Bad sleep 'dramatically' alters body | Hacker News Reader

Bad sleep 'dramatically' alters body

bbc.co.uk

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Here's a little PSA:

If you have:

* High blood pressure

* Depressive or angry episodes

* Wake up tired no matter how long you've slept

* Loud snoring

Take a sleep study. You may have obstructive sleep apnea.

I got it badly enough that sleeping for 14-15 hours daily did nothing for me. I didn't realise it at the time but I was on track to die, tired, at about 50.

Today I sleep with a little CPAP machine that keeps my throat open by pumping air into my mouth. It's changed my life enormously.

All extremely good advice, but the whole process of getting a CPAP machine drives me bonkers (at least in the US).

A CPAP machine is a couple hundred dollars [1] (certainly less than a thousand) and everyone I've ever spoken to about one has either instantly, the first night of using one had a tremendous dramatic improvement in their sleep or it was sort of 'meh'.

Given the costs and extremely minor risks (we're talking about a small fan that blows air into your mouth) you would think the diagnostic process would be to just give you a CPAP machine and see if it helped.

However you HAVE to go through a sleep study to get one, and you have to get a prescription to even buy one online. All of which means thousands and thousands of dollars of extra health care expense with very little to show for it.

1 - http://www.cpap.com/customize.php?PNum=2507&PAID=0

Agree with most everything, but when I bought a CPAP machine many years ago, I don't recall needing a prescription (I could be forgetting). I was deemed "borderline" by my sleep study, so my insurance wouldn't pay for it. I went ahead and bought a portable one online for a couple hundred, and it worked like a charm. Funny thing is the place I bought it from sent me the "nurse's manual" with instructions on setting pressure and "under no circumstances let the patient see this manual" :) I've since lost some weight and had septoplasty (to treat chronic sinus infections) and don't need it, so I donated it to my brother-in-law. If your doctor won't prescribe it, you might need to find a new one. Sleep really is one of those three pillars of health.

I managed to luck out in finding the "full" manual for my device through some googling. Basically you hold down some unrelated buttons and voila, you can adjust pressure yourself. As I've lost weight I've periodically lowered it.

You used to be able to buy them online without a prescription, but it's changed now. You can easily buy them through craigslist, though.

This is a really good criticism of the current system. I know someone who attempted to get a sleep study done but insurance denied it. The doctor's response was basically "oh well, looks like there's nothing we can do".

It's been a while, but I'm pretty sure that the first HMO I got treated at used an auto-titrating CPAP initially, just to see if I was a candidate for a sleep study. The machine can sense when you stop breathing, and adjust the pressure accordingly.

It's not always as easy as just strapping on a CPAP and seeing if it works. There are at least two major kinds of sleep apnea: Obstructive (which is the most common) and Central (where your nervous system "forgets" to breathe). Using a CPAP with central sleep apnea can cause serious problems.

There are several different things that can cause poor sleep. So just giving them a machine may miss some important things.

Also, CPAP machines can really screw with your blood chemistry.

I used a CPAP for a three or four years. Overall I had better quality sleep, but there were lots of difficulties and some very long stretches where I think I was much worse off for using the machine.

Depending on the type of sleep apnea a CPAP can make it worse.

Oh, you can sometimes find CPAP machines at swap meets and craigslist, if you look around. I've ended up with three of them, and should probably sell one or two. I know it's still a pain to get a mask, though.

Yes! This has been a huge win for me.

I'd typically fall asleep at my desk around 3pm, or be fighting micro-sleep episodes. In any case, sitting there felt like torture. Never mind the effect on coding and debugging. Been doing that for decades. Tried ADHD remedies, etc. etc.

I started using a machine on a Friday, and noticed that although I was still a bit tired, I didn't take my usual 2-hour afternoon naps on the weekend. With the initial settings, I would still get a bit tired by mid-afternoon on a work-day, but it was an improvement.

After a second sleep-study and further calibration, I don't get tired at all in the afternoon. This is going to bed at 11:30 to 12:00 and waking up at 6:30 to 7:30.

It's hard to describe the practical effects of sleep-deprivation on programming effectiveness. It's like every programming problem just got a bit easier, and every tool just works a bit better. The difference between being slightly too dumb to do the job well, and being a monster is a small one.

Unanticipated benefits are that colds are not really tiring, and my alcohol tolerance is back to University levels (not sure if that's a win). On the flip side, I'm less inclined to drink alcohol, because I don't want to mess with my new mental powers.

Good stuff. My dad had apnea so bad he had to have his nose and sinuses redrilled. I'm looking forward to the study.

Not saying this is a cure-all for everyone, but it's a good first thing to try:

My dad was diagnosed with sleep apnea. He was tired during the day and got bad migraines. They recommended a fancy apparatus but he instead sewed a golf ball into a small pocket on the back of his pjs. Like most folks, he only snored and suffocated himself when asleep on his back. So this way when he rolled from his side onto his back he woke up slightly and went back to his side. 100% cured him, no migraines since.

I did basically the same thing, but took three tennis balls, put them in a tube sock, and safety-pinned it to the back of a T-shirt. I found loose T-shirts didn't work quite as well as one that's a little tight.

lol! going to try this

Wow! That's unfortunate.

The message I've been getting from my ENT is that he'd only advocate surgery if the patient wasn't tolerating the CPAP. I.e. at higher pressure settings it might be uncomfortable, and reshaping the airways could help with that.

For me, I just pretend I'm Prometheus in an interstellar cold-sleep casket. I love the mask -- badass!

The other crazy thing is that his face now looks very different than it did when I was a kid. Old pictures don't look like the same person, doesn't fit my memory, &c. Perhaps he died and was replaced with a deep-cover Soviet spy?

It was also 20 years ago, so intervention strategies have likely improved.

A pulse oximeter can also be worn overnight to check for oxygen desaturation during the night from pauses in breathing.

Polysomnography (sleep test) is the gold standard, but O2 saturation is a good indicator as well.

An oximeter isn't a bad thing to own and can be had cheaply from Amazon. Sleep apnea can emerge with as little as 10% weight gain, acid reflux or allergies. If you really care about your sleep, heart and brain it doesn't hurt to check once in a while.

This is great advice, thanks. On that subject, I use CPAP since 2008 but I occasionally did not use it for intervals up to a week (for example, when I traveled I would not bring the CPAP with me). It turns out I had an episode of atrial fibrilation (the heart beats with a weird rhythm) due to a few factors together, but the major one being the lack of CPAP usage. It was scary and I spent the night at the hospital. The doctor explained me that this condition can be caused by low levels of O2 while sleeping, which is caused by apnea.

I think people need to be more proactive about this sort of thing. If you're uncomfortable, don't assume it's normal! See if there is something to it.

I used to have a lot of trouble breathing at night. I would sleep, but be exhausted in the morning. After college, I got surgery for a deviated septum. Then I started using a humidifier and Breathe-Right strips religiously at night. Now, I've got a baby that doesn't sleep through the night and I still wake up every morning quite refreshed. :)

Thanks. I've got #3 on your list, and working in front of a screen is unbearable most days. I've thought about doing a sleep study, this just reinforces it.

I wish you all the best.

If I got diagnosed with sleep apnea, it would be the best news I've gotten in years - it would be like winning the lottery, as I could put a name to the root of the problem, and take steps to deal with it.

I want to do my own startup, and solving my sleep issues could easily be the difference between doing it and not.

So thanks again, it means a lot.

I can absolutely relate to that. True names are power and all that jazz.

I have high-grade apnea and I use a CPAP for years (and yes, it changed my life for the better!). Just last week I started an acupuncture treatment in which the doctor applies very small electric shocks to a muscle that pulls the tongue a little, for 30 minutes. I was explained this is a bit like physiotherapy, but for the tongue and mouth. I did my first session last week and I already felt some improvement. I have 4 more sessions to go.

I cannot stop using the CPAP because my apnea index is pretty high, but it might work for someone with a mild level.

Note that even though I mentioned acupuncture, this is not a "new age" or alternative-style treatment. In my country (Brazil) acupuncture is actually regulated by the Health Ministry, and this treatment is accepted by the local medical community.

Another important thing to consider if you always feel tired, anemia. My wife was chronically anemic for years and no matter how much sleep she would get always felt tired. Started taking iron supplements and a week later felt perfectly fine.

I was having many of these problems but not too severe, a sleeping nasal clip has turned me around. It's just a little piece of plastic that slips up into the nose when I sleep that seems to keep my air passage open better.

my wife also says that I snore a lot less

(before that I was also sleeping on my side with my mouth open to get air resulting in lots of night drooling which was...messy)

Another good remedy is an oral appliance for sleep apnea. I use one to position my lower jaw forward while I sleep so I can breathe more easily. The appliance is also a lot easier to maintain than the CPAP (an occasional brushing will do it good). The downside is that it can cost a lot more than the CPAP, as in several thousand dollars.

Edit: I used to use CPAP, but I found fitting it on my face to get a good airtight seal was finicky. It was only after using the CPAP that my insurance let me consider the oral appliance.

Me too! I started using a CPAP machine about 2 years ago. It felt as though I instantly gained 10 IQ points overnight. I could focus deeply for longer. I felt better. And I didn't need to nap anymore. All for a few hundred bucks.

Could you summarize exactly what a sleep study involves?

Basically you sleep in a hotel-like room but with a bunch of wiring hooked-up to your head and body. It's painless, except for the discomfort of sleeping with all those wires. The "output" of the test is an index called AHI, which indicates your level of apnea. AHI > 5 means you might need a CPAP or some other kind of apnea treatment.

Thanks!

One thing is for sure: Reading stuff like that won't help me sleep any better.

I have no problems falling asleep, but I keep waking up after five and a half hours. For periods, I can easily go back to sleep, but when I worry about waking up, I often can not got back to sleep.

I've just started reading "The Happiness Trap"[1]. It's about accepting the ups and downs of life as normal, but at the same time it tells how to handle negative thoughts and feelings better (without getting rid of them). A former Buddhist monk recommended it to me, and my girlfriend (who is a psychologist) also liked it. The title kinda sucks though. Let's see if it helps.

[1] http://www.amazon.com/The-Happiness-Trap-Struggling-Living/d...

I recently read a news article that said making roughly in the middle of a night's sleep is natural and you should just expect to doze off again rather than worry about it occurring.

Yes, I am aware of it. It's called segmented sleep[1]. Some think it is natural, but not everybody agrees[2].

[1] http://en.wikipedia.org/wiki/Segmented_sleep

[2] http://www.supermemo.com/articles/sleep.htm#Myths_and_facts

There is an argument that it's historically common.

http://en.wikipedia.org/wiki/Segmented_sleep#Segmented_sleep...

I tend to wake up within the first 3 hours of falling asleep, and wake up 3-5 times over a 8 hour period. (When I had serious stress/anxiety issues, I'd wake up every night 1 hour after falling asleep).

I haven't found a good remedy other than eating well and relentless exercise.

Has anyone noticed how people who do not sleep a lot "look old" - I mean with wrinkles, spots, etc.

Look at investment bankers - their chronological age does not seem to match their physical appearance.

This article gives a potential explanation - bad sleep changes protein expression, but I'm curious about the visible outcomes.

Hopefully there are many sleep deprived founders, and well rested lifestyle entrepreneurs (sorry for the cliché!) reading this thread.

Do people tell you you look younger/older than what you are? And how old are you??

"Has anyone noticed how people who do not sleep a lot "look old" - I mean with wrinkles, spots, etc."

Absolutely. But I will also add that the spots and the wrinkles can come from to much exposure to the sun which can also come from having the money to take vacations in the sun or have summer homes. Excess sun exposure really ages people.

Good point. They always say that about Presidents, they age like 20 years in 8 years.

Obama 2004 (43 yo): http://www.telegraph.co.uk/news/picturegalleries/worldnews/9...

Obama 2011 (50 yo): http://www.telegraph.co.uk/news/picturegalleries/worldnews/9...

Not much hair color left..

Well that is a time where a lot of people lose their hair color.

People lose their hair color due (primarily) to a lack of catalase, which normally removes hydrogen peroxide. It is now thought that much of this work is done during sleep. So, assuming this theory is true, a lack of sleep (an effect every president has mentioned) does cause people to go gray.

That makes sense. Several of my friends in college developed grey patches in their hair that went away shortly after graduation.

It's an exaggeration, but maybe if the 2nd term doesn't go so well, this is what he could look like in 2016.

http://www.loop21.com/politics/how-obama-will-look-2016

If that happened to me, I'd bow out of a second term.

Stress is a contributor too, even if you sleep well. Clinton was known as a night owl but Bush, by most reports, got plenty of sleep and he still aged a lot.

In the past few weeks I've been shitty to my girlfriend a few times after a night of bad sleep (interrupted sleep and more dreaming than normally).

I figured out that I sleep a lot better - especially when sharing a bed with her - when I omit drinking alcohol, even small amounts.

So maybe that's worth a try for people suffering from light sleep.

I've also noticed that even small amounts of alcohol at night can have a serious effect on quality of sleep, even just a couple of beers - nowhere near enough to cause a hangover, so you wouldn't necessarily notice the effect it's having until you cut it out completely.

I read on the internet (thus potentially to be taken with a pinch of salt) that even having a single beer in the evening can cause a worsening of the second half of your sleep. (Which is a bit weird as one might imagine the alcohol would be gone from ones system by then.)

I've tried total abstinence from alcohol and it really makes an AMAZING difference to how I feel the next day. (But perhaps it's just a placebo effect, since having read that internet article... YMMV)

From my personal experiences, having a quality roommate (not in same bed) forces me to adopt a normal sleep schedule. I don't want my activities to wake my roommate up and turn his day bad, so I sleep shortly after my roommate goes to bed. But when I live alone, I procrastinate my sleep, I would rather watch videos than go to bed, it wouldn't disturb anyone anyways, and the chances of having an abnormal sleep schedule becomes the norm.

Perhaps there is some psychological/social aspects to sleeping and what you and I have described falls into this aspect.

I've found this to be true. I also find I sleep more soundly and feel much better in the morning if I drink a big glass of water before bed too sort of "tank up"; otherwise I end up waking several times throughout the night. Oh, also the amount of light in a room is huge for me, which I didn't realize until I moved and had thick curtains installed.

Or vice versa. I sleep a lot better when I time things such that I sleep with an empty bladder.

I had a period in my life when I was going sleep in the morning and waking up at 3PM, sometimes sleeping for more than 12 hours. It wasn't devastating so much to my physical health as to my mental health. Sleeping too long is as bad as sleeping too short, not to mention going sleep in the morning for several days in a row. Sleeping properly really is essential for good physical and mental health, don't sacrifice it just to 'do more'.

I used to sleep from 9:30 PM to 7:30 AM when I was in High School and I never had to study a single bit. I just remembered what I was taught in class without any trouble and aced most of my classes.

When I reached college, I got a late night job and started to sleep from 4 to 6 hours a day for about 2 years. My grades dropped badly; I couldn't remember what I was hearing in classes, I wasn't able to stay focus for as long and I ended up failing classes on my last semester.

It's probably the things that I fear the most from the lack of sleep, not being able to use my brain efficiently when I'm awake.

I remember reading about the fact that the first few hours of sleep are mostly there to physically rebuild the body, while the last hours of sleep are helping mostly with the memory. I don't have sources and considering the current article, I doubt it's as definite as what I read a while ago but might be interesting to read about more extensively.

Worth reading: http://www.supermemo.com/articles/sleep.htm

WHat stood out to me from the article -

"The findings also tie into research attempting to do away with sleep, such as by finding a drug that could eliminate the effects of sleep deprivation."

Every now and then I get upset with myself for sleeping too much, not utilizing all my time after work to work on side projects and learning new skills. I wish I could stay up till late AND wake up early or be able to do away with sleep altogether (and the need to eat)! How I wish I could do away with sleep!!

Recently after a few days of skimping on sleep, I had a few days where I let myself sleep enough and noticed how much more alert I felt during the day, I had forgotten that feeling! For now I have accepted that I need to make time for sleep. Side projects, new skills will just have to be done at a consistent even if a slow rate.

[EDIT: fixed typos]

Just what I wanted to read after pulling two all nighters. So how do periods of no sleep followed by equal periods of very long sleep affect the body? And to what extent, if at all, are these changes reversible?

I was diagnosed with OSA, and chose to use a newish alternative to surgery or CPAP, the provent strip http://www.foxnews.com/health/2011/07/14/sleep-apnea-fix/ I keep ripping it off in my sleep and can't tell if it's working. Ultimately, they said I would get used to it. You need a prescription and after getting used to it, you have to go in for a follow up sleep study so they can see if it actually works for you.

While I don't doubt the findings and won't argue the results, a group of 26 people is hardly a study. Give us the results of 260 or 2600 people, from different backgrounds.

This might explain why new parents look 5 years older after 1 year of having their first child (in my admittedly anecdotal sample, including myself)

As a single guy, I didn't realize how much sleep a parent loses until staying with my cousin and her newborns. It's like being a soldier constantly living on the front line.

Suggestions of things that works for me.

Custom made ear plugs AND ear lube when you insert them. Custom ear plugs are under $100 can be made by any audiologist or ENT. Much better sound reduction than the ones that you buy that are throwaway. The ear lube by the way creates an additional sound barrier and adds to comfort as well.

Good "bucky" brand eyshades. White noise (a fan) going.

For those who've tried cpap machines and struggled with the masks, try the so-called "nasal pillows". They are a lot easier to get a good, consistent seal; are much smaller and so don't trigger that "omfg their's an alien on my face" freak out in the middle of the night; and they allow for more variety of sleeping positions.

Wow, all the years I didn't sleep like a rockstar. Used to be able to stay up 2, maybe 3 days without an ounce of caffeine and maybe a quick 15 minute nap here or there.

Looking back, how much of that time I really needed to spend awake, I don't know. You get more effective with age.

So how much sleep SHOULD I be getting then? I assume it's based on a few things (age, weight, etc).

Well your genes are different to mine so it comes down to your body type.

Personally I'll go to bed at 1AM and naturally wake up at around 7:30AM. I usually fall asleep quite quickly and don't usually get woken up by any noise.

For you this might be a nightmare.

I know people that try and get into bed for 10:30PM. I tried that once. I was awake at 4:30AM. I basically need 6 hours sleep. More just doesn't work for me.

The problem is more that people with sleep issues don't ever feel like they have got a proper nights sleep. It can affect them deeply. You need to get to the root cause of the issue.

As an aside I went through most of my early life with sleep apnia caused by large tonsils. Luckily on a skiing holiday with some friends, we hit it off with a bunch of nurses, who heard very vocally from my friends about the nightmare that was sleeping in the same room as me and the choking noises I would make. 5 weeks later I had my tonsils removed as they were huge. It was life changing. I'd spent most of my early 20s half asleep.

You tried that once... but changing your sleep schedule is not something that happens literally overnight.

For awhile I was going to bed at 10:30pm and waking at 4:30-5am. It took several weeks before I could train my body to sleep until 6-6:30am. As a result I feel more alert in the evenings.

Your answer is different than my answer. We have 7B different answers if every combo of genes is different.

Have to start somewhere, so this study helps, but 6 hours versus 10 hours for small sample size is only a starting point.

The only way to really know is to record your natural sleep-wake cycles. Go to sleep when you feel sleepy, and wake up naturally, without an alarm.

A lot of people have mentioned sleep studies here - any idea on the process to obtain one in the US? Do I need to go to my general physician or can I call up a sleep study center?

I've been stressing out a lot about Uni recently, maybe getting a few hours sleep a night (last night I got an hour). Never have I felt worse in my life.

If there's no other way to reduce your workload, get a certificate of illness from a doctor and delay some of the work or examinations or whatever is stressing you out. Don't ruin your health. If exam preparation causes you so much stress that you can't sleep or focus anymore, please see a doctor, there's a good chance the doctor can help you with coping with the stress.

I wonder if the opposite is true as well, where good/proper sleep dramatically alters one's body.

No clue, but dramatically altering my body has equalled sleeping better, fwiw.

Did humans evolve to sleep more than 6 hours at a time?

Considering that a lot of people do sleep more than 6 hours at a time... yes

are the changes reversable?

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