One thing that stuck with me from the book Stroke of Insight (memoir of brain scientist who has and recovers from stroke) was how intently she prioritized sleep when everyone else kept trying to drag her out of bed.
In a more mundane context, I've been fortunate to organize my schedule such that I don't use an alarm to get up in the morning. So I can let my body figure out how much sleep I need.
When my wife had our children, she (and I) were handed them, stuck in a room, then distrurbed for tests and briefings every 90 minutes for 3 days.
How anyone can recover from something as savage as childbirth is beyond me. It is no small miracle that she was able to walk, let alone care for two new babies and herself (with my help, but there's only so much I can do to assist with breastfeeding or healing of major trauma).
At one point I asked all the nurses to leave and not come back for 6 hours in very angry tones.
The same thing happened to my mom in her 50s after 6 hour quadruple bypass surgery. They basically kept her awake for two days doing tests every hour after her surgery. She eventually started hallucinating from lack of sleep. It just seems so inhumane.
Not just hallucinations but lack of sleep can change your very character and behaviour. The executive part of the brain in the frontal cortex becomes inhibited and you have less conscious self-control over the expression of emotions/feelings. You will become very noticeably irritable, angry, petty, quarrelsome and even sometimes violent.
I have had the misfortune of experiencing this twice in my life so far; the first on a month-long car trip with my buddy and the second while i was the caregiver/caretaker for my Mother. In both cases it was my lack of sleep which made me very difficult to be around.
So whenever you note that somebody's behaviour has abruptly changed, always ask two questions; a) Are you sleeping well? b) What medications are you taking and what diet are you on?
It's a weird state of affairs. I spent a lot of time around doctors through family and an (ex) significant other, and my take is that you just can’t absorb the quantity of material they have to, and do the quantity of things that is required of them, without becoming a bit disconnected as a result.
The fact that med school + residency means you basically have to put your life on hold throughout all of your 20s while other people are figuring out the whole “being a young adult in the world” thing leads to very… particular emotional development.
Medical school doesn’t particularly encourage questioning the status quo or established practices.
Some of them can recalibrate after a few years in the real world, but many never really escape that bubble. It’s hard to radically change your outlook on life in your 30s (let alone when you now have to repay huge debt, in the case of many American doctors)
a lot of doctors were a bit “off” before med school starts.
Many of premed kids I knew in undergrad (or the high schoolers aspiring to premed) weren’t motivated by scientific pursuits or an altruistic desires - they just had to be the best. They needed to ace every test (and would argue incessantly with the teachers about it), they had to be in the hardest classes, etc. they became doctors because somebody told them it was hard and well respected.
I imagine that those people become doctors that are disconnected from their patients.
A lot of people are going to be disappointed. Truth is medicine is a decadent profession, worldwide. In some countries, it's in free fall and accelerating to terminal velocity. In some parts of the world, doctors are hated to the point they routinely suffer physical violence.
The US manages to keep it relevant by restricting supply and maintaining its elite status but I'm not sure doctors are still respected there. Plenty of hackers who think they can do it better than the doctors right here on HN. I'm a programmer myself and I know for a fact a computer could do significant parts of the job. Even psychiatry is in danger due to LLMs.
HN nerds[1] talking about doctors reminds me a lot about bean-counters talking about IT and software.
> Plenty of hackers who think they can do it better than the doctors right here on HN
Of course they would, it's easy to come up with solutions that are simple and wrong, when one has no point of reference. Hackers understand balancing trade-offs in programming languages or architectures, but can't imagine other fields being nuanced or even more complex. If an LLM cant tell you when to use a monorepo, then it far from telling you when a specific drug dosage is right for a patients set of circumstances.
> I'm a programmer myself and I know for a fact a computer could do significant parts of the job.
A computer does a massive part of almost any job today, so I’m not sure what exactly this is trying to say about the profession. Wait until you hear that pilots can’t even fly without an airplane. Total conmen.
Medical school is an abusive environment. It's literally filled with awesome people like hypercompetitive assholes who you will throw you under the bus, professors whose teaching method consists of socratically asking you questions until you look like a moron in front of your peers. Public humiliation was a daily experience and physical abuse was also not unheard of. Soul destroying work schedules are also imposed on you even while you're still a student. In fact, this labor is straight up integrated into the system. Students can't do much because they don't know anything but residency is comparable to indentured servitude.
It's hard to describe the effect years of this can have on the mind. Things can get so distorted you feel guilty for eating, for going to the bathroom, sleeping, resting. Normal people things like a weekend or a good night's sleep become luxuries to you. You come home and everyone's already asleep. People start out all starry eyed and thinking about making a successful career out of helping people, but as it nears its end people can't wait to just start making fat stacks already.
It functions as a sociopath breeding ground. Basically weeds out your humanity by punching you until you like it, hammering you until you get good at it so that you fit into the system. Some people just quit when faced with that, others try to take it and end up committing suicide. One of the most haunting stories I've ever heard was about young woman asking her attendings about suicide methods after a patient killed himself. They thought she was an interested student who was trying to learn about stuff so they happily dispensed all the information they knew. She efficiently and painlessly killed herself not even a day later.
People who make it out of this process might enjoy good pay and lifestyle depending on the country and the specialty they chose. It definitely costs them, though.
They have different priorities, especially with major interventions. First priority, make sure you don't die. Sleep and recovery are down the list a bit.
Disconnected? Probably. But I think that's intended and part of the current medical model. It's not necessarily a bad thing when focusing on long term positive outcomes in aggregate. But it certainly feels inhumane at times to the individual and their loved ones.
We never once saw a doctor. It was all nurses, mandatory education, paperwork, blood tests, vital checks, moving rooms, etc. At one point we were trying to sleep and a breastfeeding assistant stopped by. Super helpful that they can stop by, but jeez just coordinate for a 4 hour block where we're not disturbed.
> First priority, make sure you don't die. Sleep and recovery are down the list a bit.
But lack of sleep can impair immunity and disturb blood pressure and heart rhythm. Keeping someone with major trauma under stress (like being constantly awake) can make them more likely to die.
When someone dies in the hospital what happens in the inquiry?
Examine the symptoms of the person who died and how to detect them. Add another check.
If they left someone alone for 2 hours or 4 hours and they passed away during that time, what would the headlines read? "General Healthcare left the patient alone for X hours and didn't even bother to check on their well being."
My Dad was in palliative care and there wasn't a period of any more than 10 minutes where there wasn't interruption. I'm glad he had constant care but it was almost quite literally constant.
As son and father in an end of life situation there was no gap to contemplate or allow us to connect it was drugs injection, food, check if he ate, back again, pick up tray, more drugs, check on his breathing, bathroom break (needed assistance).
Dad was probably OK with it but we never had a chance to just have a moment and possibly say something we never would have. He died at 8:40pm on my birthday of all days as I sat next to him.
Were you in your suite in the late morning? Hotels usually assume that that's the time tourists are most likely to be out about town, so they try to cram every type of cleaning and maintenance into that period.
Hotels also schedule their check-out + check-in times to leave a gap around this period, so that at least some percentage of their suites will be "between guests" each day for a few hours, and thus able to be deep-cleaned. But if that doesn't happen — e.g. if the whole hotel is booked for a convention weekend, and it's the Saturday and nobody's checking out that day — then the cleaning staff that normally does the deep cleans will be hunting around for minor stuff to do so they can look busy.
We had to keep our daughter on a photocopier looking device for bilirubin as well as the tests. Nobody told me how common this is so I also got to enjoy a feeling of panic and dread while that was going on.
Phototherapy is so scary looking, but the NICU nurses made it clear to my wife and I that everything was going to be fine. That said, seeing your newborn in that state after you just welcomed them to the world is a real brain blast of trauma. I still remember the feeling as you described: hollow dread and fear.
They usually do. While it could be the case the hospital is just poorly managed, it's hard to say without knowing the specifics of each case. I don't know what all those "briefings" were about but there could have been medical reasons for tests every 90 minutes.
Honestly, the truth is hospitals are designed to do this. The entire purpose of the place is to have people moved into it so that these constant checks and examinations as well as treatments can be done most efficiently. The idea is to rapidly notice and react to changes in the patient's condition.
In programming terms, the core function of a hospital is to poll and update the patient's state in a loop that runs while consent is given and until cured or dead. The polling frequency is calibrated according to knowledge of the patient's general condition and the specific pathology being treated.
If you know the patient could bleed out and die after some surgical procedure, you want to check periodically that this is not happening. How frequently do you check? Depends on what you predict could happen. If you think the worst that could happen is a small and slow bleeding, then you can check less often. If you think there's risk of major bleeding, then you want to check frequently, possibly even constantly.
Depending on the situation, it's necessary to check the status of the patient every hour or so. If a condition carries e.g. an increased risk of stroke, there is no way to check for it except asking the patient to move and talk. A good night of sleep is valuable, but if you wake up with a severe paralysis and after the time window that allows e.g. removal of a clot, it's been too high a price for a few nights of good sleep
Sure, the tests I get. It was the briefings that seem weird to not cluster.
In the case of a pregnancy, I'm assuming these "briefings" are things like trying to teach the new parent things they'll need to know when they go home; or giving them status updates about tests done on their new baby if they're in the NICU, and so forth. These all seem like things that could wait.
Is the point to use the infodumping as an excuse to do the tests?
Clustering is a big goal for hospitals, since it's also easier for the nurses, but a lot of factors can interrupt that. Coordinating different people to do different tasks, getting the requisite lab results or medication approvals on time, ad-hoc requests from the patient/patient family themselves, a need to quickly double check what the monitors on the patient are saying in case something is going wrong, etc.
That is not how it always goes. We had sustained periods of sleep and time alone following delivery. My partner actually wasn’t a huge fan of her OB before the delivery but thought she was great during. Loved the combo of kind and gentle nurses and a doctor coming in and just ordering her around. Kinda personal trainer vibes.
We made it clear we wanted to be left alone over night, had reasons for why (neurological issues that are exacerbated by poor sleep) and they largely respected that. Maybe if we didn’t have that excuse it would have been worse. Shit, even the vending machine salads were pretty good. Didn’t love sleeping on a foam bench for 5 days, but we felt quite positive about the delivery center we had our child at in the US.
Yes, I know. But restful healing is important too. And it has a good track record, better than the doctors in fact. They should work around the healing instead of interfering with it.
Surely there's yet another kind of machine they could hook up, that could silently monitor you for blood loss / internal bleeding? Especially if they know where to expect that potential bleeding to appear? (The probe for that one would probably be pretty uncomfortable while you're awake, but that doesn't matter if they let you sleep!)
Not much replaces a physical examination with the physician or nurse present.
Serious complications can be quite subtle that unless you answer questions, they may be missed. Having someone come in, listen to your heart and lungs, ask a few questions can't really be replaced with machines.
I accept the answering-questions part — but it might be just barely possible today to build an "automatic stethoscope" machine, that sits there continuously listening to your heart and lungs, feeding the audio through an ML model, and alerting if it "hears" anything odd, no?
(It wouldn't even need to know what the odd thing represents; just that it's out-of-expectation enough to require someone to come over and check on you! A bit like asking a family's child to watch grandma while you speak to the mom and dad. All you want the child to do, is to freak out and get your attention if grandma does anything other than what she was already doing!)
Okay? I already said "I accept the answering-questions part."
Doctors not having to manually probe any signs of heart/lung problems each time they're in the room, would mean that they get either get more time to test each patient for consciousness/lucidity; get time to check on more patients; or (my preferred option) are able to make each check-session shorter and less invasive (no need to sit the patient up to listen to their lungs through their back, for example), and thus less disturbing of a patient's sleep quality (because it's easier to go back to sleep after a short conversation, when you haven't had your blood pressure spike from sitting up.)
Standard patient monitoring indirectly monitors for blood loss. Decreased blood pressure, increased breathing rate, increased heart rate are all signs of blood loss. This can be and is done by machines.
The thing people don't seem to understand is the fact doctors also monitor consciousness. Depressed mental state is also a sign of blood loss. The patient's neurolopsychogical state is important information, it has diagnostic and prognostic value.
The most basic way of evaluating a patient's neuropsychological state is to bother them with questions.
Having a similar experience with our first child this week. Almost a full day of labour only to have a c-section at the very end due to complications.
Even the c-section seemed absolutly brutal, at one point I was convinced one of the surgeons placed his foot on the table for leverage, given how much movement there was to her body.
As if the physical trauma wasn't enough, being in a room with multiple first-time parents struggling to breastfeed as both they and their children cried, then being visited and probed every hour by medical staff with ineffective pain relief, /and/ having work out how to care for your child when the only communication path is basically through
an amplitude modulated scream -
Honestly, I've had some low points in my life, I thought I had a high tolerance for physical and emotional pain, but I can only describe what my wife experienced this week as total, crushing anguish.
For us it was our baby daugther herself who kept us awake. For months we didn't have more than 2 hours of undisturbed sleep. After like 3 or 4 months we had around 4 hours of undisturbed sleep for a looong time. Now she's three and we sometimes get a full night of sleep but several times a week we get woken up at around 3 a clock at night by our daugther complaining about ghosts or something like that.
Indeed. I absolutely love my daughter but I think having her made me and my wife feel at least 10 years older. I always wanted two kids but now it makes me afraid and I honestly believe I would not survive a second one. At least not a similar like my daughter.
She's super cute, intelligent and active but also extremely demanding and had a lot of problems with dermatitis, tummy aches, KISS syndrome and other stuff that made her not sleep well and cry a lot (and she's super loud).
It also made me respect single parents 10000 times more than before. I can't imagine handling a situation like that alone.
I thought the same as you and delayed having a second kid as a result. Ended up having two more. The second kid was so much different than the first, slept fine, is way more emotionally regulated, etc. I regret my fear based decision making to delay. The third kid is somewhere between the first two.
Fear based decisions don’t always lead to the best outcomes, though I am in no way dismissing the fear :)
My kids are much older but something about the experience of rearing babies and toddlers changed my sleep permanently: I sleep much lighter (read: woken up by every noise and movement), and the whole concept of "sleeping in" has vanished as a possibility, even if I go to bed very late and no one else is in the house.
Of course it's a trade-off I'd gladly make again but it still sucks that I will never feel as well rested day-to-day as I did before kids.
I dress it up in other terms but this is ultimately my primary complaint about Scrum. It uses peer pressure to moralize about acceptable sleep patterns.
I'm completely ignorant here, but my understanding is that Scrum is (perhaps at a high, reductive level) a software workflow/collaboration tool. Genuinely curious how that ends up being used to moralize about acceptable sleep patterns.
If you don't show up at a particular time in the morning then you're a horrible person and not a Team Player. Every day, year after year.
Good teams make it after everyone would have reasonably absorbed their coffee. But some teams get pushed earlier. Particularly if there are people in EST, CST, and definitely if you've got people in India, where 9 am PST is when you should be reading your kids bedtime stories.
Scrum doesn't dictate any particular time for team meetings. But if you choose to work on a geographically distributed then someone will be inconvenienced regardless of the chosen methodology. You're not special.
I'm in an async company and team, we practice scrum too. Half the team in the US, half in Europe.
First of all, the standup isn't daily, it's twice a week. People still miss it for reasons (kids, doctors appointments, ...), and it's just... accepted. There's a general culture of trust.
Other than that, Slack threads go on twice as verbose and long as in other places I've worked. There's a general deluge of pull requests going around certain times of the day and they're always reviewed within an acceptable time frame. In between delivering PR's you simply pick up other work, we're all seniors that know how to work independently, I'm not sure if you could achieve the same thing with a bunch of juniors mixed in unless they have the right attitude as well.
Zapier is/was (I’ve not been there for a bit over a year) more or less async first. We still had meetings, but they weren’t supposed to be the default.
Basically for status updates, you’d just put it in Slack. We had a bot that prompted us. We did have a weekly meeting, but it was at a reasonable time for everyone.
A team I was on while there had some APAC people, and we even managed to have meetings with them, by scheduling them in afternoon hours for the U.S. Worked out pretty well.
manager here, how old are you? parents of school age children (like half the workforce) are drinking coffee by 6:30 local. overseas workers are getting paid foreign salaries, they understand the deal they made. its the under-26yo crowd who is up till 1am watching netflix and can’t get to bed on time. what categories am i missing that can’t attend a meeting at 9?
46 here with school-age children. I'm gonna disagree. I realize we're an outlier because we homeschool, but our kids wake up on their own, happy and eager for the day. Too often, I see and read about kids being dragged out of bed and sitting at bus stops while it's still dark outside. All so the working class can be at their desks by 8am? Never agreed with that.
I'm still a night owl. 12am is the baseline. 1am is not uncommon. 2 or 3am is occasional. I can attend a 9am. I prefer 10 or later. Most of my team does as well, and they all rise earlier than I do.
CEO here - check yourself. The role /you/ were hired for requires essential social skills such as understanding that some people are night owls and some are morning people. The category you're missing is the one that will naturally wake up later than you.
Also, women require more sleep than men on average.
YTA. I'm 30 and i have to waste my time in the evening because i do not get tired before midnight except when I'm physically exhausted. Which typically never happens in a office job. I can go to bed earlier but then i will just lay wake until my sleep time.
SO has it reverse, she wakes up at 7-8 am even at the weekend and is unable to get back to sleep.
What about standups? Are you implying that having to be somewhere at a certain time in the morning impedes your ability to go to sleep at a reasonable time so you can get a healthy amount of sleep?
Yes. Isn't that obvious? Everyone has different natural sleep patterns, some have later cronotypes. Meetings set too early in the day for your body's preferred time to be asleep will result in having to wake up with an alarm to attend them.
My team moved our daily standup later in the day to accommodate my delayed sleep phase and it's been extremely helpful to getting a full night's uninterrupted sleep.
There you go moralizing about acceptable patterns of sleep.
Crepuscular and nocturnal predators require tribes of humans to have some number of members who are tuned to be either awake before sunrise or awake long after sunset. Without people with genes to go bed late and wake up late we wouldn't be here having this conversation.
In modern society the former are lionized and the latter are villified as making bad choices.
I can pick when I go to sleep and wake, I've worked 3rd shift, 9 - 5 and resturant hours with no issue.
Wouldn't a tribe that is able to do as I can have the greatest evolutionary advantage and thus outcompete the tribes requiring specialization like you describe?
Unfortunately, not everyone has quite the same natural flexibility you describe. "Shift worker syndrome" has been known for decades, though a fortunate subset of people just seem immune.
Lucky you. Whatever I do, if I'm forced to be out of bed before 8 AM, I'm going to be completely useless for few days. Usually I wake up around 9:30 to get good sleep. And whatever I do, I'm simply unable to go sleep earlier than midnight, even if I lay down, I just can't sleep for hours. It's 0:29 where I live and I'm just turning on Netflix after a failed try at sleeping - even though I'm pretty tired as I didn't sleep enough yesterday.
I know that any code I write before around 9:45 in the morning will be seen as regrettable and rewritten at some point in the next few days. So the earlier I sit down to write code the more rework there will be. This is somewhat less true if my adrenaline is high from being smacked with production issues first thing in the morning, but adrenaline is not a sustainable strategy.
I am not aware of any mode of watching Netflix that is constrained to 15 minutes.
"Trying" to sleep is also doomed to failure, of course.
Personally, what works best for me is modeling solutions to issues in projects (work or otherwise).
I originally tried this, hoping for the benefit of "sleeping on a problem". I don't think it's been particularly successful for that (though it could be subtly so, I guess), but it has about a 90% success rate for inducing sleep within 15 minutes. :)
My solution and yours might be the same thing (distraction from the goal of sleep), but I'd worry about the stimulation of video, the light from the screen, disturbing partners, etc. And also that I might get interested, and stay up for hours instead (this is my failure mode for reading before sleep).
Thinking about projects prevents me from sleeping. It's the surest way to keep me up with my mind racing for a few more hours. If it works for you, great!
The "mode" for watching Netflix for 15 minutes is turn it on, watch for 15 minutes, turn it off. I won't claim it works for everyone, but it does help settle my mind at night.
The same traits that make me good at emergency situations and deep work make me lousy for early bedtime. I have some coping mechanisms now but there were years where I had to go to bed exhausted to get to sleep. And some days that’s 10:30, others that’s 2:30.
If that was the retro topic, we're already off to a bad start. You're making a judgement before we even started retro.
sleep in
to sleep until later in the morning than you usually do
Read it like this: Usually people don't wake up that late. But Tooooodd likes to sleep in, so now everyone's gotta interrupt their workflows at 10:30 just for Todd. Discuss!
Daily scrums are a stupid waste of time and completely unnecessary unless your team doesn’t know what they’re doing or are unable to coordinate, and if either of those is true then you have the wrong team or management and Scrums won’t save you anyway. It’s mostly crap designed to allow consultants from McKinsey to charge your company big bucks for “efficiency implementation”.
>> So I can let my body figure out how much sleep I need.
This is why my doctor advised (during a bout of insomnia a few years ago) not to use those "blackout" shades. They completely confuse your brain. My doctor said to sleep with the blinds open so your body can naturally reset its clock with the sunrise and sunset. Thankfully, this was in the Summer in a midwestern state, so I got back on track, but I still had to make some adjustments when daylight savings and Winter started.
Your strategy was the other recommendation my doctor said to use. Anything that allows your body to naturally find its biorhythm is the best.
Or use a 35,000 Lumen corn light (one I use https://a.co/d/idyzuiW ). Stopped a family from falling into depression regularly throughout the year. They are fanatical about getting the light because they don't want to go back.
Where I live the days are very long during summer, and short during winter. If I wake up by sunlight it's either like 4 in the morning in summer, or soon now like after 9 in the morning.
The benefit of such a powerful lightsource is that you can get roughly the same amount of light you'd get from a summer sun. That seems to be what you need to stave off seasonal affective disorder.
For waking up you'd need some kind of timed control, either old-school mechanical or maybe a smart relay. I've found that a single well-placed smart bulb programmed to ramp up over the course of 15 minutes works well to wake me up, but I'm pretty sensitive to light during sleep.
As bright as those lights are, they're still no comparison to the summer sun really.
I went into a rabbit hole a while back of investigating whether it would be possible to light a room in my house equivalent to the summer sun, so I could avoid SAD during the long nights of the British winter.
Taking that 35,000 lumen light above, even assuming it's lumen rating is accurate, in a 3 by 3 metre room, that's less than 4,000 lux, and that's if it was entirely focused on the floor area. Direct sunlight is 32,000 to 100,0000 lux. The sun is just really bright. Normal indoor home lighting is about 100 lux.
The most efficient LEDs on the market are 200 lm/watt, so a reasonable lower bound for the amount of lighting you'd need for a 3x3 room is 1440 watts to get to the minimum 32k lux, but you'd have to factor in electrical inefficiencies and the directionality too.
All that being said, those corn cob bulbs are fantastic and do make you feel a lot better. Just not quite the same as relaxing on a hammock in the garden, sadly.
The benefit is that it's much much brighter. Human eyes adjust to any amount of light so they'll "look" similar, but unconsciously it makes you happier.
What happens when the sun sets at 18:00 in the winter? I like the idea, but I feel like most people won't go to bed that early, and use artificial lights to go about their evening, thus negating a lot of the effort. Or am I misunderstanding?
Context: I struggle with insomnia and use blackout shades.
Artificial lights also interfere with sleep. If you’ve ever been 100% off grid, or even a place where you have minimal phone usage and little artificial light you will feel sleepy more correlated with when the sun sets, even if it’s at 1800.
I’ve found blackout shades useful for when I’m not sleeping a schedule correlated with the sun (eg work at 4 am) or external artificial light (streetlamps).
During the Winter, I tend to stay more active. I play several sports, do weight training and do indoor rock climbing to sort of wear myself out. So in Winter, I adaptively change the signals my body is using that tells it when its time to go to sleep.
My diet also changes in the Winter. I cut off caffeine at noon and restrict phone and screen time in favor of physical activities in the later afternoon. It takes about two weeks for my body to adjust fully to the changes, but then its fine throughout Winter. Even when I'm getting less sunlight because the sun is going down sooner.
I never knew how much your diet will affect your sleep and biorhythms until I started making changes. Even small changes can have big effects on your sleep cycles.
Can you elaborate a little about your diet adaption in terms of food classes (carbohydrates, fat, proteins, ...) if it isn't only the coffeine intake you modify? Thanks!
It's probably a lot more simple than what you're expecting.
In Summer I tend to have more carbs and proteins, along with bigger meals for both lunch and dinner since I tend to exercise later outside then during Winter. The extra amounts in both for energy allow me to be active longer before the sun goes down.
In the Winter, I tend to reduce carbs and front load my day with them, so that in effect, by the time the sun goes down, my body is running down on their energy stores for the day. I also tend to reduce proteins and only increase them if I have a heavy day for example if I have both weight training and some higher impact cardio like hockey or indoor rock climbing or snowboarding.
In Winter I tend to have a bigger lunch and smaller dinner which helps to focus in the reduction in energy. Generally by the time 7 or 8pm rolls around, I can feel my body starting to tune down for the day and signals my body is getting ready for sleep. A hot shower usually puts me over the edge. I can get into bed and I'm out cold in a few minutes.
Sorry, for disturbing late.. but hey, thanks for pointing out! (I don't get notifications, so I need to check for replies then and again..)
From time to time I'm looking into ketogenic diet and find it always inspiring how others manage carb and fat. I try to avoid carbs and if I eat them I always try to get my body moving, be it a light walk (so, not exactly practising full keto..). Main meal for me is dinner... I like how digestion and energy restoration is taking place mainly at night's rest. I don't experience problems falling asleep when giving my body food it needs. I'm usually not bothered by feelings of hunger til late afternoon (intermittent fasting so to speak, fat goes a long way..).
Most important habit for good sleep seems to be "lay down, don't touch phone".. Hope this inspires, too :)
(eventual recommendation "the ketogenic bible, wilson/lowery")
I love them all dearly but this is the one thing about having kids that I just can't get used to. No control over your own sleep. It really sucks not being able to control when and how you wake up.
Your experience of organizing your schedule to avoid alarms is a great example of how to align with your body’s natural rhythms. It’s rare to get the luxury of waking up without an alarm these days
In this day and age where you have limitless distractions/entertainment we often ignore our "less sexy" biological needs to the detriment of our mind and body. We need to treat Sleep/Nap/Rest as a "job" and not as something extraneous.
Instead of the current practice of arranging our biological needs around our work we should revert back to pre-industrial era practices where our work was arranged around our biological needs and nature's rhythms. A good way to start is to eat only when feeling hungry, nap/sleep when feeling tired/sleepy and in general listen to the body/mind needs irrespective of context.
This is spot on. These things are a delicate balance as well. When I sleep well, I can control my feeding patterns much better. When I eat well, I tend to sleep better. Exercise affects both of those, and is affected back.
Work is constantly nudging this balance in the wrong direction, putting us into a vicious cycle of accelerated death and suffering.
I may be making this sound worse than it feels though, probably because I'm writing this in between bouts of high fever. I honestly can't complain all that much from the life I lead but I do wish I could make it work much better around my physiological needs.
Saw a video few days ago from someone saying that two people with the same diet but one having a bad sleep regime would make the low sleep person gain weight and lose muscle.
Thanks. I upvoted you because this is all great advice. I'm politely going to decline it though. Not because I don't think it's valuable but mostly because I already have alternatives to achieve those results that I know work better for myself.
Unfortunately right now I don't have the time to follow through with most of it. Life happens, and right now it just happens to be happening more or less all at once. Urgency trumps priority.
Furthermore, I'm a night owl. I have at different times in my life tried to change it. I followed all the advice I could find (including a lot of the things you mention). Ultimately, if I have to wake up early in the morning for work, I might end up with a cycle of 8h on the first night, with some luck another 8h, then it goes down to 6-5h, 2h and in some occasions an all nighter to top if off.
My current sleep deprived cycle is one of relatively regular 5-6h per night. It's not very good but mostly because of the time I have to be awake.
If I could wake up at 9:30-10:00 every day, I would be able to sleep those 5-6h per night and be in top shape. I know because I've done it for a few months in the past. I was at top physical and mental shape, consistently.
Waking up at 7:00-8:00, even if I could sustain 7-8h per night, I'd still be sleepy, tired and unfocused for the most part. My brain suffers and so does my body.
At this point I just decided to accept light sleep deprivation vs. the worse alternatives.
I suggest you watch Dr. Satchin Panda's (he is the Circadian Rhythms researcher) videos (they are short TEDx ones) at the minimum. He gives a simple 6-step process which you might find very relevant.
And it's not how I hadn't already said I tried many things with invariably similar results. I might watch the videos if I find the time but it's definitely not in my list of priorities as I'm really skeptical that there will be anything there that I haven't already done or is similar in nature - mainly because outside of changing the world or CRISPR I'm not sure there is a way to "fix" this.
I've now read a summary. It's just the same light, eating, and exercise changes, mixed with some night-owl denialism. All stuff I've tried dozens of times, which maybe moves my sleep by 15 minutes.
No, you are needlessly trivializing it and maybe doing a disservice to others to whom it might be of great value.
I am not sure what you read, but Dr. Satchin Panda's research is not the "same light, eating, and exercise changes, mixed with some night-owl denialism." You can watch his(and other circadian researchers) longer videos on Youtube for more knowledge. Also two books i can recommend are a) The Circadian Code by Satchin Panda and b) When : The Scientific Secrets of Perfect Timing by Daniel Pink.
Circadian research is holistic since it studies how our body clocks (there are a set of them) are synchronized with Nature and thus when is the optimum time to do something with maximal benefit. Eg. When is the best time to take medicines for maximal efficacy, When is the best time to do exercise for maximum benefit etc. In the context of this thread, he doesn't talk about morning larks/night owls but merely allowing Natural Sunlight to tune us to its rhythms. So it doesn't matter what time you do get up in the morning (5/8/10AM etc.) but if you go and stand in the sunlight immediately after (or even better take a walk) your body adjusts itself so eventually you do get sleepy with sunset and awake at sunrise (within limits and control of other factors like exposure to other light sources). Similarly Exercise is most efficacious when done after 4PM etc.
Most of these practices are zero-cost and risk-free and easily adjustable to individual variations and much better than popping Melatonin pills etc.
I have done all that, so IMO GP is really not trivialising anything. This is about the same we've been hearing for years.
If you want to know the effect of those "fixes" on the wrong person, re-read my big text. I've done it all. The "fix" only makes me sleepy early enough for the first or second night of a roughly weekly cycle. It also means a night with enough hours but not enough quality of sleep.
> Most of these practices are zero-cost and risk-free
They are really not. I went through a lot of issues for trying them. I nearly lost a job once, and I have missed social gatherings as I had to recover sleep in the weekend.
Moreover, where I live now, I don't have the option of morning sunlight for a few months each year as there is none. In fact, there are whole days with so much grey and darkness that my body basically thinks it's always time to sleep so not easily adjustable either.
I did read all your detailed comments. They only mentioned time cycles but no other details. The reason i linked to couple of my previous comments is because i listed more details there to think about and investigate.
For example, i list Diet and separately also Gut Health to consider. One of the key neurotransmitters affecting sleep is Serotonin which we now know to be mostly produced in the intestines. The Gut and Enteric Nervous System are known as "The Second Brain" (see book of the same name by Michael Gershon) and can act independently of the central nervous system. So one cause might be your gut is not producing enough Serotonin. On the Diet side Serotonin is made from Tryptophan so another cause might be your diet does not contain enough Tryptophan. For the lack of natural sunlight (SAD is well known) you might want to consider Vitamin-D and Melatonin supplements (but only after consulting with a doctor) and use one of those fancy lamps that mimic sunlight frequency ranges.
As i pointed out, Circadian science is holistic so you need to take various factors into account both individually and in combinations to narrow down the problem. There are various scenarios to try out and see what makes a significant difference. While the science is solid the nuances are very important to consider.
I trivialized your comment because it was already trivial. You mentioned some video, but were too lazy to even link to it, much less summarize the main ideas so we could know if it was worth watching or not.
I take vitamin-d and melatonin already, and have messed with lamps, early sun, exercise, and tryptophan (and magnesium, and theanine, and dozens of other stuff). All these things together affect my sleep and wake times by maybe 30 minutes. If you really did know about something I haven't read before dozens of times, then at least you could have written a sentence or two about what it is.
You have completely missed what i was talking about. If you couldn't find some video i mentioned, you should have had the sense to infer that it was maybe linked to in a previous comment in the same chain which is what i had done. Or you could have simply asked for it when i would have readily pointed you to it. As it is you did neither but made a silly comment which is what i called out.
All that you mention in your second para are symptomatic treatments but Circadian Research is big picture systems thinking giving you a framework within which you learn to slot your life/treatments. A medicine taken at the wrong time may lose its efficacy. The references given in my previous comments and other comments linked to from some of those give you the Science. Whether you want to read/study those to get more insight into your condition and perhaps work constructively towards a solution is up to you.
Let me stop for a second. Let's assume for a minute that the information you're linking us to is in fact excellent and if I peruse the whole protocol I'll eventually adapt myself to a morning routine.
Why?
Why do I have to do all that? Why do I have to go through all this trouble, spend so much time, and energy and money figuring all this out? What happens until I do eventually figure it all out?
Why am I being required to adapt? All I need is to be left alone for maybe another couple hours each morning. That's all.
Imagine if the situation was reversed, and you had to work 1h past your bed time. Would you then be looking for multi-intervention protocols to shift your circadian clock forward so you wouldn't be falling asleep during some of your work hours? Would you happily and willingly spend all this time, energy and cash into adapting yourself to this madness?
Back to the original problem, I don't think any of this will make a difference. Maybe it will marginally improve the quality of my sleep, but at what cost? My genes are what bias my circadian rhythm that way. Will these interventions permanently alter my gene expression so I don't "fall back" into being a night person again? I doubt so. Which means these interventions will need to become a permanent fixture, causing more stress and giving me yet more work and routines to follow.
I really don't see how this can be considered a solution to anything, even if it works - and I honestly cannot see how it would. I would appreciate it if the gaslighting would just stop and we could discuss real ways to deal with the issue - like having more flexible work and life arrangements so different people could exist the way they're meant to.
I will just make a few final observations and sign off this chain.
1) Nobody is forcing you to do anything you don't want to.
2) I was merely sharing some useful Science which IMO has as yet not seen widespread adoption.
3) Our immediate environment will not change to accommodate our specific needs due to economic concerns. Due to globalized nature of work people are working longer hours and all times whether night or day. If my job which i need for survival needs me to stay awake at night i need to find means to adapt myself to it without ruining my Health. Research is showing more and more that Sleep is foundational to everything else and hence i need to treat it seriously and with high priority.
4) You are making a lot of assumptions/conclusions without having looked into the Science which i think is wrong. While DSPD is a thing it is not fully clear whether there is a genetic component to it. Also Epigenetics is a thing.
5) Finally, if the situation were reversed and i were suffering, i would do everything in my power to study as much as possible on available Science, Traditional Methods of healing etc. to come up with some plan to manage it with/without a doctor. You will find accounts in the popular press of people suffering from something which the doctors could not diagnose properly but they never gave up and kept researching by themselves and trying out new things until something worked for them (usually after consulting with a doctor on it).
Note, though, that people with eating disorders can easily not feel hungry for days at a time for no reason or conversely never not feel hungry no matter how much they have eaten.
Some people with depression or C/PTSD can sleep 14+ hours a day and not feel rested.
Many people are so dysregulated that "listening to their bodies" and "embracing what is natural" are potentially self-destructive activities.
So, keep your own body's limitations in mind. If you are affected by something that has pushed you off the track, at the very least, be aware of it before you go charging full steam ahead.
I can easily eat nothing for a day or two, though my longest was 3 days. Working out has been helpful because now I have an intellectual need to ensure I get enough calories and my macros. I can also way overeat if I have things I like available because there’s never really a “stop” signal that’s not being physically full. The only times I experience a “yeah ok I’m good now” is with extremely rich cheesecake sickening me (having still overeaten it) or 70% dark chocolate boring me. The later along with green apples are the only snacks I dare to keep around, because I’m not all that interested in eating them lol.
If I tried to go to bed when I’m tired, I’d end up doing so 2-4 hours later than the previous day, end up being awake at night and sleeping (poorly) during the day until it cycles back around and the insanity repeats all over again. Even if I’m extremely tired for some reason, it still takes at least an hour to actually fall asleep, followed by waking up multiple times during the night to toss and turn. The phenomenon of my head hitting the pillow and the next day showing up happened once when I was traveling, and was wonderful.
I’ve historically been very poor at recognizing when I’m being emotionally affected by things or stressed, which I would describe as feeling more like an android that a human, though that’s improved these past few years.
Listening to my body is still important, but I can’t intuitively just understand what it’s “telling me”, rather I need to track the consequences and intervene.
Incidentally, I am both autistic and spent much of my childhood trying to manage that hazards of my parent’s unstable emotional states rather than my own.
Every so often—maybe once a quarter—I wake up just feeling like a million bucks, like I can do anything, and I go through the whole day like that. I get so much done, and feel awesome the entire time.
I have wondered, at times, if other people feel like that more often (and some, maybe never!). I’m pretty sure I’d be emperor of the planet if I felt like that even one day a week.
When growing up (in the 1970s-1980s) i went to a school with timings of 11:30AM to 4:30PM. You had 7 periods of 40 mins each with a break of 20/30mins after the first 4 periods.
It was fantastic.
We slept well, woke up around 7-8AM well refreshed and energetic, and would have something very light (eg. multigrain congee) to drink. Mom would finish cooking by 8AM and Dad would have a good brunch and leave for work with a light lunch in hand. We would have a good brunch by 10/10:30AM and leave for school with a light lunch in hand. Never felt drowsy/sleepy/tired in school. Return home from school around 5PM, have something light to eat and go out to play with friends until it got dark around 6/6:30PM. Get back home, wash up and do homework until 8/8:30PM (whatever couldn't be finished we did the next day morning). Have dinner, do some more homework (we didn't have TV at that time) and hit the bed around 9:30PM.
IMO, this should be the ideal "work" schedule and i have often thought of adopting it again as my everyday time schedule.
What you are pointing out are extreme cases which is generally a small subset. So before jumping to this conclusion one should first setup one's daily life around circadian/natural rhythms and in general establish a healthy relationship between ourselves and the environment we are embedded in. This is fundamental to everything else.
In fact many doctors themselves are now saying that drugs are overprescribed and you don't need them for most (not all) cases. Watch the following documentaries;
I'm not going to take unsolicited homework from this site, especially one that is pushing an agenda in response to a statement that is clearly positive but cautious in response to your previous statement.
You misunderstood. There is no agenda here but merely sharing something which for some reason doesn't seem to be more commonly known/understood.
When it comes to "General Health" (both Mental/Physical) people forget that one can do a lot with what is already known (from empirical practice over generations and modern science) and with the exercise of a little bit of commonsense.
I think better advice would be poor people to boldly explore and challenge their bodies limitations, and discover what they are capable, and what works for them.
I've snored since I was a teenager, but didn't think much about it.
I met my wife about 11 years ago, and she said that I would do a kind of disturbing "stop breathing" thing when I slept pretty shortly after we met, and I didn't think much about it then either.
About a year ago, I decided to see a doctor and it turns out that I have sleep apnea; after a bit of finagling I managed to get a specialized oral appliance, I sleep much better. I don't snore anymore, my blood-oxygen levels stay in the green level, and my wife says my breathing during the night is pretty normal. Now I'm mad at myself for waiting so long to do anything about it.
Pretty much everything in my life got about 10-20% easier after I started getting proper sleep. I think a bit clearer, I process conversations a bit better, I'm able to focus on tasks a little easier. It didn't magically "solve" all my problems, but it did make them a lot easier to work around.
Exercise too. Sleeping and eating are comparatively easy because they're pleasurable activities (well, eating properly isn't always pleasurable, but it's still not unpleasant). But exercise is physically stressful and often unpleasant. Doesn't matter, taking care of this body is my duty.
I believe the 2000s-* are causing lots of subtle yet deep issues. High availability, high throughput, non linear .. all the current trends are not aligned with a good / happy life.
There has been a strong trend towards async communication though, which does help a lot.
Before it was all phone calls, in-person interactions, live TV and Radio... Both for work and leisure, now you have more options than ever to take things at your own pace rather than letting external factors dictate how you arrange your time.
I think we hit peak "speed of life" in the late 20th century to be honest, much of this is grass-is-greener thinking, we have made great progress in terms of day-to-day personal freedom.
Life has never really matched this idilic ideal of the village farmer. Things were very rough for most of history, everyone was constantly stressed to keep up with their minimal necessities to live, it was not in any way relaxed. And the industrial revolution hit ~250 years ago, with much more strict schedules and much longer work days. This is not a recent phenomenon in the least.
> Things were very rough for most of history, everyone was constantly stressed to keep up with their minimal necessities to live, it was not in any way relaxed.
I have heard this argument many times before but it is mostly not true. Most village farmers do lead a more relaxed and relatively stress-free life. You just need to visit/observe/interact with them to see the difference.
The main reason is the difference between Acute Stress vs. Chronic Stress.
Chronic Stress has what has exploded exponentially in urban areas after the Industrial Revolution and the current IT Industry has made it even worse. There are just too many things to juggle all the time each of which has a deadline with consequences (because process and efficiency) however trivial it might be in the larger scheme of things. The farmer doesn't have that many things to worry over and so only has episodic bursts of Acute Stress over truly consequential things the management of which is easier.
Another related point is that the farmer does live closer and more entwined with Nature than urban folks and this has been shown to be better for psychological health. We are evolved to interact with Nature and not isolate ourselves in a concrete jungle and grey cubicles.
Living closer to nature and animals fundamentally alters your spirit. The sound, the light, the details and complexity, the beauty of other animals (bringing back the carnivore dilemma though, but also making you more aware of what feeding yourself entails, I don't know)
> A good way to start is to eat only when feeling hungry
LOL, that's what everyone riding the "western diet" blood sugar roller coaster is already doing.
If the diet doesn't reflect the environment our biological needs evolved in, acting without self discipline, eating based on how you feel, is a sure path to obesity, diabetes, and NAFLD.
I think the charitable interpretation is that they're drawing a distinction between physical hunger and emotional hunger.
I "feel" like I could go for a bacon cheeseburger basically 24s hours today. I feel like I could eat another right after I finished the first. All of that is emotional.
That is pretty different than symptoms true physical hunger. My stomach starts to grumble after 24 hours without food. After about 48 hours I feel lethargic and cognitively disordered.
I think that a majority of Americans confuse the two because it has been years or even decades since they actually experienced the symptoms of insufficient calorie intake
For me the best change was when I got used to feeling peckish most of the time. I feel better when I am slightly hungry than after I eat, especially if it's a large meal. With that feeling as my baseline, I really can tell when I need to eat.
Yes, i meant "Physical Hunger" with an implicit proper and healthy Diet. The point was that one need not eat according to a wall clock and lifestyle choices.
> LOL, that's what everyone riding the "western diet" blood sugar roller coaster is already doing.
I don’t think so. In my observation a lot of people eat because it is time to eat, or because others are eating, or because they are bored, or because food is at hand.
> acting without self discipline
That is a curious thing to say. Not eating when one is not hungry takes a lot of self discipline. “Eat only when hungry” is a whole bunch of not eating.
> I think you're underestimating just how hungry people feel
Possible. Or people have no clue what hunger really is.
But still the advice didn’t say “eat every time you are hungry”. It said “A good way to start is to eat only when feeling hungry.” That is actually a prohibition. The advice is equivalent with: do not eat when you are not hungry.
It also in the very sentence admits that this is not the only rule to be followed. That’s the “A good way to start”. Meaning that there are other things to be aware of. One of them being what you eat as you mention.
Thanks for explaining my comment clearly. It was frustrating to see people reading it in isolation and drawing the wrong conclusions either unintentionally or willfully.
It can be good advice with additional conditions. For example I now eat whenever I feel hungry but only for the half of the time that I'm alive. For the other half I just don't eat at all. The only exception I make is for tea and occasional coffee with milk.
One day I'm eating only till 4PM and the next one after 4PM and so on.
Already lost 10 pounds in 2 months from being slightly overweight with no additional lifestyle changes and almost effortlessly because it's surprisingly easy to distract myself from eating for few hours.
I think we are tuned to eat when we want but also to the food not being available all the time.
Do you believe it has helped to vary the eating window (one day before 4pm, the next day after)? What do you believe would happen if you kept it the same every day (e.g. eating only before 4pm)?
Fasting window would be shorter so probably you'd eat more calories and lose less weight. With alternating scheme you always get at least 24h fasting periods between your eating periods regardless of your sleep schedule.
This has been very helpful to know, and I'm going to try out this intermittent fasting scheme.
Question: do you have any system or hack for keeping track of whether it's a < 4pm or > 4pm day? If you do, please share. I have a habit of mindless eating, and will likely not remember to avoid eating at my prescribed times.
I was afraid that I'll lose track too because I don't pay much attention to what day it is, but it turned out to be easy. The days that I can eat in the morning feel very different from those that I can't. But if it doesn't work for you you can eat in the morning on even dates and in the evening on the odd ones. A skip on month change is going to be insignificant and will result in shortening of a single fasting window per month at most.
By the way, if you are close to your healthy weight when doing this aim to reduce your weight so that your BMI is between 22.5 and 25. This is the area of lowest mortality. There's no point to go lower.
Once you get there you can either abandon alternating, shorten fasting window or just lessen restrictions on fasting periods like allowing eating certain type of foods, like raw vegetables or fruits or nuts so that your weight is maintained.
I started at 26 and got down to 23 in about 2-3 months with this method.
Good luck to you. I feel like being stubborn about keeping it going and able to distract yourself for few hours when hungry are keys to positive outcomes.
> It can be good advice with additional conditions. For example I now eat whenever I feel hungry but only for the half of the time that I'm alive. For the other half I just don't eat at all. The only exception I make is for tea and occasional coffee with milk.
You're effectively saying "It's good advice if I ignore it half the time", with your positive outcome stemming from the time spent ignoring it and not eating altogether.
It's silly and harmful advice. Feelings are inherently irrational, we shouldn't advise people to act on them.
When it comes to diet, what you eat largely governs how it makes you feel. The "feeling hungry" part is emergent, root cause largely being the diet.
> Feelings are inherently irrational, we shouldn't advise people to act on them.
This is silly and wrong. Emotions and Feelings are fundamental to Mental Health and by extension to Physical Health. See the research by Dr. Lisa Feldman Barrett and her book How Emotions are Made.
> The "feeling hungry" part is emergent, root cause largely being the diet.
This is silly and puts the cart before the horse. Raw Hunger is the root cause and search for food is the consequence from it. Humans have evolved to eat and digest a wide variety of foods but if you only eat harmful ultra-processed food as a lifestyle choice that's on you and needs to be changed. In addition to a proper diet, one should only eat when feeling raw hunger which can be helped with techniques like Time-Restricted Eating/Intermittent Fasting etc.
I think the essence of this advice is to avoid eating for social, customary or emotional reasons.
So what I wrote basically is totally unrelated because, you can get away with all of that and eat for any stupid reason if you restrict yourself to doing it just half of the time.
Who would've thought that sleep is good for you, right? Apparently we needed several million dollars in research to find out.
> The findings, published today in Nature, could help to guide care for people after a heart attack,
This is just hilarious. Remember to get enough sleep after a life-threatening heart attack, folks!
But your comment resonates very much with me. I am tired of this capitalist culture that reduces the human essence to value output and shames people for not pretending to be working hard enough. Part of the reason I like working from home is that I can take that fucking 20-minute nap after lunch and be infinitely more productive throughout the rest of the day.
I do think it is sad that people are so out of touch with their bodies and the idea of self ownership that they need an authority figure to instruct such simple tasks.
I think there is a huge component of trained helplessness resulting from consumerist culture and social subservience.
So how do you know to convince a person who doesn't feel it and yet needs it, without the research? If it's a treatment plan, it needs to have clear reasons behind.
Im not sure I understand your question. Who is trying to convince who?
Ultimately, individuals are responsible for managing their own health. Thinking it is the doctors job and responsibility to keep them healthy, and not their own is the root of most problems.
I think that 99% of the bottleneck is not research for basic health, and the value of research is vastly over stated for things like nutrition, health, and exercise.
A new study isn't going to convince people people to stop being obese, exercise, and take care of themselves. A study that shows that sleeping longer or eating a Mediterranean diet has a 5% improvement in some metric has almost no specificity to you.
Research is important for the 1% of the time your health is already in crisis, When you are picking between medications or interventions after.
Even then, personal data on what works for you should always trump the research, because it is statistical in nature, usually with extremely high variability. If drug A works 51% of the time drug B works 49% of the time, the difference between them is almost meaningless. You want to know which drug your body responds to. In the clinical context, I think people and doctors overvalue how much time and effort to spend figuring out where to start, and undervalue how much effort to spend responding to personal data if it works or not.
> the value of research is vastly over stated for things like nutrition, health, and exercise.
Well said! People talk as if all empirical health practices that different cultures all over the world have developed are worthless without "modern research" while the researchers themselves are looking at it for inspiration and study.
The point was that you shouldn't have to wait for some research to confirm what has actually been empirically proven health practices over generations. That can come when it comes.
A good example are practices from Yoga/Ayurveda/Qigong/Acupuncture etc. Their worldview, model of anatomy/physiology is very different than modern science but many of their techniques (not claiming all) do work even if we don't fully understand how as yet. That is why many Hospitals/Healthcare centers are adopting them for use in a controlled manner today.
It is still pretty basic stuff. You shouldn't need a bunch of mouse studies to tell you to rest after a heart attack. The article is literally about the body's natural drive to rest and sleep so that it can heal after major injury.
You need it to be sure that's a good thing, and to be able to evaluate and measure it. While not this time, we definitely did find out counterintuitive stuff in other research.
> I think there is a huge component of trained helplessness resulting from consumerist culture and social subservience.
Very True. For example, when i ask people why they need that huge cup of starbucks coffee in the morning i get every excuse but the truth that they have been conditioned by the environment and the body has maladjusted to it so that they are in a downward health spiral.
Not specific to "after a heart attack" but IME while both are important Sleep is much more important than Exercise.
Anecdata: I spent a decade as caregiver/caretaker for my late Mother who refused to do any exercises except the absolute necessary ones which a doctor would ask her to do for a specific cause eg. back pain, breathing exercises etc. As soon as that symptom alleviated she would abandon the exercises. So i encouraged her to take long naps whenever she felt sleepy and it helped keep her mental faculties sharp and physically feel spry (within limits of course).
I had a minor accident on my second day in the US and had bruises and cuts on my arms and shoulders. Did not go to the doc since my insurance was not yet covered (at a university).
I felt really sleepy after and my roommates told me I slept for 24 hours straight. For me, that sleep was the deepest I have ever slept. Felt like I had lost time. I felt much better after and the body had begun its job of healing and at some places almost healed it. That was at 22. I miss that level of healing now after 20 years.
One can see this effect also by observing an little flesh injury like a cut while staying awake. Even after 48h of staying awake the little cut will hardly have any healing and likely even more inflammation. One round of sleep and the healing is immediately there.
That makes me wonder if the slower healing of cuts/wounds one can observe on older people and some adults is simply due to them needing and spending less time sleeping.
Also interesting: deep sleep therapy where you keep the patient asleep for days or weeks. Mixed results back then; I imagine they didn't have good ways to differentiate the patients who would be helped vs harmed by the therapy.
I've found that after a hard workout at the gym I sleep better and longer. That's certainly not a life-threatening injury but working out to exhaustion does create micro-injuries to muscle tissues which then have to heal (leading to growth).
I vividly remember the difference intense hockey conditioning camps, sleep and recovery can cause. During these camp I pushed my heart, with many drills being 30+ seconds at max heart rate. Afterwards I was exhausted, chest felt terrible. But I was so tired, I didn’t have the usual movements at night, and had much longer deep sleep. The recovery the next day was so dramatic compared to prior workout sessions. Way less inflammation across my joints. As compared to sessions where I only pushed my heart rate to 30-60%
Yep, I usually average more deep sleep (10-15m) during times of regular workouts. I typically fall asleep much faster as well, though I don't typically have issues with that.
I had this question as well. Anecdotally, I've been on various anti-TNFa drugs for the past three or four years, and I feel like my sleep hasn't been impacted (and if anything has improved). Definitely no insomnia. I can nap like a champ!
I tried tossing “tnf-alpha inhibitor insomnia” into Google Scholar. Scanning the results I didn’t feel a “signal” in the papers that TNF-alpha inhibitors cause insomnia—which I wouldn’t expect either due to TNF inhibitor antibody size, right? But! There are tons of very interesting papers in the results behind those keywords. With multiple perspectives. Fruitful combo of keywords, you know?
Inhibition of tumor necrosis factor improves sleep continuity in patients with treatment resistant depression and high inflammation (2015)
Authors, full list as I have it in the buffer: Jeremy F. Weinberger, Charles L. Raison, David B. Rye, Amy R. Montague, Bobbi J. Woolwine,
Jennifer C. Felger, Ebrahim Haroon, Andrew H. Miller — Department of Psychiatry and Behavioral Sciences, Department of Neurology, Emory University School of Medicine, Atlanta, GA
First thoughts: TNF—alpha signaling becomes unfocused? TNF-alpha release outside the CNS affects receptor sensitivity or other downstream mechanisms that do straddle the blood-brain barrier?
Some beauty might have been gotten left behind on the headline writing table. The body’s response to the mycardial infarction – a cascade of signaling proteins – is beautiful, and the response to that cascade being induction of deep and restful sleep is also quite beautiful.
I have an eager immune system and I’ve known TNF-alpha as a pretty brutal card in the game. There’s beauty in coming to see it as a signal to repair and rest. Not just a “we have a problem” but a “let’s call ancient repair processes in”.
Perhaps that's not the question you should ask. You might want to ask "what is your advice based on?" instead. If you do so, you evaluate the conclusion by focusing on the quality of the argument, not features of the argumentator. You would agree, I suppose, that good medical advice could be given by non-doctors, and bad medical advice by doctors.
Has someone suffered sleep interruptions for months (or years) after having COVID [0]? I don't think it is studied too much. I have seen studies about Long Covid [1] which it doesn't seem to be the same.
> Given the findings, [...] clinicians need to inform patients [...] after a heart attack, says Rowe. This should also be considered at the hospital, where tests and procedures would ideally be conducted during the daytime to minimize sleep interruptions.
#1 - For most patients, it ain't merely "tests and procedures" which interfere with sleeping in a hospital at night.
#2 - After a major injury, it ain't just nighttime when you need to sleep. Again, most hospitals seem determined to make that as difficult as they possibly can.
What about sleeping more than 8 hours? Is there any research done on this? Will this affect negatively? I sleep 8-9 hrs most days. (No, I am not depressed or anything but I don't drink coffee or any stimulant to keep me awake so I get really tired at the end of the day.)
Absolutely nothing wrong with sleeping between 8 and 9 hours, you're actually exactly in the healthy range.
I have the same profile : no caffeine or other stimulants, good volume of physical activity; I don't need any reminder to go to bed, I get the obvious the call by being quite tired.
Discussing sleep with people, I found two types that are dominants:
- people who heard "between 7 and 9 hours" and remember "8 hours" (can't say they're wrong here!)
- people who heard "between 7 and 9 hours" and remember "the goal is 7 hours", and actually sleep between 5 and 7 hours
> The study concludes that while individuals may initially sleep more when given extended opportunities—likely to recover from prior sleep deprivation—they do not sustain excessive sleep beyond their physiological needs. Consistently sleeping more than 10 hours may indicate underlying health issues and warrants further investigation.
So more than 10 hours might indicate a problem, not 8-9 hours. Also, it's different if people work out a lot or have a physically demanding job:
> For athletes or individuals with high physical demands, 10 hours of sleep might not indicate an underlying health issue but rather an increased physiological requirement. Research has shown that elite athletes often sleep longer than the general population.
(this is not from the paper but from a quick search)
When has that been a thing? When I got a concussion 5 years ago, the hospital in Seattle let me sleep all day in bed and told me to get plenty of rest.
Yes that's already started being suggested. Had to update my first aid certificate recently and as of a few years ago the Red Cross now recommends allowing the person to sleep if possible. But they should be woken up and checked on every 4 hours or so.
In a more mundane context, I've been fortunate to organize my schedule such that I don't use an alarm to get up in the morning. So I can let my body figure out how much sleep I need.
How anyone can recover from something as savage as childbirth is beyond me. It is no small miracle that she was able to walk, let alone care for two new babies and herself (with my help, but there's only so much I can do to assist with breastfeeding or healing of major trauma).
At one point I asked all the nurses to leave and not come back for 6 hours in very angry tones.
When sleep deprived, the brain enters REM sleep even while awake. That's what those hallucinations are.
I have had the misfortune of experiencing this twice in my life so far; the first on a month-long car trip with my buddy and the second while i was the caregiver/caretaker for my Mother. In both cases it was my lack of sleep which made me very difficult to be around.
1) Sleep Deprivation - https://en.wikipedia.org/wiki/Sleep_deprivation
2) Also Related; The medications that change who we are - https://www.bbc.com/future/article/20200108-the-medications-...
So whenever you note that somebody's behaviour has abruptly changed, always ask two questions; a) Are you sleeping well? b) What medications are you taking and what diet are you on?
The fact that med school + residency means you basically have to put your life on hold throughout all of your 20s while other people are figuring out the whole “being a young adult in the world” thing leads to very… particular emotional development.
Medical school doesn’t particularly encourage questioning the status quo or established practices.
Some of them can recalibrate after a few years in the real world, but many never really escape that bubble. It’s hard to radically change your outlook on life in your 30s (let alone when you now have to repay huge debt, in the case of many American doctors)
Many of premed kids I knew in undergrad (or the high schoolers aspiring to premed) weren’t motivated by scientific pursuits or an altruistic desires - they just had to be the best. They needed to ace every test (and would argue incessantly with the teachers about it), they had to be in the hardest classes, etc. they became doctors because somebody told them it was hard and well respected.
I imagine that those people become doctors that are disconnected from their patients.
- Rich and respected -> doctor
- Rich but not respected -> lawyer, software
- Not rich but respected -> professor
A lot of people are going to be disappointed. Truth is medicine is a decadent profession, worldwide. In some countries, it's in free fall and accelerating to terminal velocity. In some parts of the world, doctors are hated to the point they routinely suffer physical violence.
The US manages to keep it relevant by restricting supply and maintaining its elite status but I'm not sure doctors are still respected there. Plenty of hackers who think they can do it better than the doctors right here on HN. I'm a programmer myself and I know for a fact a computer could do significant parts of the job. Even psychiatry is in danger due to LLMs.
> Plenty of hackers who think they can do it better than the doctors right here on HN
Of course they would, it's easy to come up with solutions that are simple and wrong, when one has no point of reference. Hackers understand balancing trade-offs in programming languages or architectures, but can't imagine other fields being nuanced or even more complex. If an LLM cant tell you when to use a monorepo, then it far from telling you when a specific drug dosage is right for a patients set of circumstances.
1. I can use that word, I am one too.
A computer does a massive part of almost any job today, so I’m not sure what exactly this is trying to say about the profession. Wait until you hear that pilots can’t even fly without an airplane. Total conmen.
It's hard to describe the effect years of this can have on the mind. Things can get so distorted you feel guilty for eating, for going to the bathroom, sleeping, resting. Normal people things like a weekend or a good night's sleep become luxuries to you. You come home and everyone's already asleep. People start out all starry eyed and thinking about making a successful career out of helping people, but as it nears its end people can't wait to just start making fat stacks already.
It functions as a sociopath breeding ground. Basically weeds out your humanity by punching you until you like it, hammering you until you get good at it so that you fit into the system. Some people just quit when faced with that, others try to take it and end up committing suicide. One of the most haunting stories I've ever heard was about young woman asking her attendings about suicide methods after a patient killed himself. They thought she was an interested student who was trying to learn about stuff so they happily dispensed all the information they knew. She efficiently and painlessly killed herself not even a day later.
People who make it out of this process might enjoy good pay and lifestyle depending on the country and the specialty they chose. It definitely costs them, though.
The power to repair people, fend off suffering and death. That's religion level power. It's bound to warp everything around it like a black hole.
It would take a society of exceptional sanity to handle it right.
Disconnected? Probably. But I think that's intended and part of the current medical model. It's not necessarily a bad thing when focusing on long term positive outcomes in aggregate. But it certainly feels inhumane at times to the individual and their loved ones.
But lack of sleep can impair immunity and disturb blood pressure and heart rhythm. Keeping someone with major trauma under stress (like being constantly awake) can make them more likely to die.
When someone dies in the hospital what happens in the inquiry? Examine the symptoms of the person who died and how to detect them. Add another check.
If they left someone alone for 2 hours or 4 hours and they passed away during that time, what would the headlines read? "General Healthcare left the patient alone for X hours and didn't even bother to check on their well being."
As son and father in an end of life situation there was no gap to contemplate or allow us to connect it was drugs injection, food, check if he ate, back again, pick up tray, more drugs, check on his breathing, bathroom break (needed assistance).
Dad was probably OK with it but we never had a chance to just have a moment and possibly say something we never would have. He died at 8:40pm on my birthday of all days as I sat next to him.
It was like they were obsessed with busy work, I couldn’t tell if they didn’t want me there or if this was VIP treatment to them
It was in another country
Hotels also schedule their check-out + check-in times to leave a gap around this period, so that at least some percentage of their suites will be "between guests" each day for a few hours, and thus able to be deep-cleaned. But if that doesn't happen — e.g. if the whole hotel is booked for a convention weekend, and it's the Saturday and nobody's checking out that day — then the cleaning staff that normally does the deep cleans will be hunting around for minor stuff to do so they can look busy.
Plus my boss kept calling me.
How odd. Why do hospitals not cluster these interactions together — the "while I've got you here..." experience?
Honestly, the truth is hospitals are designed to do this. The entire purpose of the place is to have people moved into it so that these constant checks and examinations as well as treatments can be done most efficiently. The idea is to rapidly notice and react to changes in the patient's condition.
In programming terms, the core function of a hospital is to poll and update the patient's state in a loop that runs while consent is given and until cured or dead. The polling frequency is calibrated according to knowledge of the patient's general condition and the specific pathology being treated.
If you know the patient could bleed out and die after some surgical procedure, you want to check periodically that this is not happening. How frequently do you check? Depends on what you predict could happen. If you think the worst that could happen is a small and slow bleeding, then you can check less often. If you think there's risk of major bleeding, then you want to check frequently, possibly even constantly.
In the case of a pregnancy, I'm assuming these "briefings" are things like trying to teach the new parent things they'll need to know when they go home; or giving them status updates about tests done on their new baby if they're in the NICU, and so forth. These all seem like things that could wait.
Is the point to use the infodumping as an excuse to do the tests?
We made it clear we wanted to be left alone over night, had reasons for why (neurological issues that are exacerbated by poor sleep) and they largely respected that. Maybe if we didn’t have that excuse it would have been worse. Shit, even the vending machine salads were pretty good. Didn’t love sleeping on a foam bench for 5 days, but we felt quite positive about the delivery center we had our child at in the US.
Serious complications can be quite subtle that unless you answer questions, they may be missed. Having someone come in, listen to your heart and lungs, ask a few questions can't really be replaced with machines.
(It wouldn't even need to know what the odd thing represents; just that it's out-of-expectation enough to require someone to come over and check on you! A bit like asking a family's child to watch grandma while you speak to the mom and dad. All you want the child to do, is to freak out and get your attention if grandma does anything other than what she was already doing!)
Doctors not having to manually probe any signs of heart/lung problems each time they're in the room, would mean that they get either get more time to test each patient for consciousness/lucidity; get time to check on more patients; or (my preferred option) are able to make each check-session shorter and less invasive (no need to sit the patient up to listen to their lungs through their back, for example), and thus less disturbing of a patient's sleep quality (because it's easier to go back to sleep after a short conversation, when you haven't had your blood pressure spike from sitting up.)
The thing people don't seem to understand is the fact doctors also monitor consciousness. Depressed mental state is also a sign of blood loss. The patient's neurolopsychogical state is important information, it has diagnostic and prognostic value.
The most basic way of evaluating a patient's neuropsychological state is to bother them with questions.
Even the c-section seemed absolutly brutal, at one point I was convinced one of the surgeons placed his foot on the table for leverage, given how much movement there was to her body.
As if the physical trauma wasn't enough, being in a room with multiple first-time parents struggling to breastfeed as both they and their children cried, then being visited and probed every hour by medical staff with ineffective pain relief, /and/ having work out how to care for your child when the only communication path is basically through an amplitude modulated scream -
Honestly, I've had some low points in my life, I thought I had a high tolerance for physical and emotional pain, but I can only describe what my wife experienced this week as total, crushing anguish.
She's super cute, intelligent and active but also extremely demanding and had a lot of problems with dermatitis, tummy aches, KISS syndrome and other stuff that made her not sleep well and cry a lot (and she's super loud).
It also made me respect single parents 10000 times more than before. I can't imagine handling a situation like that alone.
Fear based decisions don’t always lead to the best outcomes, though I am in no way dismissing the fear :)
Of course it's a trade-off I'd gladly make again but it still sucks that I will never feel as well rested day-to-day as I did before kids.
Good teams make it after everyone would have reasonably absorbed their coffee. But some teams get pushed earlier. Particularly if there are people in EST, CST, and definitely if you've got people in India, where 9 am PST is when you should be reading your kids bedtime stories.
First of all, the standup isn't daily, it's twice a week. People still miss it for reasons (kids, doctors appointments, ...), and it's just... accepted. There's a general culture of trust.
Other than that, Slack threads go on twice as verbose and long as in other places I've worked. There's a general deluge of pull requests going around certain times of the day and they're always reviewed within an acceptable time frame. In between delivering PR's you simply pick up other work, we're all seniors that know how to work independently, I'm not sure if you could achieve the same thing with a bunch of juniors mixed in unless they have the right attitude as well.
Basically for status updates, you’d just put it in Slack. We had a bot that prompted us. We did have a weekly meeting, but it was at a reasonable time for everyone.
A team I was on while there had some APAC people, and we even managed to have meetings with them, by scheduling them in afternoon hours for the U.S. Worked out pretty well.
I'm still a night owl. 12am is the baseline. 1am is not uncommon. 2 or 3am is occasional. I can attend a 9am. I prefer 10 or later. Most of my team does as well, and they all rise earlier than I do.
Also, women require more sleep than men on average.
SO has it reverse, she wakes up at 7-8 am even at the weekend and is unable to get back to sleep.
My team moved our daily standup later in the day to accommodate my delayed sleep phase and it's been extremely helpful to getting a full night's uninterrupted sleep.
Crepuscular and nocturnal predators require tribes of humans to have some number of members who are tuned to be either awake before sunrise or awake long after sunset. Without people with genes to go bed late and wake up late we wouldn't be here having this conversation.
In modern society the former are lionized and the latter are villified as making bad choices.
Wouldn't a tribe that is able to do as I can have the greatest evolutionary advantage and thus outcompete the tribes requiring specialization like you describe?
I'm sympathetic to your situation -- but with all due respect, this would seem to be a strategy with a vanishingly small likelihood of benefit.
"Trying" to sleep is also doomed to failure, of course.
Personally, what works best for me is modeling solutions to issues in projects (work or otherwise).
I originally tried this, hoping for the benefit of "sleeping on a problem". I don't think it's been particularly successful for that (though it could be subtly so, I guess), but it has about a 90% success rate for inducing sleep within 15 minutes. :)
My solution and yours might be the same thing (distraction from the goal of sleep), but I'd worry about the stimulation of video, the light from the screen, disturbing partners, etc. And also that I might get interested, and stay up for hours instead (this is my failure mode for reading before sleep).
Thinking about projects prevents me from sleeping. It's the surest way to keep me up with my mind racing for a few more hours. If it works for you, great!
The "mode" for watching Netflix for 15 minutes is turn it on, watch for 15 minutes, turn it off. I won't claim it works for everyone, but it does help settle my mind at night.
Move standup to 10:30am so Todd can sleep in
sleep in
Read it like this: Usually people don't wake up that late. But Tooooodd likes to sleep in, so now everyone's gotta interrupt their workflows at 10:30 just for Todd. Discuss!But also that is 2:30 p.m. for the other two guys, i.e. prime "still caffeinated and in the zone" time ;)
It's also a handy way to keep raises small. Oh you are being a human and we don't give raises to people who are human. Meets expectations, 2% raise.
At one office job, we regularly worked from home around 9-10am and would only commute after the morning rush hour faded away.
like: complain about gunmen, not guns.
methodologies and weapons do not kill people. people kill people.
that said, here's a riddle:
q: what is the difference between a methodologist and a terrorist?
a: you can negotiate with a terroris, but not with a methodologist.
also, what nradov said, here:
https://news.ycombinator.com/item?id=42143002
This is why my doctor advised (during a bout of insomnia a few years ago) not to use those "blackout" shades. They completely confuse your brain. My doctor said to sleep with the blinds open so your body can naturally reset its clock with the sunrise and sunset. Thankfully, this was in the Summer in a midwestern state, so I got back on track, but I still had to make some adjustments when daylight savings and Winter started.
Your strategy was the other recommendation my doctor said to use. Anything that allows your body to naturally find its biorhythm is the best.
For waking up you'd need some kind of timed control, either old-school mechanical or maybe a smart relay. I've found that a single well-placed smart bulb programmed to ramp up over the course of 15 minutes works well to wake me up, but I'm pretty sensitive to light during sleep.
I went into a rabbit hole a while back of investigating whether it would be possible to light a room in my house equivalent to the summer sun, so I could avoid SAD during the long nights of the British winter.
Taking that 35,000 lumen light above, even assuming it's lumen rating is accurate, in a 3 by 3 metre room, that's less than 4,000 lux, and that's if it was entirely focused on the floor area. Direct sunlight is 32,000 to 100,0000 lux. The sun is just really bright. Normal indoor home lighting is about 100 lux.
The most efficient LEDs on the market are 200 lm/watt, so a reasonable lower bound for the amount of lighting you'd need for a 3x3 room is 1440 watts to get to the minimum 32k lux, but you'd have to factor in electrical inefficiencies and the directionality too.
All that being said, those corn cob bulbs are fantastic and do make you feel a lot better. Just not quite the same as relaxing on a hammock in the garden, sadly.
Context: I struggle with insomnia and use blackout shades.
I’ve found blackout shades useful for when I’m not sleeping a schedule correlated with the sun (eg work at 4 am) or external artificial light (streetlamps).
My diet also changes in the Winter. I cut off caffeine at noon and restrict phone and screen time in favor of physical activities in the later afternoon. It takes about two weeks for my body to adjust fully to the changes, but then its fine throughout Winter. Even when I'm getting less sunlight because the sun is going down sooner.
I never knew how much your diet will affect your sleep and biorhythms until I started making changes. Even small changes can have big effects on your sleep cycles.
Hope that helps.
In Summer I tend to have more carbs and proteins, along with bigger meals for both lunch and dinner since I tend to exercise later outside then during Winter. The extra amounts in both for energy allow me to be active longer before the sun goes down.
In the Winter, I tend to reduce carbs and front load my day with them, so that in effect, by the time the sun goes down, my body is running down on their energy stores for the day. I also tend to reduce proteins and only increase them if I have a heavy day for example if I have both weight training and some higher impact cardio like hockey or indoor rock climbing or snowboarding.
In Winter I tend to have a bigger lunch and smaller dinner which helps to focus in the reduction in energy. Generally by the time 7 or 8pm rolls around, I can feel my body starting to tune down for the day and signals my body is getting ready for sleep. A hot shower usually puts me over the edge. I can get into bed and I'm out cold in a few minutes.
Hope this helps.
From time to time I'm looking into ketogenic diet and find it always inspiring how others manage carb and fat. I try to avoid carbs and if I eat them I always try to get my body moving, be it a light walk (so, not exactly practising full keto..). Main meal for me is dinner... I like how digestion and energy restoration is taking place mainly at night's rest. I don't experience problems falling asleep when giving my body food it needs. I'm usually not bothered by feelings of hunger til late afternoon (intermittent fasting so to speak, fat goes a long way..). Most important habit for good sleep seems to be "lay down, don't touch phone".. Hope this inspires, too :)
(eventual recommendation "the ketogenic bible, wilson/lowery")
"Dang, my alarm woke me up at 8:30am while I was sleeping like a baby because of my blackout shades" doesn't sound like a problem anyone is having.
In this day and age where you have limitless distractions/entertainment we often ignore our "less sexy" biological needs to the detriment of our mind and body. We need to treat Sleep/Nap/Rest as a "job" and not as something extraneous.
Instead of the current practice of arranging our biological needs around our work we should revert back to pre-industrial era practices where our work was arranged around our biological needs and nature's rhythms. A good way to start is to eat only when feeling hungry, nap/sleep when feeling tired/sleepy and in general listen to the body/mind needs irrespective of context.
Work is constantly nudging this balance in the wrong direction, putting us into a vicious cycle of accelerated death and suffering.
I may be making this sound worse than it feels though, probably because I'm writing this in between bouts of high fever. I honestly can't complain all that much from the life I lead but I do wish I could make it work much better around my physiological needs.
https://news.ycombinator.com/item?id=40978488
https://news.ycombinator.com/item?id=41538322
https://news.ycombinator.com/item?id=38445883
Unfortunately right now I don't have the time to follow through with most of it. Life happens, and right now it just happens to be happening more or less all at once. Urgency trumps priority.
Furthermore, I'm a night owl. I have at different times in my life tried to change it. I followed all the advice I could find (including a lot of the things you mention). Ultimately, if I have to wake up early in the morning for work, I might end up with a cycle of 8h on the first night, with some luck another 8h, then it goes down to 6-5h, 2h and in some occasions an all nighter to top if off.
My current sleep deprived cycle is one of relatively regular 5-6h per night. It's not very good but mostly because of the time I have to be awake.
If I could wake up at 9:30-10:00 every day, I would be able to sleep those 5-6h per night and be in top shape. I know because I've done it for a few months in the past. I was at top physical and mental shape, consistently.
Waking up at 7:00-8:00, even if I could sustain 7-8h per night, I'd still be sleepy, tired and unfocused for the most part. My brain suffers and so does my body.
At this point I just decided to accept light sleep deprivation vs. the worse alternatives.
I am not sure what you read, but Dr. Satchin Panda's research is not the "same light, eating, and exercise changes, mixed with some night-owl denialism." You can watch his(and other circadian researchers) longer videos on Youtube for more knowledge. Also two books i can recommend are a) The Circadian Code by Satchin Panda and b) When : The Scientific Secrets of Perfect Timing by Daniel Pink.
Circadian research is holistic since it studies how our body clocks (there are a set of them) are synchronized with Nature and thus when is the optimum time to do something with maximal benefit. Eg. When is the best time to take medicines for maximal efficacy, When is the best time to do exercise for maximum benefit etc. In the context of this thread, he doesn't talk about morning larks/night owls but merely allowing Natural Sunlight to tune us to its rhythms. So it doesn't matter what time you do get up in the morning (5/8/10AM etc.) but if you go and stand in the sunlight immediately after (or even better take a walk) your body adjusts itself so eventually you do get sleepy with sunset and awake at sunrise (within limits and control of other factors like exposure to other light sources). Similarly Exercise is most efficacious when done after 4PM etc.
Most of these practices are zero-cost and risk-free and easily adjustable to individual variations and much better than popping Melatonin pills etc.
If you want to know the effect of those "fixes" on the wrong person, re-read my big text. I've done it all. The "fix" only makes me sleepy early enough for the first or second night of a roughly weekly cycle. It also means a night with enough hours but not enough quality of sleep.
> Most of these practices are zero-cost and risk-free
They are really not. I went through a lot of issues for trying them. I nearly lost a job once, and I have missed social gatherings as I had to recover sleep in the weekend.
Moreover, where I live now, I don't have the option of morning sunlight for a few months each year as there is none. In fact, there are whole days with so much grey and darkness that my body basically thinks it's always time to sleep so not easily adjustable either.
For example, i list Diet and separately also Gut Health to consider. One of the key neurotransmitters affecting sleep is Serotonin which we now know to be mostly produced in the intestines. The Gut and Enteric Nervous System are known as "The Second Brain" (see book of the same name by Michael Gershon) and can act independently of the central nervous system. So one cause might be your gut is not producing enough Serotonin. On the Diet side Serotonin is made from Tryptophan so another cause might be your diet does not contain enough Tryptophan. For the lack of natural sunlight (SAD is well known) you might want to consider Vitamin-D and Melatonin supplements (but only after consulting with a doctor) and use one of those fancy lamps that mimic sunlight frequency ranges.
As i pointed out, Circadian science is holistic so you need to take various factors into account both individually and in combinations to narrow down the problem. There are various scenarios to try out and see what makes a significant difference. While the science is solid the nuances are very important to consider.
I take vitamin-d and melatonin already, and have messed with lamps, early sun, exercise, and tryptophan (and magnesium, and theanine, and dozens of other stuff). All these things together affect my sleep and wake times by maybe 30 minutes. If you really did know about something I haven't read before dozens of times, then at least you could have written a sentence or two about what it is.
All that you mention in your second para are symptomatic treatments but Circadian Research is big picture systems thinking giving you a framework within which you learn to slot your life/treatments. A medicine taken at the wrong time may lose its efficacy. The references given in my previous comments and other comments linked to from some of those give you the Science. Whether you want to read/study those to get more insight into your condition and perhaps work constructively towards a solution is up to you.
Why?
Why do I have to do all that? Why do I have to go through all this trouble, spend so much time, and energy and money figuring all this out? What happens until I do eventually figure it all out?
Why am I being required to adapt? All I need is to be left alone for maybe another couple hours each morning. That's all.
Imagine if the situation was reversed, and you had to work 1h past your bed time. Would you then be looking for multi-intervention protocols to shift your circadian clock forward so you wouldn't be falling asleep during some of your work hours? Would you happily and willingly spend all this time, energy and cash into adapting yourself to this madness?
Back to the original problem, I don't think any of this will make a difference. Maybe it will marginally improve the quality of my sleep, but at what cost? My genes are what bias my circadian rhythm that way. Will these interventions permanently alter my gene expression so I don't "fall back" into being a night person again? I doubt so. Which means these interventions will need to become a permanent fixture, causing more stress and giving me yet more work and routines to follow.
I really don't see how this can be considered a solution to anything, even if it works - and I honestly cannot see how it would. I would appreciate it if the gaslighting would just stop and we could discuss real ways to deal with the issue - like having more flexible work and life arrangements so different people could exist the way they're meant to.
1) Nobody is forcing you to do anything you don't want to.
2) I was merely sharing some useful Science which IMO has as yet not seen widespread adoption.
3) Our immediate environment will not change to accommodate our specific needs due to economic concerns. Due to globalized nature of work people are working longer hours and all times whether night or day. If my job which i need for survival needs me to stay awake at night i need to find means to adapt myself to it without ruining my Health. Research is showing more and more that Sleep is foundational to everything else and hence i need to treat it seriously and with high priority.
4) You are making a lot of assumptions/conclusions without having looked into the Science which i think is wrong. While DSPD is a thing it is not fully clear whether there is a genetic component to it. Also Epigenetics is a thing.
5) Finally, if the situation were reversed and i were suffering, i would do everything in my power to study as much as possible on available Science, Traditional Methods of healing etc. to come up with some plan to manage it with/without a doctor. You will find accounts in the popular press of people suffering from something which the doctors could not diagnose properly but they never gave up and kept researching by themselves and trying out new things until something worked for them (usually after consulting with a doctor on it).
I find this to be a disturbing way to describe eating
Some people with depression or C/PTSD can sleep 14+ hours a day and not feel rested.
Many people are so dysregulated that "listening to their bodies" and "embracing what is natural" are potentially self-destructive activities.
So, keep your own body's limitations in mind. If you are affected by something that has pushed you off the track, at the very least, be aware of it before you go charging full steam ahead.
I can easily eat nothing for a day or two, though my longest was 3 days. Working out has been helpful because now I have an intellectual need to ensure I get enough calories and my macros. I can also way overeat if I have things I like available because there’s never really a “stop” signal that’s not being physically full. The only times I experience a “yeah ok I’m good now” is with extremely rich cheesecake sickening me (having still overeaten it) or 70% dark chocolate boring me. The later along with green apples are the only snacks I dare to keep around, because I’m not all that interested in eating them lol.
If I tried to go to bed when I’m tired, I’d end up doing so 2-4 hours later than the previous day, end up being awake at night and sleeping (poorly) during the day until it cycles back around and the insanity repeats all over again. Even if I’m extremely tired for some reason, it still takes at least an hour to actually fall asleep, followed by waking up multiple times during the night to toss and turn. The phenomenon of my head hitting the pillow and the next day showing up happened once when I was traveling, and was wonderful.
I’ve historically been very poor at recognizing when I’m being emotionally affected by things or stressed, which I would describe as feeling more like an android that a human, though that’s improved these past few years.
Listening to my body is still important, but I can’t intuitively just understand what it’s “telling me”, rather I need to track the consequences and intervene.
Incidentally, I am both autistic and spent much of my childhood trying to manage that hazards of my parent’s unstable emotional states rather than my own.
I have wondered, at times, if other people feel like that more often (and some, maybe never!). I’m pretty sure I’d be emperor of the planet if I felt like that even one day a week.
It was fantastic.
We slept well, woke up around 7-8AM well refreshed and energetic, and would have something very light (eg. multigrain congee) to drink. Mom would finish cooking by 8AM and Dad would have a good brunch and leave for work with a light lunch in hand. We would have a good brunch by 10/10:30AM and leave for school with a light lunch in hand. Never felt drowsy/sleepy/tired in school. Return home from school around 5PM, have something light to eat and go out to play with friends until it got dark around 6/6:30PM. Get back home, wash up and do homework until 8/8:30PM (whatever couldn't be finished we did the next day morning). Have dinner, do some more homework (we didn't have TV at that time) and hit the bed around 9:30PM.
IMO, this should be the ideal "work" schedule and i have often thought of adopting it again as my everyday time schedule.
Unfortunately there is a feedback loop there which is consistency that is very hard to maintain to get over the proverbial hump first.
What you are pointing out are extreme cases which is generally a small subset. So before jumping to this conclusion one should first setup one's daily life around circadian/natural rhythms and in general establish a healthy relationship between ourselves and the environment we are embedded in. This is fundamental to everything else.
In fact many doctors themselves are now saying that drugs are overprescribed and you don't need them for most (not all) cases. Watch the following documentaries;
1) The Doctor Who Gave Up Drugs (Medical Documentary) - https://www.youtube.com/watch?v=g_ggnhpGvvA
2) The Truth About the Medical Industry | The Doctor Who Gave Up Drugs | Part 2 | Documentary Central - https://www.youtube.com/watch?v=33RuKhr9pag
When it comes to "General Health" (both Mental/Physical) people forget that one can do a lot with what is already known (from empirical practice over generations and modern science) and with the exercise of a little bit of commonsense.
I met my wife about 11 years ago, and she said that I would do a kind of disturbing "stop breathing" thing when I slept pretty shortly after we met, and I didn't think much about it then either.
About a year ago, I decided to see a doctor and it turns out that I have sleep apnea; after a bit of finagling I managed to get a specialized oral appliance, I sleep much better. I don't snore anymore, my blood-oxygen levels stay in the green level, and my wife says my breathing during the night is pretty normal. Now I'm mad at myself for waiting so long to do anything about it.
Pretty much everything in my life got about 10-20% easier after I started getting proper sleep. I think a bit clearer, I process conversations a bit better, I'm able to focus on tasks a little easier. It didn't magically "solve" all my problems, but it did make them a lot easier to work around.
With modern medicine people are living longer but their quality of life becomes so bad it is not worth it.
Health IS Wealth!
Before it was all phone calls, in-person interactions, live TV and Radio... Both for work and leisure, now you have more options than ever to take things at your own pace rather than letting external factors dictate how you arrange your time.
I think we hit peak "speed of life" in the late 20th century to be honest, much of this is grass-is-greener thinking, we have made great progress in terms of day-to-day personal freedom.
Life has never really matched this idilic ideal of the village farmer. Things were very rough for most of history, everyone was constantly stressed to keep up with their minimal necessities to live, it was not in any way relaxed. And the industrial revolution hit ~250 years ago, with much more strict schedules and much longer work days. This is not a recent phenomenon in the least.
I have heard this argument many times before but it is mostly not true. Most village farmers do lead a more relaxed and relatively stress-free life. You just need to visit/observe/interact with them to see the difference.
The main reason is the difference between Acute Stress vs. Chronic Stress.
Chronic Stress has what has exploded exponentially in urban areas after the Industrial Revolution and the current IT Industry has made it even worse. There are just too many things to juggle all the time each of which has a deadline with consequences (because process and efficiency) however trivial it might be in the larger scheme of things. The farmer doesn't have that many things to worry over and so only has episodic bursts of Acute Stress over truly consequential things the management of which is easier.
Another related point is that the farmer does live closer and more entwined with Nature than urban folks and this has been shown to be better for psychological health. We are evolved to interact with Nature and not isolate ourselves in a concrete jungle and grey cubicles.
LOL, that's what everyone riding the "western diet" blood sugar roller coaster is already doing.
If the diet doesn't reflect the environment our biological needs evolved in, acting without self discipline, eating based on how you feel, is a sure path to obesity, diabetes, and NAFLD.
Horrible advice.
I "feel" like I could go for a bacon cheeseburger basically 24s hours today. I feel like I could eat another right after I finished the first. All of that is emotional.
That is pretty different than symptoms true physical hunger. My stomach starts to grumble after 24 hours without food. After about 48 hours I feel lethargic and cognitively disordered.
I think that a majority of Americans confuse the two because it has been years or even decades since they actually experienced the symptoms of insufficient calorie intake
I don’t think so. In my observation a lot of people eat because it is time to eat, or because others are eating, or because they are bored, or because food is at hand.
> acting without self discipline
That is a curious thing to say. Not eating when one is not hungry takes a lot of self discipline. “Eat only when hungry” is a whole bunch of not eating.
Ever since I switched to whole food diet, I don't get nearly as hungry and easily go 12+ hours without food without a thought
I think you're underestimating just how hungry people feel
Possible. Or people have no clue what hunger really is.
But still the advice didn’t say “eat every time you are hungry”. It said “A good way to start is to eat only when feeling hungry.” That is actually a prohibition. The advice is equivalent with: do not eat when you are not hungry.
It also in the very sentence admits that this is not the only rule to be followed. That’s the “A good way to start”. Meaning that there are other things to be aware of. One of them being what you eat as you mention.
If you want a little more detailed overview see my previous comments here - https://news.ycombinator.com/item?id=42138469
One day I'm eating only till 4PM and the next one after 4PM and so on.
Already lost 10 pounds in 2 months from being slightly overweight with no additional lifestyle changes and almost effortlessly because it's surprisingly easy to distract myself from eating for few hours.
I think we are tuned to eat when we want but also to the food not being available all the time.
Question: do you have any system or hack for keeping track of whether it's a < 4pm or > 4pm day? If you do, please share. I have a habit of mindless eating, and will likely not remember to avoid eating at my prescribed times.
By the way, if you are close to your healthy weight when doing this aim to reduce your weight so that your BMI is between 22.5 and 25. This is the area of lowest mortality. There's no point to go lower.
Once you get there you can either abandon alternating, shorten fasting window or just lessen restrictions on fasting periods like allowing eating certain type of foods, like raw vegetables or fruits or nuts so that your weight is maintained.
> reduce your weight so that your BMI is between 22.5 and 25. This is the area of lowest mortality. There's no point to go lower
Thanks. I doubt I'll have to ever worry about going below 22.5 :-). I'm at 28 right now. Gonna be a huge fight to get to 25.
Good luck to you. I feel like being stubborn about keeping it going and able to distract yourself for few hours when hungry are keys to positive outcomes.
You're effectively saying "It's good advice if I ignore it half the time", with your positive outcome stemming from the time spent ignoring it and not eating altogether.
It's silly and harmful advice. Feelings are inherently irrational, we shouldn't advise people to act on them.
When it comes to diet, what you eat largely governs how it makes you feel. The "feeling hungry" part is emergent, root cause largely being the diet.
> Feelings are inherently irrational, we shouldn't advise people to act on them.
This is silly and wrong. Emotions and Feelings are fundamental to Mental Health and by extension to Physical Health. See the research by Dr. Lisa Feldman Barrett and her book How Emotions are Made.
The Mind at Work: Lisa Feldman Barrett on the metabolism of emotion - https://blog.dropbox.com/topics/work-culture/the-mind-at-wor...
> The "feeling hungry" part is emergent, root cause largely being the diet.
This is silly and puts the cart before the horse. Raw Hunger is the root cause and search for food is the consequence from it. Humans have evolved to eat and digest a wide variety of foods but if you only eat harmful ultra-processed food as a lifestyle choice that's on you and needs to be changed. In addition to a proper diet, one should only eat when feeling raw hunger which can be helped with techniques like Time-Restricted Eating/Intermittent Fasting etc.
I think the essence of this advice is to avoid eating for social, customary or emotional reasons.
So what I wrote basically is totally unrelated because, you can get away with all of that and eat for any stupid reason if you restrict yourself to doing it just half of the time.
> The findings, published today in Nature, could help to guide care for people after a heart attack,
This is just hilarious. Remember to get enough sleep after a life-threatening heart attack, folks!
But your comment resonates very much with me. I am tired of this capitalist culture that reduces the human essence to value output and shames people for not pretending to be working hard enough. Part of the reason I like working from home is that I can take that fucking 20-minute nap after lunch and be infinitely more productive throughout the rest of the day.
I think there is a huge component of trained helplessness resulting from consumerist culture and social subservience.
Ultimately, individuals are responsible for managing their own health. Thinking it is the doctors job and responsibility to keep them healthy, and not their own is the root of most problems.
A new study isn't going to convince people people to stop being obese, exercise, and take care of themselves. A study that shows that sleeping longer or eating a Mediterranean diet has a 5% improvement in some metric has almost no specificity to you.
Research is important for the 1% of the time your health is already in crisis, When you are picking between medications or interventions after.
Even then, personal data on what works for you should always trump the research, because it is statistical in nature, usually with extremely high variability. If drug A works 51% of the time drug B works 49% of the time, the difference between them is almost meaningless. You want to know which drug your body responds to. In the clinical context, I think people and doctors overvalue how much time and effort to spend figuring out where to start, and undervalue how much effort to spend responding to personal data if it works or not.
Well said! People talk as if all empirical health practices that different cultures all over the world have developed are worthless without "modern research" while the researchers themselves are looking at it for inspiration and study.
A good example are practices from Yoga/Ayurveda/Qigong/Acupuncture etc. Their worldview, model of anatomy/physiology is very different than modern science but many of their techniques (not claiming all) do work even if we don't fully understand how as yet. That is why many Hospitals/Healthcare centers are adopting them for use in a controlled manner today.
You seem to have a wrong idea of "Scientific Method" (https://en.wikipedia.org/wiki/Scientific_method) and how policies are actually enacted based on incomplete knowledge/research.
Very True. For example, when i ask people why they need that huge cup of starbucks coffee in the morning i get every excuse but the truth that they have been conditioned by the environment and the body has maladjusted to it so that they are in a downward health spiral.
Is it better to prioritize low-impact exercise or sleep after a heart attack? There's plenty of interesting angles to investigate.
Anecdata: I spent a decade as caregiver/caretaker for my late Mother who refused to do any exercises except the absolute necessary ones which a doctor would ask her to do for a specific cause eg. back pain, breathing exercises etc. As soon as that symptom alleviated she would abandon the exercises. So i encouraged her to take long naps whenever she felt sleepy and it helped keep her mental faculties sharp and physically feel spry (within limits of course).
You Asked: Is It Better to Sleep In Or Work Out? - https://time.com/3914773/exercise-sleep-fitness/
Quote: But when pressed to choose one that’s more important, Mah grudgingly decides on sleep. “Sleep is foundational,” she says.
(For an equally useless advice. Why should one follow him? What does he do?)
It was really tough. I was suicidal. My only reprieve from pain was falling asleep.
I saw a neurologist and he told me that two most important things for your brain are:
- consistent sleep schedule
- regular exercise
Once I got those two under control, the headaches finally went away.
https://en.wikipedia.org/wiki/Deep_sleep_therapy
1) Non-Sleep Deep Rest (NSDR): Exploring a World Beyond Sleep - https://positivepsychology.com/non-sleep-deep-rest-nsdr/
2) NSDR, Meditation and Breathwork - https://www.hubermanlab.com/topics/nsdr-meditation-and-breat...
3) Neuroscience of Sleep - https://en.wikipedia.org/wiki/Neuroscience_of_sleep
TNF-alpha promoting sleep is a surprise but it… makes sense. Somehow.
I wonder what happens in people who are on anti-TNFa. Maybe the antibody doesn't cross the blood brain barrier though.
I tried tossing “tnf-alpha inhibitor insomnia” into Google Scholar. Scanning the results I didn’t feel a “signal” in the papers that TNF-alpha inhibitors cause insomnia—which I wouldn’t expect either due to TNF inhibitor antibody size, right? But! There are tons of very interesting papers in the results behind those keywords. With multiple perspectives. Fruitful combo of keywords, you know?
Google Scholar is unusually non-deterministic in what it returns for a given search. You probably won’t see the same papers as I did but it’s an interesting search: https://scholar.google.com/scholar?q=tnf%2Dalpha%20inhibitor...
This paper stood out a bit:
Inhibition of tumor necrosis factor improves sleep continuity in patients with treatment resistant depression and high inflammation (2015)
Authors, full list as I have it in the buffer: Jeremy F. Weinberger, Charles L. Raison, David B. Rye, Amy R. Montague, Bobbi J. Woolwine, Jennifer C. Felger, Ebrahim Haroon, Andrew H. Miller — Department of Psychiatry and Behavioral Sciences, Department of Neurology, Emory University School of Medicine, Atlanta, GA
https://www.sciencedirect.com/science/article/pii/S088915911...
First thoughts: TNF—alpha signaling becomes unfocused? TNF-alpha release outside the CNS affects receptor sensitivity or other downstream mechanisms that do straddle the blood-brain barrier?
Some beauty might have been gotten left behind on the headline writing table. The body’s response to the mycardial infarction – a cascade of signaling proteins – is beautiful, and the response to that cascade being induction of deep and restful sleep is also quite beautiful.
I have an eager immune system and I’ve known TNF-alpha as a pretty brutal card in the game. There’s beauty in coming to see it as a signal to repair and rest. Not just a “we have a problem” but a “let’s call ancient repair processes in”.
[0] https://www.sciencedirect.com/science/article/abs/pii/S10870...
[1] https://en.wikipedia.org/wiki/Long_COVID
#1 - For most patients, it ain't merely "tests and procedures" which interfere with sleeping in a hospital at night.
#2 - After a major injury, it ain't just nighttime when you need to sleep. Again, most hospitals seem determined to make that as difficult as they possibly can.
https://www.nhlbi.nih.gov/health/sleep/how-much-sleep
Absolutely nothing wrong with sleeping between 8 and 9 hours, you're actually exactly in the healthy range.
I have the same profile : no caffeine or other stimulants, good volume of physical activity; I don't need any reminder to go to bed, I get the obvious the call by being quite tired.
Discussing sleep with people, I found two types that are dominants:
- people who heard "between 7 and 9 hours" and remember "8 hours" (can't say they're wrong here!) - people who heard "between 7 and 9 hours" and remember "the goal is 7 hours", and actually sleep between 5 and 7 hours
> The study concludes that while individuals may initially sleep more when given extended opportunities—likely to recover from prior sleep deprivation—they do not sustain excessive sleep beyond their physiological needs. Consistently sleeping more than 10 hours may indicate underlying health issues and warrants further investigation.
So more than 10 hours might indicate a problem, not 8-9 hours. Also, it's different if people work out a lot or have a physically demanding job:
> For athletes or individuals with high physical demands, 10 hours of sleep might not indicate an underlying health issue but rather an increased physiological requirement. Research has shown that elite athletes often sleep longer than the general population. (this is not from the paper but from a quick search)
https://www.redcross.org/take-a-class/resources/learn-first-...