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Sleep is more important than food (hbr.org)
437 points by panarky on Mar 9, 2011 | hide | past | web | favorite | 169 comments

Schools such as Caltech and MIT have rigorous curricula that proverbially requires constant study every day of the week just to stay in the middle of the pack. Naturally, most students cut back on sleep. Proponents of this approach are aware of this, even boast about it, saying that this is the best way to learn the material.

On the other hand, numerous studies -- including the link at the top of this page -- conclude that this is the worst way to get anything done.

They can't both be right.

Even more disconcerting is the sleeping culture/routine throughout medical residency and fellowship; arguably, the most important stages of medical education, where doctors in training learn the hands-on skills to practice medicine. Despite the importance of learning during this stage, individuals are routinely sleep-deprived:

"20% of all residents reported sleeping an average of 5 hours or less per night, with 66% averaging 6 hours or less per night. Residents averaging 5 or fewer hours of sleep per night were more likely to report serious accidents or injuries, conflict with other professional staff, use of alcohol, use of medications to stay awake, noticeable weight change, working in an "impaired condition," and having made significant medical errors." - http://www.ncbi.nlm.nih.gov/pubmed/15124713

A Wikipedia article focused on medical resident work hours: http://en.wikipedia.org/wiki/Medical_resident_work_hours

Yeah, the medical training model fosters a culture of working ridiculously long hours and shunning those that don't. As a first year surgical resident it's not uncommon to work 110-hour weeks and anything less than 80 feels like a joke.

And, as other posters have pointed out, this is despite legislation limiting the number of work hours. The fact of the matter is that if you were to actually work to the letter of the law you'd be sneered at, receive poor evaluations, and patients would suffer because there'd be no one around to do the work.

Most programs argue that these hours are necessary to train surgeons since there's not only the usual cognitive side of medicine, but also the technical side of cutting, sewing, etc. That being said, 70% of the hours I put in at the hospital are BS "scut" work which could be automated, streamlined, or passed off to assistants. The actual challenging decision points are few and far between.

Thus, even the 10,000 hour rule--which a lot of programs use to defend their dismal hours--misses the mark completely since, well, the practice isn't focused.

I don't think surgeons are going to be replaced by robots in a significant way for some time, but I would like to see the hands-on part of surgery being performed by techs. A three year, well planned course would be plenty to turn you into a competent operator--as competent as many just-licensed MDs. After all, do you really need 10 years of academic training (four year undergrad, fours of medical school, two years of little operating as a junior resident) to screw bones back together? Why should we expect surgeons to be technically AND intellectually gifted?

It's peculiar that medical residents are systematically sleep deprived but commercial airline pilots cannot fly/work longer than ~8. Most of the time the plane is on auto-pilot, but there's no such thing for zombie residents doing triage at the ER.

I'm an airline pilot. Actually, the maximum duty day is 16 hours. The maximum time that may be spent behind the controls is 8 hours. The minimum length overnight is also 8 hours from leaving the airport to showing up again curbside. This means that transportation, food, and hygiene reduces time in the bed to about 6.5 hours, after which it is legal to work a 16 hour day.

We are expecting new duty regulations later this year in response to scientific data on fatigue and the crash of Colgan 3407. Currently the data shows that on a four-day trip we are equivalently drunk with fatigue by the afternoon of day three even with around eight hours of sleep. Most people really need about nine.

Personally, I've never intentionally flown fatigued but I have been surprised by it. By the time I notice I'm fatigued the heading indicator looks like alphanumeric soup and I cannot differentiate 030 from 300 from 330 without the utmost concentration. I tell myself to "THINK, DAMN IT", but that is futile. It is something that cannot be overcome.

Having this experience, there is no way I'd want medical attention from fatigued doctors. Sleep is important for any safety sensitive job. It's always better to error on the side of safety.

Thanks for writing, I knew about the 8 hours in the cockpit, didn't realize there were an extra 8 outside.

I've asked many doctors about this. They insist that they are not effected by sleep deprivation. They claim it is safer to have the same doctor for 24-48 hours rather than hand off a patient to a new, fresh doctor.

"I've asked many doctors about this. They insist that they are not effected by sleep deprivation. They claim it is safer to have the same doctor for 24-48 hours rather than hand off a patient to a new, fresh doctor."

Absolute bunk. Doctors are the last people in the world who should "insist they are not affected by sleep deprivation." Their whole job is to make decisions based on medical evidence. It doesn't affect you? Prove it. Show me a study looking for correlations between medical errors and sleep deprivation. Show me a study measuring alertness at the end of an 80-hour work week. Don't give me anecdotes. Give me proof. To do otherwise, as a doctor, is hypocritical.

Here's my anecdote: my wife is a resident, and she comes home from a 30-hour shift so tired, she's nervous about driving and sometimes feels like she has the flu.

Is she just weak? Should other doctors look down on her?

Not without a rock-solid study to prove their point. Instead, doctors seem to have a hazing mentality - "I survived this, so you should have to, too." But it's really a question of medical fact: how do medical work schedules affect patient outcomes? Any doctor who doesn't see that is being dangerously irrational.

The problem with sleep deprivation is that unless you have an objective way of measuring your (mental) performance you're usually not able to realize when it declines, because your're self monitoring capabilities decline as well.

A simple test, that worked very well for me, was testing my reading speed (I know it is only a weak indicator for mental acuity, but it is easy and fast to test).

Under perfect conditions (well rested, optimal nutrition, completely silent room, no visual distractions, after mediation and a good cup of green tea) I am able to read about 800 WPM (which is not to bad) of the kind of text I usually need to read with good retention. For me this declines rapidly to less than 200 WPM (which is quite bad for a "knowledge worker") with sleep deprivation and/or a noisy environment, even though I believe I am doing fine.

That being said, even though I would say that doctors are handicapped "mental performance" is handicapped by their working conditions, I fully agree that it is better for patient safety to not hand off a patient to a new doctor say every 8 or 12 hours due to the amount implicit knowledge that a doctor gathers during a >24h time period about his patients that can't be transferred in a handoff.

Software Developers, imagine what a screw up it would be if you'd have to hand off your code every 8h to another developer, who'd have to continue right were you left... add to this not having a version control system, spotty test coverage and highly ambiguous specifications

"due to the amount implicit knowledge that a doctor gathers during a >24h time period about his patients that can't be transferred in a handoff."

While this may be true, the process of the handoff could be vastly improved. My wife is a resident, and the quality of info she gets during a patient handoff varies drastically, from detailed notes in a computer, correlated to medical history, to scrawled notes on paper. Sometimes she has to start from square 1.

Maybe the reason handoffs are harmful is because they're done poorly. And maybe they're done poorly because the doctor who's handing off is freaking exhausted.

That level of delusion is actually more scary than the sleep deprivation itself.

It's like a guy who's driving home after a 20 hour day that ended with a couple of drinks at the bar, calling home from the car to tell the wife that he's on his way and his driving is perfectly safe. In reality, he is so impaired by the tiredness, the alcohol, and the distraction of the call that he can no longer even understand how far off his game he must be, nor judge the horrific risk he must be taking by driving in that way.

I don't doubt that the handoff is a risky part of the process. But that doesn't mean that we can't do a better job at figuring out how to make the handoff process better.

I've had a few doctors in my family say the same thing.

I've heard this argument from medical residents, too. They say it's important for training to see full 24-hour cycles in a patient's care, and that shorter shifts would make that impossible.

One thing that I wanted to try (but never had the schedule to support) is polyphasic sleep (http://en.wikipedia.org/wiki/Polyphasic_sleep). The idea that sleeping 15 minutes every 4 hours (on a very strict schedule) to keep your mind close to a waking-REM-type sleep. Granted, every few weeks you would have to crash HARD (20+ hour rest).

The problem with this is that everyone is on the regular sleep 8 hours per-night schedule and you wouldn't be able to do this if you were working a regular job.

Seeing as I have an inability to get more than five or six hours of uninterrupted sleep a night, polyphasic sleep has always appealed to me. My life is a constant struggle against sleep deprivation and running a startup for the past year hasn't helped matters one bit.

Still, it's rather hard to see a way for a sleep schedule like this to be viable for most people unless it becomes the dominant way that people find their rest (which is hardly likely).

From what I've read about polyphasic sleep, it doesn't seem to be best for humans. A lot of people have difficulty with it. I've come to the conclusion that people are biphasic. I think people perform their best with a long night's sleep and then a short nap around 2pm. I've noticed this works for me. YMMV.

I also considered experimenting with this in college. I never ended up doing it, though.

I'm... not sure what the point of such a comment can be. It's interesting in unintended ways.

My friend is doing his residency right now. He says they make up their sleep with "power naps" during the day.


I don't have any personal experience with this though.

To some extent the sleep deprivation is a weeding process/learning experience in and of itself. Being able to perform under stress/lack of sleep is a good quality in a doctor.

I am a 3rd year in medical school, and firmly believe that sleep deprivation is a terrible weeding process. If a doctor is sleep deprived I do not want them touching me with a ten foot pole. They make enough mistakes as it is! Sure you argue that they limit work hours, but I can tell you first hand that these limits are only paid lip service to, and I routinely see residents work 80+ (sometimes 90+) hours a week. Oh and the max shift is 16 hours now so calculate out how you get to 80+ hours. You can't report your program because they will lose accreditation and you'd have to go somewhere else to get this scam of being 'board certified', and you can't really threaten because your program can find a reason to dispose of you. real big catch-22.

(just for kicks, if you worked 10hour days for 7 days a week that is only 70 hour work week... doctors work at least 12 hour days, and usually 16 hour days to get to the full 80 hours!)

Oh and as far as weeding out?

Most 'weeding' out happens first and second year of medical school. In my class alone about 10% of the class failed first year exams, and they were forced to repeat or retake the whole year. (which SUCKS when you just paid $37,000 for a year of school that meant nothing). Then Second year weeding happens again with STEP1 licensing exam:

"Overall pass rates for first time USMLE Step 1 test takers are: 92% for U.S. M.D. medical school graduates, 81% for U.S. D.O. osteopathic medical school graduates, and 73% for international medical school graduates" http://en.wikipedia.org/wiki/United_States_Medical_Licensing...

Fail a year or a board exams? You pretty much can only be a psychiatrist or family doctor with little or no hope of every specializing.

I agree with this (expect that USMLE is not a board exam).

My SO is a medical resident. They really are placed in unstable situations (to use a math/physics term). They are required to work 80 hr/week. If they report working more than 80 hr/week they get into trouble for a duty hours violation and yelled at for being "inefficient". If they report less than 80 hr/week they get in trouble for being slackers (a.k.a. "unprofessional", actually that's a catch-all phrase for anything the speaker doesn't like). No serious thought seems to be given to increasing staff levels.

You pretty much can only be a psychiatrist or family doctor with little or no hope of every specializing.

And that's the problem (not your problem but the profession's problem) - the hope is to specialize whereas being a family doctor is the booby prize.

Can you please explain more why psychiatrists get it easier?

you must 'match' into a specialty. If you do not have a good rank or board scores you can only match into the 'lower' residencies like family or psych

Uh, yes but why are thse 'lower'?

Well I know abut family but why psych?

I guess people don't want therapy at night?

How many doctors are actually weeded out after they get to their residency, though? First year of med school, absolutely. Residency is a bit late.

By the time you hit residency, you are so far into debt that not having a job that pays $100k+ (eventually) is suicidal. That being said, some people do drop out.

I know one person who dropped out, but was at married to another resident, so has a safety net. Another resident dropped out due to a medical condition that prevented him from standing for hours a day and landed a job at McKinsey. Another friend dropped out and became a receptionist! Eventually she went into a residency for a lower stress specialty (surgery -> psychiatry).

Does it have to be? There are only 133 Medical Schools in the U.S. and there is a marked shortage of doctors in some areas, most notably general family doctors.

The only area that learning how to deal with sleep deprivation would be a benefit is surgery and critical care areas (ICUs). But then again, if you could schedule things better and get more doctors in, maybe these doctors don't have to learn how to function on 5 hours of sleep.

I think you're right to the extent that the current medical service system requires doctors to learn to sleep less and less while functioning on an acceptable level (note that I didn't say satisfactory or even exceptional). But I think that's begging the question. Shouldn't we be able to change the current system and allow doctors to focus on building skills/knowledge, not the ability to function without sleep.

tl;dr: sleep deprivation is not a necessary part of being a doctor if we change the system, so saying that doctors must learn how to deal with sleep deprivation is a circular argument.

The shortage is purely artificial; the AMA keeps a cap on numbers to make sure pay stays high.

The Maine Experiment suggests that when an area has more doctors, they administer more procedures, many of them unnecessary. This counters your simple supply-demand argument--doctors actually manipulate demand.


Yes, but that doesn't refute my point. My point was sleep deprivation doesn't make better doctors or even encourage better doctors to stay.

Frankly, I'm surprised that as many doctors make it through - the working conditions are pretty terrible. Maybe the pay makes up for it, but you only get paid well once you get out of your residency or fellowship.

Better conditions will probably produce better doctors, not subpar doctors.

Yes it is. Of course hazing/weeding processes are the means used to achieve this.

Thats a big problem though. We really shouldn't be asking practicing doctors to perform under a lack of sleep like we currently do. The problem is that we have too few doctors (in the US) and part of that problem is the fact that we weed out potential doctors who can't function well without sleep or who don't want a job where they are run ragged.

EDIT: Applied s/two/too

No, those schools have cultures that promote such behavior. I was a grad student and TA at Caltech and observed that the undergrads had horrible time management skills. Procrastination and heroic effort at the last minute were the norm.

(I'm not specifically picking on Caltech undergrads, BTW. I'm fairly sure this is typical at most schools.)

"Procrastination and heroic effort at the last minute were the norm."

This may be true, but there are also plenty of students who work from the moment they wake up until the moment they go to bed and still don't have enough time to get all of their assignments done. The problem is that functionally there isn't really any difference between having a 3.5 GPA and a 2.0 GPA, so at some point most people figure out that what they're being asked to do is impossible so they might as well just do their own thing.

Perhaps they should have gone somewhere else where they had time to sleep and think instead of just studying all the time. I know that where I work, the folks who are willing to grind the hardest on assigned work are rarely the ones you turn to for difficult and responsible work. The very best people are the ones who work extremely hard at self-directed work and sometimes push back against assigned work, but they are very, very rare, much rarer than people who are willing to grind day and night on whatever you assign them. The best person for difficult assignments is usually someone who refuses to overwork himself or herself.

I can't agree with this more. However, whenever I refuse to do work I get stamped on the forehead with "lazy". For example, I figure out that the homework in a class is 25% the grade but there are 25 of them, so each is worth 1%. I understand the topic so I figure that it's a waste of my 4 hours to do the work for 1% extra. Bam, "you're so lazy".

Keep dotting your i's and crossing your t's until you're out of school. Honestly, if you're above the work, you should blow through it without too much trouble. It's designed to be doable in a reasonable amount of time for someone who is in the same position as you except that they are just coming to terms with the material. You should be able to do it in half the time. If not, then you benefited from the practice.

Once you're doing real work, turning down work will not make you lazy; it will be an opportunity to say, "Sure, I might be able to assist you with that, but you will have to talk to <important person> and <other important person> about the impact on my work on <important project> and <other important project>."

"Oh... no chance of my project taking priority over those. Shoot, and I really need it done this quarter."

"I think <junior developer> can do the job for you. He might need a little guidance, but if he does, I will be happy to make myself available to answer his questions and point him in the right direction."

"Wonderful, thank you!"

Where does this lazy stamp actually land? Surely your school doesn't actually put a little (* lazy) on your transcript? You seem to know you're not lazy and there's no way the lazy stamp is actually going to be transmitted to anybody who cares, so why do you care?

Good point. I'm not too worried. I'm rather curious as to if I start prioritizing important things that need to be done vs things that can be postponed at work, am I going to suffer? I'm guessing the answer is yes.

Depends whose opinion on importance you're using for prioritization.

If you postpone things that aren't important to you, but are important to your boss, that's not going to go well. If you postpone things your boss doesn't care about, in order to do a better/quicker job on something the boss considers important, that'll probably make your boss happy.

(Note, I'm using "boss" as short-hand for "your boss, and all the other interested parties, customers, etc. who can affect your boss's opinion of you".)

Depends if they are paying you to prioritize. If they're paying you to do what you're told and you don't, that doesn't usually end well. If you're responsible for priorities, you just have to never screw up, that's all.

Just think: Completing a pointless assignment will, by definition, provide zero benefit to anybody. Watching TV also provides little benefit. Hence, completing that assignment is at least as lazy as watching TV.

[Actually watching TV does provide a benefit: it's relaxing. The same is not true for assignments.]

So what if they call you lazy? Are you going to stop getting invited to the parties they are too busy studying to go to?

Personally I found Dartmouth GPAs correlated to how often you went to class and how much attention you paid to the lecture. If you didn't go or zoned out, you'd be working all day and all night just to catch up on that 1 hour you missed.

Scheduling Algorithms for Procrastinators: http://www.cs.sunysb.edu/~bender/pub/JoS07-procrastinate.pdf

``We are writing this sentence two days before the deadline. Unfortunately that sentence (and this one) are among the first that we have written. How could we have delayed so much when we have known about this deadline for months? (...)''

That looks like an interesting paper. I'll save it so I can read it later.

It's ``ha ha only serious'', actually. Whimsical style and solid analysis of algorithms you can actually use to schedule your procrastination & work better.

If you want to have a life outside of school (job, side projects, social life) it's very hard to stay ahead of work without losing sleep even with excellent time management.

Certain classes are worse than others and it doesn't usually depend on the content of the course, but the people teaching it. I'd blame the culture of the faculty above the school, although the school likely influences said culture.

Very few Caltech students have jobs.

The faculty contributed from what I could see, but primarily in indulging procrastination by students. It was quite common for students to hand in the majority of a terms problem sets in the last week, and the professors would accept them even if there was a stated class policy that late assignments would not receive credit. (Of course, I acknowledge that this was particularly onerous to me, because I would be the one who then had to grade a full term worth of assignments in a week.)

From my experience as a Caltech undergrad, there was a "tragedy of the commons" in some of the larger classes. A student had a choice of doing the work early entirely on their own, or waiting until their classmates had started working on it, and being able to exchange advice, compare approaches, or verify answers with those classmates. Thus there was a fairly strong dis-incentive to always being the first to dig deeply into an assignment, unless you were so much smarter than your classmates that their cooperation was useless to you.

I wonder if any studies have been done on the relationship between sleep and deliberate practice.

I find that I need a pretty consistent 8 hours of sleep a night for normal operation. However, I've found that when I'm doing something challenging (say, a startup or a new project at work, or learning a new programming framework), this spikes upwards fast. I need about 9.5 hours when doing something moderately challenging, and up to 11 hours if it's a problem that requires my absolute full attention.

I remember reading somewhere a hypothesis that sleep exists so that your mind can convert short term working memory into long-term memory. Naturally, you would need more of this if your short-term working memory is more filled up with complicated stuff. But this goes at odds with the cultural practices at Caltech or MIT or med school - if it's true, you should structure the curriculum so that students work very hard during the day, but then have enough time to go home and sleep it off before learning the next day's lesson. I wonder if there's any research on this.

I find I also dream very vividly when working on a hard problem, but this could just be correlation, as REM cycles increase in frequency toward the end of the night, and if the night is extended, there ought to be more of them.

I was also thinking of that hypothesis as I read this.

It rings very true to me. I believe that people who have trouble sleeping are often people who didn't learn that much that day, and conversely, people who learn on a given day seem to need more sleep.

I noticed this with my kids. A few months before they started learning to talk, say, at about 13 months, they seemed to need more sleep, even though they weren't exercising any more. This is the period that you can really begin to see them starting to "get it", about a lot of things in their world. Even though they aren't talking yet, they are beginning to understand what you are saying, so they are learning fast.

>A few months before they started learning to talk, say, at about 13 months, they seemed to need more sleep, even though they weren't exercising any more.

13 months has to be within a month or so of the median age for starting to walk (in my country at least, I know some start much younger) but you say your kids didn't increase their exercise; presumably then they were already walking at that age?

We have 2 boys that have been treated almost identically, obviously there have been differences and only one of them is a first child. However they have so far had vastly different sleep patterns. The one who sleeps least appears to have developed fastest in linguistic terms. His brother, the slower, was certainly no slouch (and without wishing to boast) is pretty close to top of his class for reading despite being one of the youngest.

I meet quite a lot of different parents & babies/toddlers from different backgrounds and find there are a lot of variations in sleep pattern - I don't have anywhere near enough contact with them to establish correlations with development and sleep pattern though.

My kids could be outliers. I'm sure such studies must have been done?!

tl;dr anecdotes are anecdotal and my experience doesn't bear out your hypothesis

I think there is a kind of availability heuristic effect going on here. You hear about people who regularly pull all-nighters because they do boast about them so that it seems more prevalent than is actually the case.

You don't hear the student bragging about how he got enough sleep last night and got all of his work done ahead of time.

I'm an undergrad at Stanford and I think that if you plan ahead well enough it isn't difficult to get enough sleep and get all your work done. It's not only about managing time during the term, but also about managing which classes you take together term-to-term.

There is also something to be said for developing endurance. Eventually you're going to have to do something you don't want to do while incredibly tired.. so pulling all-nighters is a kind of training for that.

It's not about education or productivity.

Top colleges, military training, and most early stage start-up environments all have either explicit or implicit cultures where part of the values indoctrination is to "achieve under fatigue".

It isn't about what's optimal for long-term productivity or health. It's about gauging mental toughness and weeding out those individuals without an adequate level of committment to that particular community's values.

If the individual can perform adequately under an extreme depravity of conditions, then they can be expected to excel, or at the very least, fall back to an acceptable baseline of trained performance when provided the surfeit of resources available under day-to-day tasking.

As a highschool student, I can tell you that the problem isn't limited to just the top universities; most of my friends and I get around 6 hours of sleep a night, and it's definitely not enough. Some nights I've gotten as little as 2 or 3 hours, but I disagree that this is the best way to learn material, because I don't remember a) any of the material I was studying or b) anything I may have learned in class the next day.

Teenagers are a special subset of the sleep problem. In recent years, there have been studies that suggest teens tend to naturally stay up late, which clashes with the hours of compulsory education. Some districts have altered hours for these students, where classes start later in the morning, and the results have supposedly been very positive with respect to both grades and student retention.

Unfortunately, not yet at my school :(

They might be drowning pigs to find the swimmers.

Or, drowning swimmers to find dopers (provigil etc).

This is the future, there can be no doubt. The rewards of performance enhancing drugs in intellectual pursuits are tremendous. Even primitive performance enhancing drugs like methamphetamine and cocaine have fuelled some of the greatest minds in history.

</socially undesirable fact of the day>

I excelled when I was a MS CS student at Stanford (I can go into detail if anyone needs convincing), and I did it on very little sleep - 4-5 hours/night for weeks at a time. I absolutely positively couldn't have done what I did on 8 hours of sleep a night. There wouldn't have been enough time in the day.

I sleep much more now. Left to my own devices, I adjust to a roughly 28-hour clock during which I sleep 9-10 hours a cycle.

What Caltech/MIT are encouraging is repetition with continued study. Repetition cements short term memory into long term, ref "Brain Rules" book. In order for this process to work efficiently, good sleep is required. Hence how the 2 are related.

What we humans fail to see is that running out of hours in a day to study (work et al) should not equal to cutting back on sleep. Cutting back on sleep is a quick & dirty approach but has its negatives which the article pointed out. If only we could see our consequences of these actions using some monitoring tool/data I'm certain many folks would be in a better position to balance/optimize their study and sleep patterns.

So, both the article and these schools can be right ;-)

There is no way they both are and I believe sleep is needed. The problem with learning late at night is that it takes longer; you may be sacrificing any sort of social life getting the right amount of sleep and rigorously studying. I guess there is always that sacrifice.

I'm surprised this article is at the top of HN. 1) It is not the announcement of a research study, rather it is just referencing previous hbr blogs and sleepfoundation.org's general guidelines for sleep. 2) It offers no unique advice. 3) The title is basic linkbait (ie, its not really about food vs sleep).

Why the upvotes? is it because everyone is tired?

The research is voluminous and has been around for a long time. Articles like this make the results easy for us normals to digest.


I think this is what surprises me - this is hacker news, not normals news. How interesting is a safe interpretation of the research that conforms to what I was taught in 2nd grade? Its like someone posted an article extolling the virtues of the food pyramid or something. Even my doctor has a more liberal interpretation of the research than this particular author (and he is probably more qualified to make this interpretation).

In the past I've experimented with quantities of sleep, polyphasic sleep, measuring sleep quality, light / sound in the room, sleep supplements, etc, etc. Why? because sleep takes up 25-30% of my life. Its a no brainer activity for me to try to hack and optimize. Further, given sleep is such a big part of all of our lives, I'm surprised more people on this site do not have a similar mindset about experimenting and tweaking their sleep patterns.

Show me some articles with new research, personal experiments, or useful tips that can allow me to hack my sleep - these kind of interpretations are much more useful to digest.

I'm no longer surprised by the number of dumbass articles from HBR, New York Times, and the like. In fact, it's boring me and I think I'll take a nap :-)

And the moment you say something like this; they down-rate you. Great going, HN.

It did nothing to advance the discussion in any meaningful way. If you don't like this article, don't read it. If you really think it's awful and doesn't belong on HN, then flag it.

In experiments, rats have actually been killed by lack of sleep. Mind you, it took about a month as I recall, but it's still a bit scary.

It may not be new or unique, but I didn't know sleep was that important.

And no, I'm not tired.

I'm one of those who normally sleep only 6.5 hours per day. As stupid as it sounds, I need someone telling me that I should sleep more. After reading an article like this I'll start sleeping 8 hours a day, and if the article is right, I'll feel better and more productive.

So the article is useful for me, hence the upvote. I do agree about 3) though.

It looks like a PR piece for a company called The Energy Project. The HBR blogger forgot to remove their link at the end: "For more tips on sleep and other forms of renewal visit our web site." (links to http://theenergyproject.com/tips).

I completely agree with you. This place is slowly growing into another Reddit with more junk crowd joining in regularly.

Not to be too snarky, but your profile shows you've been a member for less than a year -- complaining about the "new kids" is rather ironic.

That's actually called out specifically in the guidelines, even.

If your account is less than a year old, please don't submit comments saying that HN is turning into Reddit. (It's a common semi-noob illusion.)

I don't think being defensive of quality is a bad thing though. It's often unnecessary, but I'd say that's better than being under-cautious.

Less than a year on HN. So does that qualify for less brainy? Or you mean, I should have joined HN directly out of mother's womb?

Most realities are harsh to accept; but that doesn't change anything. Don't you see that some non-sense posts are making at the top here? And that is happening more too often?

I don't deny that today HN has the best of Internet and Techie crowd; but it is also a fact that there is also some junk. So let's accept it.

And yea guys, thanks for the down rating; much appreciated.

I have mixed feelings about this. I'm someone who sleeps on average 6 hours/night. When I have experiments, then I sometimes drop down to 4 hrs/night. I've found that I can manage with 4 hrs/night for about a week (it has gotten a bit harder with age)--BUT I know that I'm not as effective or creative when dealing with such little amounts of sleep. I also know that I'm more prone to make errors and try to develop habits so that I do the "right thing (TM)" when I'm too tired to think (it's like martial arts where you train reflexes...). I also try to know when to throw in the towel and just go home because if I stay I'm likely enough to make a mistake that will cost me more time in the end, or I need sleep so that I can think about something.

However, in normal running mode, 6 hrs (as long as I'm getting exercise) feels normal to me and it's what I sleep even without an alarm unless I'm recovering from severe sleep deprivation (I don't drink coffee and generally just drink tea when I really need to stay awake...). What are other people's experiences? Somehow the dark room scenario in the article seems unrealistic. I do agree that for creative work that more sleep (in my case 6 hr/night) seems necessary--but if I find myself sleeping longer (like say 9 hrs), then I just end up feeling more tired...

I'm with you on this. Like most people, I would like to consistently get 7-8 hours of sleep a night, but I've got two young children, a packed work schedule, and volunteer commitments. These days I'm operating on about 5 hours of sleep per night and I'm functioning fine. If I wasn't up at 5:00 am to get a couple of hours of work in before my kids are up at 7, I'd be falling behind right now.

I'm probably making more errors than I would normally but they're mainly minor. By about 8:00 pm I get pretty fatigued and I may nap for 10 minutes at this time, to recharge for the evening.

The work I am doing is challenging but for the moment doesn't require a lot of creativity, so the tradeoff between the sheer amount of work I can get done versus the decrease in errors is worth it to me at the moment.

I do exercise pretty consistently however (approx. 4 times/week for 30 to 45 minutes) and I find this invaluable in terms of keeping me less stressed and more productive.

"So how much sleep do you need? When researchers put test subjects in environments without clocks or windows and ask them to sleep any time they feel tired, 95 percent sleep between seven and eight hours out of every 24. Another 2.5 percent sleep more than eight hours."

The broken link there is meant to point to (http://www.sleepfoundation.org/article/how-sleep-works/how-m...) and I can't spot where it mentions this study.

In any case, you put me in a room with no clock or windows (and presumably no serious stimuli as it's likely to influence the results) and I can bet you I'll sleep twice as much - out of pure boredom.

I read about some such experiments. Some people actually preferred it, and used the distraction free environment to finish their PhD theses.

I think the theory is that once you've fully slept off your sleep debt (which I've heard can be up to 40 hours) you are no longer able to sleep much more than your natural sleep requirement, bored or not.

Very interesting, do you have any sources on this? If I forget to set my alarm I can easily sleep for 14-16 hours before I wake, any day of the week. If one possible solution to this is to go on a total sleeping binge for a week or so I'd be thrilled!

Interesting. I can sleep for 12 hours several nights in a row.

Sleep rocks! I am in the 2.5% that sleep 8 hours or more. I am much more productive during the day as a result. I am alert, my brain spins faster and I can take on more challenges. My friend is a superstar scientist/M.D. and he sleeps 9 or more hours a day.

The "executives" who sleep < 7 hours need to fine a hour more. If I was a board member, I'd insist my C-level team sleep 8 hours!

Preparing for the California Bar Exam was a fascinating experience for me. Not only was it the most mentally challenging endeavor I had ever undertaken, it proved to be the most psychologically challenging as well.

Fortunately, our two bar prep professors were not only licensed attorneys, but also Ph.D.s in neuropsychology. Part of our rigorous training therefore was not simply learning the law, but actually learning how to learn -- in particular, how to store and recall so much data on demand -- and above all, how to manage our time. (It turns out the human brain is actually quite good at writing and storing data, but really bad at what can be best described as "random access memory" operations: recalling random data at will, instantly.)

A great deal of emphasis was placed on structuring extremely precise "living schedules," for example, what to study when, for how long, when to eat, what meals, and above all, how and when to sleep. And how to force ourselves to sleep when we couldn't.

Long story short, forcing ourselves onto regular sleeping patterns was both immediately necessary and yet proved to be one of the hardest disciplines to learn: to force yourself to stop studying at a given hour (typically 10PM) even in the midst of learning something, and allow time to drive home, have a snack, rest, unwind, and then fall asleep by 11PM, to then awaken at 7 and be back at the library at 8... every single day, for 2 months... that was truly an act of willpower. Especially for me, as I've always been the personality type where, once I start doing or learning something, I can't stop until it's totally finished or mastered. Forcing myself to stop studying without having yet completed the particular matter was excruciatingly difficult.

The same thing proved true for the three-day bar exam itself of course: had to sleep between 9 and 10PM and awaken by 6AM, with virtually no studying at all in between days. At this point, you just had to trust your brain to marinate on all that it had absorbed in the 2 months leading up to those fateful three days.

Looking back on it now, it was due largely to my discipline with sleeping habits that I was able to pass the bar on my first try.

You're assigning your success to disciplined sleeping habits which seems very strange.

I would ascribe your success to proper nutrition, proper mnemonics, adequate sleep, and lots of studying.

Getting enough sleep (and not too much) is important but what is the advantage of keeping it within those tight boundaries? The natural human sleep cycle is often running on non-24 hour cycles and the science I've seen indicates that if you CAN work on these cycles it enhances memory, cognition and creativity.

I don't understand why you give so much credit to your rigid sleep schedule, especially because all the science I've seen indicates that what is important is getting adequate sleep and then studying properly, not sleeping at particular times.

I am certain that disciplined sleeping habits had a lot to do with it: absent the discipline, I would have often gone to bed around two or three in the morning, gotten less sleep -- or less quality sleep -- and, were I to have maintained this haphazard schedule, would have never been able to have set my biological clock to the necessary 10-6 sleeping schedule required for the three days of the exam itself. Beginning at 8AM, we had to be there by 7-730 or so, and I had to allow time for an adequate (light) breakfast.

Obviously I didn't mean to exclude the value of the actual studying, I'm just saying that studying -- without proper sleep and sleeping schedule -- would have lead to physical and mental and fatigue. And the nature of the bar exam material makes it virtually impossible to adequately perform on a sleep-starved mind.

How do you force yourself to sleep?

"How to store and recall so much data on demand" sounds interesting too.

A tool I've been using for the past days: http://sleepyti.me/

I'm currently testing it. The last two days I went to bed at a time which the tool suggested; getting up wasn't much of an issue, and I felt some improvements, but it's definitely too early to say that it works for me.

Placebo effect.

Sleep doesn't work in neat 90 minute cycles. They're really longer in the early part of the night, and get faster and more biased towards REM in the later part of the night. The details are very individual and also vary night to night, so you can't predict with any accuracy at the start of the night what stage you'll be in at 7:00:00AM the next morning.

(Anecdote: A friend of mine used to swear by a theory, mostly as a joke, that the recipe for good night's sleep was sleeping an odd number of hours. One day he came all happy and said, "Thank God 15 is an odd number!")

Placebo effect, more than anything else.

sleep_times = [wake_time - 1.5 * x for x in range(3, 7)][::-1]

Is that really all that's happening here?

Yep. Basically one sleep cycle is 90mins. So it just gives you 3-4 times based on minimum 2 cycles. Nothing fancy.

I don't get this. Why are there 4 different suggested times?

Nice!! :)

"Sleep is important" has been a recurring theme for the last couple of years but I am one of the few that don't buy into it at all. Maybe I fall into the 2.5% but if I sleep 8+ hours I feel overslept and groggy. I function moderately to exceptionally well on 6 hours of sleep and often times end up getting more like 3-5 hours of sleep.

I've read articles about high functioning executives that barely sleep at all and seen studies about less sleep improving lifespan along with all the standard sleep is so important articles. I think its safe to say the jury is still out on this subject and keep hoping it doesn't continue to over saturate the news/science pipeline for much longer. Until there is a definitive answer you'll continue hearing me say "sleep is overrated".

I agree for the most part. However, try going for a regular run (say 5km) once per week, same day, and track your times. Let's say you hit about 30 minutes first time, and get it down to around 20 mins over a couple of weeks. Now try greater sleep deprivation than normal one week and watch your time plummet.

I find the same sort of result with coding on little sleep. While it feels like I'm "high functioning" while coding at 4:00AM, a code review in the light of day after a good night's sleep often reveals that I wasn't.

I've begun to suspect this is because we don't notice all the little issues we'd notice if we were more awake - at 4AM, the code is Flying, because I'm not stopping to realize how crappy the code is.

I've had similar experiences. If I am very tired I don't get "coder's block", but the code is often rubbish.

It's well known that sleep is an absolute requirement for athletes. If you don't get an optimal amount, performance will suffer: http://sportsmedicine.about.com/cs/conditioning/a/aa062800a....

If it affects peak physical performance, it seems reasonable to suspect it affects peak mental performance (as studies seem to suggest). High functioning executives might get by on little sleep, but would they perform better on more sleep? Are hours clocked more important than output at the executive level?

No, it doesn't seem reasonable at all.

Athletic activity causes actual physical microdamage that takes rest time, nutrition, and hormones to repair. The elevated secretion of human growth hormone during REM sleep is a significant reason why athletes perform better on more sleep.

No such analogue exists for the human brain. Mental activities, at worst, deplete neurotransmitter levels. I have seen no evidence to suggest that massive dosages of sleep do a better job of restoring these levels than minimally adequate amounts.

I thought it was well known that sleep plays a very important role in learning?

For mental work, sleep is not replenishment, it's prep work. Your brain is thinking problems while you sleep.

Not only that, sleep also appears to be when your brain reinforces what you've learned... over and over again.

Yet people perform worse mentally without sleep - why would that be if sleep was not vital to mental performance? Have you never needed a nap or coffee to refresh your mind? Do you deny a physical influence on mental faculties?

Training involves neural adaptation, a large part of which occurs while sleeping.

The systems of the body are not neatly partitioned into modules.

Considering I used to run Xcountry and have been known to go out for 8+ mile runs in the middle of the night, I'd say for the most part my sleeping habits do not impact how I feel while running. In fact, I'd actually say more exercise is more important than more sleep as I feel much better in general when I am exercising/running regularly, regardless of my sleeping habits.

I will absolutely concede that there is a threshold where sleep deprivation will negatively impact my (or anyone's) ability to perform, its just a question of what that threshold actually is.

I need 8 and often more like 9 or 10 hours of solid sleep each night. If I'm well-rested, one night of 6 or 7 hours doesn't affect me, but it can't happen repeatedly. We may both just be outliers.

"sleep is important" is a lot different than "8+ hours of sleep is important." I'd agree with the former, but agree that the latter is dependent on the individual. Anecdotally, I definitely agree that oversleeping makes meore groggy.

> I've ... seen studies about less sleep improving lifespan

The surveys I can find associate "normal" amounts of sleep with better lifespan, and both abnormally high and abnormally low levels of sleep (<5 or 6 and >9 or 10 hours, depending on the study) with various negative outcomes. E.g. this meta-analysis pools prospective studies looking at heart attack and stroke rates: http://eurheartj.oxfordjournals.org/content/early/2011/02/03...

Depending on where you look the golden rule for longevity seems to be 6-7 hours of sleep. The interesting thing about 7 being the more common number is that 7 doesn't fit into the commonly held belief that sleeping in sync with 90 minute REM cycles is more healthy/effective. Example of study saying 6-7 hours: http://www.worldhealth.net/news/six_to_seven_hours_sleep_bes...

Most of what you site is anecdotal evidence. Most likely, you and those executives fall into that 2.5% cohort.

> ... seen studies about less sleep improving lifespan...

Sleeping less than your own individual sleep need probably does not improve life span. The participants in the studies you're referring to who slept vastly more than others were those with sleeping disorders, some with extremely bad sleep apnea. They felt the need to sleep more because the quality of their sleep was so poor. But of course, having a lot of poor-quality sleep is not equivalent to having fewer hours of good-quality sleep.

The contribution I would like to make to this discussion is that each person's sleep need is individual.

I am in absolute agreement with this. I find that if I sleep more than 6 hours a night, I am actually more tired the following day.

Normally, I get 5 hours per night and I rarely experience low levels of functioning or excessive fatigue.

And as other have pointed out, the methodology of the cited experiment in the article is highly suspect. Any normal human being, locked in a room with no stimuli, is likely to sleep as much as possible to pass the time.

At a time when I was sleep deprived I felt completely OK. When I caught up on the sleep I felt worse. I think it's because sleep deprivation also deprives you of the ability to notice the negative effects well enough.

That's probably not what's happening with you if you naturally sleep 5 hours per night without an alarm though. If you are using an alarm, you should try sleeping as long as your body feels like for two weeks. Don't block sunlight from your windows, let the sun make sure you wake up if your body thinks you've slept enough. If your body thinks you are still not rested, it will keep you asleep even in sunlight.

I totally agreed with the headline, but the evidence in the article doesn't really support it. You might as well say that water is more important than sleep, because you die if you go more than about 3 days without water. The length of time your body can go without something has little relation to how your body acts when deprived of small amounts of that thing, or how it acts when faced with short-term, quickly corrected deficiencies.

Heck, breathing is more important than all those things. Go without it for 4 minutes and you're dead. However, many people recommend controlling and slowing your breathing as a way to relax. Is that breathing deprivation?

Agreed. The OP conflates significance and urgency. There a many things that are extremely important, yet there is no need to attend to them at a given moment.

The OP defeats a straw man. He argues against complete deprivation of sleep, yet his conclusion is based on sleep that isn't limited at all. Proving that something can't be done without entirely is far removed from proving that we can't cut back a bit.

He might be right, but for an article intended to be persuasive, he does a bad job of supporting his thesis.

By that metric, heart beating is even more import than breathing.

I was hoping to see some sleep hacks in the comments here. The author cites a few in the article:

1) Naps 2) Go to bed earlier 3) Start winding down at least 45 minutes before 4) Write down what's on your mind

Does anyone here have any other sleep hacks to share?

Go to bed at the same time every day. Even on the weekends I go to bed early and wake up at about 6:30. Which I never thought would be the case, but it is. It's actually really peaceful and nice being up that early on a Saturday.

I think that #4 is extremely important and rarely mentioned. It's much easier to go to bed earlier guilt-free, and to fall asleep once you're there, knowing that you have accounted for ideas-in-progress, you have acknowledged loose ends and unfinished tasks that need to be completed on the following day(s), and that you'll be able to pick up where you left off.

True. It's similar to the advice I've heard to read fiction right before bed instead of non-fiction to ease your mind into rest.

Here are a few more suggestions from a comment in the post:

1) Wake up at the same time every morning. 2) Eat light in the evening, but have a small, low carb/sugar snack before bed. 3) Eat breakfast every day. 4) Drink caffeine before short (less than 25 minute) naps. 5) Ensure your bedroom is as dark as possible at night, and as light as possible when you wake up. 6) Sleep in the cold. 7) Stay away from bright light sources before bed (TVs, computers, bright house lights).

source: http://disq.us/1dlnu0

1)Wake up EVERY day at the same time. 2) Goto bed when your body tells you.

4) Stop using an alarm. Wake up when your body tells you to.

If you need to be up at a reasonable hour, just keep a clock in reach. You'll wake up several times during the night and morning anyway. Just make it a habit to look at the clock, and check if you can go back to sleep or need to get up.

Worked for me the last couple of days.

If I do that I wake up at 4 p.m. What is my body trying to tell me?

You need exercise?

Sleep may be more important than food but, interestingly, there seems to be a relationship between sleep and food. When fasting, less sleep is required. However, when sleep is curtailed, there is a greater desire for food.

I always figured if you're awake instead of asleep, you're actually consuming more calories and thus need more food.

Has anyone ever successfully sued a company for sleep deprivation? I know investment banks are notorious for requiring junior staff to work without sleep, lest they lose their bonus (or worse).

I used to sleep 8 to 9 hours a night, and often could have slept more, until I learned how to relax and recharge my energy. Now I need around 4 to 6 hours (absolute max) and I never feel tired, even if I work late, 7 days a week etc etc.

Over the last 12 years, when I have worked with many people with a wide range of sleep problems, I have discovered that the problem is not in fact that we do not get enough sleep. I think that with the expectations we put on ourselves these days it is almost impossible to get enough sleep. I found that sleep (and food and the other methods we use) is simply not powerful enough to recharge our batteries properly.

Probably 50 years ago it was enough to eat 3 meals a day, sleep 8 hours a night, have weekends and a few weeks holidays every year and so on. My grandfather used to work in the City of London (financial district) and they went to the office in the morning, had a long, sociable lunch and didn't do much else for the rest of the day. Look at bankers and other financial people today and there is simply no comparison. So I believe it will become more and more essential for people to find ways of recharging their energy that are much more powerful than sleep, holidays etc. That's why we are seeing an increase in the number of people meditating, doing yoga and lots of other practices that build energy levels as well as rest.

If you're interested in a more anthropological perspective on sleep and its importance, check out "Lights Out: Sleep, Sugar and Survival" (http://www.amazon.com/Lights-Out-Sleep-Sugar-Survival/dp/067...)

I am guessing that the 2.5% that needs under 8 hours of sleep is composed mainly of people in the tech industry. If I sleep under 5 hours I feel a bit groggy all morning, but if I sleep more than 6 ~ 6 1/2 hours, I feel like utter shit all day long. Incredibly, I was speaking about this same topic with some fellow coworkers and 5 (counting myself) out of 7 felt the same. It might be that they're bullshitting me or maybe the statistics are wrong, but the lack of sleep (as in the people that actually need less daily sleep, not the one's that do so because of lack of 'time') seems to have a correlation with professions that require staring at a screen all daylong. Anyways, in my experience, the number of people that need less than 8 hours of sleep is hugely over 2.5% of the population.

Something I observed from reading the comments here:

A lot of us can function on much fewer hours of sleep regularly and don't believe it adversely affects our performance (It does affect mine though). Does anyone think there may be some selection going on here?

What I mean is, perhaps it's true that HN's distribution is more skewed toward the side of people who need less sleep (and hence has more productive hours in the day) and are willing to sleep less in order to get things done. Maybe we don't really represent the general population.

Just a warning in case anyone takes our testimonials too seriously.

Everybody thinks they are above average. "I can exceed the speed limits, because I am an excellent driver." "I need less sleep than the average person."

Can function or can function optimally?

Some research shows that mood is impacted more drastically than function. Since burnout and perseverance are such key topics (and emotionally dependent ones), maybe heroic sleep deprivation is an under-recognized threat to entrepreneurial success.

“If you leave items in your working memory, they'll make it harder to fall asleep, and you'll end up ruminating about them if you should wake up during the night.”

Avoiding thinking about things when you go to bed is something I am struggling quite a bit with. I will sure try out to write down my thoughts.

Any other advice to avoid your mind thinking too much when it should be winding down?

I find that listening to interesting music helps. This stimulates my brain just enough to prevent my mind from wandering. Otherwise, yeah, I end up thinking about my unfinished business, or think of "one more thing to try real quick" and then lose hours.

Contrary to some advice, I fall asleep pretty well with the TV on or something. If there is nothing stimulating at all, I just toss and turn and think about what else I'd rather be doing. I need a "light distraction" to put myself on idle, or I will start to actively invent my own.

Read a boring book, or listen to familiar music. Works well for me.

Sleep is very important but you cannot discuss proper sleep or proper nutrition without the other.

There have been numerous studies showing a correlation between a healthy diet and sleep requirements. People who eat healthy have more energy and feel less tired throughout the day. In the same regard people with an unhealthy diet tend to feel more tired and nap more often and for longer periods of time.

Eating foods with a low glycemic index throughout the day will keep you grounded, preventing sugar highs and lows, and overall make you feel less tired.

My personal opinion based on my lifestyle is that my nutrition decisions directly affect my sleep requirements. I think it is most important to begin the day with a healthy breakfast upon waking up. This meal should include plenty of fiber, protein, and omega-3 fats.

Hey! Put me in a locked room with no windows and no clocks, and I'll sleep 7 hours too - out of boredom.

Just take some melatonin and force yourself to sleep in 30 minutes. (Plus it makes 7 hours feel like 8 hours.)

If you're still unconvinced: http://www.gwern.net/Melatonin.html

Experiment with doses, however. I found that I could be groggy on rising if I took the standard 3mg.

Apparently not for everyone:

Ngoc Thai: The Man Who Doesn’t Sleep http://www.theepochtimes.com/n2/content/view/2855/

I wish there was a way for me to sleep less than 9 hours. At least now i have a great excuse for people calling me lazy. I am special!

Try with daily jogging (30-40 minutes/day). I bet you'll feel better and will have enough sleeping 7.5-8h.

I recommend the book "Power Sleep" by Cornell professor James Maas.


Exceptional book that really transformed my college experience.

Can't think straight because you're too tired? !Try a power nap! A 15 minutes nap in the afternoon (use the timer on your iphone to not oversleep) and you'll be good as new.

> I still take the overnight "redeye" from California to New York, but I'm asleep by takeoff --even if takes an Ambien.

Seriously? I bought the guy's argument up until that point.

I was suffering from insomnia for almost 6 days last December, it was an experience, but not one I would ever like to happen again.

yes sounds true. Sleep relax whole your body and thats better to feel.

i guess atleast 8 hours sleep is needed as my doctor said me.

you can also watch this video to help you more http://www.warezvilla.net/tutorials/23345-deep-mind-brain-ev...

This guy obviously doesn't have any young children at home. I've forgotten what a good night's sleep is ;)

It is obvious to notice that, this is yet another useless research stat.

Everything is equally important for life to survive, breathing, drinking water, food, sleep, exercise. How does it matter if breathing is more important that exercise? It is common sense; you obviously breath more than you do exercise.

Subtext: we're torturing Bradley Manning.

Isn't Red Bull the same thing as sleep?

People say that you'll die... faster than without water but we know it's just a lie Scare your son, scare your daughter

For more information about how to adjust your schedule so that you can fit in the essential 7-8 hours of sleep, why powering down before sleep is so critical and how to do it, and the secret to falling back sleep when you wake up and begin ruminating, register for Tony Schwartz' webinar, Sleep or Die, on March 22 at 1pm EST. Sign up at https://theenergyproject.webex.com/theenergyproject/onstage/...

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