Sleeping on Your Side Can Prevent Dementia

Originally published on May 25, 2021. This article was updated to include audio.

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Introduction

Dementia has become one of the greatest health challenges of our time, affecting millions of families worldwide. At the center of this problem lies beta amyloid, a sticky protein that collects between brain cells. Over time, these deposits interfere with communication between neurons and are strongly linked with the memory loss and confusion that mark Alzheimer’s disease.

Scientists have long searched for the reasons why amyloid builds up in the brain. Genetics and aging play their part, but recent research has uncovered another powerful influence: sleep. Far from being a passive state, sleep acts like a cleaning shift for the brain, clearing away waste products—including beta amyloid—through a system called the glymphatic pathway.

Two recent studies help bring this story to life. The first shows how quickly amyloid can rise after just a single sleepless night. The second reveals that even the way we position our heads while sleeping may affect how well the brain clears itself. Together, they highlight how our daily choices—whether we get enough rest and how we sleep—may shape our risk for dementia.

With this in mind, let’s take a closer look at these two studies and the surprising lessons they hold for protecting the brain.

Study: One Night Without Sleep Increases Beta-Amyloid

Shokri-Kojori and colleagues conducted a study to investigate the influence of sleep quantity on beta-amyloid production in the brain.

Picture yourself walking into a quiet research center at the National Institutes of Health. Twenty volunteers, all healthy adults, have agreed to spend the night under close watch. Some are told to go to bed as usual, while others are kept awake through the long hours—no naps, no caffeine, just the challenge of staying alert until morning. Nurses observe them to make sure not a single eye drifts shut.

The next day, each person heads into a scanner room where a special brain imaging test awaits. Doctors inject a tracer called 18F-florbetaben, a substance that binds to beta-amyloid proteins. With the help of positron emission tomography (PET), the scientists can now “see” how much amyloid is sitting in different parts of the brain.

The results are striking. After just one night without sleep, amyloid levels climb noticeably in two sensitive brain regions: the hippocampus, which is critical for memory, and the thalamus, which helps regulate mood and alertness. Nineteen out of twenty participants show this increase.

Even more unsettling, the participants who had the largest rises in amyloid also felt the worst emotionally—more tired, irritable, and low in mood. It’s as if the brain, robbed of rest, couldn’t keep up with its nightly cleaning job.

This study makes an important point: beta amyloid isn’t just a long-term problem of aging. It can accumulate rapidly, even after a single night of lost sleep.

 

Sleeping on the side makes the glymphatics drain abnormal proteins and prevents dementia
Sleeping on the side allows the glymphatic system to drain abnormal proteins and may help prevent dementia. Photo from Unsplash

The Impact of Head Position on Beta-Amyloid Drainage

Now, imagine a different kind of experiment—not in a hospital, but in the comfort of people’s homes. Instead of being kept awake all night, participants simply went to bed as usual, wearing a small device on their foreheads called the Sleep Profiler. This gadget recorded brainwaves, heart rate, snoring, and—most importantly—head position throughout the night.

Levendowski and his group investigated whether sleep position influences the drainage of beta-amyloid. They followed 45 people already diagnosed with neurodegenerative conditions such as Alzheimer’s disease, Parkinson’s disease, and mild cognitive impairment. They compared them to 120 healthy older adults with no signs of memory problems.

It is worth noting that sleep problems are extremely common in Alzheimer’s disease, affecting 25–35% of patients. They often sleep less overall, wake up more during the night, and have poorer sleep efficiency. This background makes studying the role of sleep position even more important.

Over several nights, the device collected hours of sleep data. When the researchers compared the two groups, a clear difference appeared: patients with neurodegenerative disease spent much more time sleeping on their backs—often more than two hours each night.

This wasn’t just because they moved less during sleep. In fact, the number of times people changed positions was about the same in both groups. Instead, something about sleeping supine—lying flat on one’s back—seemed to be linked with disease.

Why does this matter? Gravity plays a role in how fluids circulate in the brain. Animal research suggests that side-sleeping improves the brain’s ability to clear waste proteins, such as beta amyloid, while lying on one’s back may slow this clearance.

Sleeping on the side also causes a pressure differential that widens the glymphatic channels, allowing them to drain waste materials. Widening of the glymphatic channels also allows for better oxygenation of the brain during the sleep state. These abnormal proteins eventually end up in the liver for degradation.

The very posture we choose at night could influence how well our brain flushes out harmful toxins.

Conclusion and Call to Action

Taken together, these two studies tell a powerful story. From the laboratory at the NIH to quiet bedrooms at home, the evidence points in the same direction: sleep is not optional when it comes to protecting the brain.

The Shokri-Kojori study showed that just one night without sleep is sufficient to allow beta amyloid to rise in regions associated with memory and mood. The Levendowski study revealed that even the way we sleep—especially long hours on the back—may reduce the brain’s cleaning efficiency.

This research reminds us that dementia is not only a product of aging or genetics. It is also shaped, day by day and night by night, by the choices we make.

What can you do?

  • Protect your sleep time. Aim for consistent, restorative rest each night.
  • Consider your sleep position. Side-sleeping may give your brain the best chance to clear toxins.
  • Listen to your body. Poor sleep or frequent insomnia should not be ignored—talk with your healthcare provider.

The message is simple yet profound: sleep is your brain’s housekeeper. By giving it the time and conditions it needs, you may lower your risk of dementia and preserve the gift of memory and clarity for years to come.

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Related readings

References:

  • Shokri-Kojori, Ehsan, et al. “β-Amyloid Accumulation in the Human Brain after One Night of Sleep Deprivation.” Proceedings of the National Academy of Sciences of the United States of America, vol. 115, no. 17, 2018, pp. 4483–4488. doi:10.1073/pnas.1721694115. https://www.pnas.org/doi/10.1073/pnas.1721694115
  • Levendowski, Daniel J., et al. “Head Position during Sleep: Potential Implications for Patients with Neurodegenerative Disease.” Journal of Alzheimer’s Disease, vol. 67, no. 2, 2019, pp. 631–638. doi:10.3233/JAD-180697. https://pubmed.ncbi.nlm.nih.gov/30614805/


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