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

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

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

https://www.youtube.com/watch?v=5MuIMqhT8DM

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

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

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

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

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

Same as boludo in Argentina

¡Gracias! No estaba seguro de si eran equivalentes.

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

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

Probably personal. (unless crossed fingers is the cause)

Hah! Just answered above. :)

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

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

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

* No food or blue light after 6pm

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

* No caffeine of any kind after noon

* Black-out curtains

* In bed by 9pm

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

>I've been getting supplementation

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

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

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

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

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

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

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

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

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

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

Or just sleep on your side like other primates

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

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

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

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

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

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

Source: Did contract work for a sleep apnea startup.

Thanks!

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

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

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

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

I hope you feel better soon.

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

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

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

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

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

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

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

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

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

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

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

https://youtu.be/bEbtf7uS6P8?t=6790

> Wrist-based sleep trackers are basically useless

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

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

Unfortunately not. :(

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

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

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

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

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

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

Peter Attia recommends Oura Ring.

https://peterattiamd.com/members/discounts/

What do you think was the issue?!

- fellow crappy-quality-sleeper

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

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

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

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

Fitbit is pretty good at that I believe.

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

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

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

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

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

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

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

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

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

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

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

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

please elaborate

signed, a shitty sleeper