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Night waking impacts cognitive performance regardless of sleep duration

The quality of a night of sleep — rather than the length of the night of sleep — predicted how quickly older adults processed information the next day.

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When it comes to sleep, traditional advice has focused on the number of hours a person sleeps. But for older adults, the quality of sleep may affect cognitive performance the following day regardless of their quantity of sleep, according to a new study by researchers from the Penn State College of Health and Human Development and Albert Einstein College of Medicine, Bronx, New York.

In a study published in Sleep Health, the researchers found that the quality of a night of sleep — rather than the length of the night of sleep — predicted how quickly older adults processed information the next day. The researchers evaluated sleep quality based on how much time someone was awake between when they first went to sleep and when they rose in the morning.

“Anyone who has stayed up too late knows that sleep can affect your cognition the next day,” said Orfeu Buxton, professor of biobehavioral health at Penn State and lead author of the study. “In this study, we wanted to identify which aspects of sleep health impact daily cognitive functioning so that people know how to improve their sleep. When it comes to ‘getting a good night’s sleep,’ it would appear that quality matters in the short term for older adults.”

Few studies have examined how poor sleep impacts cognitive functioning the following day, according to Carol Derby, professor of neurology and epidemiology & population health, Louis and Gertrude Feil Faculty Scholar in Neurology at Albert Einstein College of Medicine and senior author of the study.

“Understanding the nuances of how sleep impacts older adults’ cognition and their ability to perform daily activities may indicate which individuals are at risk for later cognitive impairment, such as Alzheimer’s disease,” Derby said.

Measuring sleep and cognitive performance

The study analyzed data from 261 participants who were part of the Einstein Aging Study, a multiyear study of aging and cognitive health. Participants — all over the age of 70 — lived in the community in Bronx County, New York.

For 16 days, participants wore devices similar to Fitbits or smart watches that tracked their sleep. They also completed cognitive assessment “games” six times a day on a smartphone — when they woke up, before they went to bed and four randomly selected times throughout the day. The games, which took roughly four minutes to complete each time, measured different aspects of cognitive performance including visual working memory, visuospatial memory and processing speed. At the study’s conclusion, the researchers had collected a total of 20,532 cognitive assessments from the participants.

On average, participants slept 7.2 hours each night and spent just over one hour awake during a given night of sleep. Additionally, participants took an average of 0.4 naps each day, which is two naps every five days.

When the researchers analyzed each participant’s day-to-day cognitive performance, they found that when an individual was awake for 30 minutes longer during the night than their average amount, their processing speed was slower than usual the next day. Napping the previous day, bedtime and quantity of sleep showed no effect on processing speed or any other aspects of cognitive performance.

When the researchers compared performance on cognitive tests not just to participants’ own performance but across participants in the entire study sample, they found that older adults who, on average, spent more time awake during their night’s sleep performed worse on three of the four cognitive tests. In addition to slower processing speed, participants with more wake time after falling asleep performed worse on two tests of visual working memory.

“Repeatedly waking after you’ve fallen asleep for the night diminishes the overall quality of your sleep,” said Buxton, associate director of both the Penn State Clinical and Translational Science Institute and the Penn State Social Science Research Institute and an investigator in the Penn State Center for Healthy Aging. “We examined multiple aspects of sleep, and quality is the only one that made a day-to-day difference in cognitive performance.”

What should older people do if they have sleep problems?

Nearly half of older adults report some type of sleep disruption. Over time, sleep problems are associated with higher rates of cognitive decline and Alzheimer’s disease, according to the researchers.

“My number one piece of advice is not to worry about sleep problems,” Buxton said. “Worrying only creates stress that can disrupt sleep further. This does not mean that people should ignore sleep, though. There are research-validated interventions that can help you sleep better.”

To promote healthy sleep, people should go to bed at a consistent time each night, aiming for a similar length of sleep in restful circumstances, Buxton continued.

“When it comes to sleep, no single night matters, just like no single day is critical to your exercise or diet,” Buxton said. “What matters is good habits and establishing restful sleep over time.”

For older adults who have sleep problems, the researchers recommended evaluating their sleep environment — including avoiding screens before bed and sleeping in dark, quiet conditions at a consistent time.

If problems persist, the researchers encouraged people to talk to their medical providers about cognitive behavioral therapy, which has been proven to be a safe and effective way to address sleep-related issues. In contrast, the researchers said that medication is not a good solution for many older adults because sleep medication can increase the risk of falling.

Sleep health and Alzheimer’s disease

Ultimately, the goal of this research is to support healthy cognitive aging, the researchers said, particularly factors that could prevent or delay the onset of Alzheimer’s disease and related dementias. While there is extensive research evidence linking sleep and dementia, it is not yet clear whether poor sleep is a risk factor or a consequence of Alzheimer’s disease.

“The work demonstrating the day-to-day impact of sleep quality on cognition among individuals who do not have dementia suggests that disrupted sleep may have an early impact on cognitive health as we age,” Derby said. “This finding suggests that improving sleep quality may help delay later onset of dementia.”

Other contributors to this research included Jonathan Hakun of the Penn State Department of Neurology; Martin J. Sliwinski of the Penn State Department of Human Development and Family Studies and Center for Healthy Aging; Qi Gao of Albert Einstein College of Medicine’s Department of Epidemiology & Population Health; Cuiling Wang of Albert Einstein College of Medicine’s Department of Neurology; Linying Ji of the Montana State University Department of Psychology; Alyssa Gamaldo of the Clemson University Department of Psychology; and Suzanne Bertisch of the Department of Medicine at Brigham and Women’s Hospital and Harvard Medical School.

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Study finds low-dose eye drops successful in managing adult myopia for 24 hours

A single low-dose atropine eye drop can produce daylong effects in managing myopia, or nearsightedness.

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Groundbreaking research from the University of Houston shows that a single low-dose atropine eye drop can produce daylong effects in managing myopia, or nearsightedness, which affects roughly one-third of U.S. adults.   

Professor of Optometry Lisa Ostrin and postdoctoral researcher Barsha Lal are reporting that even one drop in the eye of low-dose atropine (0.01%–0.1%) produces clear changes in pupil size and focusing ability that persist for at least 24 hours. Importantly, they also found that the drop shows no short-term structural effects on the eye, with only temporary changes in blood flow inside the retina. 

Ostrin’s latest research is published in the journal Eye and Vision. It adds to a growing body of vision research from David Berntsen, Golden-Golden Professor of Optometry at the University of Houston, who is co-leading a national $25 million NIH-funded clinical trial to delay the development of myopia in children by using the atropine drops. 

Low concentration atropine is widely prescribed to slow myopia progression in children, yet its short-term retinal and choroidal effects remain incompletely understood. Ostrin’s new study evaluated short-term effects of a range of low atropine concentrations on the length of the eye, the blood vessels in the retina and the thickness of the retina and choroid, which sits just behind the retina. These are important measurements because longer eye length is associated with myopia and as it gets longer, the retina and choroid are stretched.  

“These findings indicate that a single instillation of atropine does not alter axial length or retinal or choroidal thickness over 24 hours but may transiently affect superficial retinal perfusion in a time-dependent manner,” said Ostrin.  

In the double-masked, randomized study, twenty healthy adults received a single instillation of either a placebo or atropine in the right eye during five separate sessions. Researchers then checked the eye structure, thickness, and length in the central retina both one-hour and 24-hours later.  

“Characterizing these short-term effects is important for a better understanding of the physiological responses to atropine in clinical and research settings,” said Ostrin who previously published research results of a study investigating the short-term effects of a range of low-dose atropine concentrations on the pupils of young adults. In that study, she found similar results with a single drop of atropine inducing significant changes in the pupils. 

Together, the studies indicate that atropine induces early functional and vascular effects in the eye, in the absence of structural change.  

“By linking objective ocular responses with subjective visual experience, this work advances our understanding of how atropine works and supports more precise, evidence-based, and individualized approaches to myopia management,” said Ostrin. 

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Study: Egg consumption is associated with a lower risk of Alzheimer’s Disease

Compared to never eating eggs, eating at least five eggs per week can decrease risk of Alzheimer’s.

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Consumption of eggs is associated with a lower risk of being diagnosed with Alzheimer’s Disease for those 65 years and older, according to researchers at Loma Linda University Health

Eating one egg per day for at least five days a week reduces risk of Alzheimer’s by up to 27%, researchers found.

“Compared to never eating eggs, eating at least five eggs per week can decrease risk of Alzheimer’s,” said Joan Sabaté, MD, DrPH, a professor at Loma Linda University School of Public Health and the study’s principal investigator.

Even less frequent consumption of eggs significantly reduced the risk of Alzheimer’s. Researchers found that eating eggs 1 to 3 times per month had a 17% decrease in risk, while eating eggs 2 to 4 times per week had a 20% decrease in risk, Sabaté said.

The study, Egg intake and the incidence of Alzheimer’s disease in the Adventist Health Study-2 cohort linked with Medicare datawas published last week in the Journal of Nutrition.

Researchers said they embarked on the study because of a substantial knowledge gap in the relationship between modifiable dietary factors and risk of Alzheimer’s disease risk.

Eggs are known to be a source of key nutrients that support brain health. Sabaté said. Eggs provide choline, a precursor to acetylcholine and phosphatidylcholine, both of which are critical for memory and synaptic function, the study stated. Eggs also contain lutein and zeaxanthin—carotenoids that accumulate in brain tissue and are associated with improved cognitive performance and reduced oxidative stress. Eggs also contain key omega-3 fatty acids, and yolks are particularly rich in phospholipids, which constitute nearly 30% of total egg lipids and are essential for neurotransmitter receptor function.

Researchers said they studied the consumption of eggs in visible ways — such as eating eggs in various forms, like scrambled, fried, boiled, etc. — and hidden ways, such as eggs included in baked goods and packaged foods.

The cases of Alzheimer’s Disease in the Adventist Health Study 2 cohort were diagnosed by physicians, according to Medicare records, among the study population of 40,000 subjects. Eligibility was determined using the Medicare Master Beneficiary Summary Files. The average follow-up period was 15.3 years.

The team emphasized that moderate egg consumption should be  part of a balanced diet.

“Research supports eggs as part of a healthy diet,” said Jisoo Oh, DrPH, MPH, an associate professor of epidemiology at Loma Linda University School of Public Health and the study’s lead author. “Seventh-day Adventists do eat a healthier diet than the general public, and we want people to focus on overall health along with this knowledge about the benefit of eggs.”

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Telling people they might lose motivates more than telling them they might win, research shows

How managers choose to frame problems directly influences employees’ motivation to speak up at work. For managers, this is an insightful approach for building more open and collaborative teams.

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Athletes say they hate to lose more than they love to win. New research finds the same sentiment is shared in organizations.

A Virginia Tech researcher and his colleagues discovered that when managers frame work problems as a potential loss, employees are more likely to take action than when those problems are framed as potential gains. The research also revealed that when the potential loss impacts a larger group, employees are more likely to take action in the form of speaking up to a supervisor in hopes of finding a solution. The findings were recently published in the Journal of Applied Psychology.

For managers, this research suggests that framing work problems as potential losses can influence employees to speak up more.

“Employee voice occurs when suggestions are made to improve organizational functioning,” said Phil Thompson, associate professor in the Pamplin College of Business Department of Management. “From an organizational perspective, the positive outcomes of employee voice include improved performance, effectiveness, and workplace safety. From an employee level, speaking up is positively related to creativity, innovation, engagement, and ethical behavior.”

At its core, this research shows that how managers choose to frame problems directly influences employees’ motivation to speak up at work. For managers, this is an insightful approach for building more open and collaborative teams.

“When managers say, ‘If we don’t get this done, not only will you lose the $5,000 bonus, but everybody in this work group is going to lose a $5,000 bonus,’ it magnifies an employee’s motivation to act in a proactive way,” said Thompson. “This suggests that framing work problems as what will be collectively lost – compared to what can be individually lost – makes employees want to speak up more.”

Thompson was part of a research team led by Jeffery Thomas and Jonathan Booth from The London School of Economics and Mark Bolino from Oklahoma University. Together they analyzed responses from nearly 2,000 full-time employees, MBA students, and employee-supervisor pairs for their experience in situations where work problems were framed as either a gain or a loss. Across three different studies, framing something as a loss yielded employees to voice a work suggestion more.

For example, a manager dealing with a reputational crisis of their team, such as a product quality issue, can frame the problem in a way to spark helpful employee suggestions on how to resolve the issue. For example, instead of saying “if this product has great quality, our company will look really good” a manager saying “if this product is not up to quality standards, our reputation will be damaged” carries more weight for the team. When this reputational risk is shared by everyone, employees are more willing to step forward to help the problem.

In the first study, participants were asked to think about a problem at work that was significant for them. From there, they were randomly assigned to write about the potential losses or gains from that problem. They were also asked to indicate how likely they were to talk about these problems to their supervisor. Participants who reflected on their potential losses showed a 16 percent higher willingness to speak up compared to those who focused on the potential gains.

When it came to the MBA students, they read a fictional performance review scenario where a workplace problem was described. They then rated how willing they would be to speak up about that scenario if they were in the situation. One example suggested that the entire team might fall short of its goals if an issue was not addressed. This specific scenario yielded the most likelihood of speaking up 35 percent more than the scenario’s suggesting that only they would miss their goal, supporting the research’s findings that an employee is more likely to speak up when the loss impacts more people.

The third study looked at employee-supervisor pairings to understand how these relationships play out in the real world. Using pairings from across three industries, employees reported a workplace problem they encountered and their supervisor rated how often that employee spoke up on the job. While the first two studies involved hypothetical scenarios, this real-world evidence showed that employees were 8-10 times more likely to speak up when issues were framed as a potential collective loss compared with a potential collective gain. 

“This research is really geared toward managers so they can facilitate and understand how and why their employees will speak up,” said Thompson. “You can talk about the issue, but it always ends in terms of how we frame things.” 

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