
Sleep Scientist Warns Against Walking Through Life 'In an Underslept State' - laurex
https://www.npr.org/sections/health-shots/2017/10/16/558058812/sleep-scientist-warns-against-walking-through-life-in-an-underslept-state
======
guiambros
I've read a lot about sleep over the years (and wrote a bit [2]), but I just
finished reading the book mentioned in the article ("Why We Sleep" [1]) and
found it _fascinating_.

The author presents a vast amount of scientific evidence amount pretty much
every corner of why we sleep, from its evolutionary roots thousands of years
ago, to the importance of dreams and REM sleep for your memory, reasons and
impact of insomnia, to what happens in the neurochemistry in your brain when
you drink coffee, alcohol or sleep pills, and much, much more.

If read only one book this year, let me strongly recommend you consider this
one.

ps: if you prefer audio, the narrated version from Audible is also very good.
There are just a few non-essential graphs, that you can download from their
side in PDF.

[1] Why We Sleep, by Matthew Walker - [https://smile.amazon.com/Why-We-Sleep-
Unlocking-Dreams-ebook...](https://smile.amazon.com/Why-We-Sleep-Unlocking-
Dreams-ebook/dp/B06ZZ1YGJ5/) [non affiliate link]

[2] Quora - How do CEOs who sleep for only 4-5 hours daily manage to function
and run multi-million dollar companies for years?
[http://qr.ae/TUpOrd](http://qr.ae/TUpOrd)

~~~
jcims
Matthew Walker, the author of Why We Sleep, was on the Joe Rogan Experience
recently.

I've been in material cognitive decline over the past year or so and I'm
nearly certain it's due to my abhorrent sleep patterns. This episode really
helped me prioritize a fix over other things that would normally result in a
night of 3-5 hrs in bed or on the floor (who knows how much actual sleep).

It's a great episode:
[https://www.youtube.com/watch?v=pwaWilO_Pig](https://www.youtube.com/watch?v=pwaWilO_Pig)

~~~
hobolord
that was the last podcast I listened to, and it was so informative. As I've
grown older I've definitely been prioritising my sleep more. While in school I
was getting maybe 6h on average for 4y, but now I aim for 8 or 9h of sleep.

------
coldtea
> _Sleep is not like the bank, so you can 't accumulate a debt and then try
> and pay it off at a later point in time. And the reason is this: We know
> that if I were to deprive you of sleep for an entire night — take away eight
> hours — and then in the subsequent night I give you all of the sleep that
> you want, however much you wish to consume, you never get back all that you
> lost. You will sleep longer, but you will never achieve that full eight-hour
> repayment, as it were. So the brain has no capacity to get back that lost
> sleep that you've been lumbering it with during the week in terms of a
> debt._

What does "never" here means though? Obviously you could get back to your
normal self after a few days of sleeping well, no?

~~~
baxtr
This seems to contradict recent study that I came across [1]:

 _The mortality rate among participants with short sleep during weekdays, but
long sleep during weekends, did not differ from the rate of the reference
group. Among individuals ≥65 years old, no association between weekend sleep
or weekday /weekend sleep durations and mortality was observed. In conclusion,
short, but not long, weekend sleep was associated with an increased mortality
in subjects <65 years. In the same age group, short sleep (or long sleep) on
both weekdays and weekend showed increased mortality. Possibly, long week- end
sleep may compensate for short weekday sleep._

[1]
[https://onlinelibrary.wiley.com/doi/pdf/10.1111/jsr.12712](https://onlinelibrary.wiley.com/doi/pdf/10.1111/jsr.12712)

~~~
Terr_
It may be important to distinguish between (A) long-term mortality versus (B)
impaired cognition and mood on a daily basis.

To use an analogy, you might be able to maintain a car so that its lifetime
mileage isn't reduced, but that doesn't mean that it can't suffer in terms of
handling, speed, comfort, etc.

------
Tharkun
You can be in an "underslept state" even if you get 8 hrs a night. I usually
am. I snore. Most of the time and very loudly. So do maybe a billion other
people. It negatively impacts the quality and quantity of your sleep (and that
of the people around you). It can greatly increase the risk of a whole slew of
nasty diseases. And yet there is no cure and no effective treatment. As near
as I can tell, no one is working on magic potion to fix it either.

There are tons of gimmicks and gadgets which promise to help, but none of them
do, not really. There's surgery which is invasive and has poor long term
outcomes. There's CPAP (and variants) which many people don't tolerate well,
and many more people stop using as time goes on.

There are sleep studies in hospital, which are an expensive hassle and only a
snapshot. There are apps which track your snoring, but they can't diagnose the
cause or tell you what to do to fix it.

With such a huge potential user base, why isn't anyone working on an effective
solution (not that I know what that would look like)? I would glady give up my
Netflix subscription and gym membership and pay the equivalent amount to get
better quality sleep.

~~~
wenc
I suffered from obstructive sleep apnea (OSA) and snoring, and the two things
that helped were sleeping on my side and weight loss. The latter was difficult
to achieve but was the most high-leverage thing I ever did.

I had no idea at the time, but my OSA was contributing to a slew of health
problems like hypertension etc., and when I removed the cause, my overall
health got better.

~~~
coldseattle
Exactly. The need for a CPAP is almost always mitigated by weight loss.

~~~
0xcde4c3db
As far as I've read, weight loss almost always helps (assuming a person is
obese, which is common with OSA because it's also a symptom), but it's unusual
for it to totally eliminate the need for CPAP.

~~~
ellius
I experienced the reverse: using a CPAP finally gave me enough energy to start
exercising, which helped me lose weight. I imagine if I stopped using the CPAP
I would slowly start losing energy again and probably stop exercising and gain
the weight back. The few nights I've gone without CPAP have left me feeling
awful, even without as much weight.

~~~
wenc
Everyone's physiology differs, but I've learned that weight control is 80%
diet and 20% physical activity. (this assumes normal metabolism)

I went to the gym for years and my weight fluctuated a couple of pounds.
Cardio was especially ineffective for any kind of weight loss.

Weights were much more effective because they increased my resting metabolism.
I drastically reduced carbs from my diet, increased protein and vegetables,
and the needle on the scale started moving. I ate about the same amount, but I
changed the composition of my food -- no simple sugars or simple carbs.

I don't want to be prescriptive, since everyone's different, but for anyone
who finds it hard to adopt an exercise routine, I would encourage them to
consider changing their diets and see if that makes a difference.

~~~
0xcde4c3db
> (this assumes normal metabolism)

Such an assumption is likely to be false in cases of chronic sleep disruption
[1] [2] [3].

[1]
[https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2830474/](https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2830474/)

[2]
[https://www.ncbi.nlm.nih.gov/pubmed/14512265](https://www.ncbi.nlm.nih.gov/pubmed/14512265)

[3]
[https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3476879/](https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3476879/)

------
ta1234567890
For a few years I was sleeping about 4 hours a day on weekdays. I thought I
was fine until I started sleeping 8 hours a day and realized I had been almost
in a permanent bad mood for years due to bad sleep. My life completely
changed.

Now even though I can still get through the exceptional sleepless night/day,
the difference is so evident that my daily life is planned/scheduled to make
sure I get plenty of sleep. Life feels a lot happier and fulfilling now.

~~~
aeriklawson
Absolutely. I get irritated, anxious, and easily-stressed when I'm sleep
deprived - a full night's sleep makes me feel so much better.

------
andor
Apart from quantity, quality of sleep is also important.

I just realized how much a little light can disturb sleep. My blinds are
opaque but hung 1-2 cm from the window frame, letting in just a few unwanted
photons. I temporarily taped the blinds to the frame, leaving the room in
almost complete darkness. I haven't felt this rested in years. Do try this at
home!

~~~
newacct500
I've never understood how this could be the case, evolutionarily speaking.
Even in the absence of electrical light, there is rarely complete darkness.
Did our remote ancestors just sleep extremely poorly whenever there was a lot
of moonlight?

~~~
Reason077
Away from cities it gets very dark at night, unless there is a full moon. But
near cities there is a lot of light pollution, so we're always in a state of
near-twilight.

~~~
gardnr
Celestial lights are quite bright when away from light pollution

------
Puer
I'm currently in my 20s and I've been a type 1 chronic insomniac my whole
life. Physically, I'm healthy and fit and I have been my whole life, but
mentally my mind feels slower and foggier than my peers and I struggled
through high school and college because of it. I know this might sound morbid,
but I am fully expecting to die early despite doing everything in my power to
live a healthy, balanced lifestyle. I can't see getting 2-3 hours of sleep a
night with all-nighters ~once a week being sustainable as I age and I wouldn't
be surprised if my brain has already deteriorated in function significantly.

~~~
hugja
I'm curious have you ever tried working out in the early hours after waking
up? This alone determines if I'm getting good sleep or not. I'll end up
staying up way later into the night unless I worked out that morning.

~~~
haskellandchill
People with chronic insomnia have generally tried everything and it’s
unhelpful and annoying to offer your suggestions, I realize you’re trying to
help but yeah.

~~~
darkerside
Also pretty obnoxious to jump in as a third party and sass someone for trying
to be helpful to someone else. Puer can speak for himself if this is bothering
him, and since he's posting about it on a public forum, I actually doubt that
it does.

------
jm__87
Just a word of warning to any insomniacs on here thinking of reading Matthew
Walkers book, Why We Sleep: it is probably one of the least helpful books I
have ever read in terms of helping you sleep well. It mostly explains the many
ways you are damaging your health by not sleeping well, and reading it while I
had insomnia just made me anxious and made it more difficult to sleep. The one
good thing that came out of reading it was a suggestion for CBT for sleep, and
I would highly recommend that as that did actually help me sleep.

------
benlorenzetti
We have had industrial shift hours for nearly two centuries, and before that
in the Army and Navy. Yet large organizations are still implementing new
shift/watch schedules to (or sometimes purportedly to) improve health and
alertness based on scientific results. [https://www.navytimes.com/news/your-
navy/2016/10/28/this-lif...](https://www.navytimes.com/news/your-
navy/2016/10/28/this-life-changing-shift-has-made-submariners-much-happier/)

What is the problem with science here? Without being an expert it seems like
there are three possibilities:

1) Sleep studies are too difficult to discern results and control.

2) We have culturally been focused on the wrong results, organizational
efficiencies rather than individual health.

3) Humans actually adapt to new conditions faster than expected.

Everyone is at least mildly interested in this topic and mildly an expert. Its
easier to see problems than remedies and there are conspiracy theories too:
[http://rotateshift.blogspot.com/](http://rotateshift.blogspot.com/)

~~~
barry-cotter
4) No one gives a shit about the long term health effects.

There are lots of pieces of knowledge that have obvious practical implications
that aren’t acted upon because it’s inconvenient and the function of a system
is different from what people say it’s for. School is more childcare than
education and using the same buses for elementary and high school is cheaper
so all high school students are sleep deprived and learn less than they would
if they could get up at a natural hour. Psychological research on learning
like the forgetting curve that works is ignored while crap like learning
styles comes and goes in fads. Direct instruction works wonderfully but is
boring to teach so it isn’t adopted anywhere.

School isn’t about learning. Politics isn’t about policy. Healthcare isn’t
about health.

The purpose of a thing is what it does, not what someone says it’s for.

~~~
darkerside
Can you explain more about forgetting curve and direct instruction?

~~~
kilotaras
Forgetting curve means it's better to learn about independent topics (in lets
say philosophy) A B C in the order ABCABCABC, but almost in every school it
would be AAABBBCCC.

~~~
joveian
In a bit more detail, the basic idea is that forgetting is a regular, valuable
occurance to have better access to the useful information and the way that
useful information is determined is use over time. If you use particular
information intensely over a short period of time then stop using it at all,
that is a signal that you are done with that information and it will be
forgotten fairly quickly. But if you use it again after a while then that is a
signal that it might be useful even further into the future. Spaced repetition
is another application of this idea.

I've always liked B.F. Skinner's ideas about learning, where the forgetting
curve is paired with the idea that making mistakes is quite harmful since then
we also have the memory of the incorrect answer (that will decay more slowly
than random information due to being close to the thing we want to actually
use). So it is better to refer to the correct answer until you can recall it
correctly, which happens automatically as a standard brain optimization when
we do something repeatedly.

I don't really know anything about direct instruction, but it sounds like a
core idea is heavily scripted teacher student interaction, which sounds even
more dystopian to me than the current system (like being raised by an
automated call center in human form). But IMO a bit further in that direction
would be great. Remove teachers from the normal learning loop and provide a
variety of learning materals (books, video, audio). Teachers can then assist
students individually and spend more time being social workers or whatever
else is needed so that kids are in a place to be able to learn. Currently the
whole school experience tends towards performance art by teachers where the
presence or absence of students is a secondary concern. If learning was the
important part then the experience would be centered around learning with the
presence or absence of teachers a secondary concern.

------
Reason077
In the UK we have a fantastic service called Radio 4 which has remarkable
sleep-inducing powers. Much better than any narcotic sleep aid, in my
experience.

Podcasts also work well, in my experience.

~~~
praveer13
I've found podcasts to be incredible tools to induce sleep. It's very
difficult to stay awake for me while listening to any podcast or audiobook. I
really don't know how people do it.

~~~
henriquemaia
I have to be engaged in something physical* to listen to podcasts/audiobooks.
If I just try to listen, I inevitably fall asleep.

*I usually listen to audiobooks while I ride my bicycle to college.

------
aeriklawson
I've been amazed by how much sunlight affected my sleep quality - a year or
two ago I purchased a curtain rod and a pair of black-out curtains to put in
front of my bedroom window.

I can't emphasize how much better I sleep with it. When I forget to close them
some nights, the next day I feel significantly less rested and my sleep
quality after sunrise is a lot worse (I often wake up several times as well).

Check it out especially if your room gets lots of sunlight in the morning.

------
stretchwithme
This guy was the Joe Rogan Experience. Very interesting.

[https://www.youtube.com/watch?v=pwaWilO_Pig](https://www.youtube.com/watch?v=pwaWilO_Pig)

------
cwe
Has no one mentioned parenthood forcing sleep deprivation for 1-3+ years?

~~~
abootstrapper
This is why kids think their parents are idiots. - We are, but it's our kids
fault.

------
jaequery
Articles like this scares me greatly. About 2 years ago, I went about 3 weeks
with maybe less than 3 hours of sleep. I am sure it is hard to believe, even I
can't believe it myself, it was a crazy experience, where my mind was just
passed the point of exhaustion that I could not feel tiredness at all. After
that my sleeping have never been the same, went through almost a 2 years of
waking up every 3 hours or so. It's just about a month ago where I was able to
finally sleep without waking up every couple hours. I am so grateful these
days but I still fear the day where I may just start waking up again in middle
of the night, it was a living hell, no other way to describe it.

~~~
graeme
What caused the initial deprivation?

~~~
jaequery
I don't know. Just one day, it started it. I had some client work that was
overdue and some stress at work place. But it was nothing major.

------
Tomte
If you‘re feeling tired over the day, maybe in the afternoon or early evening
when you get home from work, go to a doctor and have your sleep monitored. You
get a portable machine that reads your breathing, your oxygen level in the
bloodstream and your sleeping position.

There is a chance you have sleep apnoea, and you stop breathing a few times
over the course of your sleep at night, lowering your oxygen levels until your
body has a suffocation reaction, over and over again. That can happen dozens
of times every night and you won‘t remember any of it.

~~~
Bradenski
I've tried the take home mask, and it was very uncomfortable to sleep with. I
did wake up once in a way I normally don't, so I felt the study was invalid at
that point. Surely the technology has changed in 5 years, but for light
sleepers like myself, sleep studies with equipment attached to your body don't
feel like fair trials. MRI sleep studies can be an option, and if I had to do
it again I think that would be optimal for me.

~~~
Tomte
Patient compliance is the bane of doctors‘ lives.

You don‘t decide that the recording is invalid. You tell your doctor what
happened and he decides which conclusions can be drawn from the data.

------
jmartrican
I'm no expert but I thought that the whole 8 hour a night thing was not true,
at least not for everyone. If I force myself to get 8 hours of sleep, by
forcing myself to stay in bed after I wake up, I get a headache. If I let
myself wake up on its own without an alarm, it averages around 6.5 hours. If I
get below that, then at some point I will sleep more than the 6.5 hours, and
maybe even 8 hours.

So from personal experience it seems like some of the things in this article
do not mesh well with personal experience. I'm just confused at this point as
to what to do. Am I suppose to stay sleeping for 8 hours even though I am
awake? If for some reason I can't sleep at night and get less hours of sleep
than expected, am I suppose to call in late to work and miss my morning
meetings? You want to do the right thing here but getting 8 hours of sleep for
some people just seems unpractical and there must be countless people who
never get 8 hours and live long fruitful lives (I have no evidence for this
but it seems like it would be true due to me not remembering anyone who told
me they get 8 hours of sleep). I guess I require more evidence that 8 hours is
what everyone should be getting. If maybe some people need 8 and others do
not, then maybe they need to word it that way.

~~~
Gatsky
Do you drink coffee?

~~~
jmartrican
Yes I do. But I have my last cup at around 2 or 3pm. I noticed that if I drink
coffee after 5pm, it could affect my sleep if I do not workout.

You think coffee in the early afternoon could affect sleep?

~~~
Gatsky
Just wondering if the morning headaches are caffeine withdrawal. This commonly
causes headaches.

------
ulisesrmzroche
"Legalize Siestas" sounds funny but I think it would change all our lives for
the better. It's likely never to happen under our current economic system
though.

~~~
gnulinux
I find Siestas the absolute worst thing possible for my sleep schedule. Even
20 minutes of noon naps completely nuke my sleep schedule and it takes days to
make it normal again. I actually tried Siestas pretty hard for at least 2
years when my insomnia was worst, but eventually I realized without naps my
sleep schedule is much more predictable.

------
aantix
Strangely whenever I have a great nights sleep it always makes it hard to go
to sleep at a descent hour the next night.

My children are up at 6am, so that’s when I have to be up.

~~~
greenhatman
I'm the same. I suspect if I actually got decent sunlight exposure during the
day I wouldn't have this problem.

------
boomskats
Book sales aside, the point about the brain being an associative device, and
the advice to avoid lying in bed awake & instead going to another room until
you're sleepier, is really valuable imho. Entrainment is very real and happens
rapidly, and this advice is not given often enough.

------
SZJX
I still think that the optimal amount of sleep really depends on the person
and you can't paint everything with a broad stroke or advise everybody to
"have 8.5 hours of sleep". I've found myself the most concentrated and
productive the next day when I don't sleep too much, e.g. when I just sleep
for 6 to 7 hours. When I sleep a lot I usually just feel too
relaxed/hyperactive for some reason and can't properly direct my attention at
tasks. I think there should be people with similar experiences out there.

Those statements might be good for raising more public awareness so that
they're not chronically extremely underslept, e.g. consecutively for 4-5 hours
a day. But to only advocate sleeping a lot is too partial IMHO.

------
extralego
What can I do? Should I forward this to my employer?

~~~
coldtea
No, unless you live to work, you should demand your right to a balanced life
without having to point to scientific literature on the benefits of sleep.

Even if it wasn't stolen sleep (say we needed no sleep, and the day had only
16 hours), constantly overworking would still be lost time (with family and
friends and me-time) that you would never recover.

~~~
haskellandchill
We work to live. It’s not our employer’s fault we are broken people.

~~~
coldtea
It is when its imposed upon people. It's not like everybody self-elects to
"work to live". Especially when they're just a cog doing a BS job just to pay
the rent and feed their family, not full-filling their entrepreneurial or
creative or other dreams through it...

(And the culture and glorification around working to live has a lot of
employer influence in it).

~~~
haskellandchill
I hope nobody self-elects work to live. It is miserable!

------
baxtr
At least, it seems as if you could recover sleep on weekends

[https://onlinelibrary.wiley.com/doi/pdf/10.1111/jsr.12712](https://onlinelibrary.wiley.com/doi/pdf/10.1111/jsr.12712)

~~~
mrexroad
Until kids!

~~~
baxtr
So true...

------
nikkwong
> "Unfortunately the current set or classes of sleeping pills that we have do
> not produce naturalistic sleep. So they are all a broad set of chemicals
> that we call the sedative hypnotics, and sedation is not sleep, it's very
> different. It doesn't give you the restorative natural benefits of sleep.
> ... If you look at the electrical signature of sleep that you have when
> you're taking those medications, it's not the same as a normal night of
> sleep."

Most of the literature I've read reports otherwise, that Zolpidem actually can
increase the quality of your sleep. Of course, it's not without it's
disadvantages as well.

~~~
mmt
I'll likely do my own more in depth looking.. but, in the meantime, do you
recall if this was true for the other "Z-drugs" (zaleplon,
zopiclone/eszopiclone)? Is there any convenient summary or meta-analysis you
could link?

------
MToD
Sleep is common problem of every people. They can know its causes and get
treatments , Here this guide may help. read here
[https://bestmattressesreviews.com/sleep-
disorder/](https://bestmattressesreviews.com/sleep-disorder/)

------
tasty_freeze
> You're trying to sleep off a debt that you've lumbered your brain and body
> with during the week, and wouldn't it be lovely if sleep worked like that?
> Sadly it doesn't.

But it does somewhat, just not fully.

Thought experiment for the author. Say he slept 6 hours every day during the
week, and come the weekend, is he going to say that there is no benefit to
sleeping more than 8 hours, or will that 10+ hour sleep do any good over 8
hours? I strongly suspect that, yes, "catch up sleep" is useful, but just not
100% restorative. But the original claim sounds more like the former, "catch
up sleep isn't useful".

------
MToD
actually sleep disorder treatment depend on its symptoms . This helpful
article will give you proper guide. Read here
[https://bestmattressesreviews.com/sleep-
disorder/](https://bestmattressesreviews.com/sleep-disorder/)

------
frankzander
Interesting would be the view of "How we sleep after consuming marihuana".

~~~
cerberusss
In his podcast, he talks about that with Seth Rogen. Turns out that marihuana
as well as alcohol induces sedation rather than sleep.

This causes the brain to withhold REM sleep until the sedative has worn off,
then suddenly catches up. So lots of people report very vivid dreams at the
end of the night.

Since the amount of REM sleep was less, the quality of the sleep is also lower
(he said only half or so).

~~~
frankzinger
That would be _Joe Rogan_. Link to the podcast is
[https://www.youtube.com/watch?v=pwaWilO_Pig](https://www.youtube.com/watch?v=pwaWilO_Pig).

------
Lio
This is unrelated to the article but I love that npr.org allows opting out of
tracking and in exchange for a plain text version of the site.

I’ll happily give up eye candy for privacy and I’m sure it’s much cheaper for
them to serve bandwidth wise.

~~~
Tomte
Do you get to the article you were linked to? Because I‘m always redirected to
their front page, with no way to get to the article that was linked.

~~~
Lio
Hmm, no I spoke too soon! Sorry, I can’t reach it either.

Even tried editing the article URL to no avail. :(

~~~
pocak
There's a nine digit number in the middle of the normal URL. You can take a
text-only URL and replace the identifier at the end.

Shame on them for not making all articles reachable from the text home page,
and for not redirecting to the article from the choice page.

[https://text.npr.org/s.php?sId=558058812](https://text.npr.org/s.php?sId=558058812)

------
coldseattle
I don’t doubt that hat the people don’t get enough sleep, but the biggest
health problem in the western world is Obesity. It has huge health,
environmental, and social costs.

~~~
abootstrapper
Might obesity be related to lack of sleep?

~~~
greenhatman
Lack of sleep can definitely contribute to weight gain. Probably in more than
one way, but I know specifically of studies that found lack of sleep makes you
crave more unhealthy high calorie foods.

