carbs should be avoided, too."

Effect on white brain matter

"There's some real-world data showing that the Mediterranean diet can prevent white matter changes on the brain, which are little white spots that develop on patients’ brains as they get older. It's also seen in patients with vascular risk factors," Dr. Franada says. "If you follow the Mediterranean diet pretty strictly, you can prevent getting those white spots. They also found people who adhere to that diet have better structural integrity. The left and right sides of the brain talk better to one another."

What about cheat days?

If you exercise five or six days a week and give yourself a “cheat day” where you splurge a bit, evaluate how the food feels in your body. Instead of packing on the calories and going bananas, Dr. Franada recommends reeling it in a bit and focusing on moderation.

"You'll probably start to recognize it doesn't feel so great," Dr. Franada says. "Maybe it's a chocolate dessert at night, or something smaller that you can do to still stay with your healthy diet, just in smaller quantities." 

Dr. Franada cautions against super rigid diets that make you "fall off the wagon" after a few weeks. "You have to find something that's sustainable for you," Dr. Franada adds. 

Video Interview Clips

We’re talking about sniffing products like paint, markers or nail polish for a temporary high. You might hear it called huffing, chroming or, in the medical community, inhalant abuse.

Health care providers like Justin Rapoff, DO, an emergency medicine physician who sees patients at OSF HealthCare, are again reminding parents about the serious health impacts of this activity and what to do if your child shows symptoms. It’s especially important for kids to steer clear, he says, because their organs are still developing. An interruption to that development could mean trouble. Young people can also be more susceptible to peer pressure, giving in when other kids tell them to try something.

“Inhalant abuse is common because these are things that are easily found in your house," Dr. Rapoff adds. “They’re underneath your kitchen sink and in your garage and bathroom. These are cheap and easy to find for kids.”

The consequences

There are short and long-term effects of inhalant abuse, Dr. Rapoff says. Among the short-term issues is the general haze the activity will put you in. If you have to, for example, drive a vehicle while under the influence, you could crash or face legal consequences. If you’re intoxicated at work or school, your performance will decline.

“You can have cognitive difficulties and even dementia [later in life],” Dr. Rapoff adds of the long-term impacts. “You can have bone marrow suppression and anemia. You can have abnormal coordination.”

Cardiac arrest, when the heart stops beating suddenly, is also possible.

What parents can do

If your child shows signs of intoxication – slurred speech, nausea, confusion and a lack of balance are big ones – call 
9-1-1 and get them to the emergency department.

“Inhalants hit similar receptors to those hit by alcohol. It causes a similar intoxication, which lasts around two to 30 minutes,” Dr. Rapoff says.

That means you should get the child checked out even if they say they feel better. Dr. Rapoff says providers will likely test the person’s blood, urine and heart. There’s no bonafide treatment for inhalant abuse, Dr. Rapoff says. Rather, providers will treat the symptoms. For example, if the child feels nauseous or is vomiting, providers may give an anti-nausea medication.

What about avoiding an unpleasant trip to the hospital in the first place? Dr. Rapoff encourages parents to talk with their kids about the risks of huffing and, generally, any emotional issues they are dealing with. The young ones may be turning to inhalants to cope. In fact, Dr. Rapoff says studies have shown that when young people abuse inhalants, they are more likely to use heroin or even commit suicide later in life.

Parents should also pay attention to kids’ behavior, especially if they make unexplained purchases of things like hairspray or whipped cream canisters. Keep items that could be misused out of reach. Put things like markers and cosmetics out only when it’s time to use them. Keep things like spray paint and gasoline canisters locked up in the garage.

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Hearing loss can affect anyone. According to some studies, about 23% of Americans ages 12 and older experience hearing loss. While it can be mild or severe, hearing loss can also increase the odds of developing dementia later in life.

That’s according to a study published in JAMA that focused on people ages 70 and older.

While the reasons aren’t clearly understood, it’s important to note that there is a causal effect between hearing loss and dementia, according to Christopher Workman, Au. D., an audiologist with OSF HealthCare.

“There's enough research out there that shows some link to it," says Dr. Workman. "Some of that may be related to the hearing loss itself. Some of it may be related to the effects of hearing loss, which could include loneliness, depression, or lack of social interaction. There may be a direct and indirect cause to dementia, Alzheimer’s, and those type of things.”

In the past 30 years Dr. Workman has seen several patients with cognitive issues including dementia, and that number is growing. Some of their symptoms are significant, which he says raises concerns about their cognitive capabilities.

He adds that one way to prevent feelings of loneliness, depression and to stay socially active is by wearing hearing aids.

“I've read a number of these studies over the past several years and there's some debate as to exactly what's happening or what's causing it," he says. "But I think that hearing aids can play a role in minimizing the potential for dementia occurring. Obviously, you could still have dementia without and have good hearing. You could also have dementia and have hearing aids early on and still have dementia. It's not a cure, but it can help minimize some of the factors that may lead to dementia.”

But getting someone to wear hearing aids isn’t always easy. Some people cite the cost of the devices, while others have issues with sound quality. Other reasons are more of a social stigma – hearing aids are associated with becoming older, and some people have a difficult time with that reality.

A new Illinois law was signed in August, which requires all insurers to provide coverage to Illinois residents if their doctor prescribes a hearing instrument. This expands on a bill in 2018 that required insurers to cover hearing aids for children under the age of 18.

“When we see a patient, I try to kind of screen where they're at mentally, as far as the acceptance of the idea of hearing aids and sometimes I'll recommend they wait if they're not mentally ready, because the last thing we want as people buying hearing aids and they sit in a drawer, so the key is mental acceptance," says Dr. Workman. "And then the second key is committing to the idea of wearing them and wearing them all day. Because if you only wear them for an hour a day, they're not providing the benefit that they need. We want to keep stimulating the auditory pathway to prevent any atrophy from occurring.”

The goal is to treat the patient’s hearing loss as soon as possible before they experience any signs of dementia or cognitive decline. Many times, if an audiologist does suspect some cognitive decline, he or she will refer the patient back to their primary care provider for further evaluation.

Dr. Workman stresses that not everyone who experiences hearing loss is going to get dementia. But he encourages patients and family members to pay close attention to potential warning signs such as asking people to repeat themselves, accusing people of mumbling or turning up the volume on the TV, for example.

“When you start realizing you're withdrawing or the spouse or children recognize that they're withdrawing, then it's time to have something done," he adds. "Get it checked out, find out what's going on and then address it before it continues to lead to further isolation, depression and loneliness.”

Dr. Workman is optimistic that the medical community will have a better understanding of the connection between hearing and dementia in the next several years as more data is compiled and further research is conducted.
 

Interview Clips 

Anxiety. Depression. Bipolar disorder. Schizophrenia.

They’re daunting diagnoses, but necessary to think about for many people.

And experts say those concerns don’t magically go away when a person reaches age 60 and beyond. Rather, older adults need to keep mental health care in mind and know the resources available to help with concerns unique to that age group.

Ari Lakritz, PsyD, is a clinical psychologist at OSF HealthCare who has taken a keen interest in this area.

“As individuals grow older, they start to prioritize their emotional needs over their professional, financial or more mundane needs,” Dr. Lakritz says. “So you may be surprised when you work with an individual who’s older at how quickly they want to work on the problems in their life and how solution-focused they are as compared to their younger cohorts.”

Dr. Lakritz has seen plenty of examples of this research-backed idea as he’s conducted counseling sessions. For example, an older adult may want to dive right into talking about death or family disputes that have been festering for years.

How does a mental health professional achieve results with this age group? Dr. Lakritz points to a concept called interpersonal therapy, which focuses on a person’s relationships and their overall place in the world.

“That is really what older adults have on their mind at this stage of their life. Many of them are retired. For many of them, financial issues or their professional climbing of the ladder have kind of taken a backseat,” Dr. Lakritz reiterates. “They are focused on their remaining relationships and making them as good as possible.”

A therapy session for an older adult may be structured the same as a younger person’s visit. But a psychologist would need to keep in mind the person’s needs. If the patient has mobility issues, for example, the office should be easy to get in and out of. If the person is homebound, a home visit or virtual visit would be necessary.

Those telemedicine appointments, Dr. Lakritz says, took on extra importance during the pandemic. Some older adults were already isolated, and COVID fears or government mandates to stay home separated them further from visiting their loved ones and practicing social or coping skills. Card games were replaced with phone calls. A trip to the community theater was scuttled in favor of watching the show on DVD.

“On the plus side, I think everyone saw and was pleasantly surprised at how quickly older adults managed to understand technology,” Dr. Lakritz says.  “[They] understand remote meetings and how to participate almost as fast as younger adults who also had to adjust very quickly.

“That was a big game changer in the field that is not going away anytime soon,” Dr. Lakritz says.

Not to mention the sense of pride from an old dog learning new tricks, as the saying goes.

“It’s very much emphasized, even in old age, to continue to pick up new skills. To acquire new knowledge,” Dr. Lakritz says. “That does lead to a great deal of self-esteem. And cognitive stimulation, learning new things, reasoning and being intellectually challenged are some of the biggest protective factors against dementia.”

One last thing Dr. Lakritz says clinicians should keep in mind when serving older adults: confronting biases or falsehoods about that generation.

For example: older adults are slower workers. The data say that’s more folklore than fact, Dr. Lakritz says.

“Many people have this misconception that working with older adults is something that is fundamentally different than working with younger people,” Dr. Lakritz says. “[Many think] you need specific, specialized training or you need to be an older adult yourself to work with older adults. And that serves as a barrier to older adults’ treatment.”

The OSF HealthCare website outlines mental health resources. Taking a look, then broaching the topic with your older friend or family member is a good first step. A necessary one, too, for some older adults who grew up in a time when “self-care” wasn’t a common term.

“If you’re a trusted person in that older adult’s life, and they trust you with more mundane concerns such as helping them get around the house and giving them rides,” Dr. Lakritz explains, “then, I think there’s a good chance they would trust you if you said, ‘I see you’re dealing with this. You’ve been dealing with it for a very long time. You haven’t been able to talk with anyone about it. There is someone we can go to’.”

And make those check-ins with your parents, grandparents and older friends a habit. They’ll be happy you did.

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Television host Carson Daly is the latest celebrity to try what some call sleep divorce. Couples who sleep in the same bed but are not getting that coveted seven to eight hours of shut eye will slumber with some degree of separation: in the same bed but with separate blankets, in separate beds in the same room or in separate rooms.

Daly called the move the “best thing” for his marriage during a summer episode of the Today Show.

“We both, admittedly, slept better apart,” he said.

The concept is one worth exploring for couples who are kept up by snoring, restlessness, differences in sleep schedule or other nighttime issues, says Nadeem Ahmed, MD, a pulmonologist at OSF HealthCare in Alton, Illinois.

But let’s get one thing straight.

“I don’t like the term ‘sleep divorce’ because it tends to blame other people. It’s not a good word. It brings anxiety,” Dr. Ahmed says.

“I like to use ‘sleep alliance.’ They’re working together. They’re working things out. They want to make sure it’s healthy for both bed partners and the sleep disturbances don’t affect the other partner’s life,” he says.

Have the discussion

Dr. Ahmed says he encounters sleep issues, like snoring, in his practice “almost every day,” and many people are shy about it.

Every case is different. Dr. Ahmed says couples should first talk out their sleep issues and try to find a solution. The partners could try sleeping in separate beds during the week and in the same bed on the weekend so intimacy is not completely lost. Some mattresses have different firmness, temperature and slant on each side, which can help.

If needed, the partners should talk to a pulmonologist or psychologist.

“A lot of psychologists will do similar things that a physician will do. It’s just the comfort level of the person,” Dr. Ahmed explains. “Sometimes they don’t want to go to a medical doctor for the sleep problem. They would rather talk to a psychologist.”

“The idea is to discuss it with some type of professional,” he says.

Dr. Ahmed adds that sleeping separately should be a short-term solution.

“Tell your bed partner this is an issue, and we need to address it. As opposed to just getting mad or feeling crummy or sleepy the next day,” Dr. Ahmed says, “Because it can affect your job, like if you’re a machine operator or have to drive a truck.”

A major cause

Dr. Ahmed says a big cause of the restlessness that leads to sleep alliance discussions is sleep apnea, when people stop breathing during sleep. This can lead to loud snoring or body movement in bed and crabbiness or grogginess the next day.

Dr. Ahmed says there are two types of sleep apnea: obstructive and central. Obstructive sleep apnea is a product of obesity. Central sleep apnea is associated with neurological deficits like a stroke.

“[Sleep apnea] is not fatal because our brains are hard-wired to let you go to a certain time, and then it triggers you to take a breath,” Dr. Ahmed explains.

But, if the condition is left untreated, there is a litany of possible issues: hypertension, cardiac arrhythmia, diabetes, dementia, headaches and frequent urination.

Diagnosis of sleep apnea would involve a sleep study, either in your home or at a hospital.

Treatment options include a mask and machine combination known as a CPAP or BiPAP, a mouth guard or a small device that’s implanted in your body in outpatient surgery. All those options aim to help you breathe normally and sleep peacefully.

“Along with that, we have to stress lifestyle changes,” to rid oneself of sleep apnea, Dr. Ahmed adds. “Eating healthy. Losing weight. Getting exercise.”

Over-the-counter options for better sleep include melatonin, an eye mask, earplugs, thick window curtains, a plush mattress and sheets and a white noise device like a smart speaker. Don’t eat or drink, aside from water, a couple hours before bedtime, Dr. Ahmed also advises.

Learn more

Learn more about healthy sleep on the OSF HealthCare website. If you’re having sleep problems, especially if it’s impacting your daytime life, talk to your primary care provider, a pulmonologist or a behavioral health provider.

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Actor Chris Hemsworth recently made headlines when he announced that he’s taking time off from acting after undergoing testing that resulted in an alarming discovery: he has a greater risk of developing Alzheimer's disease at some point in his lifetime.

The 39-year-old Hemsworth made the discovery after undergoing tests as part of his documentary series Limitless, where Hemsworth tests his body and searches for ways to live longer.

While having a predisposition for Alzheimer’s is not a diagnosis, it can help someone take the appropriate preventative measures. Hemsworth has said he is going to spend time focusing on stress and sleep management, nutrition and fitness.

According to the Alzheimer’s Association, Alzheimer’s is the most common cause of dementia, making up 60-80% of dementia cases. Dementia is not a normal part of aging, and is caused by damage to brain cells that can lead to memory problems, confusion and communication issues.

“With dementia, it's a short term, memory-deficit, but usually long term is intact," said Andrea Shewalter, a nurse practitioner with OSF HealthCare Illinois Neurological Institute (INI). "People will forget what they ate for breakfast that day and they may forget having a specific conversation with a family member that morning or the day before, but they'll be able to tell you what they did 25 years ago and be able to reminisce with stories like that.”

Typically it’s a loved one who notices the initial troubling signs of dementia such as memory loss, problem-solving difficulties or issues with daily tasks such as paying bills, taking medication or preparing meals, so it’s the patients who are accompanied by family members to an appointment who are most likely exhibiting the greatest symptoms of dementia.

Shewalter adds that anyone is a candidate for testing. And if you have a loved one who has been diagnosed with dementia you do not need to wait to develop symptoms to look into testing options for yourself.

“When patients come in we refer them for a neuro psychological evaluation, where the psychologist reviews the 12 different domains of the brain through different systems and assessments," she says. "And they can come up with a potential diagnosis and are able to tell us what part of the brain is having a deficit or what deficit of the brain is occurring.”

But arriving at a dementia diagnosis isn’t always easy. Physicians have to recognize a pattern of loss of skills and function and determine what a person is still able to do. And it usually takes more than one test to come up with the diagnosis. Tests include cognitive and neuropsychological tests, neurological evaluation, brain scans, lab tests and sometimes psychiatric evaluation.

“I would refer anyone for neuropsychological testing, where they can help determine what areas of the brain are being affected," says Shewalter. "And then we usually send the patient for imaging to make sure that there's nothing from a pathological standpoint that's going on in the brain. Is there a brain tumor? Is there Lyme’s disease? Is there some sort of disease that is affecting this? We can also look at the structures of the brain to be able to tell if there a lot of shrinkage for their age. Is the brain compensating due to the atrophy or the shrinkage of the brain?”

In the early stages of dementia, Shewalter has several recommendations for patients to remain as independent as possible, including doing crossword puzzles, playing cards and crafting – anything that involves hand and eye coordination.

She also encourages socialization – getting out in the public and being around people as much as possible. While there is no conclusive evidence, there is still benefit to taking care of yourself as much as possible. That includes a healthy brain diet and a high intensity exercise program of 150 minutes each week. Finally, get your financial affairs and power of attorney in order, especially if memory loss progresses to the point where you can’t make decisions for yourself.

“We try to treat dementia as naturally as possible," adds Shewalter. "That's why we recommend the exercise, the increase in socialization, and the brain healthy diet, because it is what you make of it. If you just sit in a house and don't use your brain or challenge your brain and let the world go by, you often have generally worse outcomes than if you were to face this head on. Do the steps that we naturally recommend to decrease the rate at which your memory declines.”

In addition to taking preventative measures and staying active, having a support system in place early on is especially important for someone with any dementia diagnosis.

For more information about dementia testing, visit OSF HealthCare.

Interview Clips 

Dementia impacts more than 50 million people in the world, and that number is expected to double every 20 years. It’s the leading cause of disability and dependency among the elderly population. 

People with dementia often struggle with emotional responses. They may overreact to situations, experience mood changes and appear indifferent to things that used to give them pleasure.

That’s where doll therapy can help. Like art or music therapy, doll therapy can be a calming influence to people who are experiencing anxiety, anger or a number of other emotions.

“Doll therapy is a distraction intervention," says Wayne Laramie, chief nursing officer for OSF HealthCare Saint Anthony Medical Center. "It's providing a doll that's lifelike, to a patient who is experiencing dementia, where they can be agitated, confused, restless, sleepless, and it comforts them, and reminds them of whether they've been a parent or a grandparent. Just that rocking, caring and thinking about somebody else really is therapeutic. That's doll therapy.”

Doll therapy has long been used in long-term and skilled nursing facilities to provide comfort to dementia patients. Now, hospitals are following suit. OSF HealthCare, for example, offers doll therapy in three of its hospitals – OSF Saint Anthony Medical Center in Rockford, OSF Saint Francis Medical Center in Peoria and OSF St. Joseph Medical Center in Bloomington.

“Doll therapy is something new for inpatient acute care," says Laramie. "So you assess those who might be eligible for it, and you try it out. You literally introduce the doll to them, and they either take to it or they don't. One way or the other, it's okay. Men and women are successful and impacted just the same - 85% of men and women who were introduced with a doll who have dementia. It's effective, and it's not gender specific.”

Doll therapy could also help decrease the rate of patients who fall while in the hospital. In 2018, OSF Saint Anthony conducted a pilot study on a medical/surgical unit that included 35 patients with dementia. The study found that patients who had a doll had zero falls compared to the control group that had a 10% fall rate.

“Many times they tried to get up out of bed and they don't want to do that when they're holding a baby because they will fall and harm the baby. So they literally will put on a call light to say they need to go to the bathroom," says Laramie. "Or when they get up they don't stand and start walking, they wait for somebody to come or they are very careful with how they're walking because they don't want to drop a baby or fall. So far, I can tell you it's been very successful: of all the babies we've given out we've had zero falls in that population and traditionally that’s one of our highest fall groups with the most injuries.”

To avoid any concern about possible infection, patients can keep the dolls and take them home or to a nursing facility. Both Caucasian and Black dolls are available, as are boys and girls. 

Hospital staff work closely with the patients to assure they are treated with dignity and not like a child simply because a doll is involved. Laramie says it’s also important to family members to be upfront with the patients that the dolls are not real.

“Doll therapy, we know is beneficial," adds Laramie. "We know that we have tried it on many patients already in just a short period of time. What we see from patients and what we hear from family is both eye opening and rewarding. Families have said things to us like this is another option that wasn't available before. They are impressed as to how calm and how it makes a difference. Many of them were skeptical to begin with, but once they see the results, it almost brings them to tears.”

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