Why does sleep become more elusive as we age?
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I firmly believe that most problems people have with sleep also depend on modern "way of living", that is highly Artificial.
For example, lots of people have Apnea, and Apnea is highly correlated with being obese, and being obese is normal in the Western world, but it was not 100 years ago.
So it is not about being older but about being overweight, something that depends on eating healthy and exercising, that most people do not do.
Another important factor is artificial lighting, again a 100 years old thing, people that have used candles know how dim they are, and people using screens in the bedroom until late, specially social media.
Social Media is addictive, but you don't need to use it, people can stop using it, but they just don't want to.
Also living in the city is noisy, expensive and stressful. Most people are worried about lots of things, and that makes them sleep badly.
"There is only one formula for healthy and refreshing sleep: Go to sleep only when you are very tired. Not earlier. Not later. Wake up naturally without an alarm clock."
Then kids + career = 10pm-5am sleep schedule and pretty much feel tired (struggling-to-function tired) 24/7.
I think the worst aspect of it nowadays is that the cycle seems difficult to break. Thanks to this conversational reminder, I'll try to hit the hay when the body seeks it, no matter how early. Waking up is not a problem. It's the falling asleep part that has caused me to gray severely in the past 3 years, through and post pandemic.
It came on so quickly and strongly, I still feel robbed.
It's ultimately a synonym for worry - and whatever it entails.
As for literally dying my hair, I did once a while ago. Never again. It felt awkward, impersonal, awkward (x2), fraudulent, and so on. It's good to feel comfotable in one one's skin, even while it whithers.
The kids would go to bed around 2am and wake up around 11am. My wife and I would go to bed around 3-4am and wake up at 11am. It was fantastic.
Sadly modern life doesn't allow for that, as we have to take them to school at a set time and I have to meet with other people now.
Some days I wake up late and miss a portion of the work day but I'm able to work later and have a fresh mind for the entirety of my work time. With this routine I've found I'm managing to accomplish way more than I did in a previously more rigid environment.
Currently I'm an IC so it's easier to have this kind of schedule. At past jobs when I was in more of a managerial role so this wouldn't have been as easy due to the amount of meetings with various partners and employees.
This experience has been so positive it's made it so that I'm now pursuing a job/career where I can maintain this lifestyle. I loathe wasting time sitting around because I'm tired.
I mean, my post above is pretty much all there is. We basically lived on that schedule until my daughter started online kindergarten. Then we made her roll out of bed at 8:38 to be online by 8:40.
When did the sun set where you lived during that time? I suppose that was a big influence on sleep times?
We live in the Bay Area, so the sun was setting around 8pm since it was spring/summer. Our whole family are night owls, but regular society just isn't designed for that.
Of course now that they have regular school they have a regular bedtime that still gets them 9+ hours sleep (actually closer to 10 hours), but they are still groggy and slow in the morning because it is not when their body wants to be awake.
As an additional plus, if you are in the United States, sleep disorders qualify as disabilities, which means employers are generally required to make reasonable accommodations, including later working hours. I find that tech companies are generally fine with varying hours anyway, but it's a nice tool to keep in your back pocket in case you have a manager that insists on 9am meetings.
I wonder where and how to get this diagnosed though.
The sleep formula article said “truly sleepy” which, to me, is significantly different from “very tired”.
I did that for years when I was younger. For me that meant a longer-than-24-hour day which quickly led to being completely nocturnal. Those were dark days, literally and figuratively. I can distinctly remember my first "day" without daylight. It wasn't a nice feeling. I would usually try to correct it when that happened which was like having a 12 hour jet lag.
Yes, it causes issues within our society. That's the only thing keeping me from it and I bemoan this on a daily basis. If we were more flexible I could thrive.
I wake up with the alarm only if I go to bed too late, otherwise I assume I have to sleep for 10 hours, go to bed and my body naturally wakes up between 830 and 930 hours of sleep. Very resting. Also if I gwt 2 days of 9 hours, the next day usually I end up sleeping 8 and still feel rested, so it seems the body naturally adjusts
Hardware designers reading this: add darker brightness settings FFS.
But I agree with your overall point. It shouldn’t be hidden under accessibility, and more devices should have lower brightness settings.
There are also a lot of other causes of sleep apnea, physiology being a big one, also obstructions in the nasal canal.
I have sleep apnea and am one of the most fit people I know. When I was in the military, I encouraged many of my friends who sleep poorly to get a sleep test and many of them - fit and young - were surprised to learn they also had it. I would not be surprised if some significant portion of the population has it and is just unaware. At anything short of severe levels, many people would never even suspect they have it.
Sleep apnea is one of the most diagnosed conditions in service members separating or retiring from the military
This means an extra $1-2 thousand per month for life in most cases. So there is this natural experiment where we have a population with a very high incentive to get tested compared to the baseline population.
Because the toll that way of life takes on your body is at least a magnitude more than most civilians realize.
Years of little sleep in poor condition while under constant low level stress, being in unfamiliar conditions where you never quite feel safe sleeping, constant interruptions because the military activities don't stop while YOU sleep, poor temperature control (hot or cold), poor hygiene availability, poor sleeping surfaces, odd work schedules, short sleeping schedules...
Those are just the factors that you deal with for decades that relate to sleep. I wasn't a grunt; I did do a lot of move fast and don't break things or people die stuff (Nuclear Power, SAR Aviation, Amphibious Operations) and that was just how life was.
We had a few overweight people, but they were the exception. Those of us who were more senior were just all broken in so many ways. I don't THINK I have sleep apnea, but I do have trouble sleeping from the pain I'm in every night from a back injury and multiple autoimmune issues that cause flareups and pain.
The cost on those that serve is absolutely astounding. I don't recommend service to anyone.
https://www.ahajournals.org/doi/full/10.1161/01.hyp.00001016...
This isn't as earth shaking as you imagine. The minimum AHI for diagnosis (in the US) IS 5. 20ahi (meaning you stop breathing 20 times per hour on average), is pretty mild. Some people have ahi over 100. Meaning a 26% decrease isn't actually doing much for you.
What I can tell you is that I know several people who seem to have sleep apnea, complaining about the symptoms, who were told by their PCP that they don't need a sleep study because they weren't fat. When your partner complains about you choking in your sleep all night, you probably should a get it checked out regardless of your BMI. I honestly believe that doing a sleep study once every couple of years should be considered routine for everyone. We check our eyes, blood pressure, testicles, skin... Why not check for sleep quality prophylactically?
I'm not saying you're wrong, but the OP using the condition as proof of societal causes of sleep issues is way off the mark. Skinny people can experience it. Children experience it. Bodybuilders are quite prone to it. As tissues loosen and sag with age across the body, old people are prone to it.
Sleep apnea is not because you have fat in your neck obstructing your airway but your tongue relaxing at night and the area below the uvula falling backwards then obstructing your airway.
This is because it reduces her baseline pain to a point where she can rest.
Why don't we characterize it as "challenging" them?
What we need to stop doing is making arguments that something being an opinion means it shouldn't be pushed back on.
It's one thing if someone says I like broccoli better than pizza, it's another when someone makes a statement that is not about their own preferences. Many of those opinions are bad and should be challenged.
They didn't push back on the _opinion_, they pushed back on _expressing an opinion_:
¨Respectfully, "I firmly believe" followed by an assertion from a non expert passing as "facts" is a pox on our modern society.¨
Nothing in there is "challenging" the opinion or "pushing back" on the opinion -- it's criticizing _expressing an opinion_.
The poster reacted to an opinion negatively and pointed out that people need to stop that behavior.
Can you imagine if someone said "raping children should be ok" and someone else tried to argue that saying people should stop raping children means they attacked the person and not the opinion?
right, they challenged the opinion, stop with the wordplay.
Consider: “I firmly believe that fire is hot”. Sounds a bit odd, no?
My mind would wander, I would worry about things, it was a nightmare.
Eventually I had to relearn how to fall asleep. I am now much older and I won’t say my sleep is perfect, but I can easily fall asleep within minutes. I had to rewire myself to empty my mind of every external real life related thought. What works for me is to build an imaginary world and dive into it. Eventually that world disappears and I fall asleep.
I know there are other techniques but this works for me.
When I was in my mid 30s, I suddenly had extreme memory issues. For example, at dinner time, I had no memory of what I ate for lunch or even if I had lunch at all. I could remember people that I knew, but I could not remember if I talked with them earlier in the day. It was all very scary.
After various neurological tests showed nothing unusual, my doctor thought we should look into sleep issues. It turned out I suffer from something called Delayed Sleep Phase Syndrome - whereas the average person has a natural bedtime that is ~24 hours after they last went to sleep, mine was significantly longer than 24 hours.
My doctor concluded that this was the source of my memory issues. That confused me a bit, as I experienced trouble sleeping my entire life prior to this diagnosis. She explained that the consequences of inadequate sleep worsen as we age.
It was inconvenient for work and social things, but I was able to start living longer days (i.e., don't go to bed until I'm sleepy). Within a week, the recall issues I'd had were a memory (see what I did there?). I was also able to fall asleep much more quickly than I had before, and sleep duration didn't have the wild swings I'd experienced all my life.
I'm facing a similar battle right now, I've always been a "night person" and on a roughly 28h day, for the past year I've been (mostly unsuccessfully) trying to force myself into a morning person and 24h day. It's kinda worked, though I get btw 3-6h of sleep, which isn't enough.
Having a time period to wake up makes it more likely I fall asleep in a predictable time period. Going to sleep at X to wake up at Y is all fail for me.
I also tried other methods, like reading a book before sleep, the 4-7-8 breathing pattern, and the white noise generator, but to me they are just distractions.
I donno, it hasn't been a big deal. I've worked for startups and also doing consulting work the past 20 years, I always mentioned my weird schedule when interviewing, maybe it's tech, maybe just my bubble, but it's fine. During that time I didn't tend to schedule many appointments.
Now I'm doing a different thing, trying to see if I can actually adapt to be on a 24h schedule and be a "morning person" and all that.
I was feeling motivated last night at 1am, and it took every inch of my body to NOT whip out VS Code.
Still couldn't sleep until 4am. Woke up today at 1pm.
--
I used to think that growing up would mean that I could go to sleep whenever I wanted, and do what I want.
Turns out that growing up means you learn that you shouldn't do those things.
But why? My mornings are usually clear of meetings, and I could just work PST hours from the east coast, and it would be fine.
Turned out that working every evening is not good for your social life, and having a social life is something I try to prioritise more than hacking all day all night.
I'm not sure why though.
I also started to excercise more for over a year now, wear a sleep mask and changed my diet to focus more on the wellbeing of my gut bacteria.
I found children were set up to fail so spectacularly when it comes to sleep that I wonder why it would become more elusive with age.
When someone jumps into a discussion and reframes a well known concept in a way that's intended to make people angry so that they can further a point of view that is orthogonal (x) to the current discussion, I always wonder, why?
Has life taught you that this is a useful way to further a discussion?
Do people respond well to it?
Or do you just like strong reactions to what you say and you have found that stating things in a way designed to elicit anger is a good way to get those?
(x) This article is about sleep patterns in adults over 60 versus younger adults, not sleep deprivation in children and teens who are forced to get up early for school. Your point is not totally unrelated, it's worth discussing, and it's also orthogonal to the actual discussion here. So again, why did you feel the need to jump in and try to make people angry about it?
The way I read these types of comments is trying to reframe typical human actions in an "impartial " light. Everybody knows kids should go yk school, if someone dared to say otherwise people would jump to "cancel" them because "think of the children". So trying to put the argument in a different light to avoid the knee-jerk reactions helps drive conversation.
I hate that English is not my first language, so my argument here surely reads somewhat funky.
Since 2020 I have manually tracked 35093 data points about my life [1]. And the one parameter that correlates most with my sleep time is how many steps I took during the day.
The median number of steps I take during a day is about 9500.
When I look at the sleep time of the following night, on average I slept an additional 9 minutes after a day with 9500 steps or more compared to a day with less than 9500 steps.
The gap increases to 16 minutes when I look at nights where I walked over 12000 steps in the previous day.
To see if that is just correlation or if there is causation at play, I also started to decide to take an additional walk or not by coin flip. So far, I did that 31 times. 16 times the coin decided to take a walk, 21 times it decided not to. On average, I slept 13 minutes longer after the coin decided that I take an additional walk. 31 is a very small N of course. I hope to have a larger sample by the end of next year.
> A widely repeated claim of remarkable longevity of the Hunza people has been refuted as a longevity myth, citing a life expectancy of 53 years for men and 52 for women, although with a high standard deviation.
I agree with the point on physical activity, but the implication that traditional cultures have as long or longer lifespans is easily dismissed as inaccurate.
All so-called "blue zones" are in traditional cultures (food and general lifestyle wise).
Blue zones seems somewhat ambiguous but if I'm understanding correctly, they are small areas of people who live more traditionally surrounded by mostly modern people? Seems like by definition those zones are made up of cherry picked people and it's unclear to me that those aren't just outliers.
HRV is generally the metric used. You can measure that with a cheap chest monitor, or get a fitness watch that tracks it continuously throughout the day and night.
Good HRV levels are highly correlated to activity level, so your base hypothesis still makes sense.
Is there a standardized way to measure sleep quality? Or are the numbers one measures only compareable as long as one uses the same device?
I would be interested in suggestions which watches measure the HRV / Sleep quality reliably and display the data on screen. Or let me get it from a Linux laptop. I hate having to install an app to get the info off the watch.
One performance and health coach I follow recommends the Polar H10 chest strap to take a measurement every morning.
https://twitter.com/Alan_Couzens/status/1723334537235607989
https://twitter.com/Alan_Couzens/status/1473672665541984259
There's also not an absolute number or threshold that's good or bad. Generally higher is better, but what really matters are the fluctuations from a personalized baseline.
Is it even possible to sleep with the H10 strap?
However, HRV is not the whole story about sleep quality. If you develop sleep apnea, for example, your HRV will not react very much, though your sleep quality will suffer. There is no substitute for sleep study to detect such issues.
I'm a little skeptical about my Garmin's ability to accurately measure sleep quality.
Sometimes I wake up refreshed and felt like I slept very well, only to have my Garmin tell me that I had poor sleep quality (usually because of too little REM sleep), other times I've had a bad night of sleeping (like the dog needed to go out several times) and I wake up tired, and my watch congratulates me on good sleep quality.
I wonder if one of the sleep monitors that uses a pad on the mattress would be more accurate.
edit: just checked, I did a 120km bike ride this year and the next night I slept for around 6h.
Intensive or prolonged exercise (especially close to bedtime) can actually interfere with sleep. I never sleep very well the night after 10k runs or 60km+ rides. There is a sweet spot (for sleep quality) between zero exercise and too much exercise.
Try weight training in the morning. I’m someone that doesn’t usually nap… but after starting weight training I find myself needing a nap in the afternoon, and it is much easier to fall asleep.
But its one of the more annoying experiments to let a coin decide if you have to take another walk :) So I'm not sure how often I will do that. I'm pretty convinced already that walking more is a good thing.
I'm in a hurry right now, but I will probably write a full blog post about the steps-sleep relationship with p values and everything some time next year.
I waited way too long to do mine and learned so much afterwards.
In my case, while I don't have apnea (many MANY people do, and not just fat people!), I learned that I have a deviated septum that causes airflow problems primarily during sleep, especially in our dusty ass house. (I have since installed air purifiers.)
My daily sleep quality improved considerably after using breathe right strips, Flonase and melatonin, all at the direction of my ENT. I still have episodes of maintenance insomnia (waking up at night), but they've gone way down.
I also didn't know that taking melatonin 1.5-3hr before bed and Flonase 30m before falling asleep can greatly help induce sleep quickly. Melatonin is also non-habit-forming and is produced naturally by the body, so taking SMALL amounts of it daily is completely fine. (small = 1.5-3mg)
There's other stuff that can affect sleep quality for sure (staying in bed when you can't fall back asleep; inconsistent sleep/wake times; doing things other than sleeping or aggressive snuggling), but getting a sleep study done and ruling out physical reasons is so, so, so important.
GET A SLEEP STUDY DONE!
(Also, if you're struggling with insomnia, look into CBT-I. It's hard work, but your sleep will improve demonstrably if you stick to the program. But not before getting your sleep study done!)
She said, “I can tell you right now that it’ll say you have sleep apnea; that’s all they ever say.”
Yes, I found a new doctor but with so many people being diagnosed with it, I do sometimes wonder.
Also a CPAP doesn't increase the amount of oxygen. It just increases the air pressure a bit to keep the airways from collapsing.
There is not an oxygen supply problem in a room even if it isn’t actively being ventilated. If there was, you’d have bigger problems. Also plenty of people do have some form of ventilation or air circulation in their homes.
Unless you’re sleeping in a tiny cramped space that is almost fully sealed, this is not an issue.
Mandatory:
- separate duvets for me & my partner, so we don't wake each other up by turning
- no screentime for ~1 hr before falling asleep
- going to bed and read a book for that ~1 hr. When I get sleepy I sleep
- bedroom as dark as possible
- physical activity of any kind
Less important:
- no caffeine in the ~8 hrs before falling asleep
- glass of warm milk before going to bed
Does the first person to get tired sleep with the room lit enough for the other to keep reading?
If you can’t sleep and you have ten things you’re worrying about then it’s probably more psychological and you might have to get that sorted before expecting night bliss.
Have been amazed the number of people who complain about sleep and have all sorts of drama going on. People have this sense that the act of laying down and closing your eyes = sleep mode.
I now work hard on meditation-style “make your mind blank” effort at sleep time. Any worry I have, it can be handled tomorrow. (But I have to in good faith have a plan to address it in the morning.) This has made it much easier to fall asleep.
[1] - https://guzey.com/books/why-we-sleep/
EDIT:
>Melatonin levels peek in the middle of the day and are lowest around midnight.
Isn't that the opposite of how melatonin works?
According to the blog post, the treatment for some sleep disorders is to take a dose of melatonin during the day, which moves your natural melatonin production earlier for unclear reasons. Maybe there's confusion between when you take the melatonin and when melatonin is naturally highest?
> A substantial number of studies have shown that, within this rhythmic profile, the onset of melatonin secretion under dim light conditions (the dim light melatonin onset or DLMO) is the single most accurate marker for assessing the circadian pacemaker. Additionally, melatonin onset has been used clinically to evaluate problems related to the onset or offset of sleep. DLMO is useful for determining whether an individual is entrained (synchronized) to a 24-h light/dark (LD) cycle or is in a free-running state. DLMO is also useful for assessing phase delays or advances of rhythms in entrained individuals. Additionally, it has become an important tool for psychiatric diagnosis, its use being recommended for phase typing in patients suffering from sleep and mood disorders. More recently, DLMO has also been used to assess the chronobiological features of seasonal affective disorder (SAD). DLMO marker is also useful for identifying optimal application times for therapies such as bright light or exogenous melatonin treatment. [1]
I remember my granddad having the complete reverse; he slept well when younger (during WOII, which I would think is an actual existential threat vs monetary one) and when he was 50, he would take heavy sleeping pills and then even only get 4 hours or so.
Oh, to be young again and when you can fall asleep without a busy mind keeping you awake.
Back then, I was practically always dead asleep within minutes of my head hitting the pillow and a snooze was always within easy reach no matter when I tried (wasn’t uncommon to have a 1-2 hour nap after coming home from school). Flash forward 16 years to today and getting to sleep isn’t too much of a problem but it’s much more common to have trouble with getting my head stopped long enough to drift off, especially nights when I don’t make a point of doing almost nothing for 2-3 hours prior to wind down.
But also, as I get older I worry less about my own mortality - me, you, everyone we both know - all going to die, and worrying about it isn't going to change that.
Podcasts do sometimes work for me and I have some sleep meditation (yoga nidra) stuff I listen to as well. Combined with the odd supplement or medication, I can usually get some sleep but I’ve yet to find a silver bullet.
You aren't sleeping less because you need less. You have lost the ability to stay asleep for a healthy amount of time.
It took a lot of effort to reset my body to obtain a more healthy amount of sleep. I think I went about a month with 1-3 hours per night. The initial cause was "sleep regression in twins", but that was only for 2 weeks. The next 2 weeks was how long it took me to get my body to sleep more than a couple hours per night.
https://www.nih.gov/news-events/nih-research-matters/gene-id...
It’s mostly a fairly simple scheduling problem, plus having one adult sleeping somewhere they can’t hear the baby during each “shift” (loud fans help). Not having to jump instantly on the crying baby also lets you slooowwwly stretch your response times longer, which is a nice smooth way work toward the glorious 1-feeding-per-night and finally no-night-feedings period (babies wake up and cry even when not hungry—past the earliest weeks, immediate feeding may not be necessary, and if you can wait a minute they may go back to sleep, because they weren’t hungry, they’d just woken up and briefly freaked out—if you keep pouncing every time as soon as they make a noise, it trains them to stay awake rather than going back to sleep, and you’ll have a bad time for, potentially, much longer)
All bets off if you have a kid who’s ill, but for most babies, it’s entirely achievable.
Wouldn't it be easier to have a soundproofed room for either the parents or the baby?
Your key assumption is "not badly space-constrained" is plausible, but no time/scheduling constraints for adults seems unlikely.
> if you can wait a minute they may go back to sleep, because they weren’t hungry, they’d just woken up and briefly freaked out—if you keep pouncing every time as soon as they make a noise, it trains them to stay awake rather than going back to sleep, and you’ll have a bad time for, potentially, much longer
Your observations would be in favor of soundproofing where delaying intervention would be a feature, not a bug.
> but no time/scheduling constraints for adults seems unlikely.
For parents with 9-5 sorts of jobs, it works fine. You don’t even need “sleep-per-parent x2” amounts of contiguous time available, because there’ll be a gap of usually a hour or three between the last time the kid wakes up for first-parent and the first time they wake up for second-parent, and it’s not like you can’t get any sleep while “on duty”. We were managing 6ish uninterrupted hours per parent in the very worst weeks for each kid, and more than that for total sleep, with a sleep window (for us, the parents) of about 10 hours. Not sure what you mean. Yeah inconsistent shift work or something could mess it up, but that messes up everything.
I'm basically non functional at less than 7h of uninterrupted sleep per night.
> We were managing 6ish uninterrupted hours per parent
It may not be enough
> What’s with the soundproofing thing?
Soundproof the room where either the parents or the baby are would be more reliable to control the noise level by preventing it from reaching out instead of adding more.
It could also be converted later into a music room
What we did was just one of us would sleep in another room with the monitor, and the other in our normal bedroom. Fan and door closed was all the soundproofing we needed in the normal bedroom. But that’s why having little space might make it a lot tougher—ours relied on having three rooms, two of which with sleeping-places for adults.
And Ok we probably weren’t averaging 7 hours uninterrupted until about 6-8 weeks, but total sleep was consistently over 7, and uninterrupted of 6ish is a lot better than what many parents report (the ones where both get up for every feeding… I’ll never understand those folks)
[edit] my overall point is that with just a little thought applied to the problem, and possibly some resources but likely not that much if you already live in a house instead of a small apartment, you’re not guaranteed impossibly-short sounding amounts of sleep just because you have an infant.
Oh I absolutely agree, I just wanted to understand the problem better and see if there was something I had missed!
and "Not having to jump instantly on the crying baby" made things worse
our experience was a not great to begin with, but the sleep deprivation only lasted around 6-10months per child and for the benefits it gave - I would definately do it again
to all the potential parents out there, please do your own research and try not to fall in the trap of the victorian mindset - which on the whole (massively over simplifying it) seems to suggest actions to make your life easier at the expense of the baby.
[edit] and actually the whole rest of this holds without capping it with that action, it just means you’ll need to keep up the shift thing for 6-12 months instead of 3, and—from what I’ve seen—deal with a couple nights a week of your kid waking up in the middle of the night the whole rest of their early childhood. The shift-sleeping strategy has no bearing on that, but does get you a couple REM cycles a night, even in the worst of it.
(But yes, worth it).
Probably because we're all dying.