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Deep Sleep May Help the Brain Clear Alzheimer's Toxins (npr.org)
355 points by spking on Oct 31, 2019 | hide | past | favorite | 213 comments

I've been dealing with a hormonal issue that's been negatively impacting my deep sleep for almost two years.

There was a week in early February this year, right after surgery, where I felt like a million bucks. Normally, I have a pretty low-grade chronic headache (yeah, it's as horrible as it sounds). However, that week, my head felt "clear". I don't know how else to explain it other than I felt like my brain had been washed. I was going to bed at 9-9:30pm, and waking up at 5am, and felt incredible. I reverted not long afterwards, and believe I recently figured out the root of the issue (fingers crossed!), but I 100% believe that you need deep sleep to function well. IMO, it's not sufficient to get light and REM sleep; deep sleep is when true brain recovery occurs. I feel like I should know; before I started treatment, I would go to bed at 9-9:30pm and sleep until 8 and still feel exhausted. You need quality sleep in addition to quantity.

Wrist-based sleep trackers are basically useless, FWIW. I've been using one pretty consistently since before my health issues started and they really can't discern the difference between light/REM/deep sleep phases. If there's anything which mirrors how I feel after waking up in the morning, it's HR dip, but even that isn't 100% reliable.

> I've been dealing with a hormonal issue that's been negatively impacting my deep sleep for almost two years.

Also, not getting enough sleep can wreak havoc on your hormones.

"Men who sleep 5 hours a night have significantly smaller testicles than men who sleep 7 hours or more. Men who routinely sleep 4-5 hours a night will have a level of testosterone of someone 10 years their senior."


> Also, not getting enough sleep can wreak havoc on your hormones.

Yep, and that was a part of my problem. Unbalanced hormones lead to poor sleep, and poor sleep leads to unbalanced hormones. My pituitary just stopped working correctly, and no matter how many hours I spent in bed, my body just wasn't doing what it needed to dial up the deep sleep requirements. Horrible negative feedback loop.

My god, popular wisdom right here. In my country, a good-for-nothing, lazy person is called 'huevón', which means 'someone with big testicles' in Spanish. It's applied to both men and women, though.

Same as boludo in Argentina

¡Gracias! No estaba seguro de si eran equivalentes.

> Men who sleep 5 hours a night have significantly smaller testicles than men who sleep 7 hours or more

Seems logic. I wonder what this men could do to kill time in all of those extra hours in the bed.

> I recently figured out the root of the issue (fingers crossed!

Don't leave us hanging, what is the root cause?

> Don't leave us hanging, what is the root cause?

This is somewhat conjecture, but bloodwork indicates that my pituitary gland completely shut down at the beginning of 2018, following multiple viral infections and a year of intense triathlon training. My hormone levels were just completely out of whack. I've been getting shots from my endocrinologist, and a week and a half later, I'm feeling like a different person. Hopefully I just need it temporarily as a kick-start, and can then wean off.

Otherwise, my sleep habits are functionally pretty close to perfect.

* No food or blue light after 6pm

* I only use my bed for sleep (no reading)

* No caffeine of any kind after noon

* Black-out curtains

* In bed by 9pm

Falling asleep and staying asleep has never been an issue for me; it's just getting good sleep that's been the problem.

>I've been getting supplementation

Can you expand on this. Is this something like melatonin to help reset your circadian rhythm for sleep? Or supplements to jump start your pituitary gland?

I guess am curious is the pituitary shut down was caused by the lack of sleep, and getting the good sleep will reactivate the gland, or if the gland is an issue you are addressing with the supplements directly.

> Can you expand on this. Is this something like melatonin to help reset your circadian rhythm for sleep? Or supplements to jump start your pituitary gland?

Shots. I'm seeing an endocrinologist. OTC supplements did nothing for me.

> I guess am curious is the pituitary shut down was caused by the lack of sleep, and getting the good sleep will reactivate the gland, or if the gland is an issue you are addressing with the supplements directly.

My sleep habits were fantastic prior to my illness. The issues started after I got two bad viruses in succession. In early 2018 I got the Flu followed by Hand, Foot, and Mouth. I just never really recovered; my body just kind of sputtered out. Hormone production tanked, which led to poor sleep, which further messed up my hormone production, etc.

Sorry to hear all this, but glad it seems to be improving now.

I had a similar issue (and like you I was engaged in serious endurance training). I would also go to sleep early, wake up at 4AM without an alarm and knock out a 2 hour run. I ended up with pityriasis rosea (which is kind of a medical mystery in terms of cause but linked to viruses), and thereafter some sleep/hormone disruptions.

In addition to what you are currently doing to address the sleep issue, consider testing your microbiome. Often bacterial infections and viruses change the makeup of the microbiome which also has significant negative influences on hormone production/regulation. In my case gut health helped break the negative feedback loop.

Probably personal. (unless crossed fingers is the cause)

Hah! Just answered above. :)

Similarly, my CPAP changed my life for the better. I went from constantly tired to being a productive member of society again.

Or just sleep on your side like other primates

I was always a side sleeper. My CPAP has made a significant difference in the quality of my sleep.

Genuine question, can you elaborate on the supposed relationship between sleep orientation and CPAP?

Parent is being facetious about this but is also overly simplifying the issue.

You can think of your airway as tube of cartilage and soft muscle. As we age (there are also other contributing factors) this tube may be narrowed or collapse under the weight of adjacent tissue. Excess weight (more adjacent tissue), alcohol consumption (more tube muscle relaxation) also contribute to the narrowing/collapsing of this tube.

The airway tube has the least amount of pressure from adjacent tisue when you are on your side. And the highest amount of pressure when lying on your back.

What parent is dismissing is that Positional Sleep Apnea is a fraction of all sleep apnea cases. I.e. his solution of sleeping on the side would 100% resolve sleep apnea for a fraction of all sleep apnea patients but certainly not everyone.

Source: Did contract work for a sleep apnea startup.


To keep with the 'tube' analogy, a CPAP machine creates a positive air pressure in the airway, which in practice pushes the tube's inner walls outwardly and prevents a collapse or narrowing of the tube.

Can you please elaborate? This describes what I have suffered from consistently for years but I haven’t been able to identify

I'm so sorry. Have you had full blood work done? My PCP had labs ordered that he normally only does for 70+ year olds. This was after more than a year and a half of suffering. I had plead with him to run everything. Pituitary, testosterone, etc.

The most frustrating thing was that doctors doubled down on their initial diagnosis of clinical depression. Surely there's no way that a young, "healthy" male could actually have a problem!

I hope you feel better soon.

I elaborate in more detail here: https://news.ycombinator.com/item?id=21419313

What do you think about meditation? I feel if I mediate regularly then I feel on top of the world

> What do you think about meditation? I feel if I mediate regularly then I feel on top of the world

Love it! Do it twice a day for 20 minutes. Sadly it had no positive benefit on sleep. :(

>I've been dealing with a hormonal issue that's been negatively impacting my deep sleep for almost two years.

How do you know this? Are you going to bed with an EEG every night?

> How do you know this? Are you going to bed with an EEG every night?

I had a sleep study done which indicated I get very little deep sleep, but no apnea.

Another data point is that I remember almost all of my dreams; I could literally write a few short stories if I wanted to every morning. Frequent dream recall is not a good sign since it indicates that REM is getting disrupted. REM is the precursor to deep sleep, so if REM is getting disrupted, you're probably not making it to Phase 3.

I agree that particularly strong and extended dream recall is a bad sign (that kind of thing is supposed to be blocked during sleep), but REM sleep is not a precursor to deep sleep. They are independent and usually deep sleep is entered most early in the night and REM later. REM episodes soon after getting to sleep are a sign of narcolepsy. Some medications (including some antidepressants) reduce or nearly eliminate REM sleep. Dreaming has been connected to dopamine that can also be affected by many medications and a variety of other things (like exercise). There are a bunch of sleep realted substances that still have unknown function so I'm sure there are a bunch of things that can go wrong completely outside the realm of current medical science.

Err. I made a typo. You're correct. Non-REM deep sleep comes first and REM comes second.


> Wrist-based sleep trackers are basically useless

Have you found any good sleep trackers that aren't wrist-based? Any recommendations?

> Have you found any good sleep trackers that aren't wrist-based? Any recommendations?

Unfortunately not. :(

Whoever can crack that nut is going to be very wealthy.

I am using the Dreem 2 (dreem.com, use my referral code for a discount: UEXBFMANU). I do not have a certified reference device but those aspects of the recordings that I can assess (start and end of sleep, awakenings, onset of sleep, position) match my experience and are more accurate than the other devices I am using (Withings Sleep, Garmin Fenix 3). There are several in depth reviews on the web comparing the device output with state of the art polysomnogram recordings.

I'm dying to test Dreem 2, but having burned by so many gadgets that went out of business, including a very similar Zeo Sleep Tracker[1] almost 10 years ago, I'll hold for a while more to see if the company will survive.

Their recent research comparing Dreem to a regular PSG [2] is pretty impressive, but I'm skeptical of their business model, and am concerned they won't survive for long.

[1] https://www.mobihealthnews.com/20772/exclusive-sleep-coach-c...

[2] https://www.biorxiv.org/content/biorxiv/early/2019/06/10/662...

Peter Attia recommends Oura Ring.


What do you think was the issue?!

- fellow crappy-quality-sleeper

I had dogshit slip that bordered insomnia for a while. I forced myself into a habit that triggered a sleep response.

For the past 4 or 5 years, I shower in the dark and walk to my room and pass out. I avoid "turning on" after that shower. No phones, no lights, no anything

Your body needs to know when its time to sleep. Texting, reading, and computer time in bed counters that.

I'm really sorry about that. I had full lab work done that indicated my pituitary was shot. I'm now getting hormone injections until we get my body functioning again. I'd recommend seeing your PCP; if they push a depression diagnosis on you, push back and ask to get full lab work. I was getting stuffed with SSRIs for more than 18 months until I couldn't take it any longer.

Fitbit is pretty good at that I believe.

Yes. They're the best of the commercial trackers, at least from what I have seen. I've worked in depth on this, and we were only able to subtly improve on Fitbit's published results using more advanced models. The best models have a Kappa (measure of agreement) compared to human polysomnography scorers of around 0.6. Where 0 would be random chance and 0.8 is the agreement between different human scorers.

I agree with this. I've been using a Fitbit for 4 years, and I can see the difference in my sleep on a good night compared to nights I've had alcohol, worked out too hard, been dehydrated, had too much caffeine late in the day...they all have measurable differences in my sleep.

Do you have a source? Like, I'd pay money for good sleep tracking, (especially if it's fitbit-level money... I would pay more) but everything I've seen thinks that if I'm in bed and quietly, say, reading a book, I'm asleep until I move.

I've been using the Oura ring for that and it works pretty well for me. Unlike the other fitness trackers, its primary focus is sleep. I don't know how well it would handle reading in bed, however.

I'm mostly concerned about reading in bed 'cause I assume if it can't detect that, it can't detect, you know, staring at the ceiling. (though I guess I'm a lot more likely to fidget while staring at the ceiling.) I mean, I could get out of bed to read, but in my experience, that's even worse for sleep than reading in bed.

I work for Fitbit. I don't speak for Fitbit; this is my personal experience. If you get a Fitbit with heart rate tracking, which nearly all have now, it won't rely just on motion. For me it's worked great, showing an awake period at the beginning or end of my time in bed. More on how it works: https://help.fitbit.com/articles/en_US/Help_article/2163#Aut...

If you buy directly from Fitbit's website, the satisfaction guarantee is 45 days so you have plenty of time to try it out and see how well it works for you.

I have a Withings sleep pad that sits under my mattress and I find it significantly more accurate than other decives I've tried.

It also easily tells between activities in bed (even motionless ones like reading or watching) vs sleeping (and all the assorted cycles). It also measures heart rate, breathing (and how many times you stop), and even snoring.

huh. I will look more into the Oura ring. In budget, but not in "buy without research" budget.

My Charge HR with “sensitive” sleep tracking setting was one of my favorite features. It always knew exactly how much sleep I got. I switched to a Garmin 935 and never look at the sleep data because it’s never accurate.

Eliminate caffeine. Increase consumption of animal products. My sleep quality improved significantly after switching to a 90% carnivore diet.

please elaborate

signed, a shitty sleeper

My watch says I get between 20 minutes and 70 minutes of deep sleep a night, out of 7 ~ 9 hours total.

I've tried Magnesium, Melatonin, turning off all devices hours before bed, turning off all lights hours before bed, sleeping in a cold room, etc.

I'm not overweight or unhealthy. I take in zero caffeine, zero alcohol/zero drugs. I do take a daily PPI.

I feel tired a lot, and I seem to feel more tired on days when my watch (Xiaomi Smart Band 3) reports the lowest deep sleep scores (I consider how I'm feeling first, then look at the sleep score to compare).

I want more deep sleep, but try as I might I don't know how to make it happen.

One thing I want to try to eliminate stress is an internet detox. I think just surfing the web, even semi-intelligent stuff like Hacker News, might be really stressful. I ditched my computer and phone today while the sun was up and it was an uneasy feeling -- beyond the withdrawal, it seemed like the world I was seeing was actually a lot brighter and safer than what I'd read about online. People seemed more approachable or at least safer and happier when I took the time to look. I cleaned my room on the third hour because I wanted to, not because some stressed out blogger told me to. Right now I feel just relaxed.

This may sound stupid but it's the first time in a while that I ditched the internet in a place where I normally would have it. Now I'm wondering if our more primitive ancestors would have viewed it as a cesspool of negativity that not only freaks us out but distracts us from more obvious personal issues.

Anyway the connection to sleep is that stress obviously can mess with your sleep.

I've often thought that the internet is like a global version of a small-town gossip network. Vital to proper functioning, but something to be minimized when possible.

Prof. Matthew Walker says the accuracy of sleep trackers when it comes to per stage time is questionable. See Peter Attia podcasts w/ Walker.

Have you thought about going to a sleep lab to get some higher quality data? It’s near impossible to diagnose someone over the Internet, especially when the subject matter is so complex.

I think the problem is that most sleep trackers try to judge sleep based on heart-rate, which I don't think is valid.

There are a few sleep headbands that use an EEG though and in my experience they've been reliable (e.g. mine correctly judges when I actually fall asleep and has correctly judged that I was in REM sleep when I woke up from a dream).

That's good to hear! My sleep tracker seems to base results on heart rate, and maybe my heart rate doesn't dip enough during sleep to register?

I'd like to do a sleep study, but it's over $1,000 out of pocket, so not a small investment.

That seems plausible to me. I don’t know if HR is a good enough signal, since it varies so much between person to person.

Didn’t know they were that pricy, ouch.

It will be worth it. No price is too high for a lifetime of good sleep.

I will not trust a "smart" watch. However, your fatigue is not a good sign. You should get medical advice.

Perhaps you are not breathing right during your sleep. A possibility is sleep apnea. I do have allergies which make me tired after sleep, during some seasons. One of the ways I cope is to do breathing exercises before I sleep. This does help sometimes.

I had a screwed up septum which created apneas & poor sleep. Took a long time to figure out, none of the sleep doctors noticed. I imagine nine out of ten of their patients are there because of alcohol, caffeine, or obesity.

Do you get good, exhausting exercise? I've found that's the magic formula for me.

The magic exercise for me is jogging at least 3 miles at about a heart rate of 150-160. I consistently get 3 hours deep sleep according to the AutoSleep app and dream heavily. Otherwise I’m usually getting 1-1.5 hours deep sleep with other exercise and less than 1 if I don’t do anything all day. Just an anecdote for comparison.

I tried running / jogging (lower HR because my heart is bad) but beside this I worked at a recycling factory. Handling truck parts, crouching to unscrew frames etc etc. This kind of evergoing physical activity drained me deeper and smoother than jogging.

This is why I wish there was a job where I could work at a computer part of the time and do some strenuous physical activity part of the time. I am so useful sitting at a desk but it’s not so useful to me to always be sedentary. Sadly nobody would want to pay my engineering rate for picking weeds in the garden or taking out all the trash.

My team (those who want to) and I spend about one hour per day working out over lunch. As team manager I believe these positive effects far outweighs the time “lost”, on so many levels.

“Working out” is difficult for many, but it can be so many things. For a year or so we spent time on movement training, something I highly recommend in general.

I worked at google and found the gym nice but not my preferred way of exercise. I want to be outdoors. I grew up outdoors. The cold white walls of the gym were as depressing as the office. Now I work at a beautiful farm though still mostly at the computer. I could try a mid day hike though! Ideally though I wish I could be getting paid for some kind of physical work part of the time. I understand that if I want to get high pay then I’m not going to be paid to pull weeds, I’m just lamenting my sedentary career.

I'm up for hire ! :p

I did this in June, 39h/week on trucks. Paradoxically I was pumped by this because having regular activity and financial safety freed me from a ton of issues. So much that during lunch pause I was doing pushups and before bedtime I'd learn Django to make an application for this job. Unfortunately the boss did me wrong so I quit.

To babble a bit more: in August I tried taking a part time morning delivery gig (4-8m 24h/week) thinking it would feel the same but not at all (newspaper delivery is physically stressful), so I quit drained after a month, even though it required no effort and was less time per week than the truck thing.

Right now I have a 30h/week food delivery gig, it's just right to keep me active and the rest of the day I'm writing vue code now.

I may try to find something that would make my body more fit. Maybe having a woodworking shop or something similar.

Here here, I feel the same. I'm not really a fan of sports or working out, but doing physical activity for a job or such (in college I worked at a supermarket stacking shelves) I enjoy.

My wife and I are thinking of buying and renovating an old apartment ourselves. Of course economically it would be better for me to work and pay someone else to do it, but the benefits of learning a new skill and doing something physical are worth it IMHO.

Ahhh yes renovating an old house sounds like fun! As long as you give yourself all the time you need to finish (otherwise it would be stressful). I think some day I’ll buy an old house and fix things on the weekend.

commenting for breadcrumbs, I'm working on a relevant project and am encouraged by how many people are expressing this sentiment!

could you tell more ?

The most basic version is to combine a sandbox or incubator with a productive rural property. I think breaking up one's building sessions with a session of physical work in a garden or similar would really help prevent burnout and would keep the costs of starting up super low. I grew up in a rural area and several of my friends and I have been discussing how those sorts of large properties could be used productively, and that is a solution we think is worth trying.

Rather than quoting the HR, it would be more useful to share the % of MHR. Is your MHR 220bpm? 170bpm? Dramatically changes the meaning of exercising @ 150-160bpm.

Good point. Never measured MHR explicitly although I know there are estimations. It’s probably between 55% and 65% of my MHR. It’s literally right at the transition point of being able to talk while running and not being able to haha

Do you run in the morning or in the evening?

I usually run in the evening. Honestly a good question because that could be significant in its sleep impact.

Great question. I suppose not exhausting enough! Getting my heart rate up from walking rapidly up steep hills, doing low-weight squats, pushups/bicep curls, etc seems to have no effect.

I guess I should try lifting heavy, consistently over weeks, and see if that does anything.

Higher intensity, which doesn't have to come from heavier weight per say, but increased power, work/time meaning total work, higher weight up or time down.

HIIT/interval/crossfit style are prime examples of in my opinion the most efficient way to achieve "exhausting" workouts (lowest time commitment, and with group gym style, lowest mental effort to formulate workout plans; it's all left to the trainer).

I’d also suggest some interval training. If you have access to stair steppers, I highly recommend them. Easy to get started, and not too tough on your joints. 2 minutes at a pace that’s tough to sustain, and then 2 minutes off. I have a max HR of ~200 and I tend to level off at 180-188 during the interval section. Once you get accustomed to it you can play around with the timing ofc.

Watch out for that spikes your adrenaline like sprinting or heavy lifting in the evening though. That said I always get amazing sleep after heavy deadlifts as done properly they fatigue your CNS much more than the individual muscles so its like your brain forces a shutdown to recover. Squats and bench just wake me up though.

I would think that more strenuous cardio would be more effective than lifting heavy.

I've found certain types of martial arts to be one of the most exhausting activities I have ever done. Boxing, Muay Thai, BJJ, Wrestling, no amount of lifting has gotten me as exhausted as those have. Slept like a baby.

I've found that it works this way for a while, but as fitness rises getting that same bone deep exhaustion gets quite difficult (at least without spending hours on it). Is there a way to switch things up and keep that going long term?

Higher intensity interval style exercises can get you there no matter your level of fitness. If you’ve never tried sprint intervals on an assault bike I’d recommend giving those a shot.

What's working for me right now is 'running' up hills. Running not in the 'fast' sense yet but it works. I found a nice route, 7-8km, 250m up and the same down in three climbs and descents each and will keep running it for now. As I can always increase speed to make it more demanding, it will be fine for a long time most likely.

For me it has the opposite effect. After intense exercise I feel more awake and energetic than before, and this lasts long enough to disrupt my sleep.

Heavy exercise makes me very hot at night for some reason. It's nearly impossible to sleep or stay still. It's worse if I do it later in the day, but if it's intense enough it doesn't matter when. I wonder why...

Do you shower off? The layer of salt makes me sticky & hot right up until I rinse it off.

Yeah always. Usually I go to the gym in the morning so I shower after getting back.

Perhaps get a chilli pad sleep cooling system for your bed

Quite expensive but maybe worth it, thanks for the tip

curious how do those apps know when you are having deep sleep? also seems that being exhausted works for me as well. thanks for mentioning.

Go get a sleep study done. That will tell you. You may have sleep apnea. Also you may want to ask your doctor about a sleep aid such as ambien.

>Also you may want to ask your doctor about a sleep aid such as ambien.

Exactly the wrong advice. Ambien decreases NREM 3 duration and amplitude. Do not ask for Ambien.

Also worth mentioning prolonged use (>2 weeks) changes the brain, making it more difficult to fall asleep again (without using more Ambien...)

The doctor who wrote Why We Sleep do not recommend those sleeping pills IIRC.

To put it mildly:

Sleeping pills do not provide natural sleep, can damage health, and increase the risk of life-threatening diseases. (p. 282)

On Ambien specifically:

If you compare natural, deep-sleep brainwave activity to that induced by modern-day sleeping pills, such as zolpidem (brand name Ambien) or eszopiclone (brand name Lunesta), the electrical signature, or quality, is deficient.

Matthew Walker wrote that book [1]. He also has a few talks on YouTube worth checking out. From memory [2] was an informative one for me.

[1] https://en.wikipedia.org/wiki/Why_We_Sleep [2] https://www.youtube.com/watch?v=aXflBZXAucQ

He's not a medical doctor, but a sleep researcher.

In general I would ask a relevant researcher if a drug is any good at all for the desired effect, and a doctor if it's the right one from me. A negative response from a researcher is pretty disqualifying (unless it's a fringe opinion)

Great book, need to finish it (always too tired...).

It would be helpful if you provided a citation that justifies your claim.

Asking a doctor is hardly a wrong advice, might produce a more informed opinion than that from an Internet forum.

You are much more likely to get good results if you go to a doctor's appointment armed with knowledge and good questions to ask. Yes, don't trust everything you read on an Internet forum, but don't dismiss it either.

Ambien is bad shit. I can't understand how it is not made illegal.

It destroy sleep, by creating an addiction making it impossible to fall asleep without it.

And it is bad sleep as the brain does not go into deep sleep

I wish there was safe pills in the US. I use benadryl.

Melatonin works for me, say once every month or two when I need it.

I pour about 1/5th of a capsule into a glass of water.

The default dosage is far too high.

If you have an uncommon issue most doctors won't be able to help you beyond a superficial level. Asking a wide range of people is helpful as long as you weigh there input accordingly.

Not suggesting you’re saying this, but I want to state that Ambien should never be the first tool in the toolbox for better sleep. The state it produces is not too dissimilar from a knockout.

Do get a sleep study to rule out sleep apnea.

Ambien is for inducing sleep, not maintaining it. It should be treated as a "in case of emergency break glass" option.

Trazodone is more widely prescribed nowadays. Ambien, sonata, lunesta and the like are generally not prescribed for long term use. Plain old benadryl may work well if you haven’t tried it.

"Common anticholinergic drugs like Benadryl linked to increased dementia risk"

"In a report published in JAMA Internal Medicine, researchers offers compelling evidence of a link between long-term use of anticholinergic medications like Benadryl and dementia."


Further, Ambien use is also linked to dementia and alzheimers: https://www.alzdiscovery.org/cognitive-vitality/blog/can-som...

Evening qigong routine, I know people who have had good results with this: https://youtube.com/watch?v=o9kvYnWKG3g

what about physical exercise ?

what about social / emotional life ?

these are the two most impactful factors I've experienced so far. Good physical exhaustion made me sleep like a baby. And a stress free job (min wage) made me sleep better too.. the simplest call for an IT job made me wake up in the middle of the night and thinking.

This is the first time i've connected running a company to poor sleep quality. Jeeze what a wake up call. Thanks!

Running a company is also not good for my teeth. I grind like crazy when sleeping at stressful times.

Maybe undiagnosed sleep apnea? I love/hate my CPAP machine, but it helps me. There is a clear difference when I opt out.

For me it was environmental. Turns out the air conditioning was dehydrating me to the point of waking up every night. Do you sleep better on vacation when you're away from home?

I had a similar problem. I was waking up in the middle of the night not able to get back to sleep for hours and then overslept in the morning feeling groggy for the rest of the day.

Here's what I did: 1. Sleep alone in a separate bed since your SO other might wake you up inadvertently - this helped me 2. Wim Hof method for a few weeks: deep breathing and cold showers in the morning.

I'm not sure which of these worked. I did these two things simultaneously and my sleep significantly improved over a couple of weeks. I'm fully recovered in the morning, feeling energized and can actually remember dreams which never happened before. I don't need Melatonin anymore and can even have an espresso in the morning. Good luck!

No idea if it works for you, but if I need to sleep _really_ well I wear ear plugs, even in a relatively quiet room. They need to fit right (rolled between your palms to squish them up, then they should barely fit inside your ear and expand to fill gaps).

The first time I did this it was revelatory. I woke up feeling like a new person. Sadly I don't much these days, because sleeping through a hungry/wet/scared infant isn't as acceptable (also I was a little disturbed what I could, in fact, sleep through, and whether that included smoke alarms)

I have tried sleeping with earplugs. For some reason I wake up gasping for breath?

Your watch doesn't know what it's talking about.

I have a watch, an under-mattress tracker and a headband with a ton of sensors (including an EEG). Typically, none of these agree with each other (and I trust the headband to actually be accurate).

I'd strongly recommend consulting a sleep specialist.

One thing you haven't mentioned is cognitive behavioural therapy, which is often the first thing people will be recommended.

I know of the under mattress thing (Beddit for example), but I've never heard of headbands for consumers. What companies are offering those?

The two I know of that are still running are Dreem (the one I went with) and Philips SmartSleep.

I chose Dreem at the time because it looked more comfortable (no ear covering) and was more readily available in my part of the world. It looks like Philips also has consumable components, which I'm not a fan of.

I've been using it for months now and I'm happy with it.

It also has a feature to "stimulate" your brain to improve deep sleep and it tells me it's quite effective (comparing with stimulation sleep to without stimulation sleep), though I can't say I've noticed a huge difference.

Thank you!

How were you taking melatonin? I got great benefit from it but only when I always took it at the exact same time every night, turned lights out, no screens, etc. it would still take about 3 hours to kick in. I’d take it and not shut off lights for about an hour and a half, fwiw.

After trial and error, I pour 1/5th of a capsule into a glass of water.

It puts me to sleep within 45 ~ 60 minutes, pretty much without fail.

But then my deep sleep is still far too low.

How about multiple sleeping periods per night? Ie wake up, do things until tired again, sleep. I can feel especially rested that way.

I think there’s something special, too, about a morning nap after some caffeine has started to kick in.

Fwiw I have the same habit and experience with my mi fit band 2. I try to gauge how much sleep I got based in how I feel, before looking to hopefully avoid placebo. I feel considerably better the nights I get 1.5-2 hours of deep sleep

Thanks for your comment, it just nudged me to install two additional heart and sleep monitoring Apple Watch/iPhone apps. I don’t wear my Apple Watch to bed, but I will start tonight and collect a few weeks of data. curiosity++

I have exactly the same problem as you. I'm looking for a solution too and it seems that deep sleep length/continuity might be linked with serotonin levels. Did you take a blood test on serotonin?

Did you check CO2 levels in the bedroom, or at least take care that CO2 should theoretically exit the room? Just unlocking the window handle a little bit can create a bit of air circulation.

Good point! I always sleep with a window in the room at least a bit open, for air flow.

And the deep sleep issues are constant across home, hotel rooms, etc.

You seem to be doing all the right things. The only thing I could suggest that might help you trying cold showers before bed as painful as that sounds. It apparently promotes more restful sleep.

Hot shower 60-90 minutes before bed. Lowers your core temperature.

If poor sleep is affecting your life and you can't understand why, see a doctor.

IF its just because your watch said so, don't worry about it.

How are your iron/ferritin levels? Low iron causes fatigue

Body is just one half of the equation for Deep Sleep

I started doing metta a few years ago when I was having a rough time. It was the one thing that made me feel better every single time.

The basic instructions for are to say (or think),

“May all beings be happy.

May all beings be healthy.

May all beings be safe.

May all beings be peaceful.

May all beings be free from suffering.”

In this way you intentionally cultivate a peaceful, benevolent state of mind. I started doing this for entirely selfish reasons—it made me feel better! But doing this regularly for a few months I noticed an undercurrent of deep peace developing in me.

You can replace “all beings” with “I”, loved ones, or people you are experiencing difficulty with. You start with whichever person feels easiest to appreciate and work your way up, so to speak :)

Best wishes

get a sleep study and find out if you have sleep apnea.

Bring out the big guns. Time you get you started on Lunesta.

Shut off your wifi and put phone on airplane mode. Don't put a blue tooth sleep tracker right buy your head either.

On what basis to you give this advice? Do you think wifi is preventing sleep, and if so, by what mechanism? Those RF frequencies do not penetrate into the brain.

Wifi absolutely prevents sleep. It does so through a mechanism called "surfing the Internet on your phone in bed." Ditching the wifi and switching to wired Ethernet won't save you from this phenomenon either! The problem is a sleep endangering device that's designed to shoot particles (which also behave like waves) directly into your head! It captures the wifi signal which the device uses to reconfigures its photon emitter, which will disrupt your sleep.

The only solution is to leave your phone on the other side of the room or if you can help it, another room entirely.

But seriously, sleep hygiene is an important aspect of basic hygiene that should be more broadly taught, but isn't.

Wifi definitely prevents my sleep through the Hacker News mechanism.

Just anecdotal. What's the harm in trying it a couple of nights? I was just as skeptical until I tried it. I could link to several fringe studies but what's the point? Nobody serious is going to fund this kind of research. And it's passed the tipping point, how could you find a control group that has not had previous exposure? But of course it does penetrate, it goes through walls.

> But of course it does penetrate, it goes through walls.

Are your walls conductive, eg, largely made of water with various electrolytes? Because otherwise the comparison is senseless. Imagine putting an 8mm or so layer of of skin/fat/bone across each wall. By what factor would that reduce received power on the other side of the wall.

The max power out of a wifi router is 100 mW, that is a tenth of a watt. The amount of power impinging on your body from any reasonable distance will reduce that power quadratically. The amount of power which makes it through your skin and bone to get to your brain, considering it is 2.2 GHz or 5 GHz, is another factor lower.

Surprised that this is the first comment about this on here but we really need a better turn-of-phrase than "toxins" because kind of language validates the fads going around that are harming people - like the "get skinny in two days!" diets or the anti-vax community.

Also, why do they use the term emphatically in the title of the article and then state, "...presumably removing toxins associated with Alzheimer's, researchers reported Thursday in the journal Science." That comes across as, "We don't actually know what this is doing but we're going to take a guess and just run with it."

In fact, from the abstract of the paper itself, "Sleep is also associated with increased interstitial fluid volume and clearance of metabolic waste products. It is unknown why these processes co-occur and how they are related."

I don't understand how metabolic waste products automatically equates to "Alzheimer's toxins" nor how they're reaching these conclusions if they don't understand their coincidence - whether accidental or intentional.

Can anyone help a stranger on the internets and connect these dots? =]

Part of the issue is the vagueness is likely appropriate to both as we don't know the depth. It is linked to Alzheimer's and its presence causes a negative effect so it is contextually a toxin at least until narrowed down to a more precise mechanism like say prions, inappropriate cell reactions, and/or inappropriate oxidation levels.

Anyway that amateur explanation aside - the woo community is inherently appropriative of things they don't understand - witness "quantum" anything buzzwords outside of the physics or numerical context.

I guess I can understand that moving fluid can at the very least dislodge other material around it, but:

- how do "the toxins" get out of the cerebro-spinal cavities

- if the flow is not unidirectional (with new fluid comming in), why would not the toxins just settle at slightly different place, after those fluid movements end

- how is the fluid itself cleaned

- what about the blood-brain barrier

I answered your questions based on what I gathered from wikipedia:

> how do "the toxins" get out of the cerebro-spinal cavities

It gets caught up in cerebrospinal fluid. Note sure if it is has to be properly dissolved in it or if it also transports mechanically.

> if the flow is not unidirectional (with new fluid comming in), why would not the toxins just settle at slightly different place, after those fluid movements end

Cerebrospinal fluid is constantly being created and then deposited to the blood stream. According to wikipedia you produce 500 mL a day and there is 125ml at any given time, so the cycling rate is pretty fast if we compare to how long Alzheimer takes to form.

> how is the fluid itself cleaned

It is extremely filtered blood, so it is basically cleaned blood. In other words it is cleaned in the creation step.

> what about the blood-brain barrier

Seems entirely unrelated, cerebrospinal fluid seems to be like its own circulation flow where blood doesn't reach. I guess it basically being a lot cleaner blood makes it another layer of protection for these parts of the brain.



Thanks! Looks like this is also related: https://en.wikipedia.org/wiki/Glymphatic_system

The handwavium chelates the toxins and they precipitate when the CSF drains into the bloodstream at the choroid plexus.

Unfortunately, the precipitate then becomes a constituent of the arterial plaque that will lead to all kinds of hypertension and heart disease. You can't win with handwavium. that's why they never tell you about it.

I'm going to start using explanations like that when I have to explain anything to my parents.

What’s your background?

It seems the answers to these questions are either intuitive or irrelevant.

> - how is the fluid itself cleaned?

See the intuitive and imaginative answer would say something along the lines of white blood cells would consume the toxins.

How is bacteria during an infection cleaned? White blood cells consume them!

Why would this point even add to your discourse? It has no relevance. Either the fluid gets cleaned or it doesn’t. Either way there is a correlation between brain health and the fluid.

Also it’s not like a fucking snow globe. Or mouth wash. It’s not just a fluid reused and swashed back and forth.

Again, this is why I’m asking what your background is. Did you even read the article?

I read the article, it talks about the brain as if it's a washing machine, which it's not either.

Why would it not be relevant? While there are white blood cells in CSF, it's several orders of magnitude less than in blood. Is it enough to clean anything? White blood cells don't pass the brain-blood barrier. So yeah, it's somewhat like a snow-globe for a lot of molecules and cells.

So yeah, how is the fluid cleared?

Also article states, that there's even less blood flow during the sleep cycle, so at the same time, there's even less opportunity to wash away things that can pass through blood-brain barrier away to the kidneys and out.

My background is watching a lot of biology and trying to understand.

> my background is watching a lot of biology and trying to understand.

I think while it is okay to ask questions and to be curious you should be careful of imply or imparting logical fallacy and making judgment on such fallacy.

Do some research and try to understand more about the CSF and the cleaning process. There are articles out there.

Again the research shows correlation, while correlation does not imply causation until you can falsify the hypothesis you should be careful creating bias. Maybe the mere act of the fluid passing around in the brain is enough to dilute and weaken the toxin bonds, which then dilutes the effect over certain areas of the brain.

Alzheimer research is very limited, and any insight into the potential cause and effect is important to give funding to. Dissent like the one you are trying to create only harms society.

Anecdotal, but we have a family friend who has just been diagnosed with early onset Alzheimer's.

She was a brilliant colorectal surgeon and highly regarded and referred in the area but she also lived for her work, spending nights sleeping on the floor under her desk for two hours before pulling another full day of work.

I am sure this lifestyle for the better part of 30 years took a toll on the body and more and more I've been hearing about the lack of sleep being related to Alzheimers

Interesting how there’s a lot of sleep trouble on HN. Here’s mine, curious if anyone has thoughts.

For over a year now I’ve been averaging around 5.9 hours of sleep. Usually I’m up at 5am and can’t fall back asleep. Compounding this, bad nights I wake at 2 and it takes an hour to get back to sleep. Even then I’m up before 6.

So, two problems: always wake up early and often wake in the middle of the night for an hour.

I can get my brain to spin up at a good level if I get six hours. If I get 5 hours the day is mostly ruined.

My Oura ring data doesn’t suggest sleep apnea and my wife says I don’t snore. I’m not waking up super fresh - so it’s not like I’m rested after six hours. I used to sleep just fine so I don’t think I have the genetic mutation that makes you not need 8 hours. I just can’t sleep much more than six hours lately.

I’ve tried all the usual things; last meal at 4:30, exercise in morning, consistent bed time of 10pm, no devices after 9, cool room, no alcohol, black out curtains, etc. I’ve tried every supplement you can think of. Phenibut will prevent 2am wake ups but even with phenibut I can’t get more than 6.5 hours. You also shouldn’t take that more than 2-3 times a week.

I’m not sure what to try next. I’d love to get back to 7-8 hours though.

I sometimes have nights like that when my wife works overnight, and my toddler wakes frequently from teething.

What I do is I take a THC tablet 2-3 hours before bed. Specifically, 5mg of delta-9 THC and 5 mg of TAC. It makes me sleepy enough that when I have to wake up for my toddler, I can quickly fall back into a deep sleep.

(I live in a state where pot is legal without a prescription.)

Many people don't realize this, but pot's effects vary widely with the strain. I suspect that the combination of THC and TAC makes the tablet very similar to an indica strain.

I sometimes take CBD but it’s hard to tell if it helps.

I’ve taken a THC tablet before and it does work but I wake up with a bit of a weed hangover. It’s also not something that I’d want to do daily.

I’ll have to research TAC, never heard of it.

Two things to consider:

How strong was the THC tablet? Sometimes I see dosage that's 10, 20, 25mg. That will give you a weed hangover unless you're a pothead.

(Related: I enjoy the weed hangover more than getting high!)

I just read the label, I'm assuming that TAC is some kind of cannaboid.

How vigorous is said exercise?

I go through this exact same pattern if I don't get enough exercise. If I do 60-90 minutes of treadmill/elliptical/rowing in the morning then I sleep like a baby for 7-8 hours and wake up feeling fresh. On the other hand if I do less than 30 minutes of cardio or skip the gym on a given morning I start regressing into the pattern you describe.

Compared to other healthier-living choices I can make (healthier eating, less drinking, etc), exercise seems to provide by far the most consistent and tangible results.

Best of luck, I hope you figure out something that works.

I do 35 minutes of heavy weight training and 40 minutes of cardio.

Have you seen a doctor about it? Doctors are usually useless about sleep issues, but a sudden change is more likely to have a cause that can be pinpointed (e.g. pituitary issues as mentioned elsewhere, maybe adrenal issue). Also, seizures that only happen at night are apparently somewhat common and can disrupt sleep. Even narcolepsy of all things can appear as sleep disruption. If you did try to see a doctor and got brushed off, maybe try again.

In my experience phenibut is the strongest medication easily available for staying asleep at night, although I switched to 10mg baclofen that is somewhat less effective than 600mg phenibut for me but I feel more confident about the safety and it is less addictive. At one point I took 600mg phenibut one day, 10mg baclofen the next, and nothing the third then repeat and that seems to work well for at least a month (I also recently tried taking baclofen for a few weeks at a time and while it didn't do much after a few days I'm fairly sure it did still do something, although I worry about using anticholinergic medication so frequently). Magnesium (600mg before bed) helps me as much as phenibut but wipes me out even more than usual the next day. I also use 150mg uridine monophosphate sublingually a few hours before bed, which doesn't help much with staying asleep but helps me feel more rested (nootropics depot is the highest quality source of the powder I have been able to find). That works best taking a few days off every month and a few weeks off every year. But I think in your case trying to figure out the cause is likely to be the most effective thing to try at this point.

I had also issues, yoga + meditation + pranayam has workws wonders.

The effects went away when I had taken a pause from the the activities and Normal sleep returned when I resumed them

I spent 10 years dealing with sleep issues.

Then I started yoga and mediation back in March.

Meditation daily before bed, Vinyasa five days per week after work and Yin on Sundays.

I sleep like a corpse. I get into bed at 11:00pm, close my eyes, and then open my eyes and it has been seven and a half hours.

edit: Yoga and meditation are no joke.

Last night's sleep: https://i.imgur.com/F7IJKy3.jpg

Last night I got into bed an hour early at 9:50pm because it was thundering raining and trick-or-treating was cut short. I meditated and read for 30 mins, noticed I was falling asleep, put my book on the nightstand, rolled over and was out like a light until 6:30am. The wake-up spike at 1:20am was probably me stirring over because my cat was trying to sleep on my face.

Before meditation and yoga, I would have been awake, lying in bed despairing, until 1am and then groggily rolling out of bed after a restless night barely making it to work on time.

Yep, they are good. But doctors still give drugs to make people fall asleep

Have you tried slow release melatonin? My sleep medicine doc suggested it and I take 6mg a night. Helped a lot with waking up in the middle of the night.

The other pieces you may consider is some form of restless legs. Sleep docs diagnose a lot more than apnea. Best of luck.

Never tried slow release. That’s not a bad idea.

Every night (takes 6 weeks before I notice a big change)

Magnesium Glycinate

EPA fish oil

If I stop the above regiment, and my insomnia flares up again, I find the following to help break the cycle until the magnesium and fish oil ramp back up.

Take an Aleve

Eat a half bunch of celery an hour or two before bedtime.

Have you ever tried Magtein?

I stopped taking fish oil a while ago but worth adding back in.

Why do you think Aleve is helping?

Inflammation. My theory is that once you have missed a number of good nights of sleep, your brain gets inflamed and that perpetuates the cycle.

Haven’t tried Magtein. The Magnesium Glycinate was prescribed by my sleep doctor. The rest I’ve picked up from online forums which others recommend and have worked for me. There are good studies to back the Magnesium. The rest.... works for me.

>Usually I’m up at 5am and can’t fall back asleep.

Do you drink alcohol regularly? Its counter intuitive but alcohol simultaneously prevents people from entering deep sleep and can cause them to wake up early.

As I've gotten older I've realized this.

Generally I'm fine with 1-2 beers, but 3-4+ and I always wake up at ~5am with a foggy head. And usually an ache in my arms.

Nope. At most, I'll have 2-3 drinks on Saturday night.

Is your bedroom small and do you keep the door and windows closed? CO2 can build up to uncomfortable levels.

Here's the Science paper they reference: https://science.sciencemag.org/content/366/6465/628

And here is the Dutch Design Week exhibition that explores how vibroacoustic sound healing might promote similar effects through somatosensory entrainment U(neuromodulation). The sound healing bit is only partially tongue-in-cheek.


I have always traditionally been someone who would stay up until 2am a few times a week, and always been lacking in sleep. I've turned that around, along with a lot of other healthy changes I've been making, along with diet, exercise, and sauna use.

But the thing that's been an absolute game changer with sleep has been red glasses. So the idea is that blue light and to a lesser extent green light, both interfere with your brain's melatonin production. Everyone tells you to avoid looking at screens or your phones after dark, but who actually manages to do that? Also, these "night light" programs like flux just tone down the blue light, they don't eliminate it. These glasses block almost all blue and green light. They also have a barrier on the side so no light comes in through the side.

Sure, these glasses make you look like a dork, but they're great. If I'm in any state of lacking sleep, I find everything much less stimulating, and I get tired really fast. But even better, I sleep like I went into a coma, and I feel like I've been dreaming a lot more than usual.

There are tons of tips for sleeping better that I think all work, but from my experimentation, the unnatural blue and green light after sun down is by far the biggest problem that we all have.

Here are some examples of what I'm talking about.



If people are interested in a 6h long conversation on everything to do with sleep they could do much worse than listen to Matthew Walker on the Peter Attia podcast: https://peterattiamd.com/matthewwalker1/

Such a good series.

I havn’t been keeping references, but this isn’t the first paper I’ve seen suggesting part of REM cycle is used to flush fluid build up in parts of the brain, and that this flushing is necessary for high cognitive utilization. Also, this flushing seems to be difficult or impossible without REM (though I suspect vigorous exercise helps).

I wouldn’t be surprised if lack of sleep could help contribute to Alzheimer symptoms, if not the actual disease side effects of brain structure deterioration.

I do not sleep very long (when I wake up, that it is; usually dingdong after 7 hrs) but when I sleep I sleep very deep. I had fitbit saying 80% deep sleep and my doctor told me to get tested for sleep apnea and other stuff but I just sleep very deep; they found nothing. I also remember dreams (I can lucid dream whenever I want; I spent a year training that when I was 18 and it is like riding a bicycle) very vividly.

I am wondering if the lucid dream training I did made my sleeppatterns like this; lucid dreaming is so much better than lsd or shrooms or games; it is free, does not harm anything and you can do anything you want (fly, infinite strength, immortal, ...) so I cannot wait to go to sleep every night.

How did you “train” for this and how do you make it happen on demand?

The trick that works best (for me), when you feel your are going to fall asleep, keep repeating, in your head, that you are are sleeping but you are awake. It took me a month at the time to get some results; after half a year it went mostly automatic. After that I have been able to do it without effort.

It takes patience though: the first 15-20 times you will likely just fall asleep and remember nothing.

Outer body experience (OBE) books, although nonsense mostly, usually have very thorough guides; I used one because I was convinced that what people call OBE is actually lucid dreaming and I was right. You can train yourself with those books (the one I had mostly had the above trick) and once in a while you will sink through your bed and hang on the roof in the room below or you ‘visit friends’ etc; obviously you are just dreaming but it is fun. You are awake enough to realize what is going and to manipulate the situation.

Not OP. This can get you going: https://www.reddit.com/r/LucidDreaming There are very simple tricks that can help, from what I understand. E.g. you can sleep with one leg outside your blanket and also writing down what you dreamt and reading it before the next day’s sleep.

This makes alot of sense. Our bodies are amazing and unique, but require a little self-exploration to optimize (sometimes it takes extra work to get good sleep).

This made the rounds a few years back, but its nice to see they are still at it.


Is there any link between cannabis use and deep sleep?

I find cannabis completely removes dreams from my sleep which come back very vivid after stopping use. Many people online report the same.

Yes, cannabis kills REM sleep pretty significantly.

I have a practical kind of question about this kind of research. How do you put a sleeping person in to an MRI machine without waking him/her up?

Usually the fall asleep in the machine.

- People selected don't have sleeping disorders. They must abstain from caffeine and stimulants 24 hours before test.

- Sleep deprivation may be used.

- Ear plugs, active noise cancelation, possibly polyurethane hood in magnet bore

- lower spatial resolution and slower gradient switching speed

When you take measures outside MRI, you may have to play the MRI sound to get comparable results.

The article said they were using cutting edge MRI techniques, whatever that means.

I have read benefits of fasting on Alheimers as well

I laughed too hard at this

Sleep on an incline - use bed risers that raise the head of the bed 4-6 inches.

You’ll sleep better.

Is that for gerd/acid reflux type of affections or it is generally better?


I haven’t done any actual tracking but others have.

There are studies linked at the bottom of this article: https://www.bulletproof.com/sleep/sleep-hacks/inclined-bed-t....

I just this day realized that I did not have any head- or sinus-ache when waking up, and I had used a pillow for once.

An inclined bed would probably be even better.

I have dust mite allergy and had infection-prone sinuses for years and lived with a chronic feverish feeling. I recently had FESS, using endoscope blades to clear passages. I slept great for a few weeks and then allergic symptoms came back again giving me muscle aches and a racing heart. So I wake up unrested. My Huawei band says I get recommended amount of deep sleep but deep sleep continuity is lower than recommended. I am waiting for the dust mite SLIT vaccine to kick in, it could take a year more. Till then I'm trying to isolate the mites in bed.

I had this exact issue and had a septoplasty procedure 4 years ago to fix it. The results were truly life changing because I could breath without being congested from dust mites. I had no idea how bad it was until I could breathe after the procedure. I can recommend my ENT specialist if you are interested. Getting this procedure cleared my nasal passages permanently and was probably THE best decision of my life. I can focus now.

Dr. Kasey Li https://drkaseyli.org/

Thanks, but we are kinda thousands of kilometers apart!

Then fly to Palo Alto and get the procedure done. It costs $5K. The recovery time with Dr. Li is quick. I went back to work 2 days after the procedure. If you are suffering from lack of oxygen during sleep, you are living in a fog. Do whatever you have to do to fix it. Good luck!


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Toxins. a poison of plant or animal origin, especially one produced by or derived from microorganisms and acting as an antigen in the body.

If you've got toxins in the brain you've got bigger problems.

It's a lost battle. It annoys the hell out of me because we used to laugh at the new age gurus that advised to "get rid of your toxins". Now this stupidity is everywhere and if you point it out you even get downvoted. Even here, where people are supposed to be rational and well informed.

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