OT? Cleaning garbage out of the brain

Investment Analysis Clubs Macro Economic Trends and Risks
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Given the increasing prevalence of Alzheimer’s Disease this may be on-topic since the very high cost of care has a Macroeconomic impact.

Even if it’s off-topic it’s probably of interest since each of us has a brain. The brain naturally produces degraded proteins which must be removed or they will build up. Recently (2012), advances in microscopy enabled the discovery of the glymphatic system, a network of tubes in the brain that are closed during the day but open during deep sleep to flush out the brain.

Since the original discovery of the glymphatic system there has been an explosion of research interest. Scientists realized that failure of the glymphatic system can lead to the buildup of garbage in the brain leading to Alzheimer’s disease (AD), Parkinson’s disease (PD), and multiple system atrophy (MSA).

As a practical person I just did some quick research on how to improve the deep sleep which is needed for the glymphatic system to turn on and do its job. I researched this using Perplexity AI so anyone who doesn’t like AI can skip this post.

I asked about older people because that’s relevant to myself. I decided to post here because many METARs are on the older side. :slight_smile:

Deep sleep decreases with age, dropping about 2% per decade after age 20. More fragmented sleep and earlier sleep-wake cycles are common, making it harder to achieve uninterrupted deep sleep.

The optimum amount of deep, non-REM sleep for a person over age 65 is generally about 1.5 to 2 hours per night, which corresponds to roughly 20-25% of total sleep time. Adults 65 and older typically need 7 to 8 hours of total sleep, with deep sleep being an essential restorative phase within that. Aiming for at least 1–1.5 hours of deep, non-REM sleep nightly supports cognitive, immune, and physical health in people over 70.

Aerobic exercise has shown promise in improving glymphatic function and cognitive outcomes by stimulating cerebrospinal fluid flow and vascular health. By the way, aerobic exercise is also effective in helping prevent Alzheimer’s Disease in people with the dreaded APOE4 double-allele and in slowing Parkinson’s Disease progression.

I then asked, “Do sleep aids inhibit the clearance of waste from the brain by the glymphatic system?”

Yes, sleep aids—particularly common sedative-hypnotics like zolpidem (Ambien)—can inhibit the clearing of waste from the brain by suppressing glymphatic system activity during sleep.

Alprazolam (Xanax) does not directly inhibit the glymphatic system, but it can indirectly reduce its waste clearance function by impairing natural sleep cycles. Chronic use increases these risks due to greater disruption of sleep architecture. Alprazolam is super-addictive so should never be taken routinely - it’s playing with fire.

I don’t take sleeping pills but I do use natural products to help sleep. I asked about those.

Melatonin, magnesium, and lithium orotate do not inhibit the glymphatic system’s waste clearance function; rather, evidence shows they may support or enhance it.

Supplementation with melatonin at bedtime can boost glymphatic clearance of neurotoxic proteins, making it beneficial for brain waste removal.

Magnesium indirectly supports glymphatic efficiency by promoting deeper, restorative sleep, a state in which glymphatic clearance is most active. By optimizing sleep quality, magnesium may help the brain’s waste removal processes occur more effectively, rather than inhibiting them.

Lithium, especially as lithium orotate, has been found to enhance metabolic waste clearance in the brain and may support glymphatic function by improving cellular detoxification mechanisms. This may offer protective potential against neurodegenerative conditions associated with waste buildup in the brain.

Alcohol can inhibit the brain’s glymphatic waste clearance system—but the effect is dose-dependent. Low levels of alcohol may improve glymphatic clearance, while moderate and high doses impair it. I personally drink seldom and then only about 2 ounces of sherry.

Anything that disrupts sleep (such as obstructive sleep apnea) should be treated because it can lead to malfunction of the glymphatic system as well as the well-known problems such as increased risk of stroke.

Chronic inflammation and vascular dysfunction impair glymphatic clearance as well as dangerous problems all over the body.

My Fitbit watch has motion and oxygen sensors. The app shows the pattern of sleep - light, REM and deep as well as “awake” which is usually an hour a night and is probably times of movement. It’s interesting to see the ups and downs of sleep patterns. I have always been aware of how important sleep has been to my well-being.

“Sleep hygiene” is a term used by neurologists to describe ways of getting better sleep.

Sleep hygiene is also “taking out the garbage” by enhancing our glymphatic system. This can (hopefully) enhance our mental acuity while aging.

Wendy

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One of the beefs I have with the sleep monitors that’re now springing up on wearables like a dose of The Pox is that they’re a bit like the calorie burn feature and imply a degree of personalization that might not be quite there. Here’s how Garmin explains away the information it’s bombarding me with..

Sleep Tracking | Garmin Technology Sleep Tracking | Garmin Technology

Fitbit looks like it might have something similar. Thing that gets me…..and I was reading up on this long before I upgraded my wearable to a watch with such capabilities…..is that the manufacturers tend to be quite cagey about the algorithms used to power all these whistles and flashing lights. It’s a double whammy because even when you do get to read some of the verbiage, you also have to understand a fair bit about the technology (and it’s limitations) and, even more so, the physiology …..which is a whole learning curve in and of itself.

I just bought my husband a new watch that had such gimcracks factored in……he’s everso disappointed to discover that, regardless of what his estimated VO2MAX seems to be, he’s not another Oskar Svendsen. I think he probably chooses to believe what his watch tells him, knowing him🤔

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Macro-devastating impact?

Could you ask Perplexity AI about REM sleep inducing foods?

The Captain

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@captainccs here you go. :slight_smile:

https://www.perplexity.ai/search/what-foods-induce-dreams-rem-s-NU3qqTlUSx2Yf3fjQXP5Xw

Wendy

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I just asked Google if Perplexity AI is reliable….and the bamboozle reckoned that it’s not 100%. Is it a case of Mandy Rice-Davies Applies?:thinking::sweat_smile:

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  1. What does Macy’s say about Gimbel’s?
  2. Perplexity links to the sources. It’s up to the user to go to the original source and decide if it’s reliable.
  3. I usually use both Perplexity and Gemini to confirm each other.

Wendy

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Google AI

Foods rich in melatonin and tryptophan, like tart cherries, kiwifruit, almonds, and fatty fish, may support REM sleep by containing melatonin or the amino acid tryptophan, which the brain converts to melatonin. Other sleep-supportive foods include those high in magnesium, such as bananas and leafy greens. Additionally, consuming whole grains with tryptophan-rich foods can help tryptophan cross the blood-brain barrier, while herbal teas like chamomile may promote relaxation.

Melatonin-Rich Foods

  • Tart Cherries and Tart Cherry Juice: A direct source of melatonin, which can help regulate sleep cycles.
  • Kiwifruit: Another food shown to contain melatonin.
  • Almonds and Walnuts: Nuts provide melatonin and magnesium, both linked to improved sleep.
  • Fatty Fish: Such as salmon, contain melatonin.
  • Eggs: A good source of melatonin.

Tryptophan-Rich Foods

  • Turkey and Chicken: Turkey contains tryptophan, the amino acid your body uses to produce melatonin.
  • Milk and Other Dairy: Dairy products like milk and yogurt are good sources of tryptophan.
  • Whole Grains: Foods like oats can provide tryptophan.
  • Peanuts and Pumpkin Seeds: Excellent sources of tryptophan.

Foods High in Magnesium

  • Bananas: Contain magnesium and tryptophan, supporting sleep.
  • Leafy Greens: Spinach and other leafy vegetables are rich in magnesium.

Other Supportive Foods and Drinks

  • Chamomile Tea: A calming herbal tea that contains compounds that promote relaxation and can improve sleep quality.
  • Grapes and Berries: Some research suggests these may also be helpful for sleep.

Foods to Avoid in the Evening

  • Caffeine: Stimulants like coffee can disrupt sleep.
  • Alcohol: Can interfere with sleep cycles and quality.
  • Heavy Meals and Sugary Snacks: Can lead to discomfort and disrupt sleep.

The 9 Best Foods and Drinks to Have Before Bed * Almonds. * Turkey. * Chamomile tea. * Kiwi. * Tart cherry juice. * Fatty fish. *

I eats quite a few of the above except grains, bananas, grapes, and peanuts.

The Captain

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Time to wheel out The Andy Letter. We were driving around the highways and byways of the Boston Metro West area when this came on the radio (even better listened to than read) Husband almost drove off the road he was laffing so hard….

As Read: The Andy Letter | Car Talk https://share.google/5H8X0pUb3qm9t60fB

I oftentimes used this back on the H&N board when the latest bit of SPPR appeared. Appearance in multiple media outlets…..NYT, Daily Mail etc….didn’t guarantee a worthwhile piece of information.

I think the idea of AI accessing multiple sources to curate a rapid, seemingly bona fide answer is AbFab. The reality seems to be that in the here and now…8/30/2025….we’re all still likely to be bamboozled by errors, artifacts, hallucinations.

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I have dealt with varying degrees of insomnia most of my adult life. The only meaningful addition I can make to your well-researched list is a full 8 week course on mindfulness based stress reduction. I started by listening to lectures offered by a well known licensed clinical psychologist at Harvard offered by the Teaching Company) I have unlimited access to their courses through Wondrium), followed by the only free 8 week course that I found that is associated with Jon Kabat Zinn and meets all the requirements for mbsr).

You have to assiduously read the materials and follow the exercises daily to get meaningful benefit from it, but it helps more than anything else I have done.

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Wendy,

As one of the older persons here, I can personally relate and attest to your relevant OP. I am a CPAP (continuous positive airway pressure) user after my pulmonologist tested and determined that I had moderate obstructed sleep apnea. He related that the CPAP would have beneficial cardiovascular and mental (I don’t remember him specially saying glymphatic system) improvements/benefits. My cardiologist, who is currently treating me for cholesterol levels and hypertension, concurred that the CPAP usage has significant cardiovascular benefits for me.

While multi-tasking typing this post and simultaneously watching the Ohio State - Texas college football game and now Alabama vs. Florida State, I did a quick search and found the following:

Journal of Clinical Sleep Medicine

Effects of continuous positive airway pressure on cardiac events and metabolic components in patients with moderate to severe obstructive sleep apnea and coronary artery disease: a meta-analysis

Published Online:December 1, 2023

https://jcsm.aasm.org/doi/10.5664/jcsm.10740

BRIEF SUMMARY

Current Knowledge/Study Rationale: The use of continuous positive airway pressure (CPAP) for improving the clinical variables was correlated with its duration, indicating that the longer CPAP is used per night, the greater the benefits. We hypothesized that CPAP usage ≥ 4 hours/night would be associated with a reduction in risk of major cardiovascular events.

Study Impact: CPAP usage in patients with moderate to severe obstructive sleep apnea and concomitant coronary artery disease was associated with a reduced risk of major cardiovascular events and all-cause death. More CPAP use exceeding 4 hours/night may add more benefits related to major cardiovascular events, repeat revascularization, and blood pressure.

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NIH National Library of Medicine

Impaired Glymphatic System Actions in Obstructive Sleep Apnea Adults

5/6/2022

https://pmc.ncbi.nlm.nih.gov/articles/PMC9120580/

Study Objectives

Obstructive sleep apnea (OSA) is accompanied by sleep fragmentation and altered sleep architecture, which can potentially hinder the glymphatic system, increasing risks for Alzheimer’s disease (AD), but the status is unclear in OSA. Our aim was to investigate the glymphatic system in OSA subjects and examine the relationships between OSA disease severity, sleep symptoms, and glymphatic system indices in OSA using diffusion tensor imaging (DTI).

Conclusion

OSA patients show abnormal glymphatic system function that may contribute to increased risks for AD. The findings suggest that the APLS (Diffusion Tensor Image Analysis along the Perivascular Space) method can be used to assess the glymphatic system in OSA patients.

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I have an upcoming appointment with my pulmonologist, who reviews my CPAP usage and results every 6 months, and plan to bring up this OSA and glymphatic system matter with increased risk for Alzheimer’s disease.

Regards,

Ray

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@imuafool please let us know what he says. I also have moderately severe obstructive sleep apnea and use a CPAP machine.

I had a sense that I had OSA but my primary care denied this because I’m not obese and don’t feel sleepy during the day. This is another example of a doctor jumping to the conclusion that a patient is well because she looks well. (Such as ignoring my heart because I was physically active at age 70 – turned out I needed open heart surgery.)

I bought a small hand-size pulse oximeter designed to be used while sleeping from Amazon.com that connects to a phone app using Bluetooth. This proved to my primary care doctor that I indeed have OSA because I was having 30 apnea episodes per hour with blood oxygen as low as 70% many times each night. Then the doctor approved the formal testing in the hospital which proved I have OSA. My CPAP machine reports that I now average under 5 apnea episodes per hour. My Fitbit watch detects low blood oxygen during the night but the incidence is much lower.

Even though it’s inconvenient it’s important to optimize our preventive care. Especially at our age.

Thanks,

Wendy

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Perplexity seems like pretty good AI for some research ideas. I had been looking up information on aging and the brain on perplexity a few days ago. I hope some of you find this interesting. It’s interesting reading about the aging brain, Alzheimers and how the brain cells start to fail. The articles also have some ideas about how to ameliorate or even prevent aging. I personally have been taking acetyl L carnitine since the 90’s. Some research done back in the early 90’s suggested that the mitochondria in the brain started to degrade as we get older leading to declining brain function and that maintaining the intracellular structures might be a key to protecting brain health/function. Hope you find this information interesting and helpful…doc

Treatment of age-related decreases in GTP levels restores endocytosis and autophagy | GeroScience

Green Tea And a Vitamin Supplement Could Protect Against Alzheimer’s : ScienceAlert

GTP energy dependence of endocytosis and autophagy in the aging brain and Alzheimer’s disease - PMC

L-Carnitine and acetyl-L-carnitine roles and neuroprotection in developing brain - PMC

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I hate to say it….but no, I didn’t find the links very useful at all. Quite apart from the studies mentioned being so far above my pay grade as to be unintelligible to me, they all seemed to be centered around somewhat preliminary data gained from studies in rodents. Mutant rodents come to that…..or cell lines derived from them.

I’d welcome an understanding of how these could pertain to human subjects (beyond providing another publication for resume padders and PhD candidates, that is) but I don’t feel very persuaded to be adding these supplements to my daily collection on this data.

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Pops,

I have done meditation with Jon Kabat Zinn for over a year during the pandemic. Very useful.

This resource has a lot of good reading in its newsletter.

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Coincidentally I was reading a recent article about how aerobic exercise enhances glymphatic waste removal.

Interestingly, this improvement does not occur during the exercise but after. The model is that improving aerobic fitness increases cerebral arterial flexibility and reduces brain inflammation, both of which impact the glymphatic system. The impact of aerobic exercise on the glymphatic system has been demonstrated in mice models and also most recently in human studies. Note that this improvement is seen when awake, so it is not an indirect effect of exercise improving sleep. Long-term physical exercise facilitates putative glymphatic and meningeal lymphatic vessel flow in humans | Nature Communications

It may be possible to run away from cognitive decline.

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@btresist thank you for sharing this fascinating information. I was especially interested in the human studies. But all the study participants, human and mouse, were young. I wish they would repeat the study with old people since we are the most likely to suffer the degenerative diseases associated with the build-up of proteins in the brain.

Think it can’t be done? Many gyms would be able to provide plenty of older folks (say, age 60 and above) who exercise regularly and have done for years. Not to mention the cardiac rehab programs for people who have had heart problems. (I recently completed mine.)

I sure would like to see how a sample of older exercisers (like my fitness class who have been working out together for 15 years) would compare with a sedentary control group.

Wendy

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I think this is one comparison where there’s no shortage of compelling, reproducible data. Senior fitness has been a “thing” for some time (since at least the early aughts when I first started in formal fitness instruction)….with programs such as Silver Sneakers etc providing evidence-based fitness classes and training programs for Medicare beneficiaries at multiple gym chains around the country.

I’m off to my personal training session right now else I’d post a few links (no shortage on Attia’s website for but one useful source, that’s for sure) …

I’ll look for it when I get back if nothing comes up, but check out something like Spinning and Parkinson’s Disease and Jay Albert’s research for but one “who’dda thunk it” moment (not exactly related to the subject of this thread….but actionable, objective data that can be applied to human sufferers)

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Don’t know of any elderly human studies on the role of exercise and specifically the glymphatic system, but lots of studies on elderly exercise and brain health: Lifelong exercise promotes brain health in older adults | National Institute on Aging

You may want to look at this review for more literature on glymphatic studies. Figure 3 is particularly relevant. https://www.mdpi.com/1422-0067/26/15/7552

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And for those who want to know more about the glymphatic system and dementia than the general public, I recommend this short review. Role of the Glymphatic System in Alzheimer’s Disease and Treatment Approaches: A Narrative Review | Cureus

Add in edit that earlier studies on running and the glymphatic system were done on aged mice. So all you elderly vermin out there should break out the running shoes!

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So, here’s one of many articles about the roll of “forced exercise”….and particularly indoor cycling….on the symptoms of Parkonson’s Disease..

Pedaling for Parkinson’s - Davis Phinney Foundation https://share.google/KORksKwP16MbbjQps

A number of dogs in this fight…a Spinning instructor (emeritus mode right now), my granddad had Parkinson’s (can’t beat an inheritable condition in the family to concentrate the mind on actionable and relevant information) …..and I had a shot at introducing something like it to my gyms prior to my move.

It also captured my imagination when I first heard the story from Jay Alberts’ own lips on a podcast hosted by one of my mentors in my early days fitness instruction. One of those stories where an observant individual spots something anomalous, thinks, “Now that’s peculiar. I wonder if….?” and, lo, another new line of research and discovery.

Edit: I should point out that a good many of the cycling classes offered aren’t quite what Alberts was researching initially….which was forced exercise via tandem use, rather than another rando “aerobic exercise” modality. I recall I got a few tips from the regulars on the Cycling Fools board who were familiar with tandems.. I can’t imagine that just a regular cycling class would produce the same effect

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I think this is wonderful. Thank you for sharing.

But, as the biomechanist, Katy Bowman, points out…cycling classes use only one motion repeated many, many times and these motions are not natural to the human motion pattern. Balance is not challenged (as it would be cycling in the real world) since a stationary bike can’t fall over.

I prefer Zumba because the movements are complex and constantly changing. All the movements of the human body are part of the dance steps. The mind is fully engaged because the dancer has to observe the instructor and respond instantly which engages the brain as well as the nerves leading to the limbs. Balance in motion is a huge part of Zumba since the turns need to be coordinated with the steps.

Bottom line: the best exercise is the exercise that you will do. However, all exercises are not created equal. Tai chi is actually more challenging than Zumba when it comes to balance (like riding a bicycle slowly) but nothing I have seen can equal Zumba (or other aerobic dance routines such as Jazzercise) for “forced exercise” aerobic conditioning coupled with tuning of the brain, nervous system and balance. The studies use indoor cycling because it’s an experimental standard, not because it’s the best exercise.

Wendy (still sweaty from the Zumba class I just did)

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