アミロイドβと睡眠の関係は？寝る事が認知症予防？

「アミロイドβ」という物質は認知症に直接繋がる物質であり、
睡眠が密接に関わっていることが分かってきました。

今日はそんな、「アミロイドβ」と睡眠の関係について詳しく見ていきます。
「夜更かしが常習化している」というか方は参考にしてみてください。

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アミロイドβとは

「アミロイドβ」とは、アルツハイマー病患者の脳に見られるアミロイド斑と呼ばれる細胞外沈着物の主成分として、アルツハイマー病に重大な関与を行う36～43アミノ酸のペプチドです。

このペプチドは、アミロイド前駆体タンパク質（APP）に由来し、β-セクレターゼとγ-セクレターゼによる切断によって産生されます。
アミロイドβの正常な機能はあまり解明されていませんが、キナーゼの活性化、酸化ストレスからの保護、コレステロールの輸送の調節、転写因子としての機能、抗菌活性など、いくつかの活性を有する可能性が発見されています。

アミロイドβは脳にたまっていくと、神経細胞を壊して認知機能を低下させると考えられています。
特に繊維状になる前のプロトフィブリルという段階のアミロイドβが最も毒性が高いと一般的には考えられています。

このため、アルツハイマー病の根本的な治療薬の開発では、アミロイドβを取り除くことを目的とした抗体医薬が注目されています。
最近では、日本の大手製薬会社「エーザイ」などが開発した「レカネマブ」という新たな抗体医薬が、アメリカで承認されました。

この薬はプロトフィブリルに結合して免疫細胞が分解できるようにする仕組みで、
治験では認知機能の低下を約7％抑える効果が示されました。
しかし、安全性については、脳が腫れたり出血したりするリスクが高まることが指摘されており、注意が必要です。

 

アミロイドβと睡眠の関係

アミロイドβは、脳が活動したときに発生する老廃物の一種で、
ノンレム睡眠（脳も体も眠っている状態）のときに脳内から排出されるという性質を持ちます。

睡眠中は、細胞が収縮して広くなった隙間に脳脊髄液が流れてくるため、ごみ掃除が活発になると考えられています。
睡眠をおろそかにしているとアミロイドβが蓄積され、20～30年後には脳はゴミでいっぱいになります。
アミロイドβの蓄積は、アルツハイマー型認知症の原因となる老人斑の形成を促進し、神経細胞を壊して認知機能を低下させます。

逆に、良質で適度な睡眠をとることで、アミロイドβの排出が促進され、認知症の予防につながります。
一晩の徹夜でもアミロイドβが増えることが分かっています。
また、睡眠の質も大切で、寝返りなどの動きが少なく安静に熟睡していた人ほど脳内アミロイドβが少ないことが解明されています。

一般的には、6時間から8時間の睡眠が望ましいとされています。
また、30分程度の昼寝をしている人はアルツハイマー型認知症の発症リスクが1/5に抑えられることも分かっています。

 

アミロイドβに年齢は関係あるの？

アミロイドβの蓄積は、年齢とともに進行すると考えられています。
早い人では40代からアミロイドβの蓄積が始まり、その約10年後からタウタンパク質の蓄積が始まります。

そこからアミロイドβとタウタンパク質は約5年かけて脳神経細胞を破壊しながら蓄積を続け、やがて認知症を発症させます。
実は、このアミロイドβは認知症の症状が現れる20年以上前から脳内に蓄積し始めると考えられています。
アルツハイマー型認知症の発症年齢は、65歳~80歳です。

つまり、40歳代から50歳代のうちにアミロイドβの蓄積が始まっている可能性があるということです。
したがって、アミロイドβの蓄積には年齢が関係していると言えます。

しかし、年齢だけではなく、睡眠や糖尿病などの生活習慣もアミロイドβの蓄積に影響を与えることが分かっています。
アミロイドβの蓄積を防ぐためには、適切な睡眠時間や血糖コントロールなどを心がけることが大切です。

 

認知症はアミロイドβと密接に関係している

アミロイドβとは、脳内で作られるたんぱく質の一種で、健康な人の脳にも存在します。
通常は脳内のゴミとして短期間で分解され排出されますが、アミロイドβ同士がくっついて異常なアミロイドβができると、
排出されずに脳に蓄積されます。

このアミロイドβの蓄積は、認知症の症状が現れる0年以上前から始まると考えられています。
アミロイドβが脳に溜まると、「老人斑」と呼ばれる染みができます。
老人斑は、アルツハイマー型認知症の特徴的な所見です。

アミロイドβが脳に溜まると、健康な神経細胞にアミロイドβがまとわりつき、毒素を出して神経細胞を破壊します。
神経細胞が破壊されると、情報の伝達ができなくなり、記憶障害や判断力の低下などの認知症の症状が現れます。
したがって、アミロイドβと認知症には深い関係があると言えます。

現在、アルツハイマー型認知症の新薬開発では、このアミロイドβを排出するか阻害するかすることで、認知症の進行を止めることができるのではないかという仮説に基づいた研究が行われています。
しかし、アミロイドβだけが認知症の原因ではありません。

他にも「タウタンパク質」という物質が神経細胞に絡みついて神経原線維変化を起こすことや、
血管や免疫系の異常なども認知症の発症に関係していると考えられています。

また、生活習慣も認知症の発症に影響します。
睡眠不足や運動不足はアミロイドβの蓄積を促進することが分かっています。
逆に、適切な睡眠時間や運動量を確保することは、アミロイドβの排出を助けることになります。

 

認知症とアルツハイマーの違い

認知症とは、脳の障害によって、記憶や判断などの認知機能が低下し、日常生活に支障をきたす状態のことです。
認知症は病名ではなく、症状のことを指します。
認知症には、さまざまな原因がありますが、その中でも最も多いのがアルツハイマー病です。

アルツハイマー病は、脳内でアミロイドβというタンパク質が蓄積し、神経細胞を破壊することで起こる病気です。
アルツハイマー病を原因とする認知症をアルツハイマー型認知症と呼びます。
アルツハイマー型認知症の特徴的な症状は、記憶障害です。

最近の出来事や話した内容などを忘れやすくなります。
また、場所や時間、人物などの見当識が低下し、自分がどこにいるかや今何時かなどがわからなくなります。

他にも、理解力や判断力の低下、言葉や物の名前が出てこない失語、
物の形や色がわからない失認、動作や手順がわからない失行などの症状が現れます。

アルツハイマー型認知症以外にも、レビー小体型認知症や血管性認知症、前頭側頭型認知症などの種類があります。
それぞれに特徴的な脳の変化や症状があります。

レビー小体型認知症は、レビー小体というタンパク質が脳に蓄積することで起こります。
レビー小体型認知症では、記憶障害よりも幻視や幻聴などの幻覚や妄想が目立ちます。

また、身体の動きが不自由になるパーキンソン症候群も見られます。
血管性認知症は、脳血管の障害によって起こります。
脳血管が詰まったり切れたりすると、その部分の神経細胞が破壊されます。

血管性認知症では、一日の中でも認知機能や体調が大きく変動しやすいです。
また、高血圧や肥満などの生活習慣病と関係しています。

 

寝ることは認知症予防になるのか

睡眠不足は免疫力を下げて風邪を引きやすくする、生活習慣病の原因になる、ということはよく知られていますが、
実は認知症の発症リスクにもつながるものです。

睡眠中には、脳の中の老廃物を洗い流す作用がありますが、睡眠不足になると、老廃物が脳に溜まり続けてしまいます。
また、睡眠時無呼吸症候群は、睡眠不足に陥り、脳卒中などを引き起こすおそれもあります。
したがって、適切な睡眠時間を確保することは、認知症予防に必要なことと言えます。

最適な睡眠時間は、おおむね6時間半から7時間だと言われています。

ただし、睡眠だけでは認知症予防に十分ではありません。
他にも生活習慣病の管理や運動、食事、社会参加などが重要です。

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「アミロイドβと睡眠の関係は？」についてのまとめ

充分な睡眠を取らない生活は、アミロイドβの排出不足となり、将来認知症になるリスクに直結します。
充分に練ることは、翌日日中の活気に繋がるだけでなく、長期的に見て認知症予防に繋がるのです。

充分な睡眠時間を確保し、活気のある翌日にするとともに将来の認知症を予防し、
少しでも長く健康的な日々をおくれるようにしたいですね。

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