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From the Townsend Letter
May 2016

Anti-Aging Medicine
An Anti-Aging Approach to Optimal Sleep
by Ronald Klatz, MD, DO, and Robert Goldman, MD, PhD, DO, FAASP
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Most people are aware of the importance of a healthful diet and exercise, but many overlook the importance of getting enough sleep each night. One of the most crucial components of an anti-aging regimen, is getting the proper amount of sleep on a consistent basis. Inadequate sleep would be counterproductive to an anti-aging regimen, as it may lead to a shortened lifespan. Of particular concern is the fact that just 1 night of sleep deprivation can lead to insulin resistance (equal to 6 months on a high-fat diet) and may promote biological aging in older adults. Sleep loss can affect brain size, which is of particular concern as we age, and can lead to brain shrinkage. Without getting adequate sleep each night, one is leading an uphill battle in the race against aging. Since sleep deprivation affects us mentally and physically, getting enough of it should be a cornerstone in the foundation of achieving optimal health – which is especially crucial with age.
The Centers for Disease Control and Prevention has called insufficient sleep a public health problem. It has gone on to state, "Persons experiencing sleep insufficiency are also more likely to suffer from chronic diseases such as hypertension, diabetes, depression, and obesity, as well as from cancer, increased mortality, and reduced quality of life and productivity." The CDC estimates that approximately 50 to 70 million US adults have sleep or wakefulness disorders. The amount of sleep that we need varies from person to person, but adults should be getting at least 7 hours of sleep per night. Many adults do not attain this. In the CDC study "Prevalence of Healthy Sleep Duration among Adults – United States, 2014," researchers found that more than one-third of the adults reported sleeping less than seven hours in a 24-hour period.

As obtaining adequate sleep is crucial to an anti-aging regimen, sleep hygiene is key. This column reviews recent studies that suggest simple and natural approaches which may assist you in obtaining optimal sleep.

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Sexton CE, Storsve AB, Walhovd KB, Johansen-Berg H, Fjell AM. Poor sleep quality is associated with increased cortical atrophy in community-dwelling adults. Neurology. 2014 Sep 3. pii:10.1212/WNL.0000000000000774.

Simple Secret to Sleep
As we age, we typically experience declines in the quality of our sleep. Mindfulness meditation is a self-administered approach that intentionally focuses one's attention on the emotions, thoughts, and sensations occurring in the present moment. David Black and colleagues from University of Southern California (US) enrolled 49 men and women, aged 55 years and older, who experienced moderately (or greater) disturbed sleep, who were divided into two groups. One group visited the study center for 6 weekly 2-hour sessions of a course in Mindfulness Awareness Practices (MAPs) for daily living. Those included meditation, eating, walking, movement, and friendly or loving-kindness practices. A certified teacher led the exercises and also instructed participants to meditate for 5 minutes daily, gradually increasing to 20 minutes daily. The other group attended 6 weeks of a sleep hygiene and education course, wherein they learned about sleep problems, self-care methods for improving sleep, and weekly behavioral sleep hygiene strategies. Prior to the start of the 6-week programs, the average sleep quality questionnaire score was 10. At the end of the study period, those in the meditation group demonstrated improvement in their sleep score by an average of 2.8 points, compared with 1.1 points in the sleep hygiene group. Among those in the meditation group, daytime impairments, including symptoms of insomnia, fatigue and depression, were improved as well. The study authors conclude: "Formalized mindfulness-based interventions have clinical importance by possibly serving to remediate sleep problems among older adults in the short term, and this effect appears to carry over into reducing sleep-related daytime impairment that has implications for quality of life."

Black DS, O'Reilly GA, Olmstead R, Breen EC, Irwin MR. Mindfulness meditation and improvement in sleep quality and daytime impairment among older adults with sleep disturbances: a randomized clinical trial. JAMA Intern Med. 2015 Feb 16.

Eight Great Sleep-Enhancing Activities
It is generally established that physical activity associates with restful sleep, and a study by University of Pennsylvania (US) team elaborates on specific types of activities that help to improve sleep quality. Michael Grandner and colleagues analyzed data on sleep and physical activities of 429,110 adults enrolled in the 2013 Behavioral Risk Factor Surveillance System, measuring whether each of 10 types of activities was associated with typical amount of sleep, relative to both no activity and to walking. Subjects were asked what type of physical activity they spent the most time doing in the past month, and also asked how much sleep they got in a typical 24-hour period. All types of activity except for household/child care were associated with a lower likelihood of insufficient sleep, as compared with those who reported that they did not get physical activity in the past month. Specifically, walking, aerobics/calisthenics, biking, gardening, golf, running, weight-lifting, and yoga/Pilates were each associated with fewer cases of insufficient sleep, and household chores and child care were associated with higher cases of insufficient sleep. The study authors submit: "Not only does this study show that those who get exercise simply by walking are more likely to have better sleep habits, but these effects are even stronger for more purposeful activities, such as running and yoga, and even gardening and golf. These results are consistent with the growing scientific literature on the role of sleep in human performance."

Chheda J et al. Physical activity and habitual sleep duration: does the specific type of activity matter?" [Abstract #0246]. Presentation at: SLEEP 2015 (Associated Professional Sleep Societies); 8 June 2015.

Nature Promotes Sleep
Previous studies report that exposure to the natural environment may improve health behaviors (by encouraging physical activity), as well as improve mental health (including to reduce levels of depression). Diana Grigsby-Toussaint and colleagues from the University of Illinois (US) analyzed data collected by the US CDC's Behavioral Risk Factor Surveillance System, which surveyed 255,171 adult men and women. The team also used a USDA index that scores the country's geographical areas for their natural amenities, using hours of sunlight, which is important in regulating a person's circadian rhythm, and temperature. In response to the survey question about sleep quality in the last month, the researchers found that the most common answer was that respondents had slept poorly for less than 1 week. Across the entire sample, individuals reporting 21 to 29 days of insufficient sleep consistently had lower odds of access to green space and the natural environment, as compared with those reporting less than 1 week. The relationship between sleep and exposure to green space was much stronger for men than for women, as well as for men and women ages 65-plus. Observing, "Access to the natural environment attenuated the likelihood of reporting insufficient sleep," the study authors submit: "Additional studies are needed to examine the impact of natural environment exposure on sleep insufficiency across various socio-demographic groups."

Grigsby-Toussaint DS, Turi KN, Krupa M, Williams NJ, Pandi-Perumal SR, Jean-Louis G. Sleep insufficiency and the natural environment: results from the US Behavioral Risk Factor Surveillance System survey. Prev Med. 2015 Sep;78:78–84.

Brain-Boosting Sleep Position
The brain's glymphatic pathway is responsible for clearing harmful wastes – particularly amyloid-beta plaques that characterize Alzheimer's disease, during sleep. Employing an animal model, Helen Benveniste and colleagues from Stony Brook University (New York, US) studied the cerebrospinal fluid (CSF)–interstitial fluid (ISF) exchange efficiency – a marker of the clearance capacity of the glymphatic pathway. The team found that sleeping in the lateral position (on one's side) may more effectively remove brain wastes, including amyloid-beta, as compared with sleeping on the back or stomach. The study authors submit: "We propose that the most popular sleep posture (lateral) has evolved to optimize waste removal during sleep."

Lee H, Xie L, Yu M, Kang H, et al. The effect of body posture on brain glymphatic transport. J Neurosci. 2015 Aug 5;35(31):11034–11044.

Fish Compound Hooks Better Sleep
An ever-expanding library of data suggests a variety of potential health-improving benefits of omega-3 fatty acids – compounds found abundantly in "fatty fish" such as salmon, herring, and sardines.  Previous studies have suggested links between poor sleep and low blood levels of omega-3 long-chain polyunsaturated fatty acids (LC- PUFAs), among infants and in children and adults with behavior or learning difficulties. Paul Montgomery and colleagues from Oxford University (UK) assessed sleep in 362 healthy 7- to 9-year-old UK schoolchildren in relation to the levels of omega-3 and omega-6 LC- PUFAs found in fingerstick blood samples. The children who took part in the study were not selected for sleep problems, but were all struggling readers at a mainstream primary school. At the outset, the parents filled in a child sleep questionnaire, which revealed that 4 in 10 of the children in the study suffered from regular sleep disturbances. Of the children rated as having poor sleep, the researchers fitted wrist sensors to 43 of them to monitor their movements in bed over 5 nights. This exploratory pilot study showed that the children on a course of daily supplements of omega-3 had nearly 1 hour (58 minutes) more sleep and 7 fewer waking episodes per night compared with the children taking the corn or soybean placebo. Writing, "Cautiously, we conclude that higher blood levels of docosahexaenoic acid may relate to better child sleep, as rated by parents," the study authors submit: "Objective evidence from actigraphy suggests that docosahexaenoic acid supplementation may improve children's sleep."

Montgomery P, Burton JR, Sewell RP, Spreckelsen TF, Richardson AJ. Fatty acids and sleep in UK children: subjective and pilot objective sleep results from the DOLAB study – a randomized controlled trial. J Sleep Res. 2014 Mar 8.


To stay updated on the latest breakthroughs in natural approaches that may help you achieve optimal sleep, visit the World Health Network (, the official educational website of the A4M and your one-stop resource for authoritative anti-aging information. Be sure to sign up for the free Longevity Magazine e-journal, your weekly health newsletter featuring wellness, prevention, and biotech advancements in longevity.

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