Two nights of broken sleep can make people feel years older, finds study
theguardian.com
theguardian.com
Now allow me a preemptive reply: I suffered apnea with a BMI below 20. Plenty of people don't have apnea because they are overweight; instead, they are overweight because they suffer apnea.
https://www.sleepapnea.org/treatment/sleep-apnea-mouth-guard...
Clearly they have to know which part of your airway is restricted. Most of the variables for sleep apnea are not related to the surgey, just factors that make it more likely to experience that restricted airway (drinking, weight, etc).
My question is, what tools are there to narrow, to a certainty, what would need to be done via surgery? In all my research I have found none. Maybe I missed them. If I did not, then it amounts to a guess by a surgeon. And that's what worries me and has fed a lot of the horror stories I've read about.
Unless you have a very specific, isolated problem (such as huge tonsils or a fucked up jaw), surgery is rarely a good option. Results are hit or miss, recovery is unpleasant, and the scar tissue created can result in more obstructions years down the line.
None of the current implants are as good as cpap and few peole qualify for them.
Mouth guards can work, but many don't tolerate them well and they can lead to TMJ issues.
Etc.
Reference https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4686746/
But the thing to keep in mind is that obstructive sleep apnea isn't so much a condition as a description of what's happening. Apnea means you stop breathing, obstructive means something is blocking it. Maybe it's because your fat belly is weighing you down, maybe it's your tiny nostrils and deviated septum, or maybe the back of your tongue is thick because your dad also had a thick tongue.
That's not even including self-imposed factors like central nervous system depressants (alcohol) and smoking, both of which can make apnea worse. Ever notice how drunk people snore?
Obstructive apnea doesn't need to be caused by fat either. I always thought sleep apnea was a fat person's problem until I realized at age 30 that when I slept on my back, the tissue mass at the base of my tongue was dropping into my airway. And I'm fit/slim and also a nasal breather.
(I used to think I always woke up gasping for breath in my 20s because I had frequent nightmares. Ugh, wish I could go back and fix it sooner.)
https://news.stanford.edu/2020/07/21/toll-shrinking-jaws-hum...
A lack of sleep means a lack of energy. You're body compensates by getting food energy.
Too much stigma around what should just be understood as a biological mechanism.
Being tired may cause you to eat more but being tired isn't making you gain weight, it's the overeating that is.
it's not something I have ever been made aware of, and I don't understand how it could be the case.
I don't have anything specific to link - it's just my own personal experience and what the doctor said.
In my own case, I had to eat much more than I theoretically should because my body wasn't able to process the food as well as it should (less than 50% of usual efficiency). And yet I was fat - not obese, but definitely not thin. The body redirected some of my food to storage even though I didn't have enough energy (glucose etc) as measured by blood screening. And it didn't use the reserves properly when I stopped eating.
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7898726/
> Effects of moderate sleep restriction during 8-week calorie restriction on lipoprotein particles and glucose metabolism
Because the conclusion starts with,
> In this study, 8 weeks of calorie restriction with and without sleep restriction of less than 90 minutes per day on 5 days with 2 days of ad libitum sleep per week, resulted in similar degrees of weight loss
Let me be clear that sleep deprivation doesn’t seem to be good for your circulating lipoprotien levels or insulin sensitivity based on that study, but they didn’t gain weight.
Reducing getting fat to thermodynamics is like reducing computing to adding numbers. While that may be the basic building block, only a fool thinks that merely by comprehension of the add operator, one is also able to debug hugely complicated soft- and hardware stacks.
The root cause of weight gain is either overeating or lack of sufficient exertion in almost every case. Sleep apnea may absolutely cause someone to overeat in part because of those dozens of biological feedback loops you mention. But that doesn't mean that sleep apnea makes people gain weight. It's still too much food at the end of the day.
It's all four fundamental physical forces actually, if you want to go that route. Which isn't helpful.
I gather that you are unaware of how sleep apnea causes poor sleep, which in turn causes insulin resistance, which in turn causes an elevated production of insulin, which in turn forces glucose into your adipose tissue, which in turn makes the rest of your tissues starved for energy, which in turn causes you to be hungrier, overeat and gain weight.
This is an oversimplification, of course, as there are hormones other than insulin and cortisol involved in the complex process of insulin resistance, but it is at least a starting point that goes beyond the useless truism that "people gain weight because they overeat". Of course they do, but the mechanisms why they are hungrier than they need to be are crucial if you want to address the problem, because in the long run every human being with free access to food will eat precisely until they are no longer hungry, whether or not they are metabolically healthy or not.
There definitely is the issue of how to reliably maintain a caloric deficit when your body is screaming at you to eat more, but the underlying mechanism is much simpler.
At the most basic levels, food choice doesn’t even really matter (specifically for weight loss, not general health), but choosing satiating foods with low calories is going to help with implementation. Eating 2,000 calories of oranges (45) is going to be a lot harder than 2,000 calories of fast food hamburgers (2).
> Being hungry does not cause you to eat
Yes, it does. That's why people eat: to alleviate hunger. You may will power your way to a caloric deficit for some months, maybe a couple of years, but eventually hunger will win and you will eat until satiety.
Metabolically healthy people aren't slim by being hungry all the time. They eat to satiety, and they are lucky enough that their satiety signalling is still working well enough. If you make them chronically hyperinsulinemic, they will be hungrier and they will gain weight -- it happens in humans and in animal models when allowed to eat ad libitum.
> At the most basic levels, food choice doesn’t even really matter (specifically for weight loss, not general health), but choosing satiating foods with low calories is going to help with implementation
As long as you are hyperinsulinemic, you will store a portion of the energy you consume in your adipose tissue, because that is one of the major effects of insulin in the body. The remaining energy left in you will not be sufficient to supply the energy needs of your body, and as a result you will be cold, tired and hungry.*
If this is the premise of your argument, it is flawed.
You have no idea if “eventually” happens to everyone. You’re making a wildly strange assumption.
Have you tried? Are you willing to try? How many people do you know that intentionally remain hungry every day for more than a couple of years, while otherwise having free access to food?
Any weight loss advice that does not adequately address hunger and satiety is naive to the point of ridicule. And any person who advises others to address their weight by telling them to be hungry in perpetuity hasn't given much thought to what they are asking for.
> Yes, it does.
Nearly 1:10 people in the world are chronically hungry. Being hungry has no impact on their ability to eat. Likewise, those with access to food eat when not hungry and (believe it or not) may not eat when hungry.
I really think you’re missing the point, though. We have a host of signals in our body that can misfire due to various conditions and people cope with them. Hunger is no different and many of us have spent months ignoring it to our own benefit (and some to their own peril).
Caloric intake in excess of expense causes weight gain. What factors lead to that excess do not.
There are certainly those with a variety of issues that make caloric deficit difficult. Fortunately, that’s not most people.
That meant measuring calories until I could generally estimate what I was taking in each day. 1000-1500 calories a day sucks at first, but seeing the scale drop is motivating. I dropped 30lbs in about 6 months.
You can’t gain weight if you are taking in less calories than you expend. That’s pretty simple. Not eating that cheesecake, on the other hand, not so easy.
The problem with that is you can reach a point were trying to reduce calories further will only further sabotage your metabolism and makes you feel like shit. Which is why treating the symptom repeatedly fails to work long term.
I’m a 5’11” male who gained weight up to ~220 pounds on ~1800 calories eating a very consistent meal rotation. I now maintain ~190 pounds at ~2100 calories. My problem was likely a combination of my food acting as a chemical signal to gain weight (high in branch chain amino acids, polyunsaturated fats from fatty pork and chicken), work stress, bad sleep, and possibly even chronically elevated blood sugar or thyroid effects from essentially what was an almost carnivore one meal a day sort of diet. My body temperature was hitting lows of 96.3 degrees F. It’s now roughly two degrees higher, which seems small, but feels so much better.
If someone is eating healthy foods and making a genuine effort to get good exercise, then we can talk about other factors. But too many people use “this is so complex” to avoid the very basics of healthy living.
I'm on mobile and don't have time to link, but a quick google search should give medical studies on this.
The "energy" thing is a simplification, but as a description of how this feels, it is apt in my view.
This is not about thermodynamics.
Potato pot-ah-to.
Bringing up thermodynamics as a generalization for biological systems is pseudo-intellectual. We aren't all equal machines that take in a fuel stock and output work. How do you account for differences in peoples' resting metabolic rates? How do you account for the difference in available energy in the foods you chose to eat, and in the differences in peoples' biological processes that extract that energy? Stress is a common hormonal modifier that impacts how the body stores fat; no where near a "rare" condition that many people experience nowadays, and yeah caused by things like sleep apnea. You betray your own argument anyway by adding an the "hormonal condition" exception (I don't see any exceptions referenced in the laws of thermodynamics, lol).
Biology has more dimensions than you are choosing to look at, and using thermodynamics as a "gotcha" when it comes to others' bodies reveals your lack of understanding and intuition.
There is no need to get into the weeds of various details of how that breaks down; the main problem is that calories are way too cheap in the modern day and age, and people's habits and instincts developed in far different eras lead to easily ingesting more than is expended. Yes the OP is not wrong, but it's not a very useful argument unless we're going to roll back the modern civilization.
It's entirely possible to eat less food and have your body decide that food is more scarce and choose to strip more calories from your food than it was when you were eating more.
Thermodynamics is an asinine thing to bring up in a system that can reconfigure its efficiency on the fly to optimize for different environments.
I don't think many people disagree with "If you starve yourself enough your body will eventually start burning fat", they disagree that it's as simple as "anyone gaining weight is necessarily doing it to themselves by eating more than other people".
And starving yourself isn't easy. It's one of the top like five things your body is designed not to let you do. So how on earth is it helpful when people are talking about factors that can influence your appetite and can literally influence the number of calories your body chooses to extract from the exact same food to say "just eat less lol"?
I might add that overwhelming research suggests that social pressure on people's weight causes people to gain weight. So even if you were right, bringing it up would be counterproductive.
That's part of the "calories out" side of the equation, that few people put in the effort to find (if they even know how). And I've found online estimators aren't very useful here, you need to find it for yourself - they say mine is around 1600 when it's actually more like 2200.
Ignoring half of CICO just because people only like talking about CI doesn't make it false.
No one said not eating is easy, especially when there's a lot of food around! I struggle with it. The laws of physics are not kind.
What I will say though, is if I exercise moderate amounts, it makes appetite control easier, at least for me. YMMV. I believe this is because insulin is more level throughout the day.
You could do a little experiment: set up an alarm to wake you up 15-30 times every hour while you try to sleep. That is what moderate sleep apnea does to you. Try this for, say, a year. See what happens to your overall health and your weight in particular. Don't forget to "eat less or move more".
I am one of those that stayed skinny as a rake throughout my childhood and mid-adulthood (in my mid-40s I'm starting to become more normal sized). I wasn't particularly active, and I ate voraciously -- third or fourth helpings of pasta bowls. But the food never stuck to my ribs. (And it wasn't a worm or anything -- the whole side of my mother's family is the same, while my dad's side is the opposite.)
No one should look at my body and say "clearly he is exercising more than he is eating" because it wouldn't have been true at all, and yet that's what the simplistic energy-in and energy-out conclusion would say.
If calories-in/calories-out didn't work, then it would be impossible to starve to death.
Where people get confused is that the number of calories changes as your metabolism speeds up or slows down.
If you are ingesting fewer calories than your body requires, you will lose some combination of fat and muscle. There is no possible way for this to be false.
Further, you could be burning more calories without doing more exercise or otherwise doing anything "useful" with the energy -- i.e. having a higher basal metabolic rate. These calories can be burned doing all sorts of things that the person has no control over: you could have a higher core body temperature, you could be spending more energy on cellular repair and other cellular processes, you could be synthesizing more hormones, you could be spending more energy metabolizing foods, etc etc.
These latter causes are obviously on the "energy out" side of the equation, but they do not relate to things under our control. Further, they can change with age, stress, and (relevant to TFA) sleep.
So a body that has been coasting by eating 2200 calories per day and never gaining a pound could suddenly change and start putting on weight, even though the person's diet and activities haven't changed.
The point is that two people could eat the exact same calories, and do the exact same exercise, and one of them go up in weight and the other go down. The "calories in vs calories out" idea usually simplistically makes people think this couldn't be true, because "calories out" is simplistically taken as "exercise."
The reason I shared my story is that so many people just quote "calories in vs calories out" as if both sides of the equation were perfectly under control, and those people are also often like me: they find it easy to keep the pounds off (because of a high metabolic rate) and so they look down on people who have trouble shedding weight and figure that those people could live just like them. But those heavier people could well be eating less and doing more exercise than them.
Is the flip-side really debated that much tho? I feel like when people talk about CICO they're primarily talking about reducing CI to lower than your CO. No?
The complexity in CICO of course is measuring your CO. Ie you could estimate your CO, reduce your CI to what you believe your CO is - and still not lose weight. But does that undermine CICO? Because as the other commenters mentioned, it's "impossible" for you to burn more than you take in without losing mass, so our issue in this example is incorrectly asserting the output (assuming of course we're not also underestimating the input).
Note my questions here are generally questions. I am not an expert here, so please correct me if i'm wrong.
> The reason I shared my story is that so many people just quote "calories in vs calories out" as if both sides of the equation were perfectly under control, and those people are also often like me: they find it easy to keep the pounds off (because of a high metabolic rate) and so they look down on people who have trouble shedding weight and figure that those people could live just like them. But those heavier people could well be eating less and doing more exercise than them.
Fwiw, i don't dispute that some people have the wrong ideas with CICO. Perhaps frequently even. But i thought it still stood as a foundational truth nonetheless; that you have to "simply" burn more than you take in. If you gain weight (ignoring water weight for simplicity), then you have ate more then you burned, always.
My takeaway with CICO is that the hardest question seems to be correctly figuring out how much you're burning. Which i feel like usually, especially for overweight people, it's much less than they think. You can't outrun a bad diet, as they say. Rarely do people actually want to exercise enough to truly compensate for the thing they want to eat. Hence why i like CICO, as to me it signals the only effective action is in restricting your CI, since increasing CO is so difficult.
If you have a 500cal deficit per day, you lose a pound of weight (fat) per week. It’s literally that simple.
There’s some auto regulation of caloric burn rate, but it’s not some impossible problem to solve.
I've manipulated my body weight a few times and the real world is vastly different from a simple model of CI/CO.
Also, if you’re trying to aim to a specific deficit, you should be calorie counting your food. If you got fatty dressing, you should be counting that. Even estimating is relatively easy once you do it for awhile. And if you don’t get it quite right, being a little off shouldn’t impact your overall average too much. It keeps you honest, which I think is by and large the main reason people don’t think they can lose weight: dishonest assessments of food consumption.
Week to week weight has extra fluctuations that make it difficult to tell what's going on, but after around 6 months of data it stabilizes, and has been consistent for any 6-month period over the last year and a half: I burn around 2200 - 2300 calories per day on average (way higher than the online estimator tools think I burn, 1600 - 1700).
Knowing this I've also been reliably able to control my weight up or down at the rate I want as long as I'm looking at it for over a month span - because as above, week to week there's too much fluctuation (fullness of stomach and bowels mostly).
A counter example to disprove this would be somebody gaining more weight in fat than the weight of fat needed to store energy from consumed food. Of course, this would have been broken pretty fundamental laws of nature and would have caused some kind of revolution in physics.
The idea that everyone is fat because we’re somehow more sinful (gluttonous, slothful) than in the past has repeatedly failed to resolve any problem except for the need for smug people to pat themselves on the back for using thermodynamics in a sentence.
That said, there is the point that calories ingested doesn't necessarily equal calories absorbed, and sleep apnea could indeed affect that. But if you're relying on that thin margin for the difference between staying at a healthy weight or not, that's a fragile state of affairs, and you could fix your diet more to be more comfortably on the right side of it.
(My own, unscientific, hypothesis: far too many people are indeed unknowingly relying on that. I think a ton of people cram in 3k calories a day while absorbing 2k because there's just too much mass for the body to process, and then when they do cut ingestion to 2k, that doesn't change absorption and that's why they don't lose weight. (Numbers here are approximate.) It's actually pretty amazing how little food the human body actually needs and how little mass 1500 calories is.)
Or how much, depending on what you’re eating. It would be physically impossible for me to eat 1500 calories of lettuce in a day (10kg worth) but it definitely aids in “feeling full” when added to a meal.
In that case you didn't change how much you ate or how many calories passed your lips, but you did change your CI by way of changing your sleep.
Is this a real example or a contrived edge case from a software dev? No clue. I'll let better minds decide that hah.
I saw this ironically during military basic training. Lots of exercise, but very little sleep. The body compensates by keeping blood sugar levels high. I was one of the many that actually gained weight during basic training. The eating routine of three solid meals eaten very quickly also was not healthy.
(for those asking what happened after 3.5 days, I basically started getting hysterical - literally just laughing at nothing - and when I was finally able to get to a bed, it took about 2 hours of staring at the ceiling before my body finally decided I was no longer under stress, and allowed me to fall asleep).
And that is moderate sleep apnea. Actually, apnea is worse because you wouldn't even be breathing normally while you are "asleep".
There are a few over-the-counter options that advertise themselves as just for snoring reduction - SnoreRX and ZQuiet are ones I've tried. I've found that wearing a BreatheRight-type strip along with one of these appliances works as well or better than the one I got from my dentist, and it's MUCH cheaper. I also take an anti-allergy nasal spray, as I have pretty bad allergies also interfere with sleep.
But I have nose blockage issues and use nasal strips nowadays, too. It prevents mouth breathing which is nice to prevent dry mouth in the middle of the night (which even a humidifier on my nightstand can't completely solve in my climate)
https://www.amazon.com/Rhinomed-Snoring-Solution-Reduction-C...
I don't understand why, but in my 30s, it's like my nostrils aren't big enough to get the airflow I need, especially when sleeping on my side where a pillow might compress one nostril.
Disclaimer: they are not very comfortable, but far more comfortable than a CPAP mask.
Sometimes just breathing hard through my nose starts to make my ears pressurize and threaten to pop
My grandfather looked into it because the surgery doesn’t last very long and he had it done multiple times.
I had something similar (ears permanently felt like they needed to be popped, for months). Was diagnosed with a deviated septum + allergic response causing my eustachian tubes to not regulate ear pressure properly. Flonase helped. But cluing in that it was partially due to an allergic response (deviated septum made my nasal passage narrow, allergies closed them all the way), I have found that Benadryl is extremely helpful with both nose breathing and preventing the issue with pressure in my ears. I only take it when I have difficultly nose breathing.
You're probably right it's allergy related. Nothing ever shows up on scratch tests though
I use a nasal steroid I just wish there was a permanent fix
But it clearly works in the best case scenario. And sometimes it's the only way I can even breathe well enough to fall asleep.
Now I can easily get up, even at hours that were previously unthinkable, and more often than not feel fully recharged.
I have no doubt that played a part in me being unhealthy - though by no means was it the sole reason.
As an aside, also getting on a dose of Semaglutide has been similarly life changing. The damn near elimination of "food noise" has been incredible.
I know there are a number of folks of the opinion that its somehow cheating. But for me I am left wondering "Is this just how normal people feel?".
It helps but the person losing weight still has to clean up their diet and start an exercise routine. There are still major changes they need to make to become successful. GLP-1 agonists help a lot of people make better decisions due to how they fight hunger. Less hunger means less chances to make bad choices when eating, and weight loss progress is a virtuous mental cycle where you keep doing what you’re doing because you see results.
None of that is cheating. There are still major changes one must make. Taking Ozempic but continuing to eat a trash-tier diet will yield little to no progress.
In addition to saying that its cheating, they will actively wish harm to the person by saying "just wait til you get X" where X is some side effect (real or imagined). Or just the "well once you stop taking it you'll just get fat again".
The most difficult part of losing weight for me personally is changing my routine and habits. Setting myself up with a kitchen that's ready to cook. Figuring out what kind of meals I'm happy to have on a weeknight that don't require a lot of cooking. Preparing parts of meals over an hour or two on the weekend to complete some of the more time consuming parts when I'm not so constrained on time. Learning to deal with the urge I (used to) have to "eat my feelings".
All of those things don't just magically go away when you stop taking a GLP-1 agonist. Losing a lot of weight isn't just about self-control like if you're just trying to lose five pounds to make your pants more comfortable for going to your 20th high school reunion; you have to rewire your habits and mind and make a life long commitment to those changes.
Rewiring your habits and rewiring your brain are things that persist if your intention going into the weight loss was to change your habits instead of just moving the number on the scale. If you are looking to do it only temporarily and are unwilling to lock in those behavioral changes then you're likely going to fail, and that has much more to do with mindset than medication.
https://glp1.guide/content/do-people-regain-all-the-weight-l...
Now, we need price to go down and availability to go up, but people who think all the weight bounces back as a sort of "gotcha" are silly. It's possible, but is a testament to the difficulty of dealing with obesity -- not some sort of gotcha of the drug.
>. I know there are a number of folks of the opinion that its somehow cheating. But for me I am left wondering "Is this just how normal people feel?".
Heavily under-weighting (heh) the opinions of people on the internet (and honestly most people in real life) is the way to go.
We generally don't (and shouldn't) ridicule people for taking scientifically proven treatments that can help save/prolong their lives.
Paid for a sleep study and the doctor walked in the room and said, "You don't have sleep apnea." I was like, " I knew that, but what can I do?" The doctor shrugged and said, "You have hypopnea. You could try a mouthguard...?" trailed off and left.
So, with this newfound wisdom I was back at square one.
Some things that dramatically helped me in recovering from years of sleep loss: - A chinstrap. - I found a study (n=1, literally) about a patient who didn't fit the typical sleep apnea profile as a thin older man. The doctors treating him wondered if it was "positional sleep apnea" and had him get a chinstrap. This held his mouth shut while sleeping and prevented his tongue from falling back and blocking his airway. I found a chinstrap on Amazon and immediately started sleeping better.
- A blood test - My doctor knew that I was dealing with adrenal issues due to not sleeping, Lyme disease, and other issues, so he ordered a blood test. This was fantastic. For me, addressing my underlying magnesium and B-12 deficiency made an enormous difference in sleep quality. I found that taking my B-12 right before bed helped my sleep be so much more restorative.
- Andrew Huberman - Andrew Huberman's podcast Huberman Labs is old news, now, but when I found him a few years ago, it was some of the more actionable advice I had ever gotten about sleep, falling asleep, and circadian rhythm.
Anyway, there were more things across the way, but these are some things I shared with others that they also found helpful. I now am in control of my sleep and feel decades younger. You can get there! It's worth experimenting and finding a doctor who is going to help you find your problem. The mental clarity, focus, and energy has definitely made up for all the the months of trying to find out what was wrong with me.
I hope you sleep well!
But, if you can breath through your nose well enough, I think some kind of mouth tape can work? I haven't tried the Hostage brand anti-snore tape, but maybe someone here has had experience with that.
If you really want the chinstrap that I got, I got this one: https://www.amazon.com/gp/product/B08DR16XGV/
Based on the pictures, it obviously pushes the jaw backwards. That obviously wouldn't work for you. I wear mine in such a way that it is helping my jaw close and stay shut. I agree that you don't want something pulling your lower jaw backwards.
Though I have this paranoia that mouth tape will increase my philtrum length, which I know is a vain worry. Another solution is one of those incline pillows - just a 20% gradient should allow me to back sleep, which I prefer.
Post-surgery I had my jaws wired shut and they had this chin strap that was like an ace bandage that around my head and chin. I could replicate that with one of those mouth guard combined with a chin strap, but I read somewhere that this would eventually pull the upper jaw down towards the airway as well (since maxillary plates are not fixed.)
It turns out that people with restless legs, which I’ve had since childhood, experience iron deficiency anemia with much higher blood iron content than the average population.[0]
My primary care didn’t consider this. A pulmonologist had no interest in checking this. An oral sleep doctor had no interest in checking this. I had people suggesting getting an implant to force my tongue to stick out when the issue was low iron.
Definitely get a sleep study (I’d recommend lab over home). I use a sleep tracker (cheap Garmin “smart” watch, but I’ve also tried an Apple Watch) as a reasonable proxy for REM and deep sleep. And if you think a practice is just trying to sell equipment, they probably are. Fortunately I found a good doctor from acquaintances that I would have never otherwise considered (not part of the local medical systems, though did take insurance).
Unfortunately, for many issues it’s not enough to trust the doctor. Do your own due diligence for your health.
0 - https://www.frontiersin.org/journals/neurology/articles/10.3...
My question is, basically, is having a non-anemic iron deficiency something that can be easily remedied by having low-dose over the counter vitamins, or is it something that requires a higher dose (to make up the difference in what you're missing) and so requires a doctor. And yet it sounds like this is difficult to diagnose.
The medical sites say a safe value is no more than 45 mg per day.
There are also low iron pills (or "gentle iron") that are 28 mg.
So not only are many over the counter pills potentially over the safe levels, but it still doesn't even really answer the question, which is whether the low-dose pills that are under the RDA effective in countering an iron deficiency.
Anyway. I think I'll ask my doctor at a once-every-several-years checkup.
[1] https://www.ncbi.nlm.nih.gov/books/NBK557376/#:~:text=The%20....
How is your B12? If you're a vegan or vegetarian and aren't taking those supplements then I would start taking them. It's always safe to take extra B12.
Unless your iron is at the upper end of the band it should be safe to take a low dose. But it won't do anything if you're not really deficient.
I find that sitting at a desk all day makes me tired. I just push past it and go for a run. Always works, and it guarantees me a good night's sleep.
Just remembered, if you walk a lot, like over 25k steps a day, or do a lot of exercise (squats?) that can also cause restless legs.
Also, your diet? Most people are getting more than enough carbs these days, but are you on some weird diet?
Unfortunately, I just had it tested last week but had given power red a few weeks prior and came in below even the normal range (20ng/mL).
I did all of the normal things and got regular exercise. I finally went to a specialist, and got an at home sleep study which found moderate apnea (on the low side of moderate). I spent several months using a CPAP and bought a sleep tracking watch. Nothing improved and I was still tired. The pulmonologist suggested one of my medications affected REM. I was able to stop taking it without any significant issue and my REM improved, but I was still tired. I asked them for an in lab study and did that and it found the same as the home study.
I had convinced myself I had narcolepsy or some similar neurological issue.
My wife’s friend coincidentally mentioned he had sleep issues and they had found a sleep doctor they liked. He was the first to ask about restless legs and have any blood work done. He confirmed that I have apnea, but thought trying an iron supplement might help based on recent studies and my iron levels.
The iron helped almost immediately. Within a week I didn’t need to take a nap, which I had done daily for at least two years. I still use the CPAP because apnea can cause heart issues long term, but don’t “feel” like it does anything in the short term.
Usually, the most common thing is the most likely, but when it’s not, it can be really hard to find someone who both believes you and can do something about it. When I was exhausted all of the time, finding that person was even more challenging.
You raise an interesting situation here though because I've also had restless leg forever and my iron tests came back normal. Still, I'm not sure how safe it is to take iron supplements under "normal" conditions.
EDIT: this is just one source, but it doesn't sound like a great idea to be taking iron supplements with normal iron levels, at least not on your own: https://ods.od.nih.gov/factsheets/Iron-Consumer/#h11
I need to have my iron levels checked semi regularly. I would imagine any doc suggesting iron supplements would suggest the same.
For most nutrients there is quite a large area between what the body needs and when it starts to become a problem.
And while you can over a long time accumulate by not only only consume more then you need but also more then your body can disperse it's not really an issue either. Doing semi regular tests in case of knowing you have some nutrition issues is pretty common and stuff like fasting once a year can help you body to flush out accumulations.
And again for a lot of supplement choices people will often not run into this issue at all anyway.
I have seen a lot of people which live quality increased by taking supplements (including non water soluble ones) but yet have to see a single case of overdosing on supplements in my environment.
It took 2 doctor changes and a lot of goggling to realise that her menorrhagia had a cause, but that she's need scans to prove she might have uterine fibroids. It took 2 procedures to correct them. Once all that was done and she got iron + B12 injections, and got her life back.
On a forum she talked to other women who were left to deal with fibroids for up to a decade because their doctors would just sigh and say, "Yes, women's problems. This is normal. Go on the pill". Unfortunately the fibroids grow so large that there is sometimes no option but a full hysterectomy. This is a common story.
I completely agree, you need to do your own due diligence these days.
This type of mistake infuriates me to no end because there’s no reason it should happen. I was recently looking at blood tests from years back to figure out my usual resting glucose levels (just got a GCM) and stumbled on my testosterone results.
I was in the green, so my doctor (and nurse practitioner) didn’t notice a problem but I had the testosterone levels of a 50 or 60 year old in my late 20s. Since the acceptable range wasn’t adjusted for age by the Quest report, the range is ridiculously huge.
My doctor sent me to do sleep apnea tests and blood work, but turns out I was vitamin B12 and B9 anemic AND seems like I have mild sleep apnea as well (I have more tests booked). But taking vitamin supplements cured most of my symptoms in less than a week. I had horrible headaches for the first couple of days of supplements though.
I got a sleep study about a decade ago, having to go in first for diagnosis and then to evaluate the right settings. Even with insurance it cost about $2000 after all was said and done due to limited coverage and out of pocket fees. THen add the ongoing $35/month copay for renting the CPAP machine (they did not offer to sell it) and limited fee for having someone deliver it, which was a scam of an 'in-home medical visit' to set it up by handing me a box and saying where to plug in the hoses.
Meanwhile, the same machine sold for $400 online, wouldn't have required me to spend overnights in a lab or go through doctor visits every couple months for continued 'check-ups' where they read the card data to make sure I'm still using the machine to justify insurance coverage of everything beyond the $35/month fee. With automatic settings (now standard on machines, perhaps not at the time) or simply using materials online to do a few nights trial and error to figure out correct settings.
I felt like I (and my insurance carrier) was getting scammed at every point along the line. But the doctors claimed these were the hoops I had to go through to get tested and treated.
Hopefully it's a lot better today, but.. I doubt it. The CPAP did work when I finally got it, though.
If your partner notices you snore or stop breathing when sleeping.
You can record yourself also. You wake with a headache and dry mouth almost daily.
My wishlist:
1. Every CPAP device should be BiLevel.
2. All data they record should be accessible to the user (for tools like oscar).
3. Either more granular pressure controls, or better algorithms (or both). Some people do well on CPAP, others do better when iPAP > ePAP (BiLevel, or EPR), while others do better when ePAP > iPAP (vcom).
4. Better masks. Seriously. It's so hard to find a good mask, and so expensive to experiment with them. A new mask can set you back €150, and if turns you hate it, you're shit out of luck. I've toyed with the idea of personalized 3D printed masks to get a better seal for each unique nose/face shape.
5. Quieter machines. Without the Philips cancer foam.
6. Quieter masks. Some have excellent diffusers in the exhalation port (P10), while others blast out a concentrated jet of air that will wake you up when it hits the pillow, or will lead to divorce faster than your snoring ever did when it hits your bedpartner.
7. Bring back travel cpap devices. The market collapsed post covid. I'd love to keep a small device and super lightweight mask/hose in my bag for sleepover emergencies. I'd pay any price for that, because having to lug a full size cpap around ruins any chance of spontaneity in my bachelor sex life.
None of these are rocket science. But Philips Respironics are a bunch of evil cunts, ResMed are goofing off, and the other brands might as well not exist.
I don't even understand why purchasing a CPAP machine requires a prescription. I'm scared of the possibility of a doctor denying me a new CPAP machine when the current one inevitably croaks. The device is a glorified fan, for goodness sake.
Masks straps could probably be fitted with an accelerometer to detect positioning. If they can make heated tubing, this isn't such a stretch. Might also be useful in correctly flagging events: my machine often incorrectly marks position switches as periods of hypopnea.
Glad some people were able to find the good ones that did
We recently all had the flu, 2 nights of the baby having a fever and both of us being sick and also having a fever was one of the most testing things in my life.
But it’s not a contest.
Also, I know saying this now doesn't help, because at the moment you are in one of the most "intense" periods of their development where they need all of your attention but give relatively little back - but that will improve. They will eventually sleep better and they will start telling you how much they love you and kiss you goodnight - and then all of those early months are forgotten :-)
How parents in the US do it when maternity is only 12 weeks unpaid... I have no idea!
I left that company the same day. We lived VERY lean for a year or so while I figured out a new direction. Thank Christ for a supportive family.
How old is/are your kid/s now if you don't mind me asking? And did you have another one after the terrible sleeper? I only ask because we're now in that phase of trying to decide whether having another one is what we want.
And nope, I'm very much against having another one, exactly because the first one was such a bad sleeper, every time I start thinking whether to have another child I remember sitting on the floor and literally crying because I was so exhausted and he just wouldn't sleep, or doing something and just knowing that he will wake up in an hour and there is nothing I can do to prevent that. It was absolutely awful and I don't want to take that risk again.
Having said that......he is an absolute angel now. Very bright, very cuddly, loves to play and hug and definitely reciprocates all the love we give him. So I do sometimes think "wouldn't it be great to have another" - and then I remember again.
> I remember sitting on the floor and literally crying
I feel this, and it's still like that for me sometimes. Last night I shouted "Just go to sleep!" at him, I got so frustrated and upset because he kept taking his own dummy out of his mouth and waking himself up. I'm really hoping that once he starts either crawling or walking he'll burn off that energy and sleep better.
Answer B: Work harder on the days you have energy.
It's a great strategy for survival. We did this a lot with our second child and still so sometimes if there is a patch of disrupted sleep.
The person with the child is not getting zero sleep. A small baby can't stay awake for an entire night. So you could get two or three hours in small batches.
You are exhausted the next day, but at least you have the following night to recover.
If you have a full time job you just do your job. You are really tired and not operating at 100℅ but you get through and it is better than having 2 or 3 hours broken sleep every night.
Our oldest child wouldn't sleep until we got him not only out of the bed but the bassinet all the way out of the room.
Our second child slept like a baby pretty much whenever.
Our third did fine in the bassinet, but now that she's older and transferred to the nursery she wakes up if even the slightest bit of light comes in through her door.
Kids are wildly different from one another from a very young age. I wouldn't assume that your cosleeping is the cause of your having fewer sleep troubles. If anything it might be the reverse.
But yes, in hindsight I would probably try some form of co-sleeping, even though everyone around us was advising against it(too much of a risk).
It turns out that co-sleeping is a risky thing if you are on drugs or are drunk.
If you are 100% sober, then it's perfectly fine. If you are high, or have had a drink, or are on some sort of flu medication (NyQuil, then the risks start ratcheting up.
So, since we're most worried about the parents that do drugs and drink around their infants, the common advice is to no co-sleep. It makes sense, I totally agree with that tack, but if you are willing to be 100% sober of all drugs and alcohol, then try co-sleeping and see how it goes.
Finally realized that I was going to fall asleep somewhere and did the same research. Co-sleeping sober ( and with a healthy BMI ) is safe and often better than sleeping somewhere else. We don't all have the money and space for cutesy recliners.
Second child did like to sleep in the bed and still does, though now we are trying to break the habit.
Each child is different and even one child can change a lot through different developmental stages.
Omg same, but for more than 2 years, because I'm a breastfeeding mom. Idk how this is healthy or normal!
Or is it about ensuring that mom and dad don't make a sibling that takes away the baby's resources?
Having run the same gamut three times, the best advice I ever got was: chunk sleep. Let the wife sleep for 4 straight hours, and then tag out, where the awake person sleeps if/when they can. I know nursing can gum this up, but either pumping, or just doing the formula thing, it's worth it.
It did! But we, in our infinite wisdom, got selfish and we now live alone. Fight nature and she fights back!
Somebody invented the crib, got rich at our expense, and now people can't imagine life any other way.
"It's very safe to sleep with your baby unless you sleep with your baby drunk or on a small couch", and
"It's very dangerous to sleep with your baby especially if you sleep with your baby drunk or on a small couch"
That last bit is right and a study found "The risk associated with being found in the parental bed was not significant for older infants (>14 weeks) or for infants of parents who did not smoke and became non-significant after adjustment for recent maternal alcohol consumption..."
See
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC28288/
Anyone who has shared a bed with a cat or small dog would note that you never roll over and crush it.
And the tradeoff makes sense -- as a parent, you are biologically programmed to go through great lengths to keep your children safe.
You mean Socially programmed.
Instincts are biological programming.
Parent under drugs/medications (including smoking) is mainly what drove the death statistics in cosleeping.
Don't have links to studies but is what is teached in official parental education courses in spain atm.
We co-slept for the first 2-3 months, then had baby in a "next-to-me" for a few months, then moved baby to a crib in his own room at 6.5 months. Prior to being in their own room, the baby would usually wake up every 2-4 hours, with the very occasional 6-7 hour stretch. After going in his own room, his sleep began to consolidate and he would regularly last from 7-8pm to 4am without needing resettling.
We have friends with a 4 year old daughter who co-slept until now and have just moved her to her own room. She wakes up screaming and needing attention most nights around midnight.
/father of a 14 and 12 year old boys
"If you are going to have kids and run a company, you all need to sleep." and then he introdued me to a sleep trainer/coach.
"No way, we are not sleep training" was my thought, but I quickly realized that there is a difference between sleep normalization and what we know as sleep training.
The sleep coach gave us a completely customized regime for 2 weeks. Once the baby is 6 months or so, you can start. (up until 6 months, I just slept with the kids in my arms every night. Oh my god I miss those nights now. It makes me cry to think about how wonderful it felt.)
We've done it 4 times now and all our children gladly sleep from 7pm to 6:30am every single night. (The older ones now go to sleep more like 9pm). Everyone in the house is rested every day and it makes a big difference. Those two weeks are a lot of work for one of the parents (it is specified that one person should be focused on it) but in our experience it works by the 3rd night or so.
The main takeaway from the aproach is to disassociate eating and interaction from the act of sleeping. It created buffers between feeding times and play times and when you finally put them down in their crib to sleep. If they do wake up during the night they don't think "oh, if I cry I will get to eat right away." and they self-soothe and go back to sleep. If they do wake up hungry, it's a failure of the parent to have ensured they've eaten properly. You adjust as they grow. (A hungry cry is totally different from a discomfort or bored cry. You learn them pretty quickly.)
When I put my 10 month old in his crib to sleep now he looks back at me briefly and then turns over and gets in his sleeping position and he's asleep before I leave the room. It's such a relief knowing that no matter how badly a day goes, you can sleep that night.
I've had a lot of friends think this isn't for them, but 100% of the ones I have convinced to do it (and in some cases have just paid for) have been successful.
I'll also add that 2 of our kids were "colicky" and were very unfcomfortable during the day for their first year. Even still we were able to have them sleeping the entire night most nights after 6 months.
Again, there is no "cry it out". In fact, the baby almost never cries at all in this process in my experience.
This kinda matches what I’ve read recently in a parenting book.
I’m currently reading Bringing Up Bébé, a book written by an American journalist who lived (maybe still lives?) in Paris and had her kids there. She wrote it after she started observing that French parents don’t seem to have the myriad of exhausting issues American parents have, or at least not with the same intensity and for the same duration.
When it comes to sleep, she writes that most French babies sleep through the night by the time they’re 6 months old.
According to her, what a lot of American parents (and from my experience as an expat, parents from several other countries too) do wrong is to immediately tend to the baby the moment they make any noise at night, in the first months few of their lives (this apparently doesn’t apply to the very first month though). That trains the baby to do exactly what you wrote, to get what they want as soon as they wake up in the middle of the night.
According to the author, French parents typically wait a few minutes whenever the baby wakes up at night. Most of the time the baby goes back to sleep.
The explanation she offers is that babies’ brains don’t know how to link one sleep cycle to the next, so they wake up between cycles and typically cry or fuss for a bit. By leaving them alone for a few minutes instead of instantly reacting, parents can help their brains learn to connect sleep cycles more efficiently. If they’re immediately picked up though, they’re actually being trained to do the exact opposite and to stay awake instead.
I really like your post btw, going to look up what you wrote about as it sounds invaluable in case the French method doesn’t work :)
It was living hell for me- my son wouldn't sleep during the night for more than 10-20m at a time, and my partner was having severe postpartum mental health issues (psychosis/rage/depression) so I was parenting solo, and up all night every night by myself with a crying baby. I eventually started hallucinating, and had a short temper and made very poor decisions. I couldn't get advice, help, or sympathy from anyone- usually something along the lines of "parenting is so easy for dads, why are you complaining?" Visiting family would expect me to serve meals to them, and not help either.
I almost lost my job also because I couldn't focus or code anymore. Once I started sleeping in a separate room from my son, I could finally think/code/work again. Understanding in the workplace for a struggling new dad was non-existant: everyone assumed the mother was doing all of the work, and I would perform like normal.
If anyone is reading this and can relate, don't do what I did- pay for help. Pay for a nanny- take out a loan if you have to. If you or your partner is struggling, get them professional mental health support. Prioritize your sleep, bodily, and mental health needs: you need to "put the mask on yourself first" or you can't help anyone else. Don't be afraid to set a crying baby in a safe crib and go sleep for a while if you need it.
Recently I tracked this down to indoor air quality, installed an ERV (basically, introduces fresh outside air into the house) and I feel much better.
There's a lot of talk about (obesity related etc) sleep apnea that's due to how the person breathes, it seems to me that there's a version of it related to WHAT you breathe.
Granted I think I am more sensitive to indoor air quality than an average person or maybe just more aware of the effect, but this seems to have been a game changer in a way.
Before you go too far that route (a multi-thousand dollar install) I recommend getting an indoor air quality meter to get a sense of what might be the problem. I recommend the Airthings View Plus, which is about $300 but is comprehensive and reliable and since (in my case) I made a multi-thousand dollar decision based on it, it was worth the investment.
In my house it was obvious there's a massive CO2 buildup, CO2 itself isn't as big a deal itself but an indicator of stale air (ie, it's not being vented out by itself) and somewhat elevated radon. The ERV isn't the "prescribed" solution for radon but since it ends up venting it out it's fine.
One last thing - for me, the connection between energy and indoor air quality was obvious in retrospect. I could wake up early and be miserable, but once I stepped outside to take my son to school I'd feel better. Or vice versa - I could be full of energy running around all day, then come home and immediately get drowsy.
It only took about 15 years to realize indoor air was the cause.
These are actually two subtly different things. ERV (what I am talking about) recovers some of the moisture content along with heat, while an HRV (heat recovery ventilator and probably what you're talking about) does the heat but not the moisture. Depending on where you live this matters or doesn't matter (eg, if your winters are really dry and/or your summers are really humid, you want the ENERGY recovery ventilator to keep the house humidity closer to what you want vs equalizing with the outside.
// We're looking at putting it in, but have a fairly poorly insulated house, so it's not clear if the heat recovery is worthwhile
This doesn't make sense to me at all. First, if your house is "leaky" then why do you need mechanical ventilation at all, versus just relying on the natural air exchange (I can think of a valid reason but just curious how you think about it.) Second, if you DO put it in, your house is obviously better conditioned inside compared to outside so why wouldn't you want to recover that heat, at least for comfort if not economy?
// There is also PIV (positive input ventillation), which blows fresh air into a property (normally the hallways)
Yut but I think your hallway is then going to be as cold as the outside in the winter?
It really gave me a fear of situations that might involve sleep deprivation - one reason among many I never thought I could handle medical school for instance.
Since I hit about 36, I've found that a poor night of sleep, such as from a red-eye flight, will wreck me for about 2 days.
In college you can bounce back after an all nighter not just because you're younger but also because it's an opt-in single event and you can opt out of the next one when you recognize that you're sleep deprived. You can also do what my brother does and regularly sleep in till 10 to make up for the late nights.
Once you have kids there's no opt out mechanism, and sleeping in isn't an option any more. There's not really an opportunity to bounce back from the sleep loss, even for a younger adult.
It's made such a huge difference. After years of having a blocked nose I sometimes just take a moment to enjoy the fact I can breathe through my nose at last. I've also gone from being a snorer to a "very quiet sleeper" according to my girlfriend.
I've also found that there's a lag on recovering from sleep deprivation, where the first night of good sleep often leaves me feeling foggy and lethargic the next day. After 2 or 3, that energy and positivity returns - not sure if that's idiosyncratic or not.
I wasn’t really here. I tripped and fell down so many times. I had not fallen down since I was in my teens and I am in my late 30’s.
I really had no idea how bad lack of sleep was going to mess me up. Of the things I had planned for in having a child, I was absolutely not prepared for this.
Well known self-reinforcing mechanism, sadly :/ https://en.wikipedia.org/wiki/Cycle_of_poverty
Same with sleep surely, where bad sleep leads to worse sleep...
A lot of the benefit of WFH is just undoing the damage of open office.
Not long ago Google was famous for having nap rooms (supposedly -- I never found it at the NYC office when I worked there in the mid teens).
But in the days of private offices, this was just normal.
Couches were always reserved for managerial class, since the 80s.
The way to sleep effectively and be most alert is to sleep when your body tells you to not when society tells you to.
Through my 20s it wasn't an issue, but I stopped gyming a few years back and it has been hard if I lose any sleep.
I started working out again and I am back to 6.5 hrs a night, no problem.
Some nights are still horrible though, and it's a hard loop to exit when you lie there at 03:43 in the morning and panicking about getting too little hours this night...
There was a point where even other people worried about me sleeping, and that made me worry about my sleep.
Eventually I decided I would go to bed when I was tired and see how it went. Been doing that half my life now. I go to bed when I'm tired (about 12-1am) and I usually wake up at 7AM feeling fine.
Forcing a whole 8 hours often makes me feel worse. YMMV
As for lifestyle changes, I'm not an expert in sleep science, but I've tried to read some of the literature to understand what works, since I struggle with sleep quality. As far as I can tell, a lot of the specific suggestions that often get thrown around (even by otherwise reputable sources, sadly) are somewhere between speculative and pseudoscience. There is some evidence that "sleep hygiene" interventions as a whole might have some kind of effect, but the individual components aren't typically tested, the studies usually aren't adequately controlled, and the effect is often exaggerated (e.g. by highlighting questionable measures like "sleep efficiency").
CBT-I has better evidence, although it's also not entirely clear which components are really worth the trouble (the evidence for sleep restriction seems pretty strong; the "CBT" elements less so, but it may be that they help different subpopulations), and clinicians who actually have experience delivering CBT-I are not readily available in many places.
It has helped me tremendously (together with other tooling like sport and meditation).
I'm not sure a smartwatch could do anything with my chronic diagnosis of "Having a toddler kicking my ribs at night."
Cutting those out would turn a hell of a lot of “night owls” or people who “can’t sleep” into people who sleep on a normal schedule just fine.
It’s obvious when you consider what all that stuff really means. Obviously it’s hard to sleep when you spend your hours after sunset in hundreds-of-candle-power lighting and have hyper-stimulation of a hundred kinds available at the press of a button.
Of course there’s also apnea and kids and such, but that’s a large proportion of the problem, overall.
> Subjective age was assessed using a single-item question: ‘On some days you may feel older or younger than your calendar age. What age do you feel right now?
When I do it this way, vs setting alarms, I'm always surprised by the sleep debt I've accrued and am now paying back.
Modern (especially urban) society demands a lot more of us than many of our bodies can sustain.
> Psychologists in Sweden found that, on average, volunteers felt more than four years older when they were restricted to only four hours of sleep for two consecutive nights, with some claiming the sleepiness made them feel decades older.
The average was four years older, with some people claiming they felt "decades" older. This should be enough to tell you how useless this methodology is. People cannot reliably estimate how much "older" they feel because it's their subjective interpretation of an experience they don't have. By definition they don't know what being 4 years older feels like.
You might as well ask them whether sleep deprivation made them feel like they'd been waterboarded for 4 hours or 4 days.
I tried Uberman a few times but I seem quite nap resistant... I only ever have those catastrophic 5 hour naps, which isn't very helpful here.
I'd spend the first few days of adaptation completely sleep deprived, then finally pass out and sleep through all the alarms.
Steve Pavlina wrote about his experiences with Uberman. Says the most useful thing he got out of it was that now (back to normal sleep) he can instantly nap anytime he wants to.
Also related and fascinating: N24, zeitgebers, etc.
We're working on improving the efficiency of deep sleep (https://affectablesleep.com, https://affectablesleep.com/science).
When I DO go back to bed after waking up like this and manage to actually sleep until 8-9am I feel more drained and tired by far. I did that last night/this morning and I am way more tired than I've been all week getting up as soon as I wake up.
I don't really go to bed late, 10-11 probably. My doc complains all the time that I'm not sleeping enough but that's why.
I’ve been discussing my issue with (for lack of a better term) chronic fatigue. He suspects it might be an issue with my sleep, but
- I fall asleep really quickly - no obvious signs of apnea - I wake up feeling pretty good
My issue is that by 10:30am I’m dragging.
I've just become accustomed to being in a semi-groggy state much of the time. I know it's not ideal, but I'm just not gifted with being a good sleeper. Conversely, my wife can sleep 10 hours in a row if given the opportunity.
In the rare situation where I get 6 to 7 hours of unbroken sleep, I feel fantastic.
Edited for clarity