Maiken Nedergaard

So there's many things that can disrupt it.

As the brain age, the blood vessels get stiffer, they do not move as much, and therefore cleaning is not efficient any longer.

And that is probably one of the reasons we accumulate proteins and we get Alzheimer's, Parkinson's disease, and so on.

But the new discovery that these neurotransmitters are such a key for driving this cleaning process opened up for the question, if you are mentally sick or you are chronic stressed during daytime, you know that the signaling for noradrenaline is not functioning normally.

And if no adrenaline signaling is messed up when we are awake, it's certainly also messed up when we are asleep, and therefore the cleaning is not as efficient as it should be.

So it's very well documented in many, many studies that if you suffer from depression, schizophrenia, you are chronic stressed, you have an increased risk of premature dementia.

And that has not been possible to really define why that happened earlier.

And I think with the dual function of these neurotransmitters, we have an answer.

We know that the neurotransmitters are basically disturbed the signaling during wakefulness, and it remains to be shown that it's disturbed during sleep, and therefore, glymphatic clearings is reduced.

But we already know that all of these diseases are associated with very significant sleep disorders.

And that in itself would very significantly reduce glymphatic flow because glymphatic flow needs healthy, long-term sleep.

Short, fragmented sleep is basically returning some of the waste to the brain.

So having normal sleep, normal neurotransmitter oscillation is probably the key to restorative sleep.

Yeah, that is completely right.

The first nerve cells that are affected in patients that are developing dementia are the nerve cells that are producing the neurotransmitters.

So it is the chicken and the egg.

But we can use this new knowledge to basically test new treatments and that would greatly accelerate drug development to delay dementia.

Yes, so the benefit of this new discovery is that we can go in and measure probably something as simple as heart rate variability with a smartwatch and basically follow not only how long do you sleep, how much REM sleep do you have, but actually measure the quality of sleep.

So it's not been proven yet.

It's fairly logic that since the neurotransmitters are regulating both sleep