Getting too little sleep can have serious health consequences (2013) | Hacker News Reader

Getting too little sleep can have serious health consequences (2013)

theatlantic.com

168 pointsgmays69 comments

I once, involuntary, went without sleep for around 72 hours. I was at a music festival and we were either pulling through the night or I couldn't sleep because of the noise. When the time came to go home, I really felt pretty good. At that time I had been awake for around 60 hours. My body was tired and my thinking was a bit sluggish, but nothing too bad...

Until I got home and tried to sleep. By then I was feeling dead-tired, but I simply couldn't sleep. This wasn't your average "Oh I can't sleep, guess I'll do something else and try again later" case of 'insomnia'. I was so extremely tired; all I wanted was to sleep. I started having hallucinations much like the early stages of a mushroom trip (minus the fun). My eyes couldn't focus, I couldn't think.

Finally I managed to fall asleep (while constantly suppressing panic attacks; something I've suffered from in the past and know how to deal with now). I had lucid dream after lucid dream during that sleep. It was very unsettling as I got the feeling (during lucid dreaming) that I wasn't getting any "real" sleep and I'd go insane.

All in all the lucid dreaming aspect was pretty cool, and in retrospect perhaps worth the unsettling experience of being awake so long. But I'll never ever want to repeat that experience.

I had sort of an 'opposite' experience following 86 hours of no sleep and lots of physical labour.

Military training, 3 1/2 days of digging ad building trenches by hand. Middle of high summer and digging through stony clay.

Interspersed between the digging were numerous patrols and mental tests.

I experienced the hallucinations whilst fully awake from about hour 76 particularly throughout the night and early morning. I vividly remember stopping so talk to a Colour Sergeant I knew and shook his hand, only to find it extremely prickly. Trying again the pain brought me to my senses and I realised I was shaking hands with a Holy bush.

During a dawn attack the following morning I frequently fell into micro-sleeps whilst 'standing to', resulting in bashed knees and a couple of trips to the bottom of the trench flat on my face.

Come an enforced rest period at hour 86 I lay down and experienced the kind of unconsciousness I've only experienced under an anaesthetic. I was utterly gone.

3 hours later I felt amazingly refreshed, just as well as there were 48 more hours to go without sleep until the exercise finished.

What possible benefit was there to be ordered to work without sleep for 86 hours?

Was this in a possible combat situation? Or a test of your mettle? I hope? :P

It's common in the military to train for extreme scenarios, because sooner or later you might encounter them in reality (i.e. war) where you are forced to do it whether you have trained for it or not.

I had a similar experience when my child was born. The birth took about two full days, the last 36 hours of which I didn't sleep. And the first week I slept about 3 hours a night with maybe a few naps during the day.

The strange thing was, I could still function. I couldn't do anything complex, but basic tasks where not much of a problem. However, when I finally had a moment to really sleep. I couldn't. It felt like every time I had to get up to do something, I got an adrenalin rush to be able to do it and all that excitement prevented me from falling a sleep.

I fortunately didn't have any hallucinations, but I can relate to the lucid dreaming. Aside from lack of sleep, I also seem to have this after a very stressful day. I wonder if it is stress related.

We just had our first child 4 weeks ago. Relationship with sleep has completely changed. Before I'd need ~8hour of straight sleep to feel completely rested, anything less I felt like my brain was very sluggish.

4 weeks later that number is 5-6 hours.

Also relationship with coffee has completely changed. 4 weeks ago drinking a strong ~16 oz of coffee in the morning would keep me up all night. Now I drink multiple cups throughout the day and can pretty much sleep at will :)

Sleep has been very light and dreams not super vivid, every now and then will fall into a vivid dream but not lucid

Falling asleep is instantanous

That's a crazy story, I could never imagine myself not sleeping for 72 hours!! When I mess up my sleeping schedule pretty bad (which happened a lot back in college), I usually do sleep paralysis when falling asleep (as opposed to when waking up). And I can do it 6 or 7 times in a row, it's a nightmare. Usually though, I realize what's going on (it's happened to me so. many. times.) after the second or third 'paralysis' and sleep on my stomach, which for some reason, allows me to fall asleep without the whole paralysis thing going on. You can actually turn sleep paralysis into a lucid dream if you 'control' it properly. I usually just wake up thinking 'thank god I'm alive' though.

For those interested in sleep paralysis, wikipedia's got a pretty good page about it: https://en.wikipedia.org/wiki/Sleep_paralysis

Sleep is truely fascinating.

Ah I get that too. I figured out why sleep paralysis happens and here's how to fix it. When you sleep on your back your pillow is compressing your brain stem at the base of your skull. Get the pillow further up on your head so as much as possible it doesn't touch your neck or the fleshy part just below the back of your skull. It'll feel a bit different (weird?) but you should be able to sleep without issue.

Tell as many people as you can after you see for yourself.

edit: As an additional tip, the way I get out of the paralysis is by trying to rock my body as if I'm building up momentum to jump or at least jerk a limb. Once I twitch a limb it feels easy enough to break everything else out. That rocking feeling is probably imaginary so I don't know how transferable the technique is to other people.

Oh man, sleep paralysis is scary. After I had it happen to me a few times, these days I either go "ugh, not this again" and go back to sleep, or just panic and try to fight it, in which case I wake with a jolt after what feels like a minute (an eternity, when you're paralyzed).

I tried polyphasic sleep where you sleep 10 minutes every 3 hours, except I couldn't fall asleep quickly enough so I didn't sleep at all for >72 hours. The strange thing is that I got the idea that I was somehow more awake, more focused. All the background thoughts in your brain disappear, and it makes you think you have laser focus on what you are doing. Except that you objectively suck at what you are doing...

A few weeks after that experiment I found out that some of my memories were missing. I was in high school at the time and I took a university course in classical mechanics with a few friends. This meant going with the train to a different city several times per week, but I had totally forgotten that I did that. I only realized this when my fiends kept talking about it as if I was there too. The memories did come back later; the lack of sleep only only broke the reference to that memory and when the reference was restored the memory itself was still in tact.

Truly horrible. I've once been trapped in a cycle of this for what seemed like dozens of times before I finally broke out of it drenched in sweat.

How to you get out of it?

I once worked for 100 hours solid (only breaks were to use the loo or fetch food; total waking time was about 110 hours) and once I got past the hours 24-40 I felt fine most of the time - no hallucinations or similar, didn't feel particularly sleepy or experience micro-sleeps, and the quality of the work was OK (not my best by any stretch, but passable).

The wierd part came when I hit the deadline for the project (10am) and had to submit it - pretty much as soon as I stopped working, I felt _awful_, barely coherent, and had to take a friend with me to submission as I wasn't sure I could find the venue despite going there five plus times a week for a couple of years. It was a pretty shocking experience to go from working OK to barely functional in a matter of minutes. Not an experience I'm in any rush to repeat either! Despite that, I ended up staying awake for the rest of the day and played Risk with friends that evening, because I just couldn't get to sleep.

Hmm, I went to a festival and stayed up at least two nights in a row plus the three days. On the third day we got on this little tiny plane to get back to the main airport and everyone and I just conked out. Same thing in the taxi on the way there. People shaking me said I wasn't waking up. Landing, taking off, nothing. Although I'm a very comfortable flyer anyways and never really have any of the anxieties some people have with flying.

I'm not sure which is preferable, without friends I may have missed all my flights, but that sleep was desperately needed.

That's actually not that weird (minus the dreams). There are times during your circadian rhythm when you will have trouble falling asleep no matter how tired you are. You probably just were in one of those periods when you tried to sleep.

Your experience really resonates with me. I too suffer from occasional panic attacks. What techniques do you use to suppress them?

Mindful deliberate diaphragmatic breathing has allowed me to completely overcome panic attacks.

A simple exercise to learn diaphragmatic breathing is to lay down on your back and put a textbook on your stomach. Place your hand on your chest. Focus on each inhalation only moving the book, your hand/chest should not move at all :)

A little late, but anyway..

I've had panic attacks in two locations: while falling asleep in bed and in crowded trains.

I guess I just kinda got used to them. Since I know what's coming I don't feel the 'panic' part of the attack anymore. I just breathe slowly, deeply and deliberately, focus on my breathing. If I get the adrenaline rush you might be familiar with, I sometimes get up and walk a bit.

They key for me is to recognize when I'm having or starting to have one and not focusing on it too much. I don't know if it helped, but I used to meditate quite often. That tought me a lot about keeping my mind in check. This helps with many things, amongst which falling asleep (I just clear my mind and I'm gone in under 10 minutes) and panic attacks.

I have panic attacks too. How do you deal with them?

See my reply to jamongkad.

Psychiatric disorders such as schizophrenia are more likely to manifest in those already susceptible to them, if they are subject to sleep deprivation. This remains one of the few known correlations in long-term effects of sleep deprivation.

http://www.scientificamerican.com/article/can-a-lack-of-slee... http://www.health.harvard.edu/newsletter_article/Sleep-and-m...

It seems like every person I know has problems with their sleep. My only reference is the United States. I wonder if other countries have such a high percentage of the population that has sleep problems?

I didn't read the article. I have read so many sleep studies; I have kinda given up on every having the sleep the kind of sleep I had up until about 25. I hate not getting enough sleep. To me, sleep is more important than money? I once remember thinking I would sell my soul to the devil in order to get some good, sound sleep. (God forgive me--just joking. Yea, I'm still not positive, and don't want to piss him off.)

"Spending 25% more time sleeping increases your life expectancy by 25%."

Awesome.

"Why a long night's sleep may be bad for you"

http://www.bbc.com/news/magazine-31928434

"Lies, Damned Lies, and Medical Science"

http://www.theatlantic.com/magazine/archive/2010/11/lies-dam...

If the baseline for the parent quote is 6 hours, 6 hours plus 25% is 7 hours 30 minutes, which is about the ideal amount in the study you linked. So yeah.

Spending 25% more time sleeping != Spending 25% more of your life sleeping.

But that extra time spent sleeping is time spent not being awake to do things. So the overall number of useful hours is the same either way?

Let's assume you spend 30% of your time sleeping (7.2 hours a day), and your expected lifetime to be T. Then your "useful time" is 0.7T. So you decide to sleep 25% more (9 hours), so you sleep through 37,5% of a day and your life expectancy is now T'=1.25T, so your useful time is 0.625T'=0.625 x 1.25T=0.781T. Your useful time grown around 12%.

Note that if you take your working hours into account and you are only interested in your free time after work, then this free time will hoard up more at the end of your life when you will be retired but you will lose free time before that.

But on the other hand, getting less sleep gives you more time when you're young.

And since your future self is like a totally different person, fuck that guy.

oh, the naivete of the young !

> But that extra time spent sleeping is time spent not being awake to do things. So the overall number of useful hours is the same either way?

Am I the only person that likes sleeping and dreaming? If I were to suddenly find sleep impossible and unnecessary, I would consider that a reduction in my quality of life.

The longer you live, the better become available treatments in the meantime to make your life even longer. ;)

The longer you live in the UK, the greater the chance the NHS will be gone and you won't be able to afford treatment. :-) Coming soon: https://www.opendemocracy.net/ournhs/richard-grimes/governme...

But you're in better physical and mental shape to use those hours, so you use them more efficiently :)

> So the overall number of useful hours is the same either way?

No, because dreaming is useful and fun. Even more so if you can cultivate lucid dreaming.

Depends. Are you spending that extra time commuting to work? Maybe putting in extra hours at work?

Also if you sleep well, and live 25% longer, that 25% will be when you're old, senile, and unable to do anything useful.

Studies about sleep are often just crazy. When did people stop using their common sense? Just have as much sleep as you think works for you.

Has every old person you've ever met been old, senile, and unable to do anything useful?

My Grandma walked to the supermarket the morning of the night she passed and was totally lucid for the entirety of her years.

I'm sorry to hear that your grandmother passed. How did her startup take the loss?

Hahaha I don't usually laugh at jokes about Grandma's passing but that got a good chuckle out of me.

> Also if you sleep well, and live 25% longer, that 25% will be when you're old, senile, and unable to do anything useful.

That's assuming you do become senile and unable to do anything useful. Doesn't necessarily have to happen, and that doesn't mean you shouldn't live a good life.

> Studies about sleep are often just crazy. When did people stop using their common sense? Just have as much sleep as you think works for you.

What's considered "common sense" can vary greatly from person to person, and people aren't always aware of how their habits can have long-term negative consequences on them.

Habits like reading every scientific paper and worrying about them?

No, habits like only getting ~4hrs sleep or oversleeping regularly.

Or perhaps the point where you become "old, senile and unable to do anything useful" will also happen later?

> So the overall number of useful hours is the same either way?

Yes but no because your `useful' hours will feel much better.

Sleep is something I've kind of battled with for some years now. I have a job with a long commute and long hours but like to still be able to come home and make dinner and watch an episode or two of some of my favorite shows but when I do I end up awake instead of tired. If I do that I get 4 - 5 hours of sleep at night but if I get the full 8+ I basically have no life but work and sleep.

Basically everyone I know always tells me "Only 4 - 5 hours? That's not healthy!". But here's the thing, I don't feel like it. I wake up fine, go about my day, and usually fall asleep when I'm tired. I don't need to chug caffeine to stay awake or take shots of some energy drink. Once I wake up I'm wide awake and alert despite getting so much less sleep then everyone tells me I'm supposed to.

Doesn't sound like you are battling with sleep then. There are some people who do get by with 4-5 hours of sleep.

Then again, there are a lot more people who think they can get by with so little sleep, but when they do start committing to 7-8 hours of sleep they realize that extra time spent watching TV or browsing the internet doesn't make them feel nearly as good as they do when they are fully rested.

It sounds like you might be a short sleeper.

http://www.sleepeducation.com/sleep-disorders-by-category/in...

This reminds me of a programmer and very talented blogger who wrote a book ("And Then I Thought I Was A Fish") about his experience of staying up for many days under the influence of LSD, and who is also committed to an institution as a result of his delusions. Very interesting and entertaining read. http://www.stilldrinking.org/the-episode-part-1

He is still in the institution? If he's still crazy, how did he write the book? Or did he half-coherently narrate it to someone who then posted it for him?

Funny how not sleeping is still considered a badge of honor -- a demonstration of strength. As a new parent, I've let go and will happily go to sleep at 8PM if the opportunity arises.

Freakonomics just did a 2 part podcast on sleep.

Part 1: http://freakonomics.com/2015/07/06/the-economics-of-sleep-pa... Part 2: http://freakonomics.com/2015/07/16/the-economics-of-sleep-pa...

Is it really such a mystery anymore?

Routine maintenance is prudent for any system. Sleep is a maintenance mode.

At night, the sun goes down, it gets cold, predators come out. You save a ton of energy and maybe your life by avoiding activity at that time. When its cold you burn extra calories just to stay warm.

Haven't biologists got a lot of evidence by now?

It's more about why/what _exactly_ ? What is taking place during maintenance ?

We don't fully know, and I'm not a neurologist. But it appears that sleep is when memories of the day get consolidated. There's also some garbage collection that runs, for the well-being of the system.

There's also, possibly, the flushing out of toxins in the brain:

http://www.nih.gov/news/health/oct2013/ninds-17.htm

I've found CBTI for Insomnia[0], an asynchronous 'course', to be helpful in improving my sleep. Of note, some elements of the program – particularly the metrics/habits that are most important to improving sleep – were not factors I had previously focused on or considered really.

I'm 3 weeks into the program and this is the first time I've been even remotely successful at improving my sleep.

I sound like an advertisement.

[0] http://www.cbtforinsomnia.com/

I've had the opportunity to sleep in a lot lately, and I've found that I feel physically and mentally the most rejuvenated around the 9 hour mark. Shorter than that and my thinking is on the sluggish side, and longer and I feel tired and unmotivated. Personally, I've found the time that I wake up to also be a factor. Waking up at 7 or 8 in the morning after 9 hours of sleep has me in a better mood than at 10 or 11 with the same amount of sleep.

The headline is, of course, tautologically true. Too much|little anything can have serious consequences, because "too much" or "too little" is defined by its negative consequences. "Getting enough sleep" can't have serious health consequences, because... it's enough not to. Too little sleep is "too little" precisely because it has health consequences.

"Too little sleep can have serious health consequences"

"Too much sleep can have serious health consequences"

Agree with first one.

Too much sleep is usually already consequence of something else.

Like so many other things in life.

Agree with both.

One angle not touched on here is the link between Alzheimer's disease (AD) and sleep. There has always been evidence that AD patients sleep less than the general population, but obviously there's a chicken and egg problem here - are they sleeping less because of neuronal disruption caused by the disease, or is the disease progression catalyzed by a lack of sleep[1-3]? While I think this is still an open question, there's growing research that interaction with sleep related systems in the brain can have a major therapeutic impact on the disease itself - obviously this doesn't actually answer if it's 'sleep' or some process related to sleep, but clearly something is going on here [4].

From the press release associated with [4];

The new research, in mice, demonstrates that eliminating the protein – called orexin – made mice sleep for longer periods of time and strongly slowed the production of brain plaques.

“This indicates we should be looking hard at orexin as a potential target for preventing Alzheimer’s disease,” said senior author David M. Holtzman, MD, head of the Department of Neurology. “Blocking orexin to increase sleep in patients with sleep abnormalities, or perhaps even to improve sleep efficiency in healthy people, may be a way to reduce the risk of Alzheimer’s. This is important to explore further.” - [5]

[1] Xie, L., Kang, H., Xu, Q., Chen, M. J., Liao, Y., Thiyagarajan, M., … Nedergaard, M. (2013). Sleep drives metabolite clearance from the adult brain. Science, 342(6156), 373–377. http://www.sciencemag.org/content/342/6156/373

[2] Ju, Y.-E. S., McLeland, J. S., Toedebusch, C. D., Xiong, C., Fagan, A. M., Duntley, S. P., … Holtzman, D. M. (2013). Sleep quality and preclinical Alzheimer disease. JAMA Neurology, 70(5), 587–593. http://www.ncbi.nlm.nih.gov/pubmed/23479184

[3] Ju, Y.-E. S., Lucey, B. P., & Holtzman, D. M. (2013). Sleep and Alzheimer disease pathology - a bidirectional relationship. Nature Reviews. Neurology, 10(2), 115–119. http://www.nature.com/nrneurol/journal/v10/n2/abs/nrneurol.2...

[4] Roh, J. H., Jiang, H., Finn, M. B., Stewart, F. R., Mahan, T. E., Cirrito, J. R., … Holtzman, D. M. (2014). Potential role of orexin and sleep modulation in the pathogenesis of Alzheimer’s disease. The Journal of Experimental Medicine, 211(13), 2487–2496. http://jem.rupress.org/content/211/13/2487

[5] https://news.wustl.edu/news/Pages/27721.aspx

Thanks for putting these links together. It's beginning to look like sleep is the brain's garbage collector.

That has been the standard theory of sleep for many years.

"Modalifinil" the solution to all the problemas

no shit!!

Oh dear

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