Hacker News new | past | comments | ask | show | jobs | submit login
Insomnia: 'No link' between sleepless nights and early death (bbc.co.uk)
123 points by sjcsjc on Nov 16, 2018 | hide | past | web | favorite | 77 comments

This seems intuitively incorrect especially if insomnia is linked "with illnesses such as dementia and depression". If they are controlling for these "confounding factors", it's highly possible that they're just eliminating the side effects of insomnia that result in an early death. It would be intuitive that someone that suffers from insomnia but suffers none of the major side effects probably wouldn't have a higher mortality rate. If they remove these controls, the results might look very different. If anyone can find the full text of the study, it'd be nice to look at.

This also flies in the face of things like Fatal Familial Insomnia and Sporadic Fatal Insomnia where patients soon die after suffering though months and months of insomnia[0].

[0] https://en.wikipedia.org/wiki/Fatal_insomnia

The abstract doesn’t say anything really, only that a meta analysis of existing studies reject null hypotheses that insomnia is linked to death. This isn’t really that useful, and digging deeper requires looking into the details of the studies. When all those results are pooled together, it only takes one bad study to skew the meta analysis.


I think the null hypothesis is that insomnia is uncorrelated with mortality, and the meta analysis failed to reject it.

>This also flies in the face of things like Fatal Familial Insomnia and Sporadic Fatal Insomnia

No it doesn't. Those are prion diseases that cause protein transcription errors in the brain. It is completely different from normal insomnia. Not a good example.

Ridiculously few people die of fatal familial insomnia

That is because FFI is very rare not because it doesn't kill you

Yes, and?

When 0% of a group have the deadly variant, that variant is useless for establishing an overall link to early death.

Several times in my twenties I've found myself pretty depressed with no seeming way out. Generally I'd find myself with insomnia that I'd try to fight, thinking more sleep would help me break it.

At one point I stopped trying to fight the insomnia, instead just trying to stay up as long as possible. I didn't have a job at the time.

After a few days of practically no sleep but all conscious activity, I'd be playing video games or reading or whatever, I fell into a deep sleep for like 12-14 hours, and when I woke up, I felt refreshed like I'd never felt before, and my depression, well it was gone.

I believe that, just as sleep clears out some brain cruft, not sleeping can perform an inverse service that's almost as vital. The focus on "getting enough sleep" as some kind of religious mantra is keeping us from doing that.

It's a well established but little known fact that sleep deprivation is an extremely effective short term treatment for depression. [1]

Obviously I am not recommending that anyone try it without medical supervision, but people should at least know that it's an option.

1. https://www.scientificamerican.com/article/why-sleep-depriva...

I experience a sense of euphoria if I stay up late enough - I wonder how common that experience is...

At one point in college I stayed awake consistently for 4-4.5 days without any caffeine or other stimulants. By the second/third day the feeling of being "tired" was entirely gone, and I felt energetic and almost intoxicated. There was definitely euphoria, as well as some auditory/visual hallucinations. Afterwards I slept for about 20 hours straight. It was an odd experience

I managed 53 hours once over a weekend of a big LAN party, drove home and slept for 26 hours after that. Apparently my mother called the doctor who just said to check I was still breathing and that I'd probably wake up soon.

I woke up thinking it was Monday but it was Tuesday. That took some explaining at work.

Felt amazing after about 30 hours of being awake and after the sleep's "jet lag" wore off.

I had a similar experience after a week long camp where I only slept a couple of hours a night, if that. On returning home I went to sleep and distinctly recall waking up about an hour later, only to discover I'd actually been asleep for ~25 hours.

I never experienced euphoria then, but in my younger years when I could still successfully pull all-nighters I found myself re-energized once the sun rose in the morning and this lasted typically until later that afternoon. This lead to a general rule where if I was planning on staying up that late I always tried to go to bed before the sun came up.

Sounds like classic hypomania. (Or maybe actual mania?)

From experience, I would say very. The longest I've been awake is ~5.5 days though.

Brain damage can start around that point... Watch out

Source? I expected harm would come much earlier.


I'm in the middle of stuff and can't google a more concise source but I recall it being about 4-5 days

I hit that figure quite a bit back in my stimulant abuse days.

But your blog post specifically refers to chronic sleep loss.

Did you do anything specific to stay awake? After a certain number of hours, I really have to keep myself busy, or my brain just shuts down.

Playing games, specifically Diablo 3 & CoD MW2, separate times

Sleep deprivation has a well-established anti-depressant effect. Sadly it does not last, the emotional state soon returns to the baseline. The temporary reprieve could push you over the edge though, if you were close to it.

At least according to Matthew Walker, in his Why we Sleep (which I recommend to everyone), it doesn't work for everybody. Only some people get anti-depressant effect.

The risk is people are more likely to commit suicide when they are mildly depressed than severely depressed. In a deep depression you lack the motivation to commit suicide.

That's true, but not specific to sleep deprivation - other methods of easing depression such as SSRI also increase the likelihood of self-harm. I would imagine sports can have similar effect.

My pet theory is that there are several conditions that look like "depression", one of them is produced by the body to prevent self-harm resulting from acute anxiety. This theory has two important consequences:

1) Trying to ease certain kinds of depression via medication or other direct-action tools is likely to cause unintended side-effects (self-harm, anxiety, mania) that the depression was there to prevent.

2) The body will fight back against any direct intervention, trying to reinstate control over unbalanced psyche, e.g. building up tolerance to medication. A more fruitful approach would be to locate and eviscerate the underlying anxiety-inducing problem; the depression should then lift on its own accord.

Like I said, it's just a pet theory, but it leads itself to validation.

I am entirely guessing, but maybe forcing yourself to sleep resulted in low quality sleep and forcing yourself awake led to eventual high quality sleep which sorted out the issues causing your depression.

Over the counter St. John’s wort is great for depression. It’s helped me out of some rough patches where I otherwise couldn’t go to a doctor. (It interacts with lots of meds though so do your research first)

Yeah be careful taking this if you are already taking an SSRI or SSNRI. You can cause Serotonin Syndrome, which I can tell you from experience is not fun (Mine was caused by taking too much 5-HTP, not by St John's Wort, but the latter can definitely do it too).

Don’t get too excited.

> But while the new report may lift concerns about an early death, it still links insomnia with illnesses such as dementia and depression, reports The Times.

I wonder how this gels with Matthew Walker’s book, which has received tons of hype this year.

Haha I actually bought that book after hearing about it in a HN thread.

Oh gosh, so did I.

I went and got it from the library. It seems, from the article, that it's entirely off-base with what his book claims.

Having just finished the book, this article runs counter to what's discussed in Why We Sleep.

Agreed. I'm only about 2/3 the way through it, but a lot of comments in this thread, and the article itself, seem to go against what he says. But, he does mention that sleep leads itself to a host of other issues, and that's what could cause the death. As to all the other claims, well, we don't really know how sleep deprived we are, as he mentions.

As someone who has struggled with sleep since childhood, I’ve been scared stiff by popular media that every ailment known to man is going to afflict me... underperformance, won’t develop muscle, won’t form memories, cancer, heart attacks, ED, high blood pressure, whatever.

I’ve always felt fine despite sleeping 5 hours. I wonder if the bell curve of what people need is centered on 8 hours and I’m just in the left hand tail somewhere?

This is extremely rare, way more rare than people who merely think they're fine with much less sleep.

Given you seem to have spent a lot of time thinking about this, perhaps you've already been to a sleep medicine doctor, but if not, you really should. They'll be able to confirm you're one of the rare individuals who actually won't benefit from more sleep.

I have the same. I need 7.30 a night, if I get more than that, I have trouble sleeping the next night, and feel terrible the next day. For a long time I was in a cycle of trying to get to bed early because I was so tired, not sleeping well, thoughts bouncing around my head, repeating ad nauseam.

I eventually found a course[1] that went through a 'sleep restriction' cycle, essentially limiting the amount of time you're allowed in bed to the actual amount of time you're asleep, according to rough measurements through an app or whatever. For me this started at 5.30 hours. It was dreadful, but each week you spent 90%+ of the time actually in bed asleep, you could give yourself another 15 minutes. Eventually I settled on 7.30 as the amount of time I needed.

I now have the occasional bad night, but I don't sweat it, and stick to 7.30 hours in bed each and every night on strict hours. It's transformed my life from the insomnia I had before.

1: https://www.sleepio.com/

Not sure about the bell curve aspect of sleep, but scientists have discovered a gene that allows a very small portion of the population to be fully rested on about 4 hours of sleep a night. I suppose it's possible that you could have this gene.


Although it's also possible you have one of the other genes or conditions that alters your sleep needs. But usually that comes with associated side effects. You report feeling fine so not sure what to make of that.

> I’ve always felt fine despite sleeping 5 hours.

Tons of people will pay good money to be genetically modified with that ability. You should feel lucky.

> I’ve always felt fine despite sleeping 5 hours

This is part of it, I think. In Why we Sleep, Dr. Walker specifically mentions that we often don't realize how sleep deprived we truly are. Given the fact that, if you rounded the percentage of people who have the mutation needed for less sleep, there's an effectively 0% chance of you having it, I'd say that's what's coming into play here.

If it makes you feel any better in a weird way, Donald Trump supposedly sleeps only 4-5 hours a night and he’s 72 years old and healthy.


Well, first, almost everything Donald says is a lie or an exaggeration and I doubt he sleeps 4-5 hours a night. Maybe on some nights but only he knows how much he sleeps. Second, I don't know how healthy he is, he seems like his mental faculties have declined drastically over the years. I watched some earlier Donald interviews and he was a lot more articulate and certainly seemed a whole lot more thoughtful, he was bragging less, etc. He totally lost that ability to control himself.

His Twitter timestamps lend some credence to his claims about his sleep. Not that anyone could believe he's doing anything productive in those hours.

That still doesn't tell the whole truth. If I wake up every day at 4 am, how much do i sleep?? Well, you can't tell because you have no information on when I go to sleep.

That could be because he's come up with a very interesting theory about how exercise is bad for you because "the human body [is] like a battery, with a finite amount of energy, which exercise only deplete[s].”[0] He's still running on a full charge, while most men his age are near empty.


Sounds like lack of sleep does funny things to his head.

Mentally or physically healthy?

I would honestly question both but I'd bet money he isn't physically healthy.

Well I for one would love to have that kind of energy at this age. He's getting close to the average life expectancy by now so all in all it's fair to say he has lived a fairly healthy life? At this given moment he might not be though and we won't know unless something happens.

I'm not sure it is an example that go in the sense you think it goes.

It's actually thanks to his healthy McDonalds based diet.

it may be more accurate to attribute his longevity to his genes, instead of his reportedly rather poor lifestyle habits. his father lived to somewhere in his mid 90's.

Due to wealth genetics. More money = better living conditions = less environment negativity

“But while the new report may lift concerns about an early death, it still links insomnia with illnesses such as dementia and depression...”

is this satire?

Donald Trump is alive and he’s 72, and sleeps 4-5 hours a night. That’s all I’m stating. It was the first example that came to mind. I’m sure there’s others, I just recalled this article.

I guess it’s like mentioning that Obama’s left handed when I say I’m left handed, conservatives would give me a weird look for comparing myself to Obama in any way, however benign.

You described trump as healthy not just alive at 72. Trump's doctor admits the report on trump's health was fake. So I'm not sure what you're basing the healthy comment on.


4-5 hours a night according to Donald Trump.

I would not trust anything that man or his person physician claims about him.

This is pretty much in direct conflict with other articles I've seen posted here.

Just a few weeks ago I had a few people telling me I was killing myself slowly by only sleeping 5.5 hours/night often times, despite not caring if it'd improve my mental performance.

HN is a den of health quackery and orthorexia.

> A new report published by the journal Science Direct

This journo has no idea of how science functions. Probably thinks Google Scholar is a journal too.

If sleep wasn't very, very important our bodies wouldn't prefer 7-9 hours of sleep each day.

I have a hard time believing long term sleep deprivation doesn't lead to an early death. If lack of sleep makes it harder to stay slim, increases chances of dementia and diabetes well then these issues probably help shorten the life expectancy?

I have a hard time believing this report.

So night shifts cause cancer[1] but sleepless nights not an early death? Seems very unlikely.

[1] https://www.medicalnewstoday.com/articles/320554.php

Agreed; it seems very unlikely that night shifts cause cancer. Seems more likely that the people working night shifts are either (or all of the below plus):

- more in debt than people who work day shifts (the primary cause of debt in the US is medical), and are working night shifts for the differential pay;

- that people working night shifts are less qualified than people who work day shifts at the same salaries, lower qualifications are easy to associate with relatively lower class origins, and sickness goes up as class goes down (lack of preventative care, tougher living conditions)

- or something as trivial as that people who work night shifts smoke more. At night, there are fewer customers and there's more time between customers. There's generally lower staffing, so both fewer coworkers to annoy with your smoke and fewer coworker conversations to distract you from your need for a cigarette. Also, poorer people smoke more.

Why does everyone assume that any correlation is causal, direct, and (a specific callout) completely unrelated to class?

Becuasw generally we are bad at probabilities at scale.

For this however, probably because of followup studies.

1) injecting mice woth cancerous cells and controlling their sleep. In sleep restricted mice it hit faster and harder

2) Sleep impairment is known to increase pathway activity that cancer uses for growth like inflammation

I have a question for you folks, do you ever enjoy not going straight to sleep? I find the time when I'm laying in bed fantasizing to be very enjoyable after a hard day of reality. If I were to immediately fall asleep, I'd lose out on that hour of imagination.

No, because when my mind goes idle it tends to start dredging up past mistakes to beat me over the head with. Fortunately, since I started taking anti-anxiety meds this tends to only happen with recent fuckups (so this week has been hard). My fantasizing at night tends to be a defense mechanism.

Yeah this happens to me too. What meds, if I may ask?

Venlafaxine 75mg ER

Thanks. And watch that right flank!

Ever since my late-20s, the thing my idle mind likes to fixate on just as I'm trying to fall asleep is my parents' mortality. Not the best sleepytime fodder.

I can't imagine taking an hour every night to fall asleep.

Sure, the occasional time spent in fantasyland can be nice, but I wouldn't want it to be necessary.

Im just wondering, do anyone else of you not dream? Like i literally cant remember when i last dreamt, whenever i wake up i just wake up.

Its like i skipped 6-7hours ahead during the night.

And one hundred thousand people finally just got a good night's sleep...


Guidelines | FAQ | Support | API | Security | Lists | Bookmarklet | Legal | Apply to YC | Contact