Power Foods for the Brain (17 page)

The call of the bathroom.
If you’re getting up several times a night for a trip to the bathroom, you’re interrupting your brain’s nighttime routine. It might pay to drink a bit less water in the evening.

If those seductive bubbles in your sparkling water are making you drink more than you need, your body soaks that water up like a sponge, only to release it later on. Switch to still water and you’ll be less likely to overdo it.

You also may benefit from cutting down on salty foods. Salt holds water in your bloodstream and body tissues, and as the night progresses, that water gradually finds its way through your kidneys and into your bladder, waking you up.

If you’re in the bathroom several times a night because of prostate problems, it’s time for a good medical evaluation and perhaps treatment. And some evidence suggests that a plant-based diet—the same one that is good for your heart and helps prevent strokes and Alzheimer’s disease—is good for your prostate, too.

Lack of exercise.
If you have plenty of physical activity during the day, you will sleep better at night. Think about children. They run around so much all day that they are practically comatose at night. As we get older, we tend to be less physically active. For some of us, the only exercise we get is the tips of our fingers typing on a keyboard. So when we lie down to sleep, our brains might feel tired, but our muscles are not, so they do not demand sleep. Your sleep will then be light and easily interrupted by the slightest noise or worry. And you will end up dragging through the day.

So to get a good night’s sleep, get a little exercise. The best exercises for a good night’s sleep are those that put a bit of strain on your muscles—push-ups or weight lifting, for example. Even a little exercise can have a noticeable effect on sleep.

It goes without saying that you should talk with your doctor before starting a new exercise program. You’ll want to be sure your heart and joints, in particular, are ready for it.

A pre-bedtime routine.
If you have a cat, watch what your cat does before going to sleep. She’ll stretch out her paws, give a big yawn, and then curl up and go to sleep. Dogs do the same. In medical school, I had a pet rat who’d been saved from a laboratory, and she used to stretch out her cute little rat paw, give a yawn, and dream about trigonometry or the rings of Saturn, or whatever rats dream about.

People do the same. Children stretch and yawn, getting ready for sleep. But have you noticed that adults often do not go through this ritual? Whether it is due to caffeine, stress, or something else, they simply close their magazine, turn out the light, and hope to doze off.

If you had imagined that these presleep rituals have no function, try a little test. About a half-hour before bedtime, open your mouth to simulate a big yawn. Reach out your arms and give them a good stretch. At first you’re just going through the motions. But do this four times—a big yawn and a stretch each time. You’ll soon trigger a genuine yawn and a deep-muscle stretch. Then notice what this does to the quality of the sleep that follows. What you will likely discover is that something about stretching and yawning prepares the body and brain for sleep.

If you are having trouble sleeping, use this simple routine, and see if it helps.

Some people are afraid to nap during the day for fear they won’t sleep at night. That’s possible, if it is a very long nap. But a short
nap will not interfere with sleep and might actually help you get rid of accumulated tension so you’ll unwind more easily at night.

A man in Virginia woke up to the sound of his alarm and went down to the kitchen to fix his breakfast. And there on the kitchen table was an open box of cereal, a selection of fruit, a loaf of bread, and a variety of other groceries. “That’s strange,” he thought. “Who put those there?” He looked in his refrigerator and found it surprisingly well stocked with orange juice, cartons of almond milk, salad ingredients, and many other things. Since he lived alone, these magically appearing groceries were a puzzle.

The night before, he had taken zolpidem, the massively popular sleeping pill, marketed under the name Ambien. Under its influence, he had driven to the store and stocked up for the week, and all memories of the shopping trip were wiped out before morning. Many other people have reported similar bizarre experiences of sleepwalking, sleep-driving, or binge-eating, with subsequent amnesia for the impromptu party they had put on for themselves the night before.

Some sleep experts swear by Ambien, saying it is much safer than many older sleep aids. But the fact is, memory problems are very common, and Ambien’s prescribing information has been updated to include stern warnings about people doing all sorts of other things they cannot remember later. I strongly suggest you avoid it.

Other sleeping medications can affect memory, too. Some of them block the neurotransmitter
acetylcholine
. On this list are diphenhydramine (Benadryl, Sominex) and doxylamine, which
is found not only in sleeping medications (such as Unisom) but also in nighttime cold remedies (such as NyQuil, Alka-Seltzer Plus Night Cold, and Tylenol Flu Nighttime). If you block acetylcholine too strongly—for example by taking too large of a dose or by combining two or more medicines with similar effects—you can end up with dry mouth, blurred vision, constipation, urinary retention, and, eventually, confusion and memory problems.

Many antidepressants are used for sleep, too, and their tendency to block acetylcholine can cause the same problem. We’ll have more to say about medications in
chapter 8
.

Sleep is essential for memory and many other aspects of health. I would encourage you to turn out the lights at 10 p.m. and let your brain get on with the work of repairing and rebuilding.

Be careful about caffeine and alcohol, skip high-protein foods late in the day, get plenty of exercise, and try the pre-sleep routines I mentioned. Your brain will thank you for it.

A
man walks out of the clinic, where he just had a routine colonoscopy. “The doctor says I’m fine,” he tells his wife who is waiting in the car. “He doesn’t need to see me for another five years.”

“Wonderful!” she says. “Did it hurt?”

“Ummm, well…” he stammers. “Actually, I don’t know. I don’t remember a thing about it. It’s weird—I can’t remember anything.”

The reason he doesn’t remember is that his doctors slipped him a dose of a drug that wiped out his memory of the event. Called midazolam and marketed under the brand name Versed (pronounced
ver-SEDD
), the drug is routinely used after minor surgical procedures. The colonoscopy could have been smooth as silk or excruciatingly uncomfortable—the medical team could have danced on the table and sung “Auld Lang Syne”—and the patient, who had been wide awake the whole time, would not remember one jot of it. While patients might well object to the
idea of being given a drug to wipe out their memory banks, the practice is as routine as hand-washing.

I once asked a colonoscopy nurse why they always used Versed. “So patients will come back,” she said. If patients remembered every last discomfort and indignity of the procedure, they would be a lot less eager for their next exam. Some anesthesiologists use propofol (marketed as Diprivan) rather than Versed. Propofol was the drug that, in combination with other drugs, was implicated in Michael Jackson’s death. It causes a similar amnesia.

Versed is an extreme illustration of an important fact: Drugs can wreak havoc with your memory. Versed is in the same chemical class as Valium, Ativan, and Xanax—all of which are commonly used for anxiety. They can all affect memory, albeit not so decisively as Versed.

And so can many other medications. Even common cholesterol-lowering drugs, including Lipitor and Crestor, can cause memory deficits that mimic early Alzheimer’s disease. You discover the truth only when you stop the medication and find that your memory gradually returns.

But there is an even more fundamental point:
All kinds of things
can affect your memory. A great many medical conditions can cloud your thinking. As words start escaping you and you start to feel less and less like yourself, there may well be a simple reason that can be identified and fixed.

In this chapter, we’ll look at the conditions that can harm your memory and what you can do about them.

When anyone experiences any sort of memory problem, medications should be high on the list of suspects. Unfortunately,
many people, including many doctors, do not think to look there until problems have carried on too long. Below we will look at specific medications that interfere with memory or cause other cognitive problems. But first, a few important points:

•
Medication effects add up.
The effects of one medication can add to those of another. For example, you might be taking an antidepressant that blocks a brain chemical called
acetylcholine
. Aside from a little dry mouth or constipation, the side effects are not too bad. But then later on you might need an allergy medicine, and it blocks
acetylcholine
, too. With two drugs blocking the same brain chemical, their side effects add up, and it can be too much for the brain, clouding your thinking and interfering with memory. A common scenario is that one doctor prescribes a medication. Then another doctor prescribes a second medicine for an unrelated condition. More and more drugs are added, but none of the doctors look at the full list of pharmaceuticals marinating the patient’s brain. Medicines, of course, are very useful and sometimes lifesaving. But it is important to step back from time to time and take a fresh look at what you are taking.

•
Drugs can interact with food.
If you were to sip a grapefruit juice, you probably wouldn’t imagine that it could disable the enzymes your liver uses to break down Versed and Lipitor. But it does, and that means the drugs stay in your blood much longer, heightening their assault on your memory. Grapefruit juice has a similar effect for many other medicines, too, typically lasting for about twenty-four hours after your last glass of juice.

•
Talk with your doctor—now.
If you suspect that medications may be causing a problem, speak with your doctor. It is
often possible to discontinue one or more medications to see if memory improves. However, the safety of taking a “medication vacation” and how to go about it differ from medicine to medicine. For example, there is little risk to stopping a cholesterol-lowering drug such as atorvastatin (Lipitor) for a few months, but stopping a blood pressure medication could lead to a prompt and dangerous increase in your blood pressure. Ditto for diabetes medicines; stopping them could mean a risky spike in your blood sugar. You do not want to stop them on your own. Also, stopping some medications can lead to withdrawal symptoms. Anxiety medications, for example, can be habituating, and it can be dangerous to stop them abruptly. The answer, in every case, is to speak with your doctor before making any changes in your medications.

•
Keep a list.
It pays to keep a list of any medications you are taking. Update it regularly, and give a copy to any doctor you happen to consult. Include the drug name, size of each pill (milligrams), what time of day you take it, and the number of pills you take each time. This will make your doctor’s job easy and will help prevent mistakes.

Here are the most common culprits—medications that are known to cause cognitive problems. This does not mean that they
always
cause problems—for some medications, memory problems are quite uncommon—or that they can be blamed for cognitive problems in any given person. But when you are looking for answers, these medications should be on your list of suspects.

Cholesterol-lowering drugs.
Cholesterol-lowering drugs are among the most commonly prescribed medications. With well over $10 billion in annual sales, Lipitor was the world’s
leading pharmaceutical moneymaker before going generic in 2011.

Lipitor is a
statin
, the group that also includes Crestor, Mevacor, Zocor, and many others. Generally, their safety profile is good. In fact, lowering cholesterol is one way to reduce the risk of Alzheimer’s disease and stroke. Because statins are so widely prescribed, many people imagine they are innocuous. Some doctors refer to Lipitor as “vitamin L,” and some have even suggested it be sold without a prescription, like aspirin or vitamins.

However, statins do have side effects, some of which are serious. They can cause muscle and liver toxicity and, in high doses, are linked to diabetes.
¹
And a number of people have reported striking effects on their memory: confusion, disorientation, and memory gaps that look like the beginnings of Alzheimer’s disease.

Duane Graveline is a physician and a former NASA astronaut who lives near the Kennedy Space Center on Florida’s Atlantic coast. Returning home from a walk one day, he felt totally disoriented. He had no idea where he was. A woman came out to greet him, and he did not recognize her. This was his wife, who saw that something was very wrong with Duane. His memory banks had been wiped out. Later on in the hospital emergency room, he tried to piece things together. The only explanation he could think of for his bizarre amnesia was the Lipitor he had started several weeks earlier. Stopping the medicine cured his memory loss.

But later on, he restarted Lipitor at half the dose, only to find that, after about six weeks, it scuttled his memory again, erasing everything after high school, including his wife, children, and everyone else. He looked into the effects of statins on memory and ended up dedicating several books (
The Dark Side of Statins
and
Statin Drugs: Side Effects and the Misguided War on
Cholesterol,
among others) and a website (
www.SpaceDoc.com
) to getting the word out.