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β-amyloid is important in the pathogenesis of Alzheimer disease (AD). A set of small vessels like lymphatics (called “glymphatics”) carry toxins away from the brain (NEJM JW Gen Med Aug 21 2018; [e-pub] and Nature 2018; 560:185) and “flush” β-amyloid from the brain during slow-wave, restorative sleep in rodents and, apparently, in humans (NEJM JW Gen Med Jan 15 2020 and Science 2019; 366:628).
Investigators from California obtained polysomnograms on 32 nondemented, healthy adults (average age, 75.5) and followed them for approximately 4 years with repeated positron-emission tomography to evaluate the burden of β-amyloid in the brain. Based on prior research, they postulated that both less slow-wave sleep (particularly slow waves in a particu…