
Sleep and Mortality: A Population-Based 22-Year Follow-Up Study (2007) - onderkalaci
https://fermatslibrary.com/s/sleep-and-mortality-a-population-based-22-year-follow-up-study
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munin
The people that want to make criticisms about how this association is not
causal can start reading halfway through the first column of page 1252. The
authors are careful to phrase their finding as an association, not a causal
relationship.

They discuss the confounds you might think of (sleep a lot because of
undetected major illness? depression? etc) and their efforts at controlling
for them.

They then acknowledge that there are still enough unknowns that they can't
make a causal link, and that there should be more in depth and controlled
experiments to investigate this phenomenon.

~~~
lucozade
I agree. I think publication of studies/experiments that don't find anything
particularly interesting should be encouraged not condemned.

It's much more of a problem that there's a bias to publishing to a headline.
I'm, slightly irrationally, more inclined to believe this than a lot of
papers.

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exclusiv
Agreed. What can we really say is causal? Not that much in the grand scheme of
things.

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andybak
I suppose one could argue that in an absolute philosophical sense there is no
causation that we can have knowledge of, only differing amounts of
correlation. It would be an extreme position to take but - like solipsism - a
difficult one to argue against.

(Anyone with an actual background in epistemology care to help me out here?)

~~~
anon1253
Hume argues this in “enquiry concerning human understanding”
[https://plato.stanford.edu/entries/hume/#Cau](https://plato.stanford.edu/entries/hume/#Cau)

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erentz
Slightly tangential to the study here but I’ve been going down the sleep apnea
rabbit hole in recent months and I strongly encourage folks to investigate
their sleep. A lot of people have sleep apnea and don’t realize it. You don’t
have to snore to have it. A surprising statistic I found was 20-30% of people
with ADHD have sleep apnea. A lot of people may be treating symptoms of sleep
apnea like ADHD and high blood pressure with medications while ignoring the
root cause. My experience with this has been that doctors are surprisingly
ignorant. They’ll happy prescribe you medications for anxiety, ADHD, blood
pressure for years, and never think to ask you about your sleep. Do some of
your own investigations or ask about it if you have any suspicions.

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elros
Do you have any suggestions on how can I not too expensively measure my sleep
quality at home?

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erentz
If you're lucky enough to have decent medical insurance I'd simply bring it up
to your primary care doctor for a referral or sleep doctor in your area (you
usually don't need a referral if you want to seek out a sleep doctor
directly).

They will have you come in for a visit to talk about your symptoms and
evaluate you, then usually they'll schedule you for an in-home test, which
means you get a little device to take home and strap to your chest. It'll have
a pulse-oximeter you connect to your finger, and an air flow meter that you
run to your nose using a nasal canula.

If this isn't conclusive or something else seems to be going on they will
bring you into the lab to sleep with even more devices connected to you
measuring brain waves, muscle activity, etc. These usually look like a hotel
room so it's not too uncomfortable.

I wanted to get a head start on my own so I set up a camera that has night
vision to record myself since I happened to have one. (Lots of home security
type cameras will have a night vision mode.) It wasn't particularly
conclusive, I couldn't really make out that my breathing was stopping, but it
did make me realize I seem to wake up and move _a lot_. Additionally I was
surprised to learn I sleep with my mouth closed, since I've always gone to
sleep with it open.

There are options I've seen online from various online CPAP stores to order an
in-home test as described above, I don't know how reliable they are,
presumably they mail you the kit and you mail it back.

~~~
hx2a
> Additionally I was surprised to learn I sleep with my mouth closed, since
> I've always gone to sleep with it open.

Do you grind your teeth or clench your jaw when you sleep? If you grind your
teeth your dentist will be able to tell. If you clench your jaw you will wake
up with muscle soreness.

When I was a trader I had a lot of stress and would slam my jaw shut with
enough speed to wake myself up, and in one case, break a dental appliance.

~~~
ethagnawl
I'm not sure if you're implying there is a connection between bruxism and
sleep apnea, but after a quick search, it looks like there is[0]. I've dealt
with some of the issues mentioned above -- in addition to bruxism -- and never
even thought to make the connection. So, whether you meant to or not, you may
have just helped my tremendously. Thanks!

\- 0: [https://sleepfoundation.org/sleep-topics/the-link-between-
sl...](https://sleepfoundation.org/sleep-topics/the-link-between-sleep-apnea-
and-teeth-grinding)

~~~
hx2a
Very happy to hear I've helped you!

I have also dealt with both bruxism and sleep apnea so I know the symptoms. I
also thought the same thing about going to sleep with my mouth open. I figured
we had something in common.

Eventually I had surgery to fix my sleep apnea. Saying the surgery was a life
changing experience is an understatement. Getting proper sleep for the first
time after being tired my entire life was a giant step forward for me as a
human being.

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miketery
Results: long (>8h) and short (<7h) sleep both associated with greater risk of
mortality.

~~~
pensivemood
Does this take it into account of the possibility that people who sleep longer
than 8hrs probably has other unhealthy habits, like lack of exercise etc..

~~~
pc86
Your question can be answered by reading the other comments here.

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xkcd-sucks
To everyone requesting more, different studies: Okay, you're correct in the
philosophy-of-science sense. No doubt that feels good.

But, current understanding of biology is that:

\- Literally no biological process is not affected by sleep

\- Disrupting sleep disrupts whichever process is being studied

\- Literally every type of organism sleeps[0]

It's a _huge waste of time_ further proving that sleep is really, really,
important, and this waste of time is actively harmful to everyone. What's
maybe not a waste of time is researching

\- How to actually get things into a shape where sleep is a priority on a
population level

\- Therapeutic interventions targeting poor sleep

\- Otherwise preventing or mitigating poor sleep

[0] Sleep:

\- Periodic

\- Quiescent (less activity, less response to environmental stimuli)

\- Homeostatic, e.g. sleep less now -> sleep more later

~~~
owenversteeg
I think studies like this are important to determine the importance of sleep
and the right amount. For example, this study suggests that too much sleep is
harmful, which isn't a universally agreed-on point.

Additionally, sleeping isn't a binary thing. People do mini cost-benefit
analyses: sleep an extra hour vs do more work? Sleep vs talk to a friend?
Sleep more or spend time eating a slow, healthy breakfast?

Maybe the health benefits of sitting down and eating a healthy breakfast
outweigh the benefits of sleeping by a large margin, although both are
helpful. More research could help people make decisions about how much they
sleep.

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ShabbosGoy
What worries me more is the link between sleep and Alzehimer’s/cognitive
impairment.

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petermcneeley
I would prefer to see an experiment (even on non human mammals) rather than
see a study that likely cannot disentangle correlation and causation.

~~~
openasocket
I'm not sure an experiment with non-human mammals would give you much either.
How would you control how much sleep the subject gets? Only thing I can think
of is sedatives to put them to sleep, and stimulants or flashing lights/loud
noises to keep them awake. And those all come with fairly significant side
effects, to the point that I imagine you'd really just be measuring the
effects of those medications on the subjects rather than the sleep. But this
isn't my area, and this is based on like 10 minutes of thought, so maybe there
are more reliable ways to control sleep with fewer side effects?

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mjevans
I would love to see the results of a slightly different study where
participants (usually) fell asleep and woke naturally (and without external
influences like apartment neighbors or flatmates) and those who's sleep cycle
terminated artificially.

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e12e
There's been a lot of studies on such sleep cycles (esp: without an external
day/night cycle). But I can't really imagine a study that removed people from
external influences on sleep (including their own children) for 20 years...
Without having serious issues with separating out other factors...

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joncrane
This is a repost from yesterday:
[https://news.ycombinator.com/item?id=16267306](https://news.ycombinator.com/item?id=16267306)

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Chris2048
"Signiﬁcantly increased risk of mortality" sounds like the participants were
immortal before..

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aargh_aargh
(2007)

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sctb
Thanks! Updated.

