Sleep regularity is a stronger predictor of mortality risk than sleep duration (2023) | Hacker News Reader

Sleep regularity is a stronger predictor of mortality risk than sleep duration (2023)

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759 pointsbilsbie410 comments

Magnesium supplementation solved my sleep issues.

I have seen many doctors, including sleep specialists, regarding insomnia. They all pointed to one source as the reason for the sleep issues: stress. And they all wanted to put me on prescription sleeping pills. I said no to that. Sleeping pills can cause dependence, and they often treat the symptom rather than the underlying cause. As a software developer, I am used to finding and fixing the underlying problem instead of relying on the quick fixes these doctors were offering me.

After much research, I figured out what I believe was the underlying problem, and the fix for it. The underlying problem was magnesium deficiency. As a software developer, I spend much of the day doing mentally demanding work. This is the kind of stress the doctors were talking about. Stress can increase the body's demand for magnesium and may contribute to low magnesium levels.

The cells in our body depend on minerals such as calcium and magnesium for normal function. In muscle and nerve cells, calcium helps switch the cell into an active state, while magnesium helps keep that activation under control and supports the return to a resting state. When you are low on magnesium, your muscles may remain tense and your nervous system may have a harder time settling down. That can contribute to muscle stiffness and difficulty sleeping.

The solution, in my case, was magnesium supplements. They fixed my muscle stiffness issues and my sleep issues. A special form of magnesium called magnesium L-threonate may be especially helpful for the brain because it appears to raise brain magnesium levels more effectively than some other forms.

Magnesium is a great supplement in general. You can definitely have too much in your system and that is undesirable, but a bit before bed time along with 1-3mcg of melatonin work well for me. It is nice after workouts. I use magnesium glycinate in powder form, which is more bioavailable than some forms as well.

I also find sauna before bed is good. I have a bed chiller so I can crank up the sauna before bed and not sweat a lot. Generally if I sauna and take the aforementioned supplements I sleep well. Exercise also seems to help me out a lot. If I exercise during the day, and a 4-5 times that week in general, I tend to sleep well.

Your report matches my experience as well!

Funny how it's basically do all the things you're supposed to do - exercise, diet, stress management - then sleep is then easier.

Mg or melatonin have 0 effects on me, Mg helps if I over-exercise but thats for muscles regeneration.

I dont have problems normally, just cant sleep in high altitude, 3000m is already showing mild effects. Guess what, I do/did quite a bit of mountaineering, its easy to get above 5000m in himalayas, highest I've been in tent attempting to sleep before summit push was 6000m on Aconcagua. Tried both Mg and melatonin up there over multiple nights, 0 improvements. I had highest O2 blood level measured in 5500m by doctor (mandatory there) from whole group.

Physical effort makes better sleep for literally everybody, thats age old knowledge and I havent met a single exception yet.

> Mg or melatonin have 0 effects on me

> I dont have problems normally

A lot of things don't have effects on people that don't have the problems the thing is trying to solve.

I meant during higher altitude adventures, as rest of my post explains in detail. Did you get to that part?

I wonder if that is an adaptation time problem? It takes about a month for the body to fully adjust. I live at 1500m elevation in the Denver area of Colorado, but I do recall feeling more restless during sleep at elevation before I lived here.

Sauna and then a lukewarm shower to cool down is also great.

> Sleeping pills can cause dependence, and they often treat the symptom rather than the underlying cause.

I found gwern's take on Melatonin interesting: https://gwern.net/melatonin

A small excerpt:

> One might object that they do not wish to tamper with their natural sleep, even if melatonin is a normally-secreted hormone.

> Sad to say, I would point out to such readers that they are already profoundly tampering with their natural sleep cycle, and indeed, all of Western civilization is tampering with it; most of my readers do not even sleep multiple times during the day, as ‘Nature intends’ and as humans have usually slept through history, but rather in a single 7–9 hour long block.

> [...]

> Finally, there are multiple lines of research suggesting chronic sleep deprivation is prevalent among young adults (including historical comparisons). It is striking that unemployed adults sleep a full hour longer than the employed , and that when normal adults are placed in settings without artificial light like camping or without any time indicators, they sleep longer than before - exactly as if they were sleep deprived.

The problem with that take is that the evidence for melatonin is quite poor outside of jet-lag and certain more serious sleep disorders, and there can be unexpected effects elsewhere in the body when supplementing hormones, e.g. increased rates of depression for melatonin in particular.

This. And maybe anecdotal, but my experience of people who have used melatonin is that they sleep very deeply, but for a shorter amount of time. But likely they will wake up after around 6/7 hours sleep, rather than the recommended 8 hours of sleep. And once woken up, it's very hard to go back to sleep.

I specifically take a timed release melatonin, really improved my sleep. Otherwise I did have inconsistent sleep on regular melatonin.

>rather than the recommended 8 hours of sleep

for people getting 7 hours of sleep you're good. Improve your sleep hygiene, ok, but artificial interventions to get 8 may not be worth it for you.

7 is enough for a lot of adults. especially 7 hours of quality sleep. After seeing a sleep doctor I realized that stressing out about not getting exactly 8 hours each night was part of my problem! I did a lot of experimentation to find my optimal hours and it was not quite 8. Trying to force extra hours doesn't really work.

AFAIK 7-9 hours is the commonly used range, anything less than 7 hours or anything more than 9 can have detrimental effects on how well rested you feel after waking up. Where did you get the notion that adults need exactly 8 hours on the dot?

It really is variable. My number is closer to 9, so even nights I get my "good 8 hours" I still end up with a sleep deficit by the end of the week.

That's what my wife and I sleep for, 7 hours. 8 and we wake up with a headache.

yeah. that’s been my experience as well. my doctor gave me the impression that melatonin helps set the cycle but magnesium glycinate is what calms the body.

This. Melatonin is a hormone. You should always be extra careful when dealing with any kind of hormone as it might affect your own body's regulations.

I take melatonin to sleep on a redeye, but otherwise don't use it. I find the effect is similar to taking a weed edible to fall asleep— basically, my wearable registers a lengthy period of deep sleep but instead of waking up feeling refreshed and ready for action, I'm groggy and fog-headed for several hours, or dependent on coffee to reverse the lingering effects.

As someone who has never been a regular coffee consumer, I really didn't want to end up with the dual dependence of melatonin at night and then caffeine in the morning.

This thread is stimulating me to want to get my magnesium checked, but barring that I've found the most effective sleep interventions are the basic ones: get some exercise earlier in the day, and don't do screens for the last few hours before bed.

"and don't do screens for the last few hours before bed" because that will help you fall asleep more quickly? or because that will help you sleep later in the morning 6 or 7 hours later? People never seem to mention that key aspect.

For me most things I do on a screen are fairly mentally stimulating (like video games), and even the ones that aren't (like watching a movie) inhibit the feeling of sleepiness I get when I abstain. So, it's better for falling asleep quickly.

I believe it's much to do with blue light emitted by screens:

https://pmc.ncbi.nlm.nih.gov/articles/PMC9424753/

I had heard that that wasn't as much of an effect as some people think - https://www.bbc.com/future/article/20260407-the-blue-light-f...

or rather, that its less about blue light specifically, and more about activity and bright light in general - the times where we are active are shifted later, and a profound lack of exposure to bright light during the day is the issue. Even with the massive amount of screen time the average person gets in a day, that much light adds up to less than a single minute of the equivalent of sunlight.

Probably the best thing you can do is go outside as soon as you can from when you wake up, and stay outside as long as you can. Failing that, get some good BRIGHT sunlight lamps. way brighter than you think could possibly be necassary

This sounds like you may be taking a very high dose. What dose do you take?

This. Try with smaller doses starting from 0.1 mg (liquids are best for this) and work your way upwards to reach the optimal dosage. Tablets are often overdosed which leaves you drowsy in the morning.

The tablets in my OTC jar are 10mg, and they're pretty small already, not easily divisible, and certainly not to 1/100th of a dose as the sibling comment is suggesting. This is an interesting suggestion though, maybe I'll try just licking one some night and see if that has a noticeable positive effect sans the downsides.

Pretty much all the melatonin in physical stores is hilariously overdosed, yes. If you're in the U.S., you'll have to look for products from specialty supplement brands. I take a tiny 300mcg capsule.

The comment above just said “sleeping pills” which is ambiguous. Melatonin is an OTC supplement. True “sleeping pills” are usually controlled substances and few doctors would prescribe them as first-line options for a patient who shows up with first time complaints of sleep problems. They won’t be prescribed long-term either. The part of the post that says doctors (plural) tried to prescribe the pills makes me think it’s not traditional sleeping pills, because in this environment you would be unlikely to find one doctor willing to prescribe scheduled sleeping pills long term at all, let alone multiple doctors pushing them.

The usual suggestions from doctors for first line treatment are more mild medications that have drowsiness as a side effect, prescribed at low dose. I would actually prefer many of these low dose options over some of the high dose melatonin supplements. Melatonin is a hormone and taking it can throw off natural production

Lots of people take diphenhydramine products as sleeping pills and they are advertised as such OTC in the US. Long term Diphenhydramine use is associated with many negative health outcomes and despite the warning labels many people become dependent on them.

Yes - I saw a very interesting video the other day that educated me a lot on Benadryl - apparently it has a lot of side effects, can cause dementia, and is probably best avoided.

Occasional Benadryl is fine. The dementia risk is from correlations found in other medicines that share some of the same properties, when taken for many years.

It’s not a good idea to take Benadryl for many years, but occasional use or even for months while going through a difficult period isn’t going to cause dementia.

The dementia risk is from disrupting the circadian rhythm and suppressing the REM phases.

The parent post was talking about doctor prescribed medications.

The reason diphenhydramine Is associated with a slight increase in dementia risk is the anticholinergic properties. This risk increase is from correlational studies on other medications with anticholinergic medicines being taken for many years by elderly people, so the risk of taking Benadryl occasionally is low to none.

The prescription alternatives like doxepin have the same antihistamine properties without the anticholinergic properties when used at the prescribed dose.

This is an example where people can get themselves into the wrong outcome by assuming anything their doctor prescribes is a last resort quick fix, but anything they can source by themself is safer and superior.

It's worth keeping in mind that melatonin is also prescription-only in many countries e.g. UK, Canada, Japan, Australia.

OTC in canada

My bad, apparently it's prescription-only for children in particular.

In Austria a lot of times as second line ( after melatonin etc ) quetiapine is prescribed for its off label effects.

> They won’t be prescribed long-term either.

Tramadol is routinely prescribed long term where I live. I know someone with a massive bottle good for something like 6 to 12 months of daily use. (I don't know if that's a good thing but it is certainly a thing.)

Tramadol is a pain medication, not a sleep medication.

It has opioid effects and can cause drowsiness but would never be prescribed for sleep.

It’s also typically a controlled substance. I don’t know where you live but I’d be surprised if anyone was handed a 12 month supply in a bottle.

There are a wild amount of countries where it’s not treated like the opioid that it is, for what it’s worth. Mostly not western ones, though.

You sure you don’t mean trazodone?

> True “sleeping pills” are usually controlled substances and few doctors would prescribe them as first-line options for a patient who shows up with first time complaints of sleep problems. They won’t be prescribed long-term either.

Modern orexin antagonist sleep medications are not addictive and can be taken long-term.

Trazodone is also not addictive and doesn't have bad side effects afaik.

Trazodone does little to improve objective sleep quality [0] when used off-label for treating insomnia. From my n=1 experience it it useful as an adjunct to an orexin antagonist in special cases when I stressed/annoyed out of my mind by work or something else, but not as a primary "sleeping pill".

[0] https://pubmed.ncbi.nlm.nih.gov/29680424/

This is a very important paragraph from quern's article

> There are few to no side-effects to melatonin use in adults (there is uncertainty about the risks & benefits in children & adolescents28), and it is not addictive or habit-forming like caffeine is. The usual dose for a night is 0.5-3 mg and I take 1.5mg [29]; my dose is highly likely to be too high. High doses may well be responsible for why some people try melatonin and report that it does nothing or hurts them, since in one study, the best dose for old people was 10x smaller (0.1mg or 0.3mg) and for one blind person, 0.5mg [30 31 32] . Zhdanova et al 1996 found 0.3mg & 1.0mg to affect sleep onset similarly. A study of delayed-release melatonin found with their high dose of 4mg (but not 0.4mg) elevated melatonin levels 10 hours after bedtime ( Gooneratne et al 2011) - potentially interfering with waking time.

It is difficult to find doses as small as 1mg sublingual (dissolve under the tongue) in my area. Everyone is trying to sell you 5-30mg chewables. And, I expect everyone is buying them under the assumption that more is better. But, here it explicitly is not.

The way melatonin works well for me is to wait until I'm already settled into bed and should be asleep, but I'm not. Do a couple body scans to relax for real. Try to think about something mindless. Then if I'm still awake, pop 1mg under my tongue. I'll usually wake in the morning with half of it drooled on my pillow :P

Natrol makes a 1mg gummy and Vitafusion has a peach flavored 1.5mg gummy (sold as “3mg” but the dose is “two gummies.” My kids use these. I get them on Amazon.

Bulletproof has 0.3mg capsules, but it's a pricier brand. On the other hand, I'm not sure which other brands actually have the dose they say they do.

Way too high in my experience. Can leave you croggy and dependent. Micro dosing using drops is more effective for me without feeling groggy in the morning. Anything above 1mg is way above the natural melatonin level of our body.

Interesting. Can you share any research tips that helped you arrive at that conclusion? I don't want to overdo it. Dosages in mainstream products are often even higher than the 1.5 so it's obviously easy to go way, way too high if what you're saying is true.

From your description it may be acting as a placebo -- the act of putting the pill into your mouth is what tells your subconscious to activate a sleep cycle.

Don’t jinx it

placebo works whether you believe or not and even if you know.

They are very powerful.

It’s less than if you don’t know though, right?

Placebos are actually very effective for improving sleep

If you call it a ritual instead of a placebo it suddenly sounds much more credible.

But a ritual sounds like something they practiced in the Middle Ages. Placebo sounds modern and scientific.

I've had the same problem finding low-dose melatonin in brick-and-mortar stores, but Natrol sells a 1mg dissolving tablet on Amazon. If I need a sleep aid, I break it in half for a ~0.5mg dose, chew it with my front teeth, then hold it under my tongue for a bit before swallowing what's left.

It usually takes 15-30 minutes before I get noticeably drowsy, but I feel no more groggy the next day than if I slept sober.

For low dose melatonin, try liquid melatonin. Around here Sprouts carries it, but you gotta look a bit to find it. The bottle says 30 drop equal 3mg. So you can take small doses easily, and it absorbs under your tongue pretty quickly.

Yes. I agree. Liquid melatonin is the way to go for micro dosing. I also have good experiences with micro doses of 0.1-0.2 mg when waking up too early and having difficulties of falling asleep again. Taking a full 1 mg leaves after 3 or 4 am you very croggy in the morning.

most bricke and mortar should have at least 1mg tablets, and you can break those in half. or break a 3mg into 3rds. not perfect but should work.

it's easy to find 0.3mg melatonin online.

It's a bit harder to find, but I've had a good experience with liquid melatonin. Each drop contains like 0.1mg, so it's easy to dial in the small dose that you need.

fyi, Whole Foods sells liquid melatonin. bottle says 30 drops contains 3mg so I only take a couple drops at night and it does the trick for me.

Long-term use of high dosage (5-10 mg) of melatonin gave me painful stiff neck and shoulders and muscle spasm.

Go get children's melatonin gummies and cut it in half. Problem solved.

It’s wild to me you’re able to shut your brain down that fast!

I agree with Gwern in that I think for the vast majority of people, short-term melatonin supplementation is useful and can cause little harm, and it is extremely safe as far as supplements go.

But I don't think it does anyone any favors to oversell the idea that it has "few" or "no" side effects -- it has mild side effects, most commonly reported in the literature are daytime fatigue, headaches and GI symptoms, and also nightmares. Mild doesn't mean it isn't a nonstarter for some people.

It's also important to remember that there are major gaps in what we know about melatonin; notably the effects of chronic supplementation are not well-studied, but earlier final awakening has been documented and this is quite commonly reported in anecdata -- I can contribute a datapoint there, as can most people in my circles who have used it.

To be clear, melatonin is great and useful, but as someone with a rare lifelong chronic sleep disorder who is intimately familiar with this substance, I think it's most useful when we're clear on what we know, what we don't know, and what actually are the limitations on a substance.

Just because downing a bottle of it probably won't cause systemic organ failure or otherwise any kind of medical emergency in most people doesn't mean there aren't tradeoffs to consider when using it, especially if you are sleep-challenged

The evidence that humans would naturally be designed to sleep “multiple times a day” is quite mixed. “Multiple” does a lot of heavy lifting here, when basically most evidence points to two batches, following either of these patterns:

- a long uninterrupted night cycle and a short (20-60 mins) afternoon nap. Around 2pm. - a night cycle split into two halves. With a 1-2h break (maybe up to 3h) starting around midnight to 2am.

The former is still very common, and imho stretching the definition of multiple cycles. The latter is more historical (more common when there are long winter nights and no electricity).

Also making it a “Western” problem is kinda weird? There are other cultures where single cycle sleep has existed. Even hunter-gatherer groups with little to no contact with the west. And alternatively afternoon naps are still quite common is some western areas. I guess the main thing that prevent it would be the classic work day schedule.

Doesn't multiple mean more than one?

An article exploring research and citations of "first sleep" and "second sleep"

https://www.patheos.com/blogs/geneveith/2013/08/first-sleep-...

Not sure why I would trust the opinions of this random person?

Everyone is different so I'm not suggesting this as a general cure-all, however I'd like to relate my own personal anecdotal experience.

I've always had insomnia since I was a kid and I just chalked it up to "being a night owl." As a teenager, I mostly solved this by living in a permanent fog during the week and "catching up" by sleeping in on the weekend. As an adult, I was suffering greatly from chronic sleep deprivation because adults (mostly) don't have much control over when they can wake up to start the day.

Around 10 years ago, I started taking 5mg melatonin. It's going to sound like I'm overselling it, but it changed my life. It _very reliably_ makes me sleepy 1-2 hours after I take it. If I forget to take it, I am fully awake until the wee hours of the morning. Is it important to note that (for me), after I take it, I have to engage in some passive activity like (calm, non-shouty) YouTube repair videos or reading. Also, the "window of sleepiness" is at most about 30 minutes and if I decide to power through it, I will come out the other side fully awake again. Melatonin does not "force" me to sleep, only highly encourages it.

I was skeptical of melatonin for the longest time. Generally, I rarely see much if any positive effect from supplements. But (for me!) this stuff really works. If anyone reading this is on the fence, I highly recommend giving it a try. (With the acknowledgement that it takes about a week to get into a solid sleep schedule if yours is currently disorganized.)

Melatonin works well to help me get to sleep, but it doesn't keep me asleep. My issue is waking multiple times in the night, mostly because I'm just uncomfortable, but my brain will immediately be thinking of some work or personal task and spinning. I solve this by putting on an audiobook each time, and that focuses my attention, and I'm asleep again in 5 minutes. So, I have developed "solutions" to my sleep problems, but they don't really fix the underlying issues.

Also, I don't take melatonin often, only when I seem to need to reset my sleep cycle, and I only take about 200-300 micrograms.

Why do you take so much? 5mg is a lot, according to the studies.

I honestly didn't know you could buy less than 1mg.

I started with 5mg arbitrarily because that seemed to be the most common dosage sold at the time. I think about lowering the dosage sometimes but at the end of the day, I know 5mg works well for me. I don't notice any side effects, and it's not any cheaper.

I also started with the special "slow release" formulas but couldn't tell any difference from the normal generic stuff.

My family doctor in Italy strongly recommended taking 0.3-0.5mg of melatonin maximum saying that more won't have a good effect and risks having bad effects such as drowsiness the whole day after waking up. And yes, in Italy most melatonin you'll find in pharmacies is <=1mg.

The Netherlands sells 500x0.1mg pills, so you can always get the perfect dose.

Have you been checked for sleep apnea? If you keep waking up throughout the night, it's a good idea to get checked.

What exactly is sleep apnea?

When your tongue relaxes during sleep, it can fall back into the throat and block your airway. This triggers the breathing pauses, gasping, and loud snoring characteristic of obstructive sleep apnea

Thanks. I haven't been checked. People always mention this though, so maybe it's common. But some people are just bad sleepers even without sleep apnea?

I’m not saying it will work for you, but it may be worth trying GABA or 5-HTP to help you stay asleep. As a chronic insomniac of many years, I take both and not melatonin. Sometimes if my sleep schedule gets bad enough I’ll take 25mg of diphenhydramine HCL to get to sleep, but it gives me strange dreams and makes me a little foggy the next morning.

Eh, I was prescribed 2mg of slow-release melatonin to help with insomnia (baby-related).

Man, were these the worst nights of my life! I’d get 2-3 hours of shut-eye and then be FULLY awake. Ready to go, couldn’t sleep the rest of the night. I was dead tired by day 7 and gave up.

Tried 0.3mg. Tried 5mg. Nope. There’s some evidence that melatonin can mess you up if you’re sensitive to cortisol/have too much of it. I’m not touching it again. No side effects? Sure.

N=1, but if it’s not working for you, don’t push it. My doctor instead prescribed a bit of therapy (CBT-i) and my sleep went back to normal after a couple of sessions.

I find it impossible not to reflect on my personal experience whenever this comes up. I spend 8+ hours a day on a computer, looking at screens. Probably more. I am looking at a screen literally 10 minutes before falling asleep (watching stuff on my iPad).

I can easily sleep 8+ hours. Today slept 10.5.

I'm either not convinced screens are an issue, or they simply are not an issue for me personally, but if thats true -- WHY?

>and that when normal adults are placed in settings without artificial light like camping or without any time indicators, they sleep longer than before - exactly as if they were sleep deprived.

I’ve been on a few multi-year camping trips, and it never stops amazing me that I feel like a different person after six months or so of sleeping with the sun. 10+ hours of sleep for many months is incredible.

Don't eat pills. Fix your diet.

Why?

I'd refine it as 'If feasible, try fixing your diet before going for pills'. The body is adapted to function within a healthy nutritional range. If your diet falls outside that range, it's expected that your body won't function properly. If problems persist despite a good diet, then pills become a more reasonable option.

Because it's unlikely that a specific deficiency is your only single problem.

Based on what? You seem to be assuming that the only way to be deficient in something is to have a junk diet. It is quite easy to be deficient in just one nutrient.

Did you take a blood test for magnesium level?

Blood tests are pretty useless for magnesium. The deficiency is in cells, magnesium level in blood is not a good test for that deficiency.

They have blood tests for both (serum or RBC):

The Magnesium RBC Test measures magnesium inside red blood cells, providing a more accurate assessment of magnesium status than serum tests.

what is a good test for magnesium deficiency?

They only have blood tests, and that's not very useful.

wouldn't a cell deficiency lead to it depleting also the magnesium levels in the blood, simply based on osmosis?

The organism dumps Mg on the blood as much as necessary because it needs to remain in stable concentrations.

When a serum Mg test comes out low, the patient already has severe deficiency and visible symptoms, so isn’t very useful unless you’re investigating a systemic issue.

As explained by my endocrinologist.

If blood concentrations drop, you die.

For me glycine helps amazingly. It's an amino acid that the brain needs during sleep. I take about 5 grams in water about an hour before I go to sleep. I'm not sure how much the glycinate in magnesium glycinate has the same effect.

Oddly, it has the opposite effect as sleeping pills on me, it doesn't make me sleep more but I'm more rested when I wake up. It even happened a few times that I only slept 5 hours but still could focus well at work and bike intensively for an hour in the evening, without glycine that was impossible.

At 20 euro/kg I think I'll take it for the rest of my life, and it probably will add a few years to my life.

Yep, I've been taking glycine and magnesium for years. I am not as consistent as I should be but it makes a big difference when I use them.

Same here. Only thing that’s ever worked.

Your comment sounds like an AI-generated advertisement.

So where's the advert link to his favourite supplement, search those phrases and there will be 200 different brands selling this same commodity so which one is paying him commission ? All?

Hmmmmmmm

People sharing their experience doesnt immediately mean AI-generated advert

I'm not taking either side but people don't need to directly link to their own store to benefit from increased awareness and "hype" in some product category - a rising tide lifts all boats.

"Health" and more specifically the supplement industry is just a revolving door of fads. There's also survivorship bias, those who are obvious get banned quickly.

If my Instagram feed is anything to be believed, apparently we all need to be taking extra electrolytes in now.

All of those supplements are made with “magtein (r)” branded magnesium l-threonate. It all goes back to the same company and that company is the one that has supplied the “studies” that prove its effectiveness. And by “supplied” I mean that the literal vice president of the company’s research arm was an author on at least one of their studies but didn’t disclose his connections until a follow-up update to the study.

I don’t think it’s AI-generated, but it is repeating a lot of the points that are commonly repeated in supplement ads: The claim that Mg L-threonate is special originates from the person who patented it and sues anyone else who produces it. The claims that multiple doctors tried to push “sleeping pills” and they’re all bad is a common theme in communities that accept supplement research and claims unquestionably (like patented magnesium forms being superior) but have an innate distrust of doctors and medicine.

I think this is just what happens if you read a lot of supplement forums and listen to the supplement podcasts a lot: You start developing elevated beliefs about the supplements, disdainful beliefs about doctors, and think you’re making superior choices having done your own research. That last point is some times critical for the supplements working, because if you believe you’re taking something special after having cracked the mystery by listening to 50 hours of Huberman or Rhonda Patrick (as examples) then the placebo effect will supercharge the result. Having belief that you’ve solved the problem makes the effects much stronger, especially for cases like this where the underlying problem was already pointed out as being stress related.

Why AI-generated? Because the quality of his writing is better than that of his critics?

I'm inclined to agree. I and my partner have tried various forms/brands of Mg, around 5 of them, and they have had zero effect on sleep. I have to wonder if all positive experiences here are either placebo or shills. Similar goes for the several supplements out there.

Yes, magnesium has helped.

For me, avoiding high histamine foods as well as histamine liberators had helped tremendously.

The theory:

Anti-histamines like Benadryl make you sleepy by blocking histamine.

Well, instead of blocking the histamine, get rid of it in the first place by avoiding histamine foods (for example aged or preserved meats).

Histamine has different pools, functions, and receptors in the body. You’re reducing it all to one single level that goes up or down with diet but that’s not how it works.

The brain histamine in your neurons is primarily synthesized from an amino acid. The histamine levels in neurons are different than the levels in mast cells.

There are a lot of degrees of hand waving in your theory that don’t work.

Hey Aurornis,

I definitely haven't looked into the underlying models of histamine to see how things work.

My observation is that, when I avoid histamine related foods, I sleep longer and fall asleep faster. The naive model is what led me to try that. But I totally acknowledge that there's likely way more at play under the hood. And I would like to know more about why this works! Or, at least why it works for me.

Thank you for pointing out the complexity of the underlying mechanism.

> Magnesium supplementation solved my sleep issues.

Which type, if you don't mind my asking? And how long did it take before you felt the benefits? I took it for a month once (forget which type) an hour before bed and nothing changed.

I've tried both Magnesium Glyconate and Magnesium L-Threonate and both have helped my sleep, Magnesium Citrate did very little. Which makes sense, the latter is known to not be absorbed very well.

I've not noticed any significant difference between the other two.

Magnesium citrate works well for constipation, IME.

Yeah, magnesium citrate is used medically as a laxative. Because it is poorly absorbed, it draws water into the stool osmotically, making it softer. (But that also draws water out of the body and can be dehydrating.)

Magnesium Glycinate worked well for me, take it an hour before bed or so. L-Threonate is too expensive, citrate gave me diarrhea.

Much more deep sleep with Glycinate, some folks don’t like it because they feel too groggy after waking.

I find that Magnesium Glycinate works well for me. Magnesium Taurate also works.

Magnesium Glycinate has been a game changer. My legs used to be tense to the point of cramping at night, and they’re now relaxed, enabling better sleep. I also use L-theanine as an additional supplement for a long duration deep sleep, and think it helps.

Interesting about the legs. I wake up with that in the middle of the night and have trouble falling back asleep because of it. Heck, if MC just took care of that, I'd be happy. Thanks for your input!

Suffered for a decade till I discovered this. I’d reached a point where I was actively skeptical about anything working, till this worked out. Good luck!

What I've found to fix leg cramping is skin rolling my legs (ideally every 6 months but takes maybe a couple of years to fully undo the effect). Lightly pinch some skin between your thumb and two fingers and walk it forward with the two fingers. If you need it it will feel "crunchy" in some spots rather than smooth. Ideally cover the full area at least twice at 90 degree angles (not necessarily all on one day and doesn't need to be perfect coverage, more is helpful if it still feels "crunchy"). Warning: while only mildly painful for me when doing it, after sleeping I wake up with quite sore legs which lasts two full days. Doing it every 6 months or so avoids this and is also when I start to occasionally get cramping again.

> As a software developer, I am used to finding and fixing the underlying problem instead of relying on the quick fixes these doctors were offering me.

Bro Science, HN Edition in one sentence. Nice.

In Mice!!!!

I am a brogrammer and I fix problems, bro. Magnesium for life.

It's funny you talk about treating the root cause, and take magnesium, instead of addressing the workplace stress factor.

I get what you’re saying, but I think it’s fair to view it as equivalent to drinking a protein shake after a workout. You used the resources in a productive and healthy way, now you need to replenish them.

sure if you're just taking it as a dietary supplement, but clearly OP is using it as a form of sleeping pill. which is also fine but just seems like mental gymnastics.

The magnesium deficiency would probably still exist if you removed the stressful job. Unfortunately switching jobs or careers is not an option in this current job market.

You are absolutely right about that. It is important to reduce stress. Insomnia is only one of the ways excessive stress shows up.

> You are absolutely right about that

Not helping the 'AI ad' claims lol

Stress pays my mortgage unfortunately, and I don’t have a way to make money otherwise because all the jobs in my profession of over a decade are stressful.

I can also vouch for magnesium and the l-threonate variant. I take both before bed along with glycine powder, phosphatidyl-serine, l-theanine, l-tryptophan, ashwagandha, and saffron. No melatonin, no sleeping pills. Finally getting decent sleep for over a year now.

On the other hand, reducing supplementation solved my sleep issues. I was taking Magnesium at night, and D+C+Fish+CoQ10+Iron+B12 in the morning.

I don't know what the hell I was taking too much of, but I didn't have a good way to test it. I wish the body had some indicators.

> A special form of magnesium called magnesium L-threonate may be especially helpful for the brain because it appears to raise brain magnesium levels more effectively than some other forms.

The study that made this claim was performed by the person who patented magnesium L-threonate and sells it at a high price. They go after any company that tries to sell cheap generic versions. The study was in mice and only showed small increases.

Magnesium L-threonate doesn’t get absorbed into your body and go into your brain as a lot of the supplement podcasts and social media posts have been implying. Magnesium supplements like this dissociate into their components in your digestive tract. Magnesium and threonate get absorbed separately. So if magnesium L-threonate has some special properties, it would be because threonate does something to improve absorption or maybe has other effects in the body, but that’s a big if. Remember that the person claiming it works better has been making a lot of money off of that one study.

If you have the cash and don’t mind paying the price then there’s no reason to switch. Many people find that magnesium glycinate, which is cheap, works just as well if not better. Glycine supplementation has been found independently to improve sleep, so taking a magnesium supplement that dissociates into magnesium and glycinate might be helpful in its own way.

Magnesium builds up in the body. Some people are deficient and get strong effects from initially correcting the deficiency. Take high doses for too long and you can start accumulating enough to get into excessive magnesium range, which brings problems. That was previously a rare observation but it’s occurring more as people get into magnesium supplements from podcasts that encourage constant high dose protocols and repeat claims that everyone is severely deficient. Keep the dose moderate.

> And they all wanted to put me on prescription sleeping pills. I said no to that. Sleeping pills can cause dependence, and they often treat the symptom rather than the underlying cause. As a software developer, I am used to finding and fixing the underlying problem instead of relying on the quick fixes these doctors were offering me.

“Sleeping pills” could mean a lot of things. Few doctors will put a patient on long-term hypnotics with high dependence liability like Ambien in the 2020s. Most doctors are hesitant to prescribe them at all in the current environment, and when they do it’s short term. I would be very surprised if you went to multiple doctors who offered to prescribe you something like that as a new patient without a complicated history. Even the people with significant long term insomnia complain about how hard it is to get doctors to prescribe those.

What they usually recommend is weaker medications with somnolence as a side effect, but the effect is weaker and doesn’t target pathways prone to addiction. Trazodone, doxepin, and a few others are common. These are not in the same category as what people think of as “sleeping pills” like Ambien that have higher dependence and addiction liability. They should not be dismissed together as one big category of drugs that are all bad for you.

Good point about L-threonate. It is indeed expensive. I use some of it, but mostly I rely on Magnesium Glycinate.

Magnesium L-Threonate is actually very cheap to produce. There’s nothing special about it other than the patent.

There were some generic versions available but the Magtein people go after them. They have to in order to protect their cash cow until the patent expires.

Even a simple ZMA worked wonders for me when my fitness coach recommended it. Got some of the deepest sleep of my life

100 the same.

I tried magnesium before but didn’t see any effects after a week so threw in the towel. Then I read a comment by someone here that had the exact same symptoms as me (brain wouldn’t turn off), explained the underlying cause, suggested L-threonate, and explained that it’s a long-term deficiency and might take some time to build up sufficient reserves.

I have had insomnia my entire life, since I was a child. I would go to bed around midnight and fall asleep at 3am, if I was lucky. I simply could not get my brain to disengage.

Within a month of supplementation, I thought I noticed a bit of improvement. By two months, my insomnia was gone. Not better. Gone. I fall asleep within minutes now.

But how come you have magnesium deficiency in the first place, what are you not eating? People who need magnesium supplements still absorb magnesium, so the problem isn't absorption must be consumption.

Fresh fruit and veg, nuts, and other fresh things. Thing is, modern farming and distribution practices have negatively affected the magnesium content. Drinking water also used to naturally contain more minerals but in many places is removed to cause less issues with plumbing and because “hard water” also makes it harder for soap to lather. Absorption also depends on vitamin D, so if you’re low in D, you won’t absorb as much magnesium. I have also read that magnesium is required by the body to make GABA and melatonin; supplements other commenters are mentioning.

Holy Dunning–Kruger effect...

As a software developer, I am a much better doctor than actual trained doctors, and am definitely immune to any placebo effects.

I don’t know anything about the specifics of this case. I do know there are lots of bad doctors. Doctors routinely make mistakes or overlook things, especially relatively trivial things like this.

I don’t know what people think you learn in medical school that makes you an infallible source of health knowledge.

Doctors do overlook simple natural solutions. This is because of how evidence-based medicine works.

The problem is not with evidence-based medicine itself, but with how the evidence is generated. The gold standard of medical evidence--a large, randomized, double-blind clinical trial--is extraordinarily expensive. In practice, much of this research is funded by private industry, which must have a reasonable expectation of earning a return on its investment. That naturally directs research toward treatments that can be patented, commercialized, and sold at a profit.

This creates a structural blind spot. Many naturally occurring compounds cannot be patented in their natural form, making it difficult to justify the enormous cost of conducting the kind of trials that modern medicine demands. As a result, potentially useful natural therapies often remain under-studied, not because they have been proven ineffective, but because the economic incentives to investigate them are weak.

This is the reason your doctor is much more likely prescribe Ambien CR than to suggest trying magnesium supplements.

Trained doctors pushed opiates and benzos on me when they were very much not needed and in both cases led to dependancies and horrific withdrawals. I'm sure many others can chime in with their own similar experiences. Medical professionals are incredibly crucial to the wellbeing of society, but they have also been responsible for much suffering because they are human just like us.

> Holy Dunning-Kruger effect…

Do you know they’re wrong? Please don’t invoke Dunning Kruger like this, it’s cliché and also wrong to do. There’s no indicator for whatever it is Dunning & Kruger showed, you cannot know if it applies to a single person. Their main plot showed a positive correlation between confidence and competence. Their paper has problems, their methodology has been rightly questioned, and some attempts to reproduce have failed. Plus keep in mind that, ironically, for people who are intimately familiar with the debate over DK, using it to essentially name-call someone backfires and has the opposite of the intended effect, it makes the name caller look confidently ignorant.

The claim is anecdotal and entirely possible that it's a placebo effect. But the author is making it sound like a definitive root cause to their issue. This is so typical of the software dev community.

> entirely possible that it’s a placebo

Placebo Effect is not Dunning Kruger. Making incorrect assumptions or having incorrect beliefs is not Dunning Kruger either.

Possible is not certain. So if it’s not a placebo effect? If the author found a solution that is in fact a better root cause fix for themselves than sleeping pills? What does that make their comment? What does it make yours?

> This is so typical of the software dev community.

IMO this is a worse assumption with less evidence than the one you’re complaining about, and it’s pure unsupported assumption and far more likely to be wrong. Distrust of doctors and “western medicine” is common enough to hear it all the time, I know more non-devs than devs who carry such beliefs. Unless you have statistics on devs compared to the general population, your personal sampling is entirely anecdotal, and biased.

Those invoking Dunning-Kruger are, with high probability, an instance of just that :) (also, see the comment below that touches upon the many gaps in the original paper, which is at this point just garbage invoked by midwits). Finally, there’s a thing called heterogeneous treatment effects, which really is hard to detect at medical research scale … and placebo effects, if they help with the underlying issue without breaking the bank, and still helpful.

Doctors simply don’t treat things well that are not classified as a particular disease. If you want to get stronger or more fit, you may well be better off asking your local bro than your PCP.

Sleep is sadly in the same category. If you don’t have sleep apnea, and you want to get treated for sleep, you will be offered any number of pharmaceuticals, all of which are terrible. Better advice comes from other people dealing with sleep issues in this case.

Doctors generally aren't trained in systemic level thinking, probably because given how complex the body is any such broad connections can only be "intuitive" rather than rigorous, more an art than a science.

This is probably the only reason why "naturopaths" and other "holistic" doctors are still in business, because they'll actually bother to consider a broader picture of a symptom as hinting at some structural imbalance rather than solely treating the symptom as a localized issue to resolve.

Does this need to be supplement or can I "just eat the right food"?

Or is there a "maximum low level deficit" which you will never leave with just eating the right stuff?

(Like VitamineD deficit - it can get so low, that you cant fix it by "just going more into the sun")

From my experience, it took about a month of 150mg magnesium supplementation per day to see effects, two months for my insomnia to go away entirely.

Doing a quick search for magnesium-rich foods, it seems like it would take either an unsustainable focus on eating these foods to see results on a similar timeline or an extremely prolonged timeline to see similar results.

That said, I am not a doctor or nutritionist. But my instinct is that you can get so far in the hole with a lifetime of magnesium deficiency that supplementation is by far the most time- and lifestyle-efficient to digging yourself out. Whether or not switching to magnesium-rich foods can sustain you being at correct levels will end up depending on what the size of the deficit was in the first place, but is probably worth a try.

This one: -- take either an unsustainable focus on eating these foods to see results on a similar timeline --

Same as with VitD, seems like - at some point, your level is just that low that you cant restore it by "just eating right", you need more firepower

Aka solar power

Nice ad!

Good for you. Personally I just take four zzzquil ultras every night.

Speaking of which, I think it's a great idea for everyone to get their vitamin levels checked. Your doctor is unlikely to order such a blood test unless you are in an extreme situation, but it's cheap (around $100) to get a pretty extensive panel done.

I did it recently and found out basically all my b vitamins were in the toilet along with my vitamin D level. I started taking a b complex vitamin and D3 supplement and found immediate improvements to brain fog and exhaustion.

Interesting, my doctor recommends doing a blood panel every 5 years.

A lot of doctors only want to do a more critical set like like triglycerides, c-reactive protein, cholesterol, stuff like that. I've never had a doctor proactively want to test things like b vitamin levels.

I find magnesium great - but I also like 5-HTP which I find also helps me sleep if I take it with a little food about 30 mins before bed. I find I feel a lot calmer when taking it - and it helps my ADHD - though I don't take it for too long, as I never like to take anything for too long.

Never taking a supplement for too long is great advice. Always cycle things in and out to avoid some potential for accumulating too much in the body.

There are some horrifying case studies where people took like too much zinc, or copper, or some other thing for years and got really really messed up.

The only thing I did take for a long time was Fenugreek seed extract, but recently read long term us is potentially toxic, so stopped that, but I really liked how that made me feel.

> As a software developer, I am used to finding and fixing the underlying problem instead of relying on the quick fixes these doctors were offering me.

I'm skeptical that avoidance of "relying on the quick fixes" generalizes to software developers as a whole :)

To be fair I care way more about the long term sustainability of my body than all the software I write regardless of how business critical or interesting it is. Or hardware for that matter, the "temporarily" zip tied CPU cooler fan says hi lol

Retired software developer and my wife suggested the same and it worked. As a veteran I also believe it mostly fixed my sleep apnea episodes that I never sought formal diagnosis for before. We also do 5 mg melatonin now which helps. The magnesium oxide at bedtime is great though.

Steve Jobs?

Do you mind sharing which type you take (brand as well)? I tried magnesium glycinate supplements for two nights in a row and they kept me wide awake.

In some people they can do ths.

Most magnesium doesn't cross the blood brain barrier, such as the one you tried.

Try magnesium threonate, which does.

Which form do you take? Have you tried different forms?

Magnesium glycinate and magnesium taurate work for me. I mainly rely on the former.

I’ve read so much on magnesium and believe in the benefits of supplementation, but when I try it (regardless of type) I end up feeling devoid of energy and borderline depressed for three days after.

FYI here. I and my partner have tried various forms/brands of Mg, around 5 of them, and they have had zero effect on sleep. I have to wonder if all positive experiences here are either placebo or shills. Similar goes for the several supplements out there.

It does literally nothing for me.

I have severe sleep issues and have tried a bunch of sleep related supplements and medications. Although I do not have a dietary deficiency Magnesium might be the single most effective for me at keeping me asleep, although it does nothing to help me get to sleep and unfortunately the most effective dose taking magnesium alone is around 500mg which is enough to make me even more tired than usual the next day (so not really a good option on its own for me). I have found a combination of 250mg magnesium (carbonate or extended release oxide + citrate, which seem to work equivalently in my limited testing other than that the scoop I have for the carbonate powder is for 350mg so I might take somewhat more in that form) and 2.5mg baclofen to work better than either at higher doses alone (baclofen in higher amounts quickly stops working when taking it multiple days). Unfortunately sleep issues of any severity are often fairly random so it takes quite a while to have any confidence that something is actually helping even if it seems to at first; magnesium is one of the very few that seem to help me.

I have recently been taking those with .3mg DR melatonin and 8-9mg diphenhydramine and it still has some effect the next day but much less than the higer doses of magnesium. The diphenhydramine is for my Non-24 and does not help me sleep but can improve my functioning some the next day when part of my body wants to be sleeping during the day (unfortunately like many things it seems to quickly lose effectiveness so I am going to try taking it less often). My thinking is that for long term use for sleep it is imporant that the medication or supplement be cleared from the body quickly, though too early and it may be hard to stay asleep.

Sleep doctors have told me that waking up at the same time every day is most important. It doesn't look like the paper tried to differentiate between irregularity waking up and irregularity going to sleep but I suspect trying to wake up as close to the same time every day as you can reasonable manage is the best thing most people can do to improve their sleep quality (getting to sleep earlier some days if needed). My sense is that the most obvious part of what we consider to be sleep quality is actually waking up quality. Sleep deprivation affects memory in subtle and eventually not so subtle ways but not feeling awake seems in my experience to be based on how waking up happens and sleeping less when relatively well rested often has a positive effect on feeling awake (at least for a while, getting tired early is another effect of not sleeping enough). There is a particular thing that I notice maybe a couple of times a year that feels like rapidly cycling between being asleep and awake multiple times when I am waking up and I always feel much more awake the day it happens.

> As a software developer, I am used to finding and fixing the underlying problem instead of relying on the quick fixes these doctors were offering me.

Your body isn't a piece of software.

It can get easily get stuck in conditions that we aren't used to happening in computers. Eg, some injury causes inflammation and pain in a different part of your body, and even after the initial injury heals itself, the inflammation and pain in another part of your body continues of its own accord, and a "quick fix" of some NSAIDs can cure it within hours.

I'm glad you are feeling better, but reading all that great stuff about magnesium could have primed you to think that supplementing it would work, therefore it worked. The placebo (and nocebo) effects are very powerful.

And what is the root cause of your magnesium deficiency? How come you're not getting enough of it from food?

Magnesium also solved my restless leg syndrome at night. I take magnesium glycinate. I bought the powder and sprinkle some on my nighttime ice cream sundae a few hours before bed.

>nighttime ice cream sundae I assume that’s a joke.

Magnesium absolutely helps, and with our modern farmed diet, most people are deficient. It it part of over 300 chemical reactions in the body.

I've also been seeing a lot of comments about melatonin. For those taking it, as long as you aren't on an SSRI or other seratonin regulator, take 500mg (up to 2g) of L-Tryptophan. It's one of 9 essential amino acids (of like 22) that we only get from food, and is the basis of seratonin. The chemical process in the body is Tryptophan -> 5HTP -> Seratonin -> Melatonin. Again, because of our modern diet, we don't get enough of these essential amino acids. Many people with mild anxiety have gotten off anti-anxiety meds by switching to just taking tryptophan. Anyway, it's helped me, but it gets a bad rap because "tryptophan makes you sleepy after Thanksgiving". Actually, no it doesn't, it's the amount of food you eat, honestly.

Magnesium, melatonin and none of the other supplements really worked for me.

I microdose with an specific drug and it did help improve my sleep. I know it's not placebo because sometimes I forget to take it and it coincides in the sleep log with worse sleep.

Anyway this drug isn't a panacea but a paliative while a treat the root cause. In my case it is a stress-related disorder and the real treatment isn't quick and easy, it requires life changes.

Do you take magnesium specifically at night, or does it not matter when you take it? I'm not sure if it's something your body stores for use when it needs it or if it just throws away what it doesn't need or use.

I take it at night. Unfortunately I haven't found a controlled release version of magnesium that works.

I sometimes also take it during the day when I feel my muscles getting stiff, I get relief within 15 minutes.

>As a software developer

My man has written too many JIRA story descriptions

I wonder how much of this is driven by confounding variables they haven't accounted for.

They do factor in shift work as a categorical variable, and employment status as a categorical variable not taking into account occupation. But probably occupation (not a variable here) interacts with sleep status. Any job that involves a lot of flying (pilot, crew, people travelling for business) get more cosmic radiation exposure, for example, and potentially more sleep disruption. Certain operations and manufacturing jobs correlated with exposure to carcinogens also likely correlate with less regular sleep, possibly in a way that isn't corrected for by the limited shift work categories.

I thought the same. If your life is so in order that you routinely sleep on the same interval, perhaps your life is not as stressful as others who sleep more chaotically

usually these studies are done across a very narrow sample of Earth's population. often from similar region or country etc. Which dont get me wrong, is a lot of stuff to process for such a study, but the number is statistically insignificant. many more similar studies would need to show identical results.

this one selected about 100k people from a dataset of around 500k. All from one country/region (UK)

furthermore they dont measure sleep but they estimate if someone was maybe asleep based data from an accelerometer. so they cannot measure what sleep state someone acheived or if they were actually really sleep or just u know staring at the ceiling in an existential crisis....

> the number is statistically insignificant ... they dont measure sleep but they estimate if someone was maybe asleep based data from an accelerometer

These two goals are kind of at odds with one another. We can only get insight into depth of sleep achieved if we bring you into a sleep clinic, but we can't do that for a significant sample size...

they had controls

No they didn't. A control group inherently implies the researchers made an intervention in the first place (or else there was a "natural experiment" where people were randomly placed in group or another). That didn't happen here, as this was purely an observational study.

Observational studies can have synthetic controls. The term, as such, doesn’t mean precisely what you think it means.

I understand that. But saying "they had a control" in any case implies an "intervention" group of some sort, whether synthetic or natural, and this is very different from saying "they controlled for other factors", which is what they did in this study.

The study authors aren't even purporting to show a casual relationship (i.e. that improving sleep would necessarily reduce mortality), just that irregular sleep predicts mortality.

The confounding variable I think is most important is that many people have an internal clock that is shifted or lengthened relative to other people in the same house.

If others in the house prefer to sleep from 10-6 and you prefer to sleep from 12-6, but others start making noise a 6, your sleep quality in the last two hours is destroyed. Then over time, it just results in poor sleep regularity, as you cycle between exhaustion and trying to sleep according to your internal clock.

This describes a lot of people with young kids pretty accurately

If you did read the paper, you'd have noticed that people who slept more regularly in this research were also wealthier, and more physically active. They did say they adjusted for these variables, but who knows. Maybe they didn't adjust them enough, maybe there are more covariates they didn't consider.

I don't know if they can have controls for "specific activity that changes their sleep schedule".

In the past few years I went from having relaxed 11AM daily meetings to rigid 8AM meetings, and my sleep has suffered immensely. But nothing else in my life has changed, so it wouldn't show up in my socioeconomic data.

If you die younger than you otherwise would have, let them know because that will help normalize the rest of the data as well.

I guess it just seems extremely obvious to me that people who live a predictable-enough life to sleep and wake at the same time every day are less likely to face mortality than people with schedules so chaotic they sleep at different times regularly. It’s still good science to do, but without a solid cause or two, I don’t think anything helpful is actually being revealed by this study, at least from a layman’s perspective.

Are you assuming that everyone prefers sleep regularity such that access is the only predictor?

Yep. I'm sure there are a few exceptions, but they'd be very rare overall.

Yeah, this type of observational data often falls over when you dig into the details. And yes, they say they adjusted for a number of variables, but even if hypothetically they perfectly adjusted for all possible confounding variables (highly unlikely IMO), it's possible that the causation simply runs in the other direction: poorer quality sleep and variable sleep cycles could just be a symptom of illness or being generally unhealthy, not the root underlying cause.

Or just being sick messes with your sleep.

As always with a lot of these: it's not saying causation.

You might measure the speed of your car by putting your hand out of the window and notice that the wind force on your hand is strong when the car goes fast.

Putting your hand out of the window and then blocking the wind with a book doesn't make the car slow down.

Keyword: "associated"

EDIT: I meant to communicate that it doesn't make the car slow down as much as your hand behind and blocked by the book (feeling almost no wind), would imply.

Maybe you can't stop the car that way, but if you feel that kind of wind on your hand you should worry that your car is going fast.

> ... you should worry that your car is going fast.

Only if we know of an intervention that will likely slow the car down and the risks+cost of that intervention justify the benefit.

Otherwise, we worry without purpose.

EDIT: I will say that there is a philosophical question here related to "basic research" / "pure science" / "fundamental science." Usually just "knowing new things" eventually proves valuable, especially in a long timeline. So in that sense, TFA could be important.

Bad example because yes it does make the car slow down.

I think the point is that while it does act as negative acceleration there isn't a causal relationship with the actual speed of the car, which is mainly related to how far the gas pedal is pressed.

Drag is a causitive input to speed though.

    nextCarSpeed(currentSpeed, wheelPower, dragForce, mass, deltaTime) =
    currentSpeed + ((wheelPower / currentSpeed - dragForce) / mass) * deltaTime

Increase "dragForce", and the resulting car speed decreases. That is a causal input, not an association.

Initially I assumed it to be negligible but the numbers are actually very close!

I calculate around a 3% drop in speed (from 60mpg) for holding an average sized book out of the window. That's surprising to me.

It's not quite right to use hazard ratios to calculate life expectancy. But if we force it, it looks like being in the top 20% of "regular" sleepers compared to the bottom 20% confers 3-4.5 years of extra life (from birth, assuming everything else equal, assuming USA, etc.). That's 3.8%-5.7% more life (79 year life expectancy at birth in the USA as of 2025). So the numbers are actually close.

I made a bad analogy :)

But you get my point!

In this example you're determining the speed of the car based on the wind flow on your hand. Putting the book in front might slow down the car, and it will probably also slow down the flow on the hand. However, if you still try to determine the speed of the car from the air flow on the hand, you'll probably be off, because car speed and wind flow aren't linked like that when the book is in the picture.

I can't tell if this is germane to the analogy or not, but the air flow over your hand, even behind a book, is still a function of the car's speed. As an illustrative example, imagine the feeling when the car is at 0 compared to when the car is at 60.

It's a multivariate system, the dragforce is determined by the car geometry + book, hand, whatever.

They are both causes to speed.

In fact you don't even need flow to infer speed. You can just use pressure calculations and temperature, which is how airplanes measure their speed.

Controlling drag is a major component of the inputs to speed when flying an aircraft.

Bertrand Russell objected to the notion of causation in the 1900s, because merely stating the updated dynamics of a system doesn't imply causation in any grand sense. Like hume, he dismisses causation, but not because of the problem of induction or anything, but because the concept seems incoherent to him. He especially emphasized this in physics - although maybe you can argue that for everyday human language, causation is good (Alice caused BCD to happen), in physics it doesn't belong.

Not that I entirely agree with his account but just some food for thought.

Original comment assumes the size of my hands is not 50m^2. Very presumptuous.

But what color is that bike shed ??? /s

Right??? The HN pissing contest...

Sorry but it's counterproductive to people's understanding of the causation vs correlation distinction to provide an example of the former and call it the latter.

You think blocking the wind from hitting your hand slows the car down?

>Putting your hand out of the window and then blocking the wind with a book doesn't make the car slow down.

...yes it does?

only if the book is being held by someone in the car.

Presumably, the example missed the part where they stated the book was being held in front by an outside agent, because that is the only way it would make sense.

The study is clearly about correlation and not causation, but still the term "important predictor" keeps triggering me. People can't sleep due to stress or noise or disease (e.g. coughing), and while "predictor" seems to be normal science lingo I feel it nudges the conclusion of this study into the direction of causation instead of very clearly saying that it is pure correlation.

Nobody goes to bed and wants to wake up 2 hours later.

But they choose to. Alcohol, caffeine in the afternoon, just not realizing blackout curtains matter, lights or displays on in the room... you can't help someone who isn't making bad choices, but most people can make simple choices that improve their sleep a lot!

Racing stripes would be a better example. Though negligible, a hand out the window does have a causal impact on speed.

On the other hand racing stripes have zero impact, but do correlate to the speed of the car.

What about speed holes?

We could pick a company car in my previous company (it's a tax thing). We could pick any color, apart from red, because the insurance forbade it - red cars get into more accidents. Somehow that must have made it all the way to the policy without someone asking "is it the red car or the kind of person that picks a red car that causes more accidents?"

The solution is clear: Offer the red car option as a trap, banning anyone who chooses it.

I drive a "Victory Red" 2005 Chevy Silverado. I always thought it was a "safer" color for a vehicle.

I have always assumed that, being in a larger vehicle that is bright red, people would be more likely to spot the vehicle from further away, notice it out of the corner of their eye, or that I would generally be MORE visible to other drivers.

I'm sure the correlation insurance companies are looking at is that the driver's of red vehicles are the cause of the higher accident rate.

IDK. I got a hand-me-down sporty car when I was in high school, which was initially white, then I had it painted orange as a birthday gift a year or two later. Comparing the before and after, there was a noticeable shift in how other drivers responded to me, and not universally for the better. I was less likely to go unnoticed (think people trying to merge into me, or jumping out in front of me when they have a yield), but a subset of people (mostly other young men, sometimes older men driving minivans) would act significantly more aggressively. No one ever tried to race me when my car was white. It'd happen like once a week once the car was orange. People actively speeding up to avoid me passing them also increased substantially.

The anecdotes I picked up in my early driving days suggested that red being more visible also meant it was more visible to traffic cops and get more attention - and thus more speeding tickets even for relatively small violations. (No idea if this was supported by insurance data - in the most solid of the anecdotes, the driver in question had just traded in a bright red porsche for something comparably fast but "not red" and didn't have followup numbers yet :-)

> As always with a lot of these: it's not saying causation.

But what they are saying is, it would be valuable if it was causative wiggles eyebrows

Last sentence of the abstract:

> Sleep regularity may be a simple, effective target for improving general health and survival.

But why would it NOT be? Seems stupid for us to have evolved into beings that need our sleep to be irregular.

Because for it to be effective it must have reasonable cost compared to the benefit. The cost for such a sweeping lifestyle adjustment seems quite high, and the authors have not showed any benefit to interventions.

There are things that are causal and have little to no effect and things that are causal and have a large effect. I think determining whether and how much something matters, especially when the target audience is "all humans" is a worthwhile endeavor. So it may seem obvious to you, but many many important scientific findings were because somebody looked a little deeper at something that seemed obvious to everyone else.

> Putting your hand out of the window and then blocking the wind with a book doesn't make the car slow down.

Technically the book would add drag and the car would slow down but likely imperceptibly to a mere mortal

Assume the book is the same form and size as the hand (though very thin).

Well in another example, I might put my arm out of the window and feel the wind moving fast on my arm and wrongly assume my car is going fast when it is simply windy and I am stationary.

I wonder how many of these "surprising" results are markers of other life style decisions.

Regular sleeping hours as a marker for a less stressful life?

Also ran across this:

https://pmc.ncbi.nlm.nih.gov/articles/PMC5105607/

I doubt it's the actual reading. Maybe having a calmer life where you take the time to relax with a book.

Also, reading lowers stress. Which in turn improves sleep an overall mental / physical health. I always read before going to bed for at least 30 minutes, and anecdotally I have a much easier time to fall asleep that way.

> I have a much easier time to fall asleep that way

Unless the book is really good :)

True indeed, I definitely missed some sleep because of books.

We wrote about the "why" on our blog a few months ago [1], but the short version

Sleep is a complex interplay of multiple systems within the body. A consistent/regular schedule means the brain/body is not guessing what you are asking of it. It knows when to reduce cortisol, drop body temperature, etc. etc.

A simple example: When you force yourself to stay awake longer, your body attempts to compensate by increasing cortisol, then when you try to go to bed later, it can't just switch off the cortisol. It needs to clear it in your system. Then the next domino falls of when does your brain/body expect you to wake up? What are you asking of it?

[1]https://blog.affectablesleep.com/p/the-hidden-work-of-sleep-...

Couldn’t this effect be classic cause vs correlation?

Perhaps someone who has a consistent schedule is hypothetically more likely to make healthier choices on average?

tfa: "Results were adjusted for age, sex, ethnicity, and sociodemographic, lifestyle, and health factors"

Sometimes it is a cause vs causation. Sometimes the scientist didn’t adjust for a variable that clearly would impact both fields they were measuring. To make such a claim, I think it’s appropriate to name that hypothetical third variable. Otherwise the comment is so general it applies to all statistical studies.

But you can just apply this to anything. I feel unlike unless you're an insider with skin in the game, your criticism doesn't land other than a generic surface one.

To be clear, I apply an equal deep skepticism to most fields that aren't math (in the sense of a priority) or physics (in the sense that you aren't trying to study the entire world, but a specific set of phenomena that you can reliably control enough + repeat to run intervention on), whether the results agree with me or not. Maybe a bit of intellectual closed-mindedness. But then that means that me, personally, I can't in good faith use the criticism as a proper 'debunk' argument - at best it's a heuristic to avoid spending cycles to evaluate it (which is 'rational' behavior, as much as I hate that word, IMO).

People love nitpicking about scientific articles, it kind of exploded with the pandemic. Especially when the conclusions of the paper don't align with the expectations of the reader.

The way I see these is "these persons invested a lot of time putting this together and all I have to counter it are personal vibes", so unless my LLM of choice can find plenty of conflicting papers, I tend to assume it's reasonably valid work.

Considering the importance of the subject, it still seems important to bring this out, especially if there's conclusions that if you have irregular sleep you are significantly increasing your odds of dying earlier. I think intuitively we can know how important sleep is and I desperately want to sleep better. It's fine to speak of it being predictor etc, and all that, then they end the abstract with "Sleep regularity may be a simple, effective target for improving general health and survival.", which is technically fine since they use "may", although later articles based on the study will likely make the statement more confident.

But I guess what might be slightly triggering is claiming that it's a "simple" target. Don't I wish I could sleep on command and better?

So a clear question is - why do people choose to sleep or why do they naturally sleep irregularly?

Because for that there must be a logical cause in the first place. They say they control for mental health and all that, but is it then that ultimately it comes down to preference in their mind? I'd think most people want to sleep in healthy way.

Basically - if they were able to control for all possible confounding variables, what exactly was the cause of irregular sleep?

Anecdotally I can say that I sleep more irregularly the more stress there is, and stress could easily affect health, but if they controlled for stress, what then?

I guess ultimately they are saying it's a desirable target to measure, so it's fine in that sense. They are not really saying that choosing to sleep irregularly is what is causing the issues.

Did they explain how exactly they adjusted those results?

Do you even bother to click on links before asking a question?

There is a whole paragraph on "Statistical analysis" that even provides five supplementary methods (S1.5, S2.2 and S2.4-6) if you want detailed information.

Would love to see a causal model [0] to help better understand all of the mediators considered as well as confounders. I'm close to finishing up an interesting read from Judea Pearl/Dana Mackenzie - The Book of Why: The New Science of Cause and Effect [1]. Talks alot about Causal Models, Causal Inference, the 3 ladders of causation, etc. I liked the graphical approach to help outline exactly how one thinks about direct and indirect effects and how it facilitates counterfactual analysis and causal mediation analysis.

[0] https://en.wikipedia.org/wiki/Causal_model

[1] https://en.wikipedia.org/wiki/The_Book_of_Why

McElreath's Statistical Rethinking is also a great reference for causal thinking and modeling.

What I wonder is even if they did the perfect adjustments, what would have been driver for different sleep regularity.

E.g. considering some common causes like work stress - if they did the causation and compared people who did the same type of work, and they controlled for stress levels then why did one group of people have sleeping regularity issues more than compared to others?

Like there has to be some other driver then that they didn't control for, as in personality, environmental or physical difference?

Most people do want to have healthy sleep, the ones who don't usually have something causing those issues.

Or maybe if you are sick you don't sleep as well.

Pretty much my thoughts. People in lots of pain don't have a regular schedule to do anything, including sleep.

As someone when a poor sleep schedule, the inability it stick to a routine in this area tends to show up in every area… exercise, diet, etc.

I would imagine that someone with a very regimented life tends to stick to a lot of healthy habits. They aren’t going out to the bar every night, then waking up at 6am for their morning routine.

I my younger self had a terrible sleep schedule. I suffered pre-occupied thoughts of either what did or was about to happen.

I have a very consistent sleep schedule now and it is a real pleasure. I my sleep schedule has 2 or 3 3-4 hour stretches of solid sleep. I make my own schedule now so sleep is usually available when I'm ready.

>Couldn’t this effect be classic cause vs correlation?

Sometimes changing the correlated item, also affects the cause, through a link of causual changes.

E.g.: "Night visits to the fridge linked to high cholesterol".

Now, that's just correlation: it's not the visiting of the fridge, it's the snacking.

But if you read that and stop visiting the fridge, you likely reduce your snacking too as a side effect, and thus lower your cholesterol, without consciously trying to address the primary cause.

I feel like your example is flawed, I just can't put my finger on it.

Maybe it's because I don't see how sleep regularity is a factor you can change as willingly as visits to the fridge, or maybe its because I don't see why people wouldn't just eat more before heading to bed.

It could also just be that I find a treatment of symptoms to be less desirable than causes.

>I don't see how sleep regularity is a factor you can change as willingly as visits to the fridge

In some cases it might be hard (e.g. insomnia), in others it might be as easy as e.g. changing your schedule, or stopping binge-watching/gaming/doomscrolling late, or some such change.

>It could also just be that I find a treatment of symptoms to be less desirable than causes.

It is more opaque.

But the point is not that it's necessarily easy. It's rather than even if X -> Y is mere correlation, by forcing yourself to fix X (even if hard), the resulting changes might also help with Y.

And technically "bad sleep" here isn't necessarily a symptom either. It can be a co-effect of the same symptom.

> Perhaps someone who has a consistent schedule is hypothetically more likely to make healthier choices on average

At least they aren’t shift workers

The article never says anything about causation. It says sleep regularity is a predictor of mortality. That means if you find someone who already has poor sleep regularity they're more likely to die sooner, not that if you force someone into a bad sleep schedule they will become more likely to die sooner.

It could be, but it also might not be?

Most things have second order effects, having a consistent sleep schedule may allow more healthier second order effects based on a more regular sleep pattern than duration. Duration also doesn't mean quality either.

Studies that reach HN and other pop places usually have a lot in common: they link a widespread, modifiable and 'catchy' factor (like sleep, sugar/meat etc consumption, human relations) with a single sensational end point (death), and involve 5/6-figures number of participants. Another common one is a huge confounding spill that makes them useless for practical decisions but valuable for further, more rigorous research design.

I think in this instance, it wouldn’t be shocking that irregular sleep would increase all cause mortality.

Another common property of such studies is that their result is mildly surprising. Not much so that it will be scrutinised and questioned and not indifferent because no one will care about them. So, you receive your expectation.

My problem is that I'm always sleepy throughout the day and when I have to go to bed at nigh, then I feel so active and energetic, as if my body tries its best to avoid sleeping.

My doctor said "you have to earn your sleep". I had the same problem until:

- two pieces of fruit per day

- two portions of vegetables per day

- half an hour of outside sunshine per day

- twice per week exercise until you sweat

- no sleep during the day

- get out of bed every morning around the same time

- no processed food!

Kinda funny seeing this reply side to side with the "I just took LSD" one

I wish your doctor's advice worked on me. I'm in the same boat as the person you're responding to, and I follow all this advice as well.

I was in the same boat as you and it seems I solved it.

What I did :

- LSD (microdosing + a semi dose one year ago) did absolute wonders on my anxiety (which was what kept me energetic). I would then describe myself as having a general anxiety disorder and I now describe myself as chill af. It's amazing. I'm still stressed out by things but that's normal and not my default mode anymore.

- Prolonged-release melatonin keeps me asleep for the whole night

- Took the habit of reading in the bed. I'm so tired that most evenings, I have a really hard time to read 5-10 pages, I must fight to keep my eyes open.

okay, I'm curious, have you build an addiction? or do you think you can keep on reducing the dose and stop using it but still have the benefits. I've read somewhere that LSD can kind of re-wire your brain

LSD has risks, especially if you're already prone to certain kinds of mental illness (you might not know it), but addiction isn't really one of them.

Going for a walk can also rewire your brain, but doing so on LSD will probably rewire it more quickly. Whether that's good or bad depends on whether you do a good job with the rewiring. It comes down to how well you trust yourself.

> if you're already prone to certain kinds of mental illness (you might not know it)

Though you can have some solid hints. First it's important to say we are talking about psychosis related illnesses.

First one is nobody had mental illness in your family. Second one is your age : most mental illness develop when you are a teenager or in your early twenties. If you are 30+, you can consider that LSD will not reveal anything hidden.

Though you still get the risk of bad trip, which you can manage with a good set & setting and not being alone if you prefer.

LSD actually has an anti addictive effect. There are multiple studies about it, for example on smoking cessation (IIRC). It's pretty interesting. You're unlikely to get addicted to it.

LSD is not addictive. Actually it’s the opposite, I take it way less than I would because I just forget regularly or I don’t want to take it at all. I take it (microdose) maybe once a week instead of once every three days.

I do want to take a bigger dose again because of the healing effects it had the first time but I’ve been procrastinating it for the last 6 months. So I’m stuck with irregular microdosing.

Also the effects are really long, like 12 hours. While it’s not an issue when you microdose (because you barely feel anything), it’s extremely complicated to find the right time to take anything bigger than that.

You need a full day free of any responsibility, in a good place and you need to want to dedicate the day to it. I have a job and I’m a dad so let me tell you that those days never happen :D

And the only time I took a biggest dose (half a tab), I felt very good after it but, hard to describe, I was was satisfied/happy with my experience and with the effects but still I just didn’t want to redo it for multiple months, not because it wasn’t good but because I felt I didn’t need it anymore.

I do that, it seems like a self-reinforcing pattern I end up in after messing up my sleep schedule. I take a sleep aid (like Zzzquil) for a bit to get back on schedule. Caffine before 1pm or so helps too.

This is a shifted circadian rhythm. If you get up late, you'll be sleepy late; additionally, blue-light exposure at night (from screens) suppresses melatonin production and can delay onset. The fix isn't to "go to bed early" first, it's to get up early and get exposure to sunlight then and during the day, and the sleep pressure in the evening will follow in kind. This is further facilitated by giving yourself time in the evening to wind-down away from screens, by having a ritual/routine (an hour at least) such as preparing breakfast, reading, doing yoga, whatever.

Think of it like jet lag. If you travel to the other side of the world, you rapidly shift schedule in accordance with your habits (the timing of your meals, light exposure, activity, socializing etc), whether that be night or day. These inputs more than ever influence morning-ness or evening-ness qua chronotype, with the advent of limitless evening light and entertainment.

Chance is you are not breathing in your sleep. You have Apnea or UARS and are slowly suffocating. Easy tells: you look like shit in the morning and it takes hours for you to normalize, you sometimes wake up all sweaty, you tend to open window ASAP in the morning "to get rid of the stuffy air", you are confused and/or have headache in the morning.

If you want to make sure, get a sleep study done.

Why do you think you are avoiding the bed as if you were afraid of dying in there. Exactly! You literally are.

I thought I had UARS too, and did a sleep study. I couldn't sleep at all when I was there. My neurologist then just gave me fucking prozac.

It's not that simple to figure out what's going on unfortunately.

Just stay awake, you're sleepy all the day anyway... Not meant as joke, but I've learned that trying to sleep when I'm not sleepy is senseless. When I really have a month where I get every day my 7h sleep, I need one night without sleep, otherwise I can't sleep at night anymore.

Largest medical insurance company (Discovery Health) in South Africa has just launched a sleep rewards program as part of their wellness program (Vitality). The idea is that you get rewarded for getting good sleeping scores... which is not entirely in your control, but anyway. Their model is built by looking at years of sleep data combined with health insurance claims. They place a large emphasis on sleep regularity. Anyway, just interesting to see this study come up and it seems to match up sort of with the Vitality stuff. There will ofc be many confounding variables though...

It would suck to pay more based on bad or poorly understood data. Especially since I doubt they'll willingly give refunds if their foundational data is proven to be problematic.

Oh for sure. It's a carrot-type program though. So you don't get any penalties for not doing something, but you get rewards for doing things.

Discounting from higher default prices rather than penalizing from lower default prices is more of a branding difference than an economic difference:

https://news.ycombinator.com/item?id=47952034

Yeah but in South Africa medical aid rates are regulated by the government and all companies have to stick with that rate. The idea is that if you keep your customers healthy then there are fewer claims.

I have epilpsy, with an implanted device that both acts like a pacemaker and records my brainwaves.

Basically my doctor's biggest concern right now is making sure I don't die in my sleep because of something the device records that I and my wife never even know happened. Its a point of debate right now how much to disrupt my life with side-effects to do that.

Just my 2c

Bryan Johnson says you should base your life around your sleep. He’s totally right

… but he won’t get young men to sleep in at 8pm

New sleep meds are creating a new lever here and serve a real empowering function in a way that culture hasn’t caught up to yet

When we think of traditional sleep meds we think of sedatives and it has an identity connotation to it. The new meds coming out, not just in sleep either, are changing a lot of things. I’m talking about designer drugs, new pathways, multiple agonists etc etc.

By total accident a month ago, I was prescribed a medication for sleep, lemborexant (not into trade names for drugs, more power to generics)

I didn’t plan on ever getting a sleep med. I don’t see myself as a sleep med guy lol. I didn’t walk into a clinic thinking I’d ever want one either. But to me this feels like a peptide or an athletic recovery supplement. And I think there’s even better and newer out there

Having this lever has personally helped me a lot. Why? Because it’s very easy to let sleep quality slip over time. Here are a few questions I wished someone had asked me a year or two ago:

-Have you been dreaming? When’s the last time you had a vivid dream? If you can’t even recall that, it’s a big red flag. If you haven’t been dreaming, your sleep quality could be junk

-Erections during sleep? Just something to take note of

-Waking up tired or ready for the day?

-How long does it take you to fall asleep? There’s a key distinction there between how long you’re in bed vs. how long you’re actually sleeping. Check your apple health data. It’s so easy to mess this up, in this modern age especially, it’s why I’m hooked. There are far too many variables that could affect a key function of your life, especially for young guys. An afterparty, a hookup, a stressful period in business, a productive all-nighter, or just overthinking instead of sleeping

People notice when you don’t sleep well

>… but he won’t get young men to sleep in at 8pm

i've never had a problem with staying or even falling asleep, instead my issue is *wanting* to go to bed and getting myself there. adhd, executive dysfunctoning/akrasia, screens, chores i procrastinated all evening, etc, all give me too many things to do at night instead of tucking myself into bed. i basically don't feel tired at all until i lay down. i don't notice i'm mentally wiped until i start bottomfragging in a video game at 2 am.

i've taken melatonin (and magnesium) for a long time, but only in the past few months i started taking it like 3 hours before bed, after reading scott alexander's psychiatry website, instead of right beforehand.

i also happen to have been recently RXd a drug called guanfacine which dampens sympathetic activity (think fight-or-flight) and when i take it with the above pills, i finally *feel* tired at 10 pm. my body is heavy and slow and my brain starts craving being turned off. it's remarkable. there's something about *feeling* tired that is humbling and makes me feel human. weird!

BJ et all aren't joking when they say the biggest performance enhancer is sleep and especially regularity. i would rather sleep 6 hours and wake up at my normal time, than slide my schedule around and hit 8 and sleep in. but when i hit 8 on my usual schedule it's like i have superpowers. i don't make gains at the gym unless i sleep well. and it's such a funny thing to say out loud, but i don't need coffee when i'm rested. when i'm rested and take a coffee, it feels like i just drank 3 coffees and i'm ODing on top of my natural alertness.

I totally agree

Melatonin gummies help for sure, I have zero complaints. I embed the lex into the gummy

Same with adhd btw

You should def try this. My prescriber just somehow knew, likely bc of vyvanse. I spoke to him again the following day, and I was telling him dude this is great, I want a permanent supply of this lol. Maybe it’s a common issue amongst us ADHD people

I’m really looking forward to Centanafadine, looks like it’s going through approvals this month?

I’m thinking of trying guanfacine, wonder if it’s actually worth it. It apparently widens your pfc veins or something? A very veiny brain sounds awesome

Cheers!

Sleep disorders are 100% a common issue with ADHD (as my psychiatrist explained)! I’ve been on guanfacine (1mg) but it doesn’t really help with sleep. It’s only the first couple weeks that you feel drowsy from it, after that it doesn’t help. But it does help me want to get out of bed in the morning which is pretty nice.

> i started taking it like 3 hours before bed, after reading scott alexander's psychiatry website, instead of right beforehand.

He seems to suggest something like 7 hours before you go to sleep. Where did you get 3 hours?

If you find a good sleep med it can be life changing. I found a natural supplement called muscimol that's a silver bullet for me. Gets me to sleep in 20 minutes every time, gives me great sleep, and isn't habit forming. It can be hard to find because people like to try to take huge doses to trip, even though it's an awful delirious experience(never tried it but read stories).

At low doses though it works by mimicking GABA in the brain, so it actually increases REM sleep time. A lot of sedatives will get you to sleep but give you worse sleep because it's working in a very unnatural way. It totally eliminates the issue of taking a long time to fall asleep.

Now you still have to be able to get yourself to bed in the first place, but that's half the battle already won. My life is so much better using it as I've always had a hard time falling asleep. Hopefully we'll have similar medication available to everyone soon as I really think it can solve a lot of suffering people experience

Bryan Johnson is hardly someone you should aspire to follow or listen.

His entire adult life has been focused on the "live forever, stay young" culture, where he takes dozens if not hundreds of pills a day, avoids direct sunlight, takes blood plasma from his son, experimental longevity interventions such as injections derived from baby foreskins and whatever else he has tried over the years.

He's lived this insane "healthy" life and now he is suffering from yet another auto-immune disease, and in his own words "My stomach is eating itself."

Eating healthy, regular sleep schedules, and avoiding stress are all things we should do, there's no denying that. But it should NOT come at the detriment of living your life and living it well. Plus these recommendations are just basic things that everyone talks about, it doesn't take same health guru's advise.

I have a family member that just turned 104, all her children are dying or severely impaired, she's still there, still alive and looking like she'll easily turn 105. She drank, she smoked, she ate red meat, and she takes one pill a day to regulate her blood pressure which hasn't been a problem in over three or four years.

The biggest factor in people's health is genetic luck. Then your healthy habits, followed by medical help (medication, etc...) The last two you can control, the first is just that, luck of the draw.

I do bi/tri phase sleep, 6 hours at night, and 1-2 naps a day (I work remotely so allows me to nap when I want) This is the best, sleep when you need to you body knows best.

Do you think our ancestors slept exactly 8 hours a night from 10pm to 6am? No they slept when they wanted.

There’s plenty of evidence that people used to sleep very early, and have a period of activity in the night, before having a second period of sleep.

I follow the same schedule as you do, and also work remotely, and usually take a single 1-2h nap somewhere between 12pm - 3pm. It makes me have two moments of “morning productivity”, which works very well for me.

In the end, listen to your body.

> Do you think our ancestors slept exactly 8 hours a night from 10pm to 6am?

Yeah I pretty much do expect that (but more like 6 or 7). They were awake a few hours after sunset by fire light, then get up fairly early. I certainly don't imagine them napping during the day, when they could be working together to get food, unless it's a climate where it's too hot to do anything in the middle of the day.

Studies of modern hunter gatherers seem to back this up e.g. [1]

It's widely known that Victorians would have two sleeps over night, with a productive period in the middle, but this seems to be a misconception based on a passing remark in one court case. Even if true, this is a post-industrial society with unhealthily long working hours and I don't think we should be copying their sleep patterns.

[1] https://www.sciencedirect.com/science/article/pii/S096098221...

Nearly all predators spend large portions of their day sleeping, why would humans have been different?

Bears sleep about 7-8 hours/day, similar to humans.

Well that's a purely intellectual question, given that empirical data on human hunter gatherers.

But I'd guess it's because (1) humans aren't purely predators, we're have a mixed diet with plants too, and (2) humans hint in a fundamentally different way to most predators, by chasing their prey to exhaustion over several hours rather than outrunning them over a few minutes.

Watch male lions they sleep when they want, laze about all day until they need to eat. Or you can be a deer caught in the corporate wage slave, alarm clock prisoner headlights.

Artificial light has a huge effect on drowsiness for me. This is quite noticable when I am out in the woods, camping in a tent. After sundown, I have about an hour left before I get so drowsy that I cannot keep my eyes open. Back home, indoors, I can stay awake almost indefinitely.

Watch birds they fly when they want. Or you can be a slave worm bound to the earth. The choice is yours

If you watch birds you will see they don't use alarm clocks nor go to work, but still find food each day.

Birds don't need to cooperate in groups to find food.

In animals that do, you can bet that they have a way to wake together. If you're camping in the same tent as other humans you'll soon find that out. Alarm clocks are a workaround for not living communally with the rest of your tribe.

What about female lions?

Male lions don't hunt, females do. In human hunter gatherer society, it's the males that hunt while females gather plants.

Also, as I mentioned in a sibling comment, humans hunt in a fundamentally different way to most predators, including lions: humans chase to exhaustion over hours while lions try to outrun their prey over minutes or less. (That's why humans have three gaits: walking, jogging, running, while most animals only have walking and running.)

I've tried this but naps make me groggy for the rest of the day, or sometimes I get confused thinking it's the next day. What's your secret to waking up refreshed from a nap?

I am groggy but I drink a Coke Zero and within 10-20 mins I feel great. Whereas without sleep I would be flagging.

My PhD advisor likes to drink a coffee just prior to falling asleep. That way the caffiene slowly kicks in and wakes him up. I can't do this--I already have trouble sleeping and I feel the effects of coffee quickly.

But to answer your question-- for me, washing my face helps a lot. I don't know why. Not that I nap all that often.

Your naps are too long. Think of it as a reboot, not a full power-down cycle.

I set a 25 minute timer and usually wake up a few minutes before it goes off. You don't want to go all the way into deep sleep which really requires 2-3 hours to properly do a REM cycle, and if you wake up in the middle you'll be super groggy.

Having just spent a few months reading circadian entrainment papers for a circadian rhythm app I just finished,[1] I wonder if this effect might be about circadian amplitude[2] (rather than phase, which has gotten more attention).

[1] https://www.impulsearc.com/wavelength/

[2] e.g. https://www.nature.com/articles/s41540-023-00300-w

Also just the general timezone stuff, genetics ~ I've moved from the right end of a timezone to the left end, it's been killing me.

Something that has worked surprisingly well for me is journaling via voice recording on my phone. It's been so effective that I've mapped it to my phone's physical shortcut button.

I have struggled with on-and-off sleep issues for a while, and I'll admit I don't always follow perfect sleep hygiene. But there is something about dumping my thoughts out loud that completely shuts down the repetitive, circular thinking that usually keeps me awake.

Is there a particular structure to it, or just whatever is at the top of your mind?

I kinda realize that the most important factor for personal success (whatever kind of success you want) is mental stability.

Like, John Carmack said that he NEVER burned out, never went into a dark corner (verbatim from his interview), and everyone agrees that he works like a machine. And I don't think he actually spent a lot of mental training to achieve that stability, because, he has been like that from a young age. This is THE best thing you can have in the world, if you want to achieve something, anything. If you don't have the mental toughness, you won't be able to make through that 10,000 hours (cliche, I know). I guess that's also why many self-help book talk about being consistent -- to be consistent, is to have mental stability. And I think there is a whole difference, between someone who trains his mental to stay stable for 6 months, then collapse, from someone who actually doesn't need to train and just be stable somehow.

This also leads me to realize that good sleep is one of the fundamentals of a stable mind. As a parent, I actually don't remember when was the last time I had a good sleep, and my definition of a night of good sleep is perhaps just trivial for someone else. At the same time, I consider myself lucky, because at least I don't suffer from serious mental issues. I still have a job and a house, and that's better than many out there.

This then leads me to despise the human body. It is a machine so delicate that you have to be very lucky to be super productive, whatever your definition of being productive is. It seems to ignore the input in short term (e.g. you can eat garbage food for a month and nothing really happens, or, you can sleep 4-6 hours every day for the last 6 years and still function normally), but once the long term shows up it is very hard to reverse. And there are so many theories focused on it that we have no idea which one is best for the individual. You might as well spend years doing A/B test on yourself and still have no idea what the hell is going on. Or you need to be super rich to have some medical team monitor you 7/24 to figure out what the hell is going on.

Carmack always seemed to have a really strong idea on what was important for him to work on. How much of that is mental toughness vs having a believable purpose?

Believable is important because you have to internally 100% without a doubt believe that what you're doing is the right thing to be doing now.

As soon as the "what ifs" starts to creep in for the big picture items or goals, that can destroy everything. I'm not talking about running into technical implementation problems along the way (those can be fun), it's more like "did I pick the right language for this?" level of questions that sit in the back of your mind.

Personally when I find something to work on that I like and will have what I think is a favorable outcome, it's easy to put in 8-10 real 100% laser focused hours into a task every day, even if it spans weeks or months. I'd like to think most people can do this too, the hard part (for me at least) is having these things to work on.

You are spot on. I see all this in me, too. Very interesting to encounter your take.

I try to turn what-ifs into actions. Instead of a what if rumination it is a small task, or a small trial of something, or a move in general forward rather than not. Not even remotely close to doing this well all the time, but I notice an overall boost in mood and productivity when I reorient my mint to progress rather searching in the uncertainty space.

I half-agree with you. I agree with you because I kinda had that experience from time to time. I'd focus on a certain learning project for about 4-6 months, usually without much break, all done after-work. I disagree because I usually burn out myself so much after that 4-6 month period, that I usually don't do anything related for another 4-6 months.

This shows up in my github repo contribution chart, but more importantly I retain very little whatever I learned -- concepts maybe, not nothing else. That's why I so admire Carmack's machine-like consistency.

Maybe I don't really believe in the course as strong as he did. Maybe I'm more tuned to burn out early. Whichever the reason it is, you could imagine that I'd very much love to improve.

I sometimes think about the same. Its a sad truth that if you bad days those days may be at the worst moment. Sleep definitly helps for a good mind but also exercise!

> Like, John Carmack said that he NEVER burned out, never went into a dark corner (verbatim from his interview), and everyone agrees that he works like a machine.

> https://x.com/ID_AA_Carmack/status/2069799283369345247

That's because he was the one burning people out while he was there living out his hobbies.

Maybe that's what people with strong ideas do. They execute and they kinda push each other around.

Not sure about that, what I'm sure is that J.C. did it and he obviously regrets this, so maybe people with strong ideas should take notes from someone that knows better. Maybe their ideas work not because but despite grinding people down.

I would also argue for regular exercise as a fundamental of a stable mind. I've always been an anxious person, but since I started running 3-4 days a week consistently, my baseline neuroticism has significantly dropped.

The deep post-exercise sleep doesn't hurt.

I think it helps a bit, but no longer makes a big difference. Guess that's because I'm "old" (40+).

But again, maybe it helps more than I thought, because I haven't done any A/B test on myself -- I'm kinda getting used to exercise now.

struggled and still struggle with a lot of health problems and lack of motivation. too much data, too little time. really hard to manage. been building something to help with all of this and it's been working pretty well for me, curious if you're interested in checking it out? nbd if not. biggest advice I have is get some social accountability

Well, I'm screwed...

My thought exactly. For people who struggle with this, and conventional wisdom doesn't seem to stick, what are we supposed to do?

Did you cut out all caffeine?

> conventional wisdom doesn't seem to stick

I wouldn’t say cutting out all caffeine is conventional wisdom. Every sleep specialist (sample size of 3) I have spoken to has basically said, while they don't recommend caffeine, if you only drink it early in the day it’s probably fine.

I’m asking a question to determine his view of “conventional wisdom,” which could be all kinds of things. Why would you assume that his view of “conventional wisdom” necessarily includes cutting all caffeine?

I think the question is fair. I don't tend to drink caffeine after about 5pm so had kinda written this off as a potential.

Let's create a Discord/Signal/WhatsApp/mailing list group to help each other figure it out... it's time to end our sleep irregularity once and for all!

Would you actually be up for trying a one-week version of this? I'm building something rn that would let us run this in iMessage super easily!

The only thing that worked for me was having a kid. He wakes up early every day, so I have no choice. Taking care of him is so taxing, being sleep deprived isn't on the table.

What's more, you have little difficulty falling asleep any time, any place!

Don't watch any kind of screen in the evening. Read a book instead. You'll fall asleep sooner.

Isn't that "conventional wisdom"?

I do watch screens in the morning, but reading in bed (though still a screen, Kindle) still knocks me off in max 15 minutes. I would love to know why... I only know it works.

Could be related to the light spectrum. Kindles aren't really "screen" like the others; they do have background light but you can turn it off and use it with its paper-like screen (which is what I do and really like it). But traditional screens have blue light as part of the normal light they emit, which is known to disrupt sleeping patterns. When I am using my cell phone or computer right before sleeping, I usually turn on colour filtering to make my whole cell phone be tinted red. This helps wonders. I found this page that explains how this can be done: [0].

[0]: https://ios.gadgethacks.com/how-to/keep-your-night-vision-sh...

With this [0] I find i read 2 pages and I fall asleep consistently and really with a will to sleep. My mind wanders into far away lands and empires and says, "I take it from here".

[0] https://www.amazon.com/dp/0691134952

Lifelong severe insomniac (sleep onset mostly) and cured myself pretty much entirely over the last year or so. My suggestions in order of what I perceived to be their cost vs effectiveness ratio:

1. The Sleep With Me podcast, especially if you struggle with racing thoughts (if you have a partner who can't stand hearing this, the Ozlo Sleepbuds are a good if imperfect solution)

2. Stellar Sleep, an app that delivers CBT-I, evidence-backed cognitive therapy for insomnia; this reset my sleep clock in about two months, which is now maintained by the other items on this list

3. Eight Sleep mattress pad to keep temperature low during sleep, especially on warmer nights

4. Manta Sleep Mask to get full light blackout

Also I've definitely just doxxed myself. But worth it to help some fellow insomniacs!

Thank you!

Conventional wisdom does work for me but it is immensely difficult. I would say take the advice seriously but don't take the timeframe or problem difficulty assesment coming from other people.

It is only natural that it takes months to years to fix a problem if you had the problem for years.

Hard to answer precisely without knowing what conventional wisdom didn't stick.

The common levers I know and that worked at least a bit for me:

- start by having a fixed waking time, and get sunlight or bright light quickly after waking up. Normally relatively fixed sleep time is supposed to follow. For me waking up is the easy part, transforming that into getting up and going outside is harder. Another option here is a strong (like, really strong) lamp on a timer, or letting the morning light in your bedroom (this one is usually not recommended I think, most people seem to be blackout curtains style, but for me it gave me a nice 6am waking time with good sleep last summer).

- melatonin. Two main ways: using it as a kind of hypnotic, so ~30 minutes before sleep, experimenting with 0.3mg to ~2mg doses ; then using it as a circadian regulator, this is a good resource https://lorienpsych.com/2020/12/20/melatonin/, search for "TO TREAT" in the page.

- app timers, for me it was mostly no twitter and no youtube, or a very low time for each.

- light, ie reduc light before sleeping. Not just blue light and not just screens, if I'm on my phone in bed I'll reduce the luminosity a lot, same with computer, same with e-reader. I also try to avoid using too much the lights in my room. More light tend to make me feel more "wired" and less ready to sleep.

- "meditation" to cut rumination, by which I mean "lay down in my bed, gently try to find sensations in the body and to stay focused on them, by gently I mean it's a very low stakes game where the goal is to find sensations in the body and give them attention, but losing focus for a while is not a big deal".

- shower in the evening, as I don't like feeling dirty when I am in my bed, but also not just before bed as sometimes I don't really want to go take a shower and this delays my bedtime

- clean bedsheets, bedroom, stuff in/on your bed

- AC in the summer, I wouldn't be able to sleep properly without it

- sleeping mask. It helps going to sleep, but it falls of my head every night so it doesn't prevent waking up with light too.

- making getting good sleep the priority of the evening. This is easy/possible for me due to my circumstances (ie low responsibilities in the evening). The way I do it is that unless something is actually important, what I'm trying to accomplish in the evening is prepare myself for sleep and get good sleep. This can look like not starting a movie at 11pm, not booting up games, not eating a super heavy meal, not drinking too much water after 6pm to avoid waking up to pee, if I have things I want to do try to do them early so they're done earlier, move some stuff I want to do every day like spaced repetition in the morning.

"If I'm on my phone in bed" is throwing out a major, proven impactful piece of conventional wisdom.

Yeah, in an ideal world where I'm the ideal me I wouldn't use my phone in my bed, but I haven't found a way to stop doing that which I can stick with, so I try to limit the damage.

Part of what I wanted to say is, there is conventional wisdom, then there is how you actually put that wisdom in practice in a way you stick with. I've struggled a lot with the implementation, but sometimes by throwing lots of stuff at the wall I find something that brings me halfway there. It's not the "golden way" but it leaves me in a better place than before, with a bit better sleep, a bit more self knowledge, and a small victory.

That totally makes sense. Also, thanks for sharing your list! I'll see if I can try anything on it. :)

Exercise, often, not too hard, over short time you'll get your personal level better than any coach could do. It will also prolong your life easily by 10 years and add tons of quality into it, will make you happier and more connected to your own body. All people I know also corrected their eating habits aggressively, its all connected.

If you dont have enough time get to the point when you can do HIIT safely, its literally 15-20 min max. If you have time, add long walks on rest days for example, or whatever is available to you nearby (ie swimming/surf if usable water body nearby).

My follow-up: I'm grateful for the advice from commenters. I perhaps should have specified that my issue isn't insomnia, it's sleep procrastination, which gets a lot less sympathy.

Are you? Would be happy to die by 65-70 instead of struggling through 80s…

Easy to say when you're not 65-70.

No one knows for sure how they will be in their old age. My grandmother didn’t seem to struggle until her mid to late 90s. That’s a lot of years to leave on the table. Years that allowed her to meet and enjoy time with her children, grandchildren, and great-grandchildren.

Had she died at 65, I wouldn’t have even known her. Instead she was around for my entire childhood and well into adulthood.

I'd rather live through my 80s without much struggling. Longevity and quality of life until the end. And I try to live in the way that lends itself towards that.

There are really different kinds of 65-70.

My parents are both 70 and very active. I often meet 65 year olds who are frail and slow with chronic pain and diabetes, when my dad is going on 50 mile bike rides a few times a week. I would hate to develop a significant health condition at 55 and be seriously ill by 60. I would much rather be healthy until my late 70s.

From what I understand, whether you will struggle depends a lot on whether you eat well, sleep well, drink, smoke, and exercise.

My dad played futsal until the end (~70 yo, car accident, be was perfectly healthy otherwise); I met one of his classmates from school, he looked 20 years older, no exaggeration. My dad looked like he was barely 50.

Note: how old someone looks is very biased by their "generation", as people tend to drink and smoke less these days.

If it's of any help to you: if TFA is true, I should be dead already. I've got the absolute most fucked up sleep schedule. Thankfully I've got a lovely wife who accepted it (to be honest as it's been like that since I was 20 y/o, she knew...).

To me burning the midnight oil is my way of life.

In a past life, two decades plus ago, I used to write books: I'd write at night, when all is quiet. I'd go buy two or three warm "croissant" at 6:30am when the shop would open, then I'd go to bed.

And I love the hours later at night that then becomes early in the morning to get work done.

Because I'm such a night owl (not to party nor drink at all), I've got a different view on, for example, city life. Or rural area life. Things are different in the middle of the night.

Last night I had something that needed solving: went to bed at 8am.

My wife shall never ever take an appointment for me in the morning.

If it's of any comfort to you, I'm still fit and made it to 53 y/o so far and my doctor laughs at me when I go see him, saying I'm totally fine.

Anyhow seeing the old wreck my fater is at 78 y/o, I kinda came to peace with the notion that it's okay'ish if I don't make it that far.

Those with fucked up sleep schedules: you're not alone.

P.S: if I wasn't such a night owl, I'd never have met my wife... Long story but the butterfly effect: 25 years ago, coming back from my editor (who was also a night own) at something like 3am I decided to stop at a club knew but to which I'd never been, for there was some forms of life still awake too. There I met a girl, which became my girlfriend for a while. I kept in touch with her and through her I met a friend: a crazy dude. And through that crazy dude I met my wife. So had I not decided to stop at 3am at that club, I'd never have met my wife. So there's that.

Try Trazadone. I've struggled with sleep my whole life and now, after 45 years, I can finally say I have the problem thoroughly licked.

The only thing that has worked for me to keep my sleep regular is to go outside first thing in the morning and sit for 15-20 minutes. Rain or shine. Even if it's cold or cloudy.

This has been game changing and keeps me on a regular sleep routine.

Seconding that the time you get up, and light exposure then and during the day, has a massive impact. If you habitually sleep in late, then "going to bed early" does not work as you'll lack sleep pressure. It's putting the cart before the horse. You have to treat it the same way we do jet lag; when we travel to the other side of the world, we adjust by just gritting through the morning. Takes few days to shift.

Could it be that irregular sleeping is caused by inner clock being off due to genetic errors, and genetic errors are the main cause of mortality? I.e. irregular sleep is not the cause but the indicator?

Or irregular sleep corresponds to bad habits like drinking and using drugs and they are the cause of mortality?

Or, could it be that problems with sleep are caused by using alarm clocks, i.e. not waking up naturally but forcefully at unnatural time? Waking up at the same time every day benefits people whose inner clock has 24h period and disadvantage people with clock tuned to 23h or 25h day.

Or I am wrong?

> Adjusted R2 values for each model were 0.085 (linear), 0.118 (quadratic), and 0.125 (cubic)

I get the study design is not causal and all, but this R^2 looks very underfit for a study that claims a stronger predictor?

Sleep is a predictor of poverty and poverty is a predictor of mortality.

But i suspect if you hop over the second part there will be more funding in telling poor people to sleep there way to longevity.

> Sleep is a predictor of poverty

Curious. Any sources for this. How does this work? Feel like many high paying, stressful jobs are actually bad for your sleep.

plenty of studies into this;

https://www.sciencedirect.com/science/article/abs/pii/S13899...

https://futurecarecapital.org.uk/latest/deprivation-linked-t...

https://www.nature.com/nature-index/topics/l4/socioeconomic-...

A good night's sleep is no longer an option for me. My area is experiencing widespread, constant ground vibrations throughout the day and night. It feels as if your whole body is vibrating. No supplement can help with that, and there's nothing the local authorities can do until the major construction projects are completed over the next few years.

I'm so sorry. This sounds horrible. Have you local elected officials or the contractors been made aware of this and are willing to do anything about it? Even help sound proof windows, outdoor areas, etc.

I think this kind of behavior by the groups causing this impact on you is irresponsible and harmful, even if it's not known. If they know I think they are being unethical - I think its fair if they suffer harm and damage as a result such as in court or you similarly start to coordinate a group of people that can make their jobs harder as well through legal means of course.

Maybe ya'll stand outside their work and speak with megaphones for as long as possible, or just stream a speaker blasting audio towards them as they work.

I wonder if having springs in the bed legs would help to damp vibrations. Or.. something like that

https://engineering.stackexchange.com/questions/42284/vibrat...

https://www.bolonhome.com/news/bed-frame-vibration-control-d...

I remember a Youtube video about a story of a skyscrapper that added something to damp vibrations so that it would be more comfortable due to high winds or something like that. If it's feasible to damp vibrations on a whole building, you can do it on a smaller scale as well

I read the abstract, pretty interesting. I did a word search for "wake" looking for if they talked at all about early waking times being correlated with overall regularity, as that has been my personal experience. Unfortunately they didn't talk about it, or if they did I couldn't find it.

I am also curious about this. The best sleep I ever had was when I was teaching an early morning class. Part of my morning routine is a short run, so this meant I was regularly waking up at 5am. I fell asleep regularly at 9pm when I was on this schedule. I use a sleep band [1] to track sleep, and it was the only time when I've been able to consistently get "high scores" on it.

[1] https://www.garmin.com/en-US/p/1650098/

It's strange to me that adolescents are (or seem to be) wired to want to wake late and sleep late, since waking early and sleeping early is a predictor of a predictor of lower all cause mortality!

I solved my sleeping patterns by sleeping very early at around 7 p.m. or 8 p.m., also it feels like sleep and hunger have something in common like if you skip the hunger for a while, you won't feel hunger for a while same goes with sleeping. At least it is my own experience.

Well that sucks, given I have a gene variant related to delayed sleep according to 23andme.

Last year I did an experiment of sorts while unemployed for a time and found that if I just slept and woke when tired that my sleep time would naturally recess and eventually "flip" after about a month.

My entire life I've wondered why I feel incredibly tired and found waking up so difficult. Turns out that if you follow your bodies dominant sleep cycle it's a synch to wake up. Unfortunately, it doesn't work with modern life very well.

I've found my sleep regularity to be pretty malleable. It can become a habit. When I was in grad school I went to bed at midnight and woke up at 7am. Once I started running more in the mornings, I gradually shifted to going to sleep at 9pm and waking up at 5am.

The first couple days or week will feel pretty bad, but if you give yourself enough time then you'll shift your sleep schedule around. Now I get tired at 8:30pm and fall asleep at 9ish like clockwork. grad school me would have considered that insane considering I'm doing less work on average during the day. My day is just shifted now so that I do more stuff in the mornings and really relax in the afternoons, which is the opposite of before.

A key is actually giving yourself enough time to fall asleep. Most people think they can hop into bed and just get 8hrs, when you actually need to hop into bed around 30mins beforehand and really relax with a book or something.

I also think it's important to not stress about sleep a lot. Unless you're literally feeling miserable or have apnea, I think it's better to just let yourself relax if you wake up in the middle of the night. Sometimes I'll snap awake at 2am and just read for 2hrs, then get 2 more hours of sleep and generally feel fine.

People are different. What you find easy and trainable, someone else will find it doesn't require training and someone else will try as hard as they can and won't succeed.

The only way I really made an early wake up work was wearing amber safety glasses to block blue light for an hour or two before bed every night.

I will note that if you feel absolutely terrible on 8-9 hours of sleep, you should check with a doctor about it. I have hypothyroidism and was on too low a dose of medication, and felt so tired after work that I almost drove on the wrong side of the road. I'd thought this was simply from moving my sleep schedule and getting less sleep after starting a new job, but I got a blood test for unrelated reasons and found I was hypothyroid. A couple weeks after starting the new dose of medication and I feel like a new person.

I also have sleep drift problem and consistenyly had it for the past 7 years.

I discovered that it helps when I actually put in effort to fix my sleep schedule. Like getting off screen 1 hour before I sleep. Boxing bedtime to 23:00-08:00. And similar things.

It is just really difficult to fix for me but it doesn't feel impossible. I have made progress in last 6 months but trying different methods and only some portion of that progress stays permanent.

Also have the same experience fighting depression-like symptoms and anxiety. It just takes a lot of time and is difficult. Some people just don't have these problems and I do but this doesn't mean I am genetically attuned to be like this and I can't do anything. It is just difficult.

I have had a similar experience. I would find my sleep schedule constantly drifting later and later, which made it harder to wake up in the morning, so I would self medicate with caffeine which made me anxious, which contributed to the same cycle. But even when I stopped taking caffeine I always found it difficult to actually go to bed at the same time every day.

What finally worked for me were red light glasses. I wear the True Dark Twilights Classics (though I’m sure there are other brands on the market) for 2-3 hours before bed time and I’m actually sleepy. Way more effective than taking melatonin tablets ever was in my experience. And I haven’t even had to substantially change my screen usage either (though the glasses do make everything come out monochrome, which makes it difficult to use anything that’s not in color blind mode).

Interesting, at first I though you mean the active red-light therapy things. I've seen that a lot on Instagram.

Might have to try that myself. Do you still use your phone/tablet/etc or does it also encourage you to use them less?

Yeah, I'm not sure about the efficacy of those, my understanding is that blocking blue and green light is more important than exposure to red light, but not an expert.

I do still use my phone, and more importantly for me my computer, basically right up until bedtime. I have probably decreased my usage some but it’s not a huge factor.

Good points, if I am careful about caffeine and do all of that it's not unmanageable. Being outdoors and camping and getting good physical activity is the best I found. But it's a struggle for me.

> Also have the same experience fighting depression-like symptoms and anxiety. It just takes a lot of time and is difficult. Some people just don't have these problems and I do but this doesn't mean I am genetically attuned to be like this and I can't do anything. It is just difficult.

Should I mention that "neurodivergence" and different sleep pattern genes have a large co-morbidity? E.g. many people with anxiety / ADHD / dyslexia / depression / etc have a very high likelihood of having delayed sleep or other genes.

You might find some benefit from an app like Wavekength[1] that uses iPhone camera to coach your light exposure, based on current+desired circadian rhythms.

Disclaimer: I made the app.

[1] https://www.impulsearc.com/wavelength/

I had that my entire life, and then one day started having the strangest medical condition where it is literally impossible to sleep past ~6:30am.

It sounds unbelievable but you’d have to experience it to understand. But the end result is it “fixed” the delayed sleep issue.

I’d give just about anything to be able to just sleep and keep sleeping, but on the up side now I’m an early bird with extreme regularity and quite like it.

> having the strangest medical condition where it is literally impossible to sleep past ~6:30am.

It's it really? What if you go to bed at 6am? Will you really still wake up 30 mins later?

Yes.

I might be ruining the joke, but are you talking about kids?

You are not alone.

Recalling from college neuroscience classes and subsequent reading of research, the studies show the ordinary human sleep cycle when unrestrained adds about a half hour per day, so 24.5 hours is 'natural'. Long-term studies with all time cues carefully removed ended up with subjects on a ~50 hour sleep schedule, as in awake 36-38 hours and sleeping 12-14hrs.

This is also why it is easier to travel across time zones to the west than to the east.

I think I'm gonna try and find a study that had the 50 hour sleep cycles

It was a person free-running in a cave. Here's one article about it [0] to get you started, and here's another [1] of multiple 9-day studies showing the fairly immediate shift to 24.5 - 25 hour cycles (we're actually Martians?).

[0] https://howandwhys.com/michel-siffre-time-experiment-body-sl...

[1] https://www.researchgate.net/publication/339110740_Living_Wi...

Do you have non24 sleep disorder? Eliezer Yudkowsky has it and @exfatloss150 . Both have written about how they manage it.

Without blue light or loud noises there are no sleep issues. You just fall into rhythm with the sun and rise and sleep more or less by the seasons. No industry coaching, science or reliance on an expert needed - *except the sun.

I'm really pissed that I went through 6 cloudflare captcha loops with no result. I swear they're guarding this website from VPN users as if it's the fort knox.

Somewhat related, I once met the author of a book about sleep [1] and asked about my specific case. At that time I was splitting half my time across two continents 10 time zones apart but working largely in the same timezone, about 2 - 3 months at a time. That is, every 2 - 3 months I switched from a 1st shift sleep schedule to a "2.5th shift" one. So I asked him how bad that was for my health.

He said that as long as people are mostly regular in their sleep hours, the actual timings don't matter much. However, extended periods of irregular sleep schedules are actually (his words) "classified as a type of carcinogen."

I briefly looked into the evidence at the time but did not find it very concerning. TFA does make a more compelling case by linking it to all-cause mortality.

[1] I believe it was The Sleep Solution by M. Chris Winter, though I may be wrong. I can only remember it had a blue cover, but turns out pretty much ALL books about sleep have a blue cover. ¯\_(ツ)_/¯

(2023)

Some more discussion then: https://news.ycombinator.com/item?id=42022151

because of how we evolved biologically, there are some processes, particularly in the brain and not just the body, that can only happen during sleep

like "garbage collection"

ie. https://pmc.ncbi.nlm.nih.gov/articles/PMC4651462/

This makes sense to me as a correlation. Mental health disorders alone seem like they’d contribute significantly.

ADHD, for example, is correlated with both sleep cycle issues and worse outcomes in life (including higher rates of crime and participation in risky activities).

Sleep apnea symptoms are initially similar to ADHD. Apparently a ton of kids gets mis-diagnosed with ADHD while they are slowly suffocating because they have UARS. Stimulants mask it.

As my diabetes has progressed, I find myself sleeping more odd hours (it can be hard to fight off the tiredness that comes after a meal), and I can be frequently woken up my extreme lows where my body is screaming for carbs.

What's missing is how much ability you have to sleep, rather than some sort of sometimes controllable factor like schedule. In my case, my brain wakes me up with anxiety one hour or more before the alarm rings (I never check time, I'm guessing). My room is always cold and relatively dark - not photo development dark, but not far.

The cortisol spikes are what get me. I can drink or not drink, exercise or not exercise, take magnesium or not take magnesium. The brain wants to tell me at 630 or 7 all the things that can go wrong or todos, instead of letting me sleep til 8. Sometimes it's much earlier than that.

I also wake up at the slightest sound or movement. It's been like this since I was a child. I'm defective, and all the bro science Youtube videos with top 10 science -based 'hacks' don't solve the problem. Know what does? Anti anxiety medication, but doctors don't prescribe benzos anymore.

This sounds similar to me. I get cortisol spikes throughout the day and that can interfere with my sleep.

Conventional recommendation is to go see a talk therapist, but I have never really bought into it. Other thing I have seen recommended is LSD/DMT which I would have tried by now if I wasn’t married, it seems like too bug of a risk that LSD/DMT will alter my psyche in such a way that ruins my marriage which is not fair to my partner.

Best I have found is detaching from society, back country camping, no technology. But I don’t want to become a hermit in the woods to just be able to sleep regularly.

Mushrooms are not quite the same, but give you more intensity control (and are much shorter duration). And legally there is ketamine therapy.

I'm not sure if it'll completely remove the cortisol issues I have. This feels biological, maybe due to early traumas. Are psychedelics supposed to fix these? I thought it was more for depression than always-on vigilance.

Removing all real dangerous stressors (like work and house woes) would really help. I tend to be a lot more tolerant of less sleep while on vacation. That said, I spend a lot of money and time finding quieter hotel rooms or airbnbs.

My understanding is that LSD/DMT can “re-wire” your brain and give you an out of body experience that allows your psyche to realize what patterns are serving you and which ones are not (hence why LSD/DMT being very successful curing addicts). My theory is that early trauma and a somewhat explosive father has lead my nervous system to be on a hair trigger as a coping mechanism, if somehow I can convince my nervous system that this is no longer a necessary coping mechanism that would help.

That sounds familiar to me.

Ketamine with psychotherapy has become mainstream and legal I think in a wider context, and there are different ways they do it - one is to give that heroic dose under supervision with a drip which can be a controlled administration.

Psychedelic therapy with mdma or mushrooms is only legal in very few places. Personally I find mdma is more promising for what you (we) experienced there. There's a sort of ancient wiring due to childhood threats. MDMA has been proven to help soldiers with PTSD, which I think is a big adjacent to this (the vigilance being the common facor)?

So if I regularly sleep at different hours, is it OK?

Opened this thread expecting to see a bunch of anecedotal sleep tips. Did not disappoint.

Interesting, though it seems quite annoying to read research papers with all that jargon without using an LLM

Research papers are written to be read by other researchers, not laypeople. If you have no scientific background and want to read up on a topic that you are not familiar with, you'll have to find other sources of information.

Sure, by "other researchers" you mean other people who learned jargon terminology.

And why would someone need to have a scientific background to read about sleep regularity and how it affects mortality?

Would you expect to be able to read a string theory research paper too just because the topic sounds interesting to you? And to be clear: You don't need a scientific background to read about sleep regularity and how it affects mortality. I'm sure there are more than enough popsci articles that will pick this up. You only need it if you want to understand the original research papers. Because unlike popular science magazines (which have journalists writing for laypeople), research papers are written by scientists for other scientists.

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