Sleep

Infographic

https://www.reuters.com/graphics/HEALTH-SLEEP/mopakyjmnpa/

About Sleep

It is said that wake time is determined by practical matters [1]. Even better would be to set ideal wake time based on our needs - consistent with nature - and fit the day around it. Sleep is critical for health, and we should not mess up our sleep. Ie, wake up with the sun if you can, and like Benjamin Franklin, Early to bed, early to rise, makes a man healthy, wealthy, and wise. Is there scientific evidence for Ben's claim?

In other words - are there any historical examples of movers and shakers (people who have contributed to progress in society) who did not rise early (or stay up all day), and had a long life? The only exception appears to be Descartes. [2]. Descartes died at 53.

Exercise and sleep are a mutually-reinforcing positive loop. [3]. Without good sleep, people get less exercise (energy) due to fatigue. However, definitive experiments showing that better sleep means higher activity have not been done. How obtuse! Is there really no definitive experiment showing that if you get good sleep, you are more active in the day? Or is that shown for individuals, but not for statistical groups?

• This poor scholarship, and specifically in this paper - can be encapsulated in its conclusion - However, while intervening on physical activity levels has been shown to improve sleep, improving sleep has not resulted in increased levels of physical activity. How can that be? That is a sad state if we still don't know an answer to this basic question. Maybe we will study it at OSE, etc. And - note also the unclear writing - did the author mean to say 'improved sleep has not resulted in...' or 'improved sleep has not shown evidence of' - 'increased levels of physical activity? It seems the author meant the latter. NB - this paper was written in 2015.

10% of the adult population has insomnia. Best treatment is CBT, not drugs. A step-wise model is presented for making CBT accessible (scalable, due to time and expense required) -[4]. DIY is first, BSM (Behavioral Sleep Medicine) professional is top.

It is not known how the timing of exercise affects circadian rhythm, but it is known that nocturnal exercise inhibits onset of melatonin. [5]

The ideal sleeping condition is pitch black and a temperature between 60 and 67 degrees.

Chronotype is genetic but you can change your chronotype according to this source [6].

Is chronotype genetic? There are genes that influence chronotype, like there are genes that influence everything about you. Clear causal relationships are unknown, and combined with epigenetics - the case for stating that 'your genes determine your chronotype' is false. One can say 'genes may affect chronotype, but how they do so is unknown'. [7]. Other people say that 'chronotype is genetic and you can't change it'. [8]

Best Time To Wake Up

• Ayurveda sez wake up between 1:36 and 48 minutes before sunrise ideally, but definitely not after sunrise. [9]
• Waking time from 9:30 in 20s to 6:30 in 70s? [10]. Sounds far-fetched for young people to do that. Is that based on science?
• Sleep at night until 7. [11]
• There are night owls, early risers, lethargics, and energizer bunnies. [12]
• Early risers are more successful, night owls are more creative. Earlies procrastinate less (study). Early risers are persistent, cooperative, agreeable, and conscientious - studies showed persistence and agreeable-ness. Early risers get more exercise. A study says 'Morning people tend to be healthier and happier as well as having lower body mass indexes.' Study - if you don't get good sleep, you gonna be ugly. [13]

Evolution

• We sleep less than other primates because we dropped to the ground and needed to be more vigilant? [14]. Sleep paradox - predictive model based on primates says humans should sleep 9.5 hrs, not 7.

Howto

• [15]
• Get light first thing. Keep light in the day, don't hole up.

Other Notes

• Nobody changed the world on 40 hours a week [16]
• Uberman sleep cycle - [17]
• Musk's daily routine - [18]
• There are clearly successful people who don't wake up early, but it seems that generally, success is correlated with early rising. [19] and [20]

Sleep and Longevity

• Do you live longer if you sleep more? U-shape: both longer and shorter sleep lead to higher mortality [21].

Long Sleepers

• Long sleepers are normal - they require 10-12 hours of sleep. [22]
• Long sleepers are not normal - 10-12 hours - 2% of population has it [23]
• Mortality does increase for long sleepers [24]. How much?
• 'Not considered a disorder, but a normal variant' - [25]. Sleep medicine specialist says there is no evidence of physiological consequences for healthy individuals'. A medical consensus statement stated it is uncertain if there are any negative health effects of >9 hrs of sleep. Vascular dementia - not enough blood to brain
• one study shows long sleepers to be worrier types [26]
• Psychiatric and BMI issues present, but not any other physiological issues - [27]

Chronotype

• Test - [28] - see middle one.
• Change it like this - [29]
• But - non-diurnal chronotypes are at a health risk. Ex: 'So-called “night owls” were seen to be more vulnerable to having muscle loss, diabetes and metabolic syndrome, as opposed to who went to bed and woke up at times in accordance with the dark cycle and day’s light, in spite of getting the same quantity of sleep.' [30]

OSE Notes

MJ sez - I am blown away that science has not yet answered such a fundamental question: 'does improving sleep improve physical activity'. This to me seems yet another poignant examples of how humanity is trying to reach for the stars, but is missing evolution on many basics. Typical related to human performance and positive psychology - as demonstrated clearly by (1) 10-20% of the global population not able to read or write; (2) nearly half the global population lives in poverty. [31]. This is where collaborative open source development could help.

Nocturnal Awakenings

• It appears natural that most people wake up many times. 9 on average - [32]
• Note that sleep time is NOT the time you go to be and wake up. It is that time minus the awake times. Thus, if you plan on the recommended 8 hours - you need to spend more than 8 hours in bed. It is 55 minutes more on average according to available data - [33]. THIS IS A BIG POINT TO HEED FOR ANYONE WANTING TO GET THE RIGHT AMOUNT OF SLEEP, OR IF THEY WONDER WHY THEY are tired if they 'go to sleep for 8 hours'
• Remember that proper sleep, diet, and exercise are critical physical requirements of health

Training the Mind to Fall Asleep Rapidly

• Author says his insight came from a book, "Insomnia and Other Adult Sleep Problems

• How to train your brain subconsciously to fall asleep in 30 seconds [34]. (1) remove caffeine in training period (2) good diet; (3) exercise; (4) wake at same time, no lingering - which trains your brain it's all it gets, which incentives brain to fall asleep at the same time to adapt. It's the lingering that teaches the brain that it's ok not to wake up, so brain never trains itself to fall asleep immediately. (5) caffeine can be added back once brain is trained.
• Herbal stimulants - peppermint, cayenne, ginger, cinnamon - [35]

Assessment

• Polysomnogram and actigraphy
• Stanford or Epstein Sleep Scale
• Fitbit or other cheap China health watches ($40)

Night Lux

• No more than 5 lux is recommended [36]

Sleep Deprivation

• Critical distinction: acute vs chronic deprivation. [37]. We know that we can make up acute sleep debt, but there are no studies that show definitive results of making up 'chronic sleep debt'. Those studies would take many years. Wow, that's amazing, though.
• One of the worst things you can do to your body. [38]
  • Apparently, polyphasic sleep is trainable. Say 2 shifts of 4 or other.
• People in non-industrial societies sleep 7 hrs - [39]. Chimps do 9.5 hours - more than humans.
• Deprivation, even minor, is such that one doesn't notice the negative effects including one still stays quite awake - but actual performance is in reality decreased. [40] and [41]. Ie, people don't notice that they are deprived of sleep, but they don't perform either. Ie - Accumulating sleep debt doesn’t always mean that we feel tired - even if our physical and mental performance is decreased.
• While sleeping in for a morning or two may help, it’s often not enough. Research has shown that it can take up to four days to recover from one hour of lost sleep and up to nine days to eliminate sleep debt10. A full recovery from sleep debt returns our body to its baseline, reducing the risks associated with sleep loss. - [42]
• Recover is not easy - Research has shown that it can take up to four days to recover from one hour of lost sleep and up to nine days to eliminate sleep debt [43]

Sleep Banking

• But, can you bank sleep? If you get more one night, can you get less on another?
  • Yes, doable if you nap in the day to prepare for a long night of work [44]
• Yes - For athletes, the best practice for sleep is to achieve 10 hours per night (i.e. 70 hours per week), and not surprisingly, very few athletes achieve this dose. - [45]
• Researchers investigated the effects of “sleep banking” prior to a period of sleep deprivation to see if it could off-set the typical declines in cognitive and physical performance seen after sleep deprivation. They took 12 healthy men and extended their sleep for six days, assessing physical performance and neuromuscular function before (and after) one night of total sleep deprivation. The study found adding an extra two hours of sleep per night, over six days, significantly improved time to exhaustion during sustained isometric muscular contraction. [46]
  • Of the 2 hours - note 2 hrs is not sleep - it's bed time - and actual added sleep was 75 minutes

Nocturnal Arousal

• 30-90 minutes awake is common - [47]
• Middle of night insomnia - [48]
• Is it good to have 0 nocturnal arousal? Historically, apparently not. There is first and second sleep. [49]. And if our sleep is light, we can be somewhat aware of the environment and we will underestimate how much we actually slept. [50]
• high cognitive arousal contributes indirectly to the overall insomnia experience through its association with psychological maladjustment - [51]
• Unwind. Have a good sleeping environment. Avoid exercise 4 hrs before sleep - [52]
• Structured problem-solving procedure can relieve pre-sleep cognitive arousal (worry)
• Light - 50%, deep - up to 25% - REM - up to 25%. Ideally no wake time. [53]

Polyphasic

• Types of sleep - Uberman, Everyman, and more - [54]
• None seems to be sustainable, with highest chance of success being Everyman pattern [55]
• Tesla calims to have been polyphasic (2 hours per day), but he went nuts at 25, so this kind of sleep pattern cannot be said to be sustainable in terms of a 'balanced' life.

Just Right

• 13-23% should be deep sleep [56]
• Too much or too little sleep is linked to dementia in older age - [57]. Hmm. What does this really mean? Can it mean that the people studied were accustomed to a wrong amount of sleep? It does not necessarily mean that 8 hrs is optimal, but only that this amount was least related to dementia. What is this logical fallacy called?
• How much sleep do you need? Dr. Breus says 5 cycles of 90 minutes - or 7.5 [58]. And, if people are early or late risers - they still need the 7.5 hrs. Naturally, this is bullshit. Sleep cycles may range from 60-110 minutes [59].
• Consistency is important. The more consistent (same bed/rise) - the more REM you get - about 1/2 hour more REM.

Sleeping Pills and Mortality

• 10k people - 6% died in 2.5 years. [60], compared to 1% of non pill users. Does this mean in 20 years, 50% died? Probably more as that would skew the population to older.
• 10-20% death in 15 years, depending on drug type - [61]

Wehr Study

• [62] - in the 90s it was shown in an experiment that with 14 hours of night, one's sleep.cycle turns biphasic with one hour wake time. +

Links

• Non 24-Hour Sleep Phase Disorder - [63]. Occurs in most blind people! Lack of sunlight through eyes?
• Good PDF - Your Guide to Healthy Sleep - [64]
• Delayed Sleep Phase Syndrome - [65]