> “Although the study found inadequate sleep duration was not an issue in brain atrophy in this study, we cannot say there is no association,” she said, noting that a previous CARDIA study showed that shorter sleep was associated with worse white matter integrity, indicating lower cognitive functioning.
That quote seems to directly contradict the headline.
From the public results only[1] (I don't have a copy of the whole study) they studied the following things looking for correlation with brain decline:
* short sleep duration
* sleep quality
* difficulty initiating sleep (DIS)
* difficulty maintaining sleep (DMS)
* early morning awakening (EMA)
* daytime sleepiness
They only found that the middle four were correlated. I don't know what exactly "sleep quality" is but the others are pretty easy to understand. And the point is that the duration of a person's sleep is not what mattered, it was the quality.
Also, worth saying: these things were based on self-reported data, which is basically crap.
>To estimate the effects of sleep quality on the brain, the researchers surveyed approximately 600 adults on how well they slept. The participants were asked the same questions five years later and underwent brain scans 10 years after this.
This is press-release science. Maybe the latter three things you can remember, but I have sensors and whatnot in a fancypants mattress (i.e. I'm highly motivated to know), and my subjective opinion of my prior night's sleep is pretty uncorrelated with what they say. I couldn't begin to tell you the quality of my sleep from a week ago.
you're wrong. The only evidence we have for gravity is the correlation of mass and attraction. The theory of gravity does not contain any hint of a reason why, it simply points out what we can observe. Correlation is the only evidence we have.
And you have not ruled out that complaining about sleep in various ways isn't a direct side effect of brain shrinkage so the hypothesis remains open.
Sleep quality, if excluding DIS, DMS, EMA, usually will refer to things like apneas, nasal congestion, digestion, noise or light in the room, etc. Disturbances that don't wake the person but do tax the brain.
I would describe low sleep quality as "difficulty entering or maintaining the restorative phases of sleep." It's the thing a sleep clinic measures with an EEG.
I'm approaching midlife and noticing the quality of my sleep has declined. I can't sleep in anymore. Sometimes I'm waking up in the middle of the night occasionally and something I'm wide awake because I'm thinking about work or something like that. Very frustrating.
Another reminder to try to pull myself away from the screens late at night.
I've also found it's hard to sleep in, I recommend going to sleep sooner. It's like I'm hardwired to wake up at a certain time, the only thing I can control is when I go to bed.
Yeah, same here. I'll wake up at noon, no matter what time I go to bed. If I go to bed at 2, I'll have ten hours of sleep, if at 6... You get the idea.
Now all I need is to have fewer interesting hobbies and builds at night.
My god, this is not only exactly what I've done for years, but you described it in exactly the same way I describe it when telling people about it, almost word for word.
Not there yet (or maybe I am, going by my country's average male lifespan), but after years of wondering what the fuck sometimes happens I finally realised what mostly causes sleep issues for me:
- not getting rid of screens at least 30 mins before I hit the bed (60 is ideal)
- not getting tired/exercise enough during the day
- sleeping in the afternoon and anytime during the day more than 40-50 mins
- having coffee after 4-5pm
- having dinner after 8-830pm (though this is minor and I am not really sure it affects much)
- and this is the biggest culprit of all (or maybe second worst - next to screen time): even though it's past my sleep time (1030pm) not actually just getting down on the bed and close my eyes and just try to relax even though it seems maybe I am not sleepy. This also applies if I wake up before my wake up time and I do not force myself to go back to sleep that is at least "kinda" pretend i.e just lie down closing my eyes.
What helps:
- reading myself to sleep (paper books are what I read, so not sure about e-readers)
- hot chocolate (half glass) after dinner but 10-15 mins before hitting the bed
- allergy medication (when it becomes unbearable for me) :D (no it's rare for me to take that and I don't take without asking my doctor)
- listening to rain/thunder sound on my phone from a distance
- if there are things pending or things bothering in my head → then heading to my ToDo list "TCOT" (abbr. for take care of this) in Reminders.app and log/dump it there before hitting the bed → I have noticed that those things usually do not bother me at night then (but I don't have much personal/anecdotal data on this either)
Have you tried afternoon naps to compensate? I remember reading this theory a while back that we sort of naturally switch to a different sleeping cycle over the course of our lives, where older people tend to stay awake at night and sleep during the day as a sort of evolved way to split shifts for camp defence during the tribal era. No idea if there's any solid data to back it up though.
I will add a comment in support of the very low dose of melatonin. I take 1mg, same as another user, but will experiment with dropping it. I find that it works best if I take it some time before I plan to sleep. Currently I have a reminder set for 9:15 and I fall asleep between 10:30 and 11:30 most nights.
I am a historically terrible sleeper but the past year has been the best sleep of my life. Here is my overall process:
Bedtime routine:
1mg Melatonin at 9:15ish. Don blue light blocking glasses. My understanding is that the science behind these is mostly bunk but they help me. (Probably because of a general reduction in light and the psychological routine). Read book outloud w/wife and then watch a boring youtube video. If the youtube video is interesting, it's not good. Books are also not good because I find them too entertaining.
Day routine:
Wake up early, ish. Eat more food early than late. Exercise. Focus on using up energy at work or during the day. I am working on getting 30 min of sunlight every morning.
1 mg sublingual (dissolve under the tongue) melatonin works for me. I find it works best if I wait until I'm well settled in and should be asleep, but aren't. That's the time to quietly pop the tablet so it nudges me over the edge.
Biggest problem is that 1mg sublingual is hard to find. Walgreens/CVS is excited to sell you 5, 10 even 20 mg pills and gummies. But, those are so strong they are counter-productive.
I thought work stress kept me awake at night, but it was sleep apnea. I had a device that propels the lower jaw forward, to clear the throat, it stopped apnea but moved my teeth, but I then was brave enough to lose ~5kg (sleeping more makes you brave), and now I don’t need the jaw device.
I noticed that too, but assumed it is a natural part of the body being in stasis and no longer growing/developing. I definitely remember being most tired during teenage years and other phases when the body was changing. You and others seem to imply that it has to be with increased stress, and maybe so, but I would like to see data on other cultures. Does someone who has been farming since age 17 have the same sleep patterns in middle age?
My issue is I seem somehow wired to wake up early. I sleep better when I go to bed earlier. Screen use seems to have nearly no impact on my sleep, and what has the most impact is the type of screen usage (i.e. reading news, books & watching film is fine, but instagram/tiktok before bed tends to lead to worse sleep for me).
I started exercising (a lot) in the year and found that has helped me fall asleep faster. It doesn't have to be a whole lot either. 30 minutes of jogging or fast walking is enough to do it for me.
I definitely feel it on days where I sit and do nothing. I have a harder time falling asleep.
I find a light exercise for extended duration of time right before sleep helps my sleep the best. The key for me seems not doing anything stressful right before sleep after the exercise, and drinking plenty of water but not food/sugar. I wonder blood sugar level is associated with some of the sleep problems.
ahh the old 3am ruminating toss and turn never fails to put me back asleep a half hour before my alarm goes off and mostly never closer to solving the problem at hand
I sometimes wonder what damage 20 years of undiagnosed sleep apnea has caused. My sleep report showed 50 incidents of breathing issue per hour on average. I finally got a CPAP and it has literally made a world of difference to my life.
Now I hear my toddler snore and hope that he doesn’t have it. At least, I can intervene early.
When I am 86kg, I have quite heavy sleep apnea. When I am 83kg, I don’t. Everyone has different possible actions, because for some it is due to the shape of the nose cartilage, for others it’s the throat, but discovering that made a world of difference.
I wake up in the morning and I’m awake. And courageous. It’s incredible.
Lucky you. I had textbook symptoms of sleep apnea four years ago with a BMI of 19.
Due to COVID I could not get tested until my BMI was 23.5. The air pressure I was prescribed was ludicrously wrong and after a couple of years of tweaking it I'm still not sleeping great, but it's a massive improvement over receiving no therapy.
I just got one. It is silent according to my wife. It is kind of loud for me because it is blowing air into my nose which makes noise inside my head. But I like white noise - helps with the tinnitus.
With the mask on, it’s like having a white noise machine at a volume of 3-4. My wife wasn’t getting enough sleep because of my snoring, so this white noise isn’t bothering her at all.
I went with the doctor prescribed one, through insurance and have a Resmed Airsense 11. Did not explore second hand and I don’t think you can buy one without a prescription. I Change the mask every 3-4 months, but you can extend it as long as you wash it every 3-4 days.
You know what the best way to stop sleeping well is? Read about all the things that poor sleep does to you. Especially when the quality of the research is as shaky as this link.
Matthew Walker, author of Wy We Sleep agrees with you. He has a page where he addresses some common reader concerns and criticisms and anxiety around quantity and quality of sleep is something he acknowledges:
I experienced severe insomnia for awhile due to stress illness, and some stuff from The Sleep Coach School helped quite a bit. I'm doing well now, but I get a bit facepalmy when I see healthy people go looking for things to worry about.
I was at a conference last week, and for the first time heard about a study that suggested that the cycle is that a build up of amyloid, tau, lew bodies, and other metabolic waste in the brain reduces the slow-wave power which is responsible for clearing out this metabolic waste (via the glymphatic system).
This cycle is still not proven, but it was an interesting early hypothosis.
We've been developing slow-wave enhancement technology for the last 4 years which increases slow-wave activity, and the first 3 studies in Alzheimer's and MCI are now published. These are early studies with lots left to go.
This study is just awful. Can we stop funding epidemiological studies with little to no reproducibility? At least use more frequent objective sleep measurements, and account for confounding variables.
- They openly acknowledge they "can't say that poor sleep causes dementia" aka they established a correlation but no direction of causality
- There's self-reporting bias where participants were "asked about" their sleep patterns
- There's selection and survival bias: the participants were around 40 y/o, the ones that remained for 10 years might be different than those who dropped
- The sample was for a cardiovascular disease study
- They didn't control for unmeasured confounders other than "age, sex, education, health and lifestyle factors"
- The 1.6-2.6 years of brain aging were measured using ML algorithms and this is a small enough effect to be within a margin of error...
My only hope is that now that we seemingly have a cure for obesity, as the population greys the next common non-cancer/heart disease ailment to tackle are brain issues that set in during old age. Maybe they'll have a pill that gets rid of all of the plaque or proteins or prions or whatever that sleep is for.
There must be a nuanced distinction b/w short sleep duration and the other sleep quality metrics since nearly all of them likely cause short sleep duration as a side effect. I wonder how the researchers disentangled this.
> “Although the study found inadequate sleep duration was not an issue in brain atrophy in this study, we cannot say there is no association,” she said, noting that a previous CARDIA study showed that shorter sleep was associated with worse white matter integrity, indicating lower cognitive functioning.
That quote seems to directly contradict the headline.
From the public results only[1] (I don't have a copy of the whole study) they studied the following things looking for correlation with brain decline:
* short sleep duration
* sleep quality
* difficulty initiating sleep (DIS)
* difficulty maintaining sleep (DMS)
* early morning awakening (EMA)
* daytime sleepiness
They only found that the middle four were correlated. I don't know what exactly "sleep quality" is but the others are pretty easy to understand. And the point is that the duration of a person's sleep is not what mattered, it was the quality.
[1]: https://www.neurology.org/doi/10.1212/WNL.0000000000209988
Also, worth saying: these things were based on self-reported data, which is basically crap.
>To estimate the effects of sleep quality on the brain, the researchers surveyed approximately 600 adults on how well they slept. The participants were asked the same questions five years later and underwent brain scans 10 years after this.
This is press-release science. Maybe the latter three things you can remember, but I have sensors and whatnot in a fancypants mattress (i.e. I'm highly motivated to know), and my subjective opinion of my prior night's sleep is pretty uncorrelated with what they say. I couldn't begin to tell you the quality of my sleep from a week ago.
self-reported data is basically crap as it regards actual sleep patterns, but it could (hypothetically) be a rock solid predictor of brain shrinkage
You can't just take crap data and compare it to a hard outcome and claim victory if you find a correlation.
Crap data is crap, no matter what you compare it to.
you're wrong. The only evidence we have for gravity is the correlation of mass and attraction. The theory of gravity does not contain any hint of a reason why, it simply points out what we can observe. Correlation is the only evidence we have.
And you have not ruled out that complaining about sleep in various ways isn't a direct side effect of brain shrinkage so the hypothesis remains open.
Sleep quality, if excluding DIS, DMS, EMA, usually will refer to things like apneas, nasal congestion, digestion, noise or light in the room, etc. Disturbances that don't wake the person but do tax the brain.
I would describe low sleep quality as "difficulty entering or maintaining the restorative phases of sleep." It's the thing a sleep clinic measures with an EEG.
The subtitle is UCSF-led study finds that insomnia, but not lack of sleep, may hasten brain shrinkage.
Yes. Let's use that above.
I like how scientists use words like less and more as if we know what reference points they are thinking
The science publication complex is incredibly problematic.
I'm approaching midlife and noticing the quality of my sleep has declined. I can't sleep in anymore. Sometimes I'm waking up in the middle of the night occasionally and something I'm wide awake because I'm thinking about work or something like that. Very frustrating.
Another reminder to try to pull myself away from the screens late at night.
I've also found it's hard to sleep in, I recommend going to sleep sooner. It's like I'm hardwired to wake up at a certain time, the only thing I can control is when I go to bed.
Yeah, same here. I'll wake up at noon, no matter what time I go to bed. If I go to bed at 2, I'll have ten hours of sleep, if at 6... You get the idea.
Now all I need is to have fewer interesting hobbies and builds at night.
what works for me in this case is to pop in a single ear bud and turn on an audio book I've already listened to.
because there is a narrative, it shuts down rumination. because there's nothing novel, my brain is quite happy to drift off to escape the tedium.
My god, this is not only exactly what I've done for years, but you described it in exactly the same way I describe it when telling people about it, almost word for word.
Not there yet (or maybe I am, going by my country's average male lifespan), but after years of wondering what the fuck sometimes happens I finally realised what mostly causes sleep issues for me:
- not getting rid of screens at least 30 mins before I hit the bed (60 is ideal)
- not getting tired/exercise enough during the day
- sleeping in the afternoon and anytime during the day more than 40-50 mins
- having coffee after 4-5pm
- having dinner after 8-830pm (though this is minor and I am not really sure it affects much)
- and this is the biggest culprit of all (or maybe second worst - next to screen time): even though it's past my sleep time (1030pm) not actually just getting down on the bed and close my eyes and just try to relax even though it seems maybe I am not sleepy. This also applies if I wake up before my wake up time and I do not force myself to go back to sleep that is at least "kinda" pretend i.e just lie down closing my eyes.
What helps:
- reading myself to sleep (paper books are what I read, so not sure about e-readers)
- hot chocolate (half glass) after dinner but 10-15 mins before hitting the bed
- allergy medication (when it becomes unbearable for me) :D (no it's rare for me to take that and I don't take without asking my doctor)
- listening to rain/thunder sound on my phone from a distance
- if there are things pending or things bothering in my head → then heading to my ToDo list "TCOT" (abbr. for take care of this) in Reminders.app and log/dump it there before hitting the bed → I have noticed that those things usually do not bother me at night then (but I don't have much personal/anecdotal data on this either)
Have you tried afternoon naps to compensate? I remember reading this theory a while back that we sort of naturally switch to a different sleeping cycle over the course of our lives, where older people tend to stay awake at night and sleep during the day as a sort of evolved way to split shifts for camp defence during the tribal era. No idea if there's any solid data to back it up though.
Two low impact things to try are:
* A very small amount of melatonin. .300 to .500 mg.
* Breathe right strips, these increase airflow
Other health issues can also cause wakefulness.
I will add a comment in support of the very low dose of melatonin. I take 1mg, same as another user, but will experiment with dropping it. I find that it works best if I take it some time before I plan to sleep. Currently I have a reminder set for 9:15 and I fall asleep between 10:30 and 11:30 most nights.
I am a historically terrible sleeper but the past year has been the best sleep of my life. Here is my overall process:
Bedtime routine: 1mg Melatonin at 9:15ish. Don blue light blocking glasses. My understanding is that the science behind these is mostly bunk but they help me. (Probably because of a general reduction in light and the psychological routine). Read book outloud w/wife and then watch a boring youtube video. If the youtube video is interesting, it's not good. Books are also not good because I find them too entertaining.
Day routine: Wake up early, ish. Eat more food early than late. Exercise. Focus on using up energy at work or during the day. I am working on getting 30 min of sunlight every morning.
1 mg sublingual (dissolve under the tongue) melatonin works for me. I find it works best if I wait until I'm well settled in and should be asleep, but aren't. That's the time to quietly pop the tablet so it nudges me over the edge.
Biggest problem is that 1mg sublingual is hard to find. Walgreens/CVS is excited to sell you 5, 10 even 20 mg pills and gummies. But, those are so strong they are counter-productive.
Have you found somewhere else to get it?
I get the lowest dose and then break them up. Not precise, but if you get a 2-2.5 mg pill, it's pretty ok.
Melatonin gave me nightmares. So, YMMV.
Don't forget: Try pausing caffeine intake.
At least 8 hours before sleep [1].
[1] https://www.sleepfoundation.org/nutrition/caffeine-and-sleep....
I thought work stress kept me awake at night, but it was sleep apnea. I had a device that propels the lower jaw forward, to clear the throat, it stopped apnea but moved my teeth, but I then was brave enough to lose ~5kg (sleeping more makes you brave), and now I don’t need the jaw device.
I noticed that too, but assumed it is a natural part of the body being in stasis and no longer growing/developing. I definitely remember being most tired during teenage years and other phases when the body was changing. You and others seem to imply that it has to be with increased stress, and maybe so, but I would like to see data on other cultures. Does someone who has been farming since age 17 have the same sleep patterns in middle age?
My issue is I seem somehow wired to wake up early. I sleep better when I go to bed earlier. Screen use seems to have nearly no impact on my sleep, and what has the most impact is the type of screen usage (i.e. reading news, books & watching film is fine, but instagram/tiktok before bed tends to lead to worse sleep for me).
I started exercising (a lot) in the year and found that has helped me fall asleep faster. It doesn't have to be a whole lot either. 30 minutes of jogging or fast walking is enough to do it for me. I definitely feel it on days where I sit and do nothing. I have a harder time falling asleep.
I find a light exercise for extended duration of time right before sleep helps my sleep the best. The key for me seems not doing anything stressful right before sleep after the exercise, and drinking plenty of water but not food/sugar. I wonder blood sugar level is associated with some of the sleep problems.
There is a natural reduction in sleep quality as we age. This is related to the decline of health in aging.
Moving my phone from beside my bed to across the room dramatically improved my sleep quality.
ahh the old 3am ruminating toss and turn never fails to put me back asleep a half hour before my alarm goes off and mostly never closer to solving the problem at hand
Sorry to hear that! I hope your sleep quality improves. :)
Taking a magnesium vitamin pill before sleep helps a lot. Try it out.
I sometimes wonder what damage 20 years of undiagnosed sleep apnea has caused. My sleep report showed 50 incidents of breathing issue per hour on average. I finally got a CPAP and it has literally made a world of difference to my life. Now I hear my toddler snore and hope that he doesn’t have it. At least, I can intervene early.
When I am 86kg, I have quite heavy sleep apnea. When I am 83kg, I don’t. Everyone has different possible actions, because for some it is due to the shape of the nose cartilage, for others it’s the throat, but discovering that made a world of difference.
I wake up in the morning and I’m awake. And courageous. It’s incredible.
Lucky you. I had textbook symptoms of sleep apnea four years ago with a BMI of 19.
Due to COVID I could not get tested until my BMI was 23.5. The air pressure I was prescribed was ludicrously wrong and after a couple of years of tweaking it I'm still not sleeping great, but it's a massive improvement over receiving no therapy.
How’s the noise? Do you have a partner? I do day and night apnea and love to try a CPAP but my partner needs a quiet room to sleep.
What features/specificities should one consider to choose a model? Can I buy second hands, does some parts wear off?
Maybe should get one for when she don’t sleep at home, I’d love to feel rested at morning sometimes.
I just got one. It is silent according to my wife. It is kind of loud for me because it is blowing air into my nose which makes noise inside my head. But I like white noise - helps with the tinnitus.
With the mask on, it’s like having a white noise machine at a volume of 3-4. My wife wasn’t getting enough sleep because of my snoring, so this white noise isn’t bothering her at all.
I went with the doctor prescribed one, through insurance and have a Resmed Airsense 11. Did not explore second hand and I don’t think you can buy one without a prescription. I Change the mask every 3-4 months, but you can extend it as long as you wash it every 3-4 days.
Same here. My CPAP changed my life literally on the first night. I woke up feeling 20 years younger.
You know what the best way to stop sleeping well is? Read about all the things that poor sleep does to you. Especially when the quality of the research is as shaky as this link.
Matthew Walker, author of Wy We Sleep agrees with you. He has a page where he addresses some common reader concerns and criticisms and anxiety around quantity and quality of sleep is something he acknowledges:
https://sleepdiplomat.wordpress.com/2019/12/19/why-we-sleep-...
In that same post he addresses some of Alexey Guzey's oft repeated criticism of his work.
I experienced severe insomnia for awhile due to stress illness, and some stuff from The Sleep Coach School helped quite a bit. I'm doing well now, but I get a bit facepalmy when I see healthy people go looking for things to worry about.
https://youtube.com/@thesleepcoachschool8192
This
We work in the sleep space, and this isn't new.
I was at a conference last week, and for the first time heard about a study that suggested that the cycle is that a build up of amyloid, tau, lew bodies, and other metabolic waste in the brain reduces the slow-wave power which is responsible for clearing out this metabolic waste (via the glymphatic system).
This cycle is still not proven, but it was an interesting early hypothosis.
We've been developing slow-wave enhancement technology for the last 4 years which increases slow-wave activity, and the first 3 studies in Alzheimer's and MCI are now published. These are early studies with lots left to go.
Studies https://pmc.ncbi.nlm.nih.gov/articles/PMC10758173/ https://pubmed.ncbi.nlm.nih.gov/37593850/ https://www.proquest.com/intermediateredirectforezproxy
You can find out more about us at https://affectablesleep.com
We're raising an Angel round, and I'll be travelling through the US from Mid-Nov to early Dec. pete[a] domain if you want to learn more.
> We work in the sleep space
Is this another way of saying you work from bed?
Joop Zoetemelk once famously said: "You win the Tour de France in your bed"
https://www.teamvismaleaseabike.com/longread/winningtogether...
What can I say? I'm a hard worker. ;)
This study is just awful. Can we stop funding epidemiological studies with little to no reproducibility? At least use more frequent objective sleep measurements, and account for confounding variables.
- They openly acknowledge they "can't say that poor sleep causes dementia" aka they established a correlation but no direction of causality
- There's self-reporting bias where participants were "asked about" their sleep patterns
- There's selection and survival bias: the participants were around 40 y/o, the ones that remained for 10 years might be different than those who dropped
- The sample was for a cardiovascular disease study
- They didn't control for unmeasured confounders other than "age, sex, education, health and lifestyle factors"
- The 1.6-2.6 years of brain aging were measured using ML algorithms and this is a small enough effect to be within a margin of error...
My only hope is that now that we seemingly have a cure for obesity, as the population greys the next common non-cancer/heart disease ailment to tackle are brain issues that set in during old age. Maybe they'll have a pill that gets rid of all of the plaque or proteins or prions or whatever that sleep is for.
There must be a nuanced distinction b/w short sleep duration and the other sleep quality metrics since nearly all of them likely cause short sleep duration as a side effect. I wonder how the researchers disentangled this.
What is the term for cursed knowledge that may also be untrue?
Fearmongering? Misinformation? Something with a vector around there probably.
I’ll let my baby know that when he wakes up in the middle of the night it’s impacting my brain.
Related:
Sleep regularity is a stronger predictor of mortality than sleep duration (2023)
https://news.ycombinator.com/item?id=42022151
Related:
How to Train Yourself to Go to Sleep Earlier
https://news.ycombinator.com/item?id=42016904
Insomnia bad and the discovery of how sleep flushes toxins seem to jive
I'm so screwed...
Awww sheeiiiiittttt