How Your Sleep Position Changes Dementia Risk

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This is not just about sleep duration or even about sleep quality… It really is about which way your body is positioned.

Goodnight, glymphatic system

The association between sleeping position and dementia risk is about glymphatic drainage, which is largely powered by gravity (and thus dependent on which way around your head and neck are oriented), and very important for clearing toxins out of the brain—including beta-amyloid proteins.

This becomes particularly important when the glymphatic system becomes less efficient in midlife, often 15–20 years before cognitive decline symptoms appear.

The video’s thumbnail headline, “SCIENTISTS REVEAL: THE WAY YOUR SLEEP CAN CAUSE DEMENTIA” is overstated and inaccurate, but our adjusted headline “how your sleep position changes dementia risk” is actually representative of the paper on which this video was based; we’ll quote from the paper itself here:

❝This paper concludes that 1. glymphatic clearance plays a major role in Alzheimer’s pathology; 2. the vast majority of waste clearance occurs during sleep; 3. dementias are associated with sleep disruption, alongside an age-related decline in AQP4 polarization; and 4. lifestyle choices such as sleep position, alcohol intake, exercise, omega-3 consumption, intermittent fasting and chronic stress all modulate* glymphatic clearance. Lifestyle choices could therefore alter Alzheimer’s disease risk through improved glymphatic clearance, and could be used as a preventative lifestyle intervention for both healthy brain ageing and Alzheimer’s disease.❞

…and specifically, they found:

❝Glymphatic transport is most efficient in the right lateral sleeping position, with more CSF clearance occurring compared to supine and prone. The average person changes sleeping position 11 times per night, but there was no difference in the number of position changes between neurodegenerative and control groups, making the percentage of time spent in supine position the risk factor, not the number of position changes❞

Read the paper in full here: The Sleeping Brain: Harnessing the Power of the Glymphatic System through Lifestyle Choices

*saying “modulate” here is not as useful as it could be, because they modulate it differently: side-sleeping improves clearance; back sleeping decreases it; front-sleeping isn’t great either. Alcohol intake reduces clearance, exercise (especially cardiovascular exercise) improves it; omega-3 consumption improves it up a degree and does depend on omega-3/6 ratios, intermittent fasting improves it, and chronic stress worsens it.

And for a more pop-science presentation, enjoy:

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Want to learn more?

You might also like to read:

How To Clean Your Brain (Glymphatic Health Primer)

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  • 5 ways to naturally boost the “Ozempic Effect”

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    Dr. Jason Fung is perhaps most well-known for his work in functional medicine for reversing diabetes, and he’s once again giving us sound advice about metabolic hormone-hacking with dietary tweaks:

    All about incretin

    As you may gather from the thumbnail, this video is about incretin, a hormone group (the most well-known of which is GLP-1, as in GLP-1 agonists like semaglutide drugs such as Ozempic, Wegovy, etc) that slows down stomach emptying, which means a gentler blood sugar curve and feeling fuller for longer. It also acts on the hypothalmus, controlling appetite via the brain too (signalling fullness and reducing hunger).

    Dr. Fung recommends 5 ways to increase incretin levels:

    • Enjoy dietary fat: this increases incretin levels more than carbs
    • Enjoy protein: again, prompts higher incretin levels of promotes satiety
    • Enjoy fiber: this is more about slowing digestion, but when it’s fermented in the gut into short-chain fatty acids, those too increase incretin secretion
    • Enjoy bitter foods: these don’t actually affect incretin levels, but they can bind to incretin receptors, making the body “believe” that you got more incretin (think of it like a skeleton key that fits the lock that was designed to be opened by a different key)
    • Enjoy turmeric: for its curcumin content, which increases GLP-1 levels specifically

    For more information on each of these, here’s Dr. Fung himself:

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  • Top 8 Fruits That Prevent & Kill Cancer

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    Dr. Amy Dee, pharmacist and cancer survivor herself, lays out the best options for anticancer fruits:

    The fruits

    Without further ado, they are:

    • Kiwi: promotes cancer cell death while sparing healthy cells
    • Plums & peaches: an interesting choice to list these similar fruits together as one item, but they both also induce cell death in cancer cells while sparing healthy ones
    • Dragon fruit: this does the same, while also inhibiting cancer cell growth
    • Figs: these have antitumor effects specifically, while removing carcinogens too, and additionally sensitizing cancer cells to light therapy
    • cranberries: disrupt cancer cell adhesion, breaking down tumors, while protecting non-cancerous cells against DNA damage
    • citrus fruits: inhibit tumor growth and kill cancer cells; regular consumption is also associated with a lower cancer risk (be warned though, grapefruit interacts with some medications)
    • cherries: induce cancer cell death; protect healthy cells against DNA damage
    • tomatoes: don’t often make it into lists of fruits, but lycopene reduces cancer risk, and slows the growth of cancer cells (10almonds note: watermelon has more lycopene than tomatoes, and is more traditionally considered a fruit in all respects, so could have taken the spot here).

    We would also argue that apricots could have had a spot on the list, both for their lycopene content (comparable to tomatoes) and their botanical (and this phytochemical) similarities to peaches and plums.

    For more information on each of these (she also talks about the different polyphenols and other nutrients that constitute the active compounds delivering these anticancer effects), enjoy:

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  • A new emergency procedure for cardiac arrests aims to save more lives – here’s how it works

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    As of January this year, Aotearoa New Zealand became just the second country (after Canada) to adopt a groundbreaking new procedure for patients experiencing cardiac arrest.

    Known as “double sequential external defibrillation” (DSED), it will change initial emergency response strategies and potentially improve survival rates for some patients.

    Surviving cardiac arrest hinges crucially on effective resuscitation. When the heart is working normally, electrical pulses travel through its muscular walls creating regular, co-ordinated contractions.

    But if normal electrical rhythms are disrupted, heartbeats can become unco-ordinated and ineffective, or cease entirely, leading to cardiac arrest.

    Defibrillation is a cornerstone resuscitation method. It gives the heart a powerful electric shock to terminate the abnormal electrical activity. This allows the heart to re-establish its regular rhythm.

    Its success hinges on the underlying dysfunctional heart rhythm and the proper positioning of the defibrillation pads that deliver the shock. The new procedure will provide a second option when standard positioning is not effective.

    Using two defibrillators

    During standard defibrillation, one pad is placed on the right side of the chest just below the collarbone. A second pad is placed below the left armpit. Shocks are given every two minutes.

    Early defibrillation can dramatically improve the likelihood of surviving a cardiac arrest. However, around 20% of patients whose cardiac arrest is caused by “ventricular fibrillation” or “pulseless ventricular tachycardia” do not respond to the standard defibrillation approach. Both conditions are characterised by abnormal activity in the heart ventricles.

    DSED is a novel method that provides rapid sequential shocks to the heart using two defibrillators. The pads are attached in two different locations: one on the front and side of the chest, the other on the front and back.

    A single operator activates the defibrillators in sequence, with one hand moving from the first to the second. According to a recent randomised trial in Canada, this approach could more than double the chances of survival for patients with ventricular fibrillation or pulseless ventricular tachycardia who are not responding to standard shocks.

    The second shock is thought to improve the chances of eliminating persistent abnormal electrical activity. It delivers more total energy to the heart, travelling along a different pathway closer to the heart’s left ventricle.

    Evidence of success

    New Zealand ambulance data from 2020 to 2023 identified about 1,390 people who could potentially benefit from novel defibrillation methods. This group has a current survival rate of only 14%.

    Recognising the potential for DSED to dramatically improve survival for these patients, the National Ambulance Sector Clinical Working Group updated the clinical procedures and guidelines for emergency medical services personnel.

    The guidelines now specify that if ventricular fibrillation or pulseless ventricular tachycardia persist after two shocks with standard defibrillation, the DSED method should be administered. Two defibrillators need to be available, and staff must be trained in the new approach.

    Though the existing evidence for DSED is compelling, until recently it was based on theory and a small number of potentially biased observational studies. The Canadian trial was the first to directly compare DSED to standard treatment.

    From a total of 261 patients, 30.4% treated with this strategy survived, compared to 13.3% when standard resuscitation protocols were followed.

    The design of the trial minimised the risk of other factors confounding results. It provides confidence that survival improvements were due to the defibrillation approach and not regional differences in resources and training.

    The study also corroborates and builds on existing theoretical and clinical scientific evidence. As the trial was stopped early due to the COVID-19 pandemic, however, the researchers could recruit fewer than half of the numbers planned for the study.

    Despite these and other limitations, the international group of experts that advises on best practice for resuscitation updated its recommendations in 2023 in response to the trial results. It suggested (with caution) that emergency medical services consider DSED for patients with ventricular fibrillation or pulseless ventricular tachycardia who are not responding to standard treatment.

    Training and implementation

    Although the evidence is still emerging, implementation of DSED by emergency services in New Zealand has implications beyond the care of patients nationally. It is also a key step in advancing knowledge about optimal resuscitation strategies globally.

    There are always concerns when translating an intervention from a controlled research environment to the relative disorder of the real world. But the balance of evidence was carefully considered before making the decision to change procedures for a group of patients who have a low likelihood of survival with current treatment.

    Before using DSED, emergency medical personnel undergo mandatory education, simulation and training. Implementation is closely monitored to determine its impact.

    Hospitals and emergency departments have been informed of the protocol changes and been given opportunities to ask questions and give feedback. As part of the implementation, the St John ambulance service will perform case reviews in addition to wider monitoring to ensure patient safety is prioritised.

    Ultimately, those involved are optimistic this change to cardiac arrest management in New Zealand will have a positive impact on survival for affected patients.The Conversation

    Vinuli Withanarachchie, PhD candidate, College of Health, Massey University; Bridget Dicker, Associate Professor of Paramedicine, Auckland University of Technology, and Sarah Maessen, Research Associate, Auckland University of Technology

    This article is republished from The Conversation under a Creative Commons license. Read the original article.

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  • 8 Signs Of Iodine Deficiency You Might Not Expect

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    Health Coach Kait (BSc Nutrition & Exercise) is a certified health and nutrition coach, and today she’s here to talk about iodine—which is important for many of our body functions, from thyroid hormone production to metabolic regulation to heart rate management, as well as more superficial-but-important-too things like our skin and hair.

    Kait’s hitlist

    Here’s what she recommends we look out for:

    • Swollen neck: even a slightly swollen neck might indicate low iodine levels (this is because that’s where the thyroid glands are)
    • Hair loss: iodine is needed for healthy hair growth, so a deficiency can lead to hair loss / thinning hair
    • Dry and flaky skin: with iodine’s role in our homeostatic system not being covered, our skin can dry out as a result
    • Feeling cold all the time: because of iodine’s temperature-regulating activities
    • Slow heart rate: A metabolic slump due to iodine deficiency can slow down the heart rate, leading to fatigue and weakness (and worse, if it persists)
    • Brain fog: trouble focusing can be a symptom of the same metabolic slump
    • Fatigue: this is again more or less the same thing, but she said eight signs, so we’re giving you the eight!
    • Irregular period (if you normally have such, of course): because iodine affects reproductive hormones too, an imbalance can disrupt menstrual cycles.

    For more on each of these, as well as how to get more iodine in your diet, enjoy:

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  • In Crisis, She Went to an Illinois Facility. Two Years Later, She Still Isn’t Able to Leave.

    10almonds is reader-supported. We may, at no cost to you, receive a portion of sales if you purchase a product through a link in this article.

    Series: Culture of Cruelty:Inside Illinois’ Mental Health System

    State-run facilities in Illinois are supposed to care for people with mental and developmental disabilities. But patients have been subjected to abuse, neglect and staff misconduct for decades, despite calls for change.

    Kaleigh Rogers was in crisis when she checked into a state-run institution on Illinois’ northern border two years ago. Rogers, who has cerebral palsy, had a mental health breakdown during the pandemic and was acting aggressively toward herself and others.

    Before COVID-19, she had been living in a small group home; she had been taking college classes online and enjoyed going out with friends, volunteering and going to church. But when her aggression escalated, she needed more medical help than her community setting could provide.

    With few viable options for intervention, she moved into Kiley Developmental Center in Waukegan, a much larger facility. There, she says she has fewer freedoms and almost nothing to do, and was placed in a unit with six other residents, all of whom are unable to speak. Although the stay was meant to be short term, she’s been there for two years.

    The predicament facing Rogers and others like her is proof, advocates say, that the state is failing to live up to the promise it made in a 13-year-old federal consent decree to serve people in the community.

    Rogers, 26, said she has lost so much at Kiley: her privacy, her autonomy and her purpose. During dark times, she cries on the phone to her mom, who has reduced the frequency of her visits because it is so upsetting for Rogers when her mom has to leave.

    The 220-bed developmental center about an hour north of Chicago is one of seven in the state that have been plagued by allegations of abuse and other staff misconduct. The facilities have been the subject of a monthslong investigation by Capitol News Illinois and ProPublica about the state’s failures to correct poor conditions for people with intellectual and developmental disabilities. The news organizations uncovered instances of staff who had beaten, choked, thrown, dragged and humiliated residents inside the state-run facilities.

    Advocates hoped the state would become less reliant on large institutions like these when they filed a lawsuit in 2005, alleging that Illinois’ failure to adequately fund community living options ended up segregating people with intellectual and developmental disabilities from society by forcing them to live in institutions. The suit claimed Illinois was in direct violation of a 1999 U.S. Supreme Court decision in another case, which found that states had to serve people in the most integrated setting of their choosing.

    Negotiations resulted in a consent decree, a court-supervised improvement plan. The state agreed to find and fund community placements and services for individuals covered by the consent decree, thousands of adults with intellectual and developmental disabilities across Illinois who have put their names on waiting lists to receive them.

    Now, the state has asked a judge to consider ending the consent decree, citing significant increases in the number of people receiving community-based services. In a court filing in December, Illinois argued that while its system is “not and never will be perfect,” it is “much more than legally adequate.”

    But advocates say the consent decree should not be considered fulfilled as long as people with disabilities continue to live without the services and choices that the state promised.

    Across the country, states have significantly downsized or closed their large-scale institutions for people with developmental and intellectual disabilities in favor of smaller, more integrated and more homelike settings.

    But in Illinois, a national outlier, such efforts have foundered. Efforts to close state-operated developmental centers have been met with strong opposition from labor unions, the communities where the centers are located, local politicians and some parents.

    U.S. District Judge Sharon Johnson Coleman in Chicago is scheduled in late summer to decide whether the state has made enough progress in building up community supports to end the court’s oversight.

    For some individuals like Rogers, who are in crisis or have higher medical or behavioral challenges, the state itself acknowledges that it has struggled to serve them in community settings. Rogers said she’d like to send this message on behalf of those in state-operated developmental centers: “Please, please get us out once and for all.”

    “Living Inside a Box”

    Without a robust system of community-based resources and living arrangements to intervene during a crisis, state-operated developmental centers become a last resort for people with disabilities. But under the consent decree agreement, the state, Equip for Equality argues, is expected to offer sufficient alternative crisis supports to keep people who want them out of these institutions.

    In a written response to questions, Rachel Otwell, a spokesperson for the Illinois Department of Human Services, said the state has sought to expand the menu of services it offers people experiencing a crisis, in an effort to keep them from going into institutions. But Andrea Rizor, a lawyer with Equip for Equality, said, “They just don’t have enough to meet the demand.”

    For example, the state offers stabilization homes where people can live for 90 days while they receive more intensive support from staff serving the homes, including medication reviews and behavioral interventions. But there are only 32 placements available — only four of them for women — and the beds are always full, Rizor said.

    Too many people, she said, enter a state-run institution for short-term treatment and end up stuck there for years for various reasons, including shortcomings with the state’s discharge planning and concerns from providers who may assume those residents to be disruptive or difficult to serve without adequate resources.

    That’s what happened to Rogers. Interruptions to her routine and isolation during the pandemic sent her anxiety and aggressive behaviors into overdrive. The staff at her community group home in Machesney Park, unsure of what to do when she acted out, had called the police on several occasions.

    Doctors also tried to intervene, but the cocktail of medications she was prescribed turned her into a “zombie,” Rogers said. Stacey Rogers, her mom and legal guardian, said she didn’t know where else to turn for help. Kiley, she said, “was pretty much the last resort for us,” but she never intended for her daughter to be there for this long. She’s helped her daughter apply to dozens of group homes over the past year. A few put her on waitlists; most have turned her down.

    “Right now, all she’s doing is living inside a box,” Stacey Rogers said.

    Although Rogers gave the news organizations permission to ask about her situation, IDHS declined to comment, citing privacy restrictions. In general, the IDHS spokesperson said that timelines for leaving institutions are “specific to each individual” and their unique preferences, such as where they want to live and speciality services they may require in a group home.

    Equip for Equality points to people like Rogers to argue that the consent decree has not been sufficiently fulfilled. She’s one of several hundred in that predicament, the organization said.

    “If the state doesn’t have capacity to serve folks in the community, then the time is not right to terminate this consent decree, which requires community capacity,” Rizor said.

    Equip for Equality has said that ongoing safety issues in these facilities make it even more important that people covered by the consent decree not be placed in state-run institutions. In an October court brief, citing the news organizations’ reporting, Equip for Equality said that individuals with disabilities who were transferred from community to institutional care in crisis have “died, been raped, and been physically and mentally abused.”

    Over the summer, an independent court monitor assigned to provide expert opinions in the consent decree, in a memo to the court, asked a judge to bar the state from admitting those individuals into its institutions.

    In its December court filing, the state acknowledged that there are some safety concerns inside its state-run centers, “which the state is diligently working on,” as well as conditions inside privately operated facilities and group homes “that need to be addressed.” But it also argued that conditions inside its facilities are outside the scope of the consent decree. The lawsuit and consent decree specifically aimed to help people who wanted to move out of large private institutions, but plaintiffs’ attorneys argue that the consent decree prohibits the state from using state-run institutions as backup crisis centers.

    In arguing to end the consent decree, the state pointed to significant increases in the number of people served since it went into effect. There were about 13,500 people receiving home- and community-based services in 2011 compared with more than 23,000 in 2023, it told the court.

    The state also said it has significantly increased funding that is earmarked to pay front-line direct support professionals who assist individuals with daily living needs in the community, such as eating and grooming.

    In a statement to reporters, the human services department called these and other improvements to the system “extraordinary.”

    Lawyers for the state argued that those improvements are enough to end court oversight.

    “The systemic barriers that were in place in 2011 no longer exist,” the state’s court filing said.

    Among those who were able to find homes in the community is Stanley Ligas, the lead plaintiff in the lawsuit that led to the consent decree. When it was filed in 2005, he was living in a roughly 100-bed private facility but wanted to move into a community home closer to his sister. The state refused to fund his move.

    Today, the 56-year-old lives in Oswego with three roommates in a house they rent. All of them receive services to help their daily living needs through a nonprofit, and Ligas has held jobs in the community: He previously worked in a bowling alley and is now paid to make public appearances to advocate for others with disabilities. He lives near his sister, says he goes on family beach vacations and enjoys watching professional wrestling with friends. During an interview with reporters, Ligas hugged his caregiver and said he’s “very happy” and hopes others can receive the same opportunities he’s been given.

    While much of that progress has come only in recent years, under Gov. JB Pritzker’s administration, it has proven to be vulnerable to political and economic changes. After a prolonged budget stalemate, the court in 2017 found Illinois out of compliance with the Ligas consent decree.

    At the time, late and insufficient payments from the state had resulted in a staffing crisis inside community group homes, leading to escalating claims of abuse and neglect and failures to provide routine services that residents relied on, such as help getting to work, social engagements and medical appointments in the community. Advocates worry about what could happen under a different administration, or this one, if Illinois’ finances continue to decline as projected.

    “I acknowledge the commitments that this administration has made. However, because we had so far to come, we still have far to go,” said Kathy Carmody, chief executive of The Institute on Public Policy for People with Disabilities, which represents providers.

    While the wait for services is significantly shorter than it was when the consent decree went into effect in 2011, there are still more than 5,000 adults who have told the state they want community services but have yet to receive them, most of them in a family home. Most people spend about five years waiting to get the services they request. And Illinois continues to rank near the bottom in terms of the investment it makes in community-based services, according to a University of Kansas analysis of states’ spending on services for people with intellectual and developmental disabilities.

    Advocates who believe the consent decree has not been fulfilled contend that Illinois’ continued reliance on congregate settings has tied up funds that could go into building up more community living options. Each year, Illinois spends about $347,000 per person to care for those in state-run institutions compared with roughly $91,000 per person spent to support those living in the community.

    For Rogers, the days inside Kiley are long, tedious and sometimes chaotic. It can be stressful, but Rogers told reporters that she uses soothing self-talk to calm herself when she feels sad or anxious.

    “I tell myself: ‘You are doing good. You are doing great. You have people outside of here that care about you and cherish you.’”

    This article is republished from ProPublica under a Creative Commons license. Read the original article.

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  • Scheduling Tips for Overrunning Tasks

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    Your Questions, Our Answers!

    Q: Often I schedule time for things, but the task takes longer than I think, or multiplies while I’m doing it, and then my schedule gets thrown out. Any ideas?

    A: A relatable struggle! Happily, there are remedies:

    • Does the task really absolutely need to be finished today? If not, just continue it in scheduled timeslots until it’s completed.
    • Some tasks do indeed need to be finished today (hi, writer of a daily newsletter here!), so it can be useful to have an idea of how long things really take, in advance. While new tasks can catch us unawares, recurring or similar-to-previous tasks can be estimated based on how long they took previously. For this reason, we recommend doing a time audit every now and again, to see how you really use your time.
    • A great resource that you should include in your schedule is a “spare” timeslot, ideally at least one per day. Call it a “buffer” or a “backup” or whatever (in my schedule it’s labelled “discretionary”), but the basic idea is that it’s a scheduled timeslot with nothing scheduled in it, and it works as an “overflow” catch-all.

    Additionally:

    • You can usually cut down the time it takes you to do tasks by setting “Deep Work” rules for yourself. For example: cut out distractions, single-task, work in for example 25-minute bursts with 5-minute breaks, etc
    • You can also usually cut down the time it takes you to do tasks by making sure you’re prepared for them. Not just task-specific preparation, either! A clear head on, plenty of energy, the resources you’ll need (including refreshments!) to hand, etc can make a huge difference to efficiency.

    See Also: Time Optimism and the Planning Fallacy

    Do you have a question you’d like to see answered here? Hit reply or use the feedback widget at the bottom; we’d love to hear from you!

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