Alzheimer’s: Sleeping pill suvorexant may reduce toxic protein buildup
- About 32 million people around the world have Alzheimer’s disease.
- Most scientists believe Alzheimer’s disease is caused by a buildup of amyloid and tau proteins in the brain.
- Researchers from the Washington University School of Medicine in St. Louis have found people in a small study who took an insomnia medication experienced a drop in both Alzheimer’s-related proteins.
The buildup of
Now researchers from the Washington University School of Medicine in St. Louis, MO have found in a small study that people who took the insomnia medication suvorexant experienced a drop in both Alzheimer’s-related proteins.
The study was recently published in the journal
What are beta-amyloid and tau proteins?
Beta-amyloid forms when a larger protein found in
Beta-amyloid is known to be chemically “stickier” than other parts of APP, causing the beta-amyloid fragments to clump together. This forms
Tau protein is also found in neurons. When a person has Alzheimer’s disease, the tau proteins can act abnormally, causing them to stick to each other.
This causes what is known as
How sleep issues affect Alzheimer’s disease
Medical News Today spoke with Dr. Brendan Lucey, an associate professor of neurology and director of the Sleep Medicine Center at Washington University School of Medicine in St. Louis and first author of this study.
Dr. Lucey said sleep and Alzheimer’s disease are hypothesized to have a bi-directional relationship:
“Sleep disturbances are a risk factor for Alzheimer’s disease and the changes in the brain associated with Alzheimer’s disease are associated with sleep disturbances.”
A
Dr. Lucey and his research team have also previously published research showing a link between
Additionally, researchers have found sleep issues to be
“This raises the possibility of monitoring sleep as a marker for Alzheimer’s disease risk and — as with this study — using a sleep intervention to delay/prevent Alzheimer’s disease,” Dr. Lucey added.
How orexin affects cognitive function
Dr. Lucey said the idea for this trial came from previous work showing that a dual orexin receptor antagonist decreased both soluble amyloid-beta levels and amyloid pathology in a mouse model.
“This study was conceived as the first direct translation of that finding using the first FDA-approved dual
Orexin is a natural biomolecule that promotes wakefulness. The orexin receptor system plays an
Previous studies have linked orexin as a
And other research has found blocking orexin activation helps prevent stress-induced memory issues.
Findings on suvorexant for brain health
For this study, Dr. Lucey and his team administered the insomnia drug suvorexant to some of the study participants. There were 38 participants in total, all between the ages of 45 and 65 with no signs of
For two nights, study participants were either given a low 10mg dose, a higher 20mg dose, or a placebo.
Using
Additionally, those receiving the higher dose of suvorexant saw a 10% to 15% drop in the amount of hyperphosphorylated tau protein in their cerebrospinal fluid, compared to people who received the placebo.
“We hypothesized that amyloid-beta would decrease,” Dr. Lucey commented. “The p-tau findings were surprising to me. I was also surprised by how long into the day amyloid-beta and pT181 remained lower.”
Next steps in Alzheimer’s research
Dr. Lucey is quick to point out that this study does not support using suvorexant and dual orexin receptor antagonists to prevent or delay Alzheimer’s disease, nor does it support or justify additional studies giving the drug for longer periods and to test that it prevents/delays Alzheimer’s disease symptoms.
“Suvorexant is approved for treatment of insomnia, including in mild-to-moderate Alzheimer’s disease patients,” he continued. “Patients should discuss with their doctors if suvorexant and other dual orexin receptor antagonists are an option to treat their insomnia.”
As for the next steps in this research, Dr. Lucey said he has clinical trials enrolling participants without problems with thinking and memory, but who have amyloid in their brains.
“Participants will receive dual orexin receptor antagonists for months and we will follow Alzheimer’s proteins like amyloid and tau,” he explained. “These studies will test if chronic administration of these drugs lowers Alzheimer biomarkers over longer periods of time.”
Treating sleep disorders to slow cognitive decline
MNT also spoke with Dr. Karen D. Sullivan, a board certified neuropsychologist and creator of the I CARE FOR YOUR BRAIN education program, about this study.
She said as this is a small, proof-of-concept study, it would not impact how she talks to her people at high risk for Alzheimer’s disease about sleep issues:
“I would continue to talk to them about the vital importance of long periods of continuous sleep to optimize the immune-mediated ‘cleaning out process’ that happens during deep sleep. Identifying and treating sleep disorders remains one of our most evidence-based ways of reducing risk and impact of most dementias.”
“Meta-analysis have shown that there are numerous sleep changes that happen in Alzheimer’s that are correlated with worsening cognition,” she continued. “These include reductions in sleep efficacy, less total sleep time most importantly in REM stages, and increased awakenings. Many of these can be improved with
“I would like the authors to explain the mechanism of action and how their analysis fits in with the larger literature on amyloid and cerebrospinal fluid as a
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