The Arising · Sleep & Rhythm

THE ARISING · LONGEVITY & HEALTHSPAN SUNDAY, OCTOBER 18, 2026 IN THIS EDITION · LONGEVITY & HEALTHSPAN 1 ACOG Now Recommends Hormone Therapy for Many Women With Hot Flashes 2 Cardiologists Urge Doctors to Prescribe Exercise as Routine Heart Care 3 Fasting and Autophagy in Humans: Summary Calls Link Unproven 4 Gut Supplements May Modestly Improve Cognition in Adults Over 60, Review Finds 5 Higher Ultra-Processed Food Intake Linked to Silent Brain Damage on MRI 6 Higher VO2 Max Linked to Lower Depression and Anxiety Risk in UK Biobank 7 Bonn Lab Study Shows Blood Cells From Older Donors Lose Epigenetic Age in a Dish 8 Longer Sleep Linked to Kidney Disease Risk in Type 2 Diabetes LONGEVITY & HEALTHSPAN · WEEKLY READ · 3 MIN JOURNAL OF THE ENDOCRINE SOCIETY · 2 SOURCES Longer Sleep Linked to Kidney Disease Risk in Type 2 Diabetes Sleeping more is usually treated as a good sign. A new study of people with type 2 diabetes suggests that, for kidney health, longer sleep may be a signal worth noticing. he research is a prospective cohort study, a type of observational study in people. It followed 678 Japanese outpatients with type 2 diabetes for anT average of 6.0 years (give or take 2.7 years). It was published in 2026 in the Journal of the Endocrine Society. Observational studies can find links. They cannot show that one thing causes another. The researchers looked at diabetic nephropathy, also called diabetic kidney disease. This is kidney damage caused by long-term diabetes. They counted either new cases or worsening of existing disease as a single combined outcome. During follow-up, 215 of the 678 participants reached that outcome. The team recorded lifestyle habits at the start, and again at year 2 and/or year 5. They averaged each person's measurements up to the point of the outcome or the end of follow-up. Of all the lifestyle factors they examined, average sleep duration was the only one linked to the outcome, according to the study's abstract. THE ARISING · OCTOBER 18, 2026 PAGE 22 The direction mattered. The authors conclude that longer sleep, but not shorter sleep, was associated with a higher risk. The trend held after adjusting for key lifestyle and diabetes-related factors. The link was stronger in older participants and in those who already had microalbuminuria (small amounts of protein in the urine, an early sign of kidney damage) or reduced kidney function. Only the abstract was available to us. It does not give the sleep-hour categories or the size of the risk, so we cannot report them. The authors do not claim long sleep harms the kidneys. In a statement released by the Endocrine Society, study author Tomoya Mita of Juntendo University in Tokyo said longer sleep "may be a readily observable marker of underlying health vulnerability." He also said people should not read the findings as advice to sleep less, because "we cannot establish a causal relationship." The Endocrine Society release also states that diabetic kidney disease affects about 30% to 40% of people with diabetes. FOR YOU What does this mean for personal health? The study did not test sudden changes in sleep. It looked at average sleep over years. Mita said longer sleep may be a useful clue to identify people with diabetes who may need closer attention to their kidney health. Beyond that, any advice here is our editorial suggestion, not a finding of the study: if someone notices a clear, lasting increase in how long they sleep, it may be worth mentioning to a clinician. It may be most relevant to older adults with diabetes and to people whose kidney tests already show early changes. Readers should not change their sleep habits or diabetes care without talking to their clinician. There are limits. All participants were Japanese outpatients with type 2 diabetes, so the results may not apply to other groups. The abstract does not say whether other health conditions could explain the pattern. The weakest point of the argument is that we cannot tell from the abstract what sleep lengths counted as long, or how large the risk was. This differs from the REM sleep study we covered on October 6, which tracked sleep stages and disease risk in nearly 96,000 UK adults. That was a different study with a different design. This one adds that sleep length alone may carry information in a specific group, though both are observational. THE ARISING · OCTOBER 18, 2026 PAGE 23 Next, watch for studies that measure sleep objectively and track changes over time. They could show whether longer sleep helps flag kidney risk in routine diabetes care. Sources: Journal of the Endocrine Society (2026), Endocrine Society / Journal of the Endocrine Society (via Newswise) THE ARISING · OCTOBER 18, 2026 PAGE 24

OCTOBER 17, 2026 Older adults who napped most days had a 48% higher hazard of developing dementia over the next decade than those who rarely or never napped. Falling asleep without meaning to carried a separate, slightly smaller 39% higher hazard. That is the finding of a new study in The Journals of Gerontology: Series A. It is an association, not proof of cause. Our own view, which the study does not test, is that frequent or unplanned daytime sleep may be worth raising with a doctor, not only changing as a habit. An ordinary pattern of daytime sleep may contain information worth understanding. This cohort links frequent napping with later dementia classification, without establishing that napping causes it. This is an observational study in people. It cannot show that napping causes dementia. Researchers at the Johns Hopkins Bloomberg School of Public Health used data from the National Health and Aging Trends Study, a survey of U.S. Medicare beneficiaries aged 65 and older. The analysis included 995 participants who showed no sign of possible or probable dementia in 2013. They were followed up to 2023. In 2013, participants answered questions about their napping. Those who said they napped "never" or "rarely" were counted as non-nappers. Those who napped "some days" were infrequent nappers. Those who napped "most days" or "every day" were frequent nappers. Participants were also asked whether naps were planned or whether they fell asleep without meaning to. They were asked how long naps usually lasted, either 30 minutes or less, or more than 30 minutes. Dementia was identified at each yearly round by a validated algorithm, not by a clinical exam. The outcome was "possible or probable" dementia. Possible dementia meant impairment in one area of thinking. Probable dementia meant a reported diagnosis, an informant report of dementia, or impairment in at least two areas. Compared with non-nappers, frequent nappers had 1.48 times the hazard of developing possible or probable dementia (95% confidence interval 1.14 to 1.94). Unintentional napping was also linked to higher risk (hazard ratio 1.39; 95% CI 1.06 to 1.81). Infrequent napping and intentional napping showed no association. The results for length were less clear. Naps of 30 minutes or less were linked to higher risk (hazard ratio 1.40; 95% CI 1.06 to 1.85). Naps longer than 30 minutes were not clearly linked once the analysis also adjusted for sleep factors (hazard ratio 1.28; 95% CI 0.96 to 1.69). So the study does not show that short naps are worse than long ones. The analysis adjusted for age, sex, race and ethnicity, education, smoking, body mass index, number of health conditions, depressive and anxiety symptoms, nighttime sleep duration, daytime sleepiness and risk of obstructive sleep apnea, a breathing disorder that disrupts sleep. The authors also tried to address reverse causation, meaning that early brain changes might cause the napping rather than the reverse. They excluded dementia cases in the first five years of follow-up. According to Neuroscience News, which covered the study, the associations for frequent and unintentional napping held steady. The coverage went further than the study in saying this shows napping changes emerge years before diagnosis. The paper itself describes napping as possibly a risk factor "if supported by further evidence." The paper notes that napping may reflect disease rather than drive it. For example, damage to wake-promoting brain cells linked to tau pathology can cause excessive daytime sleepiness. "More frequent napping could be a marker of changes in the brain, rather than a cause of brain changes that lead to dementia," senior author Adam Spira told Neuroscience News. FOR YOU What does this mean for personal health? The study does not show that cutting back on naps lowers dementia risk. The paper notes that naps can result from disturbed nighttime sleep, including undiagnosed sleep disorders. Our suggestion, not a finding of the study, is that falling asleep without meaning to, or a new pattern of napping most days, is worth raising with a doctor, who can look for causes such as sleep apnea or other health problems. The study did not test any such steps, and this is the weakest link in the argument. The study has limits. Napping was self-reported at one point in 2013. Dementia was classified by algorithm. The sample was limited to those who answered the sleep module, and those left out of the main analysis were older, had lower education and more depressive and anxiety symptoms. The authors call for studies with more detailed napping measures and longer follow-up. Lead author Kening Jiang said, according to Neuroscience News, that monitoring napping could be an early and accessible marker of higher risk. The study was supported in part by the National Institute on Aging. What to watch next: studies that track napping with wearable sensors and test whether treating poor sleep changes cognitive outcomes. More detailed measurement could help distinguish a warning signal from a causal factor. That distinction would make the observation more useful and less alarming. Sources: The journals of gerontology. Series A, Biological sciences and medical sciences (2026), Neuroscience News (Johns Hopkins Bloomberg School of Public Health study) The journals of gerontology. Series A, Biological sciences and medical sciences (2026): https://doi.org/10.1093/gerona/glag208 Neuroscience: https://neurosciencenews.com/daytime-napping-dementia-neurology-31310/ ---

OCTOBER 16, 2026 Cannabis is often promoted as a sleep aid, but a long-running study suggests it may be linked to poorer sleep in midlife, and people who use it may not notice. How a night feels and how sleep is recorded can tell different stories. A long observational study of cannabis use and midlife sleep brings that difference into focus. The work was published in JAMA Network Open in 2026. It is an observational study in people, so it can show associations but cannot prove that cannabis caused any sleep problem. The researchers analyzed 1,266 adults from the Coronary Artery Risk Development in Young Adults (CARDIA) study. CARDIA followed participants for 35 years, through an examination conducted in 2020 to 2022. The team measured cannabis use in two ways. Cumulative use was counted in "cannabis-years," where one cannabis-year equals 365 days of use. Recent use meant use in the past 30 days, compared with former use or never use. Sleep was measured in two ways. Objective sleep came from seven days of wrist actigraphy, a wrist-worn monitor that tracks movement. Subjective sleep came from the Pittsburgh Sleep Quality Index, a standard questionnaire. In all, 891 people had objective data and 1,128 had questionnaire data. Among those with objective data, the average age was 60.7, 63.3% were women, 41.0% were Black and 59.0% were white. After statistical adjustment, each additional cannabis-year was linked to higher odds of three problems. These were low sleep percentage, meaning less than 85% of time in bed spent asleep (odds ratio 1.10); high sleep fragmentation, a measure of restlessness during sleep (1.04); and prolonged wakefulness after sleep onset, meaning 30 minutes or more awake during the night (1.21). Recent use was also linked to poorer sleep. Compared with former and never users, recent users had higher odds of low sleep percentage, high fragmentation and prolonged time awake at night. Compared with never users, recent users had 3.23 times the odds of prolonged waking (95% confidence interval 1.44 to 7.27). They also had 4.60 times the odds of long sleep, over eight hours, rather than six to eight hours (95% confidence interval 1.81 to 11.70). Those wide ranges mean the exact size of these effects is uncertain. The questionnaire results differed. Cannabis use was not associated with self-reported sleep quality. A person can feel they sleep fine while a monitor records more broken sleep. The authors say this shows why both kinds of measurement matter. There are limits. The study cannot say whether cannabis disrupts sleep, or whether people with disrupted sleep use more cannabis. The sleep monitoring covered one week. The abstract does not say how cannabis was taken, so these findings cannot be broken down by smoking or edibles. The authors conclude only that the results suggest a potential adverse association between long-term recreational use and midlife sleep health. For adults in midlife who use cannabis to sleep, the practical point is that feeling rested may not show the whole picture. Do not start or stop cannabis, or any sleep aid, without talking to your clinician. Next, watch for studies that track sleep before and after people start or stop using cannabis, which could help separate cause from association. Following changes before and after exposure would help clarify the relationship. Both subjective experience and objective measurement deserve a place in the answer. Sources: JAMA Network Open (2026), Northwestern University via EurekAlert! (JAMA Network Open) JAMA Network Open (2026),: https://doi.org/10.1001/jamanetworkopen.2026.38303 Northwestern University via EurekAlert! (JAMA Network Open): https://www.eurekalert.org/news-releases/1147171 ---