Pathologies and hacks

April 19, 2017 — August 16, 2023

Figure 1: I finally got my bed just how I like it

Things about sleep.

1 Do we sleep enough?

The photogenic researcher who keeps on making pronouncements about the pathologies of modern work schedules, and whose name I can never remember is Till Roenneberg. He is attached to the EUCLOCK project, and the MPG and LMU etc. I’m not convinced, BTW, by the Munich Chronotype Questionaire due to him and Martha Merrow; the questions make almost no sense for my own personal routine, so I wonder who else they cover poorly? Plus there is all the usual challenges of inferring anything from a survey. However, the strident lifestyle advice that these folks give out rests on more data than that particular survey, I hope (?)

AFAICT the question of sleep is not at all solved. Alexey Guzey, argues.

If you take one thing away from this entire essay, remember this: as long as you feel good, sleeping anywhere between 5 and 8 hours a night seems basically fine for your health …, regardless of whatever Big Sleep wants you to believe.

All of the evidence we have about sleep and long-term health is in the form of those essentially meaningless correlational studies, but if you’re going to use bad science to guide your sleep habits, at least use accurate bad science.

Guzey change his mind about some of his sleep theses.

2 Why do we sleep?

This is suggestive. The electrochemical pump that seems to clean out the crap from our brains. Maybe. (Fultz et al. 2019) (“why” in evolutionary context is always fraught anyway.

3 Getting better sleep

Figure 2

4 7 8 sleep method for falling asleep

I put the tip of my tongue where the ridge of the gum meets my upper front teeth before exhaling forcefully through my mouth to make a whooshing sound. Then, I close your mouth and inhale through my nose for a count of four. Next, I hold my breath to a count of seven, then exhale through my mouth making the same whoosh sound for a count of eight.


3.1 Light

Avoid blue light before sleep: Why blue light before bed time is bad for sleep (for some of us?) (Chang et al. 2015):

We have known for quite a while now that light is the most powerful cue for shifting the phase or resetting the time of the circadian clock. We also know that melatonin is present at low levels during the day, begins being released a few hours before bedtime and peaks in the middle of the night. Past studies have shown that light suppresses melatonin, such that light in the early evening causes a circadian delay, or resets the clock to a later schedule; and light in the early morning causes a circadian advancement, or resets the clock to an earlier schedule. […] we found that humans display a peak sensitivity to light in the blue wavelength region of the spectrum. Rods and cones […] could not account for this differential regulation of melatonin production, so we postulated another type of photoreceptor was responsible for mediating such physiological responses. These wavelength-sensitive photoreceptors were identified soon after and are known as melanopsin-containing ganglion cells

Possible get blue light in the morning though, which can be a sleep intervention (Danielsson et al. 2018; Terman and Terman 2005).

There are also Seasonal Affective Disorder interventions based on lights. I’m not sure how they relate.

3.2 Melatonin

Gwern on Melatonin

The 2005 meta-analysis Brzezinski et al concluded that, over all (mostly healthy) adult participants, melatonin improved on placebo to the extent that it [statistically-]significantly reduced sleep onset latency by 4.0 min (95% CI 2.5-5.4) [The normal limits for latency to sleep are considered to be 15-20 min.]; increased sleep efficiency by 2.2% (95% CI 0.2-4.2) [The normal sleep efficiency is about 90-95%.], and increased total sleep duration by 12.8 min (95% CI 2.9-22.8). […] 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 […]

Scott Alexander on Melatonin:

So if you want to go to sleep (and wake up) earlier, you want to take melatonin early in the day. How early? Van Geijlswijk et al sums up the research as saying it is most effective “5 hours prior to both the traditionally determined [dim light melatonin onset] (circadian time 9)”. If you don’t know your own melatonin cycle, your best bet is to take it 9 hours after you wake up (which is presumably about seven hours before you go to sleep).

Figure 3

4 Snoring, sleep apnoea

  • SnoreLab is smartphone app for quantifying snoring

4.1 Anti-snoring exercise


4.2 Anti-snoring garments

For “positional therapy”, a.k.a. “not letting you sleep on your back” (Permut et al. 2010). NB, none of these retailers will shop to Australia, even ones who clearly can such as Amazon. Presumably some quirky features of Australian therapeutic good regulations prohibits them selling padded shirts in Australia because it is too medicine-adjacent.

4.3 Weird machines

When this mic-enabled system detects snoring sounds, an under-bed base station sends a burst of air up into a pillow insert, lightly shifting how your head is positioned.

5 Incoming

Alexey Guzey, Theses on Sleep

In this essay, I question some of the consensus beliefs about sleep, such as the need for at least 7 hours of sleep for adults, harmfulness of acute sleep deprivation, and harmfulness of long-term sleep deprivation and our inability to adapt to it.

It appears that the evidence for all of these beliefs is much weaker than sleep scientists and public health experts want us to believe. In particular, I conclude that it’s plausible that at least acute sleep deprivation is not only not harmful but beneficial in some contexts and that it’s that we are able to adapt to long-term sleep deprivation.

I also discuss the bidirectional relationship of sleep and mania/depression and the costs of unnecessary sleep, noting that sleeping 1.5 hours per day less results in gaining more than a month of wakefulness per year, every year

See also The Effects on Cognition of Sleeping 4 Hours per Night for 12-14 Days: a Pre-Registered Self-Experiment.

6 References

Belenky, Wesensten, Thorne, et al. 2003. Patterns of Performance Degradation and Restoration During Sleep Restriction and Subsequent Recovery: A Sleep Dose-Response Study.” Journal of Sleep Research.
Bessone, Rao, Schilbach, et al. 2021. The Economic Consequences of Increasing Sleep Among the Urban Poor.” The Quarterly Journal of Economics.
Chang, Aeschbach, Duffy, et al. 2015. Evening Use of Light-Emitting eReaders Negatively Affects Sleep, Circadian Timing, and Next-Morning Alertness.” Proceedings of the National Academy of Sciences.
Chee, Tan, Zheng, et al. 2008. Lapsing During Sleep Deprivation Is Associated with Distributed Changes in Brain Activation.” The Journal of Neuroscience.
Danielsson, Jansson-Fröjmark, Broman, et al. 2018. Light Therapy With Scheduled Rise Times in Young Adults With Delayed Sleep Phase Disorder: Therapeutic Outcomes and Possible Predictors.” Behavioral Sleep Medicine.
Debono, Ghobadi, Rostami-Hodjegan, et al. 2009. Modified-release hydrocortisone to provide circadian cortisol profiles.” The Journal of Clinical Endocrinology and Metabolism.
Dinges. 1995. An Overview of Sleepiness and Accidents.” Journal of Sleep Research.
Drake, Roehrs, Shambroom, et al. 2013. Caffeine effects on sleep taken 0, 3, or 6 hours before going to bed.” Journal of clinical sleep medicine: JCSM: official publication of the American Academy of Sleep Medicine.
Durmer, and Dinges. 2005. Neurocognitive Consequences of Sleep Deprivation.” In SEMINARS IN NEUROLOGY.
Foster, and Wulff. 2005. The Rhythm of Rest and Excess.” Nature Reviews Neuroscience.
Fries, Dettenborn, and Kirschbaum. 2009. The cortisol awakening response (CAR): facts and future directions.” International Journal of Psychophysiology: Official Journal of the International Organization of Psychophysiology.
Fucci, Scanniello, Romano, et al. 2020. Need for Sleep: The Impact of a Night of Sleep Deprivation on Novice Developers’ Performance.” IEEE Transactions on Software Engineering.
Fultz, Bonmassar, Setsompop, et al. 2019. Coupled Electrophysiological, Hemodynamic, and Cerebrospinal Fluid Oscillations in Human Sleep.” Science.
Gomes, Tavares, and de Azevedo. 2011. Sleep and Academic Performance in Undergraduates: A Multi-Measure, Multi-Predictor Approach.” Chronobiology International.
Guzey. 2022. Theses on Sleep.”
Hafner, Stepanek, Taylor, et al. 2016. Why Sleep Matters — the Economic Costs of Insufficient Sleep: A Cross-Country Comparative Analysis.”
Harrison, and Horne. 2000. The Impact of Sleep Deprivation on Decision Making: A Review. Journal of Experimental Psychology. Applied.
Killgore, Kahn-Greene, Lipizzi, et al. 2008. Sleep deprivation reduces perceived emotional intelligence and constructive thinking skills.” Sleep Medicine.
Kuriyama, Soshi, and Kim. 2010. Sleep Deprivation Facilitates Extinction of Implicit Fear Generalization and Physiological Response to Fear.” Biological Psychiatry, Neuroplasticity in Anxiety Disorders,.
Levandovski, Dantas, Fernandes, et al. 2011. Depression scores associate with chronotype and social jetlag in a rural population.” Chronobiology International.
Lockley, Cronin, Evans, et al. 2004. Effect of Reducing Interns’ Weekly Work Hours on Sleep and Attentional Failures.” New England Journal of Medicine.
Lovallo, Whitsett, al’Absi, et al. 2005. Caffeine Stimulation of Cortisol Secretion Across the Waking Hours in Relation to Caffeine Intake Levels.” Psychosomatic Medicine.
Lucassen, Zhao, Rother, et al. 2013. Evening Chronotype Is Associated with Changes in Eating Behavior, More Sleep Apnea, and Increased Stress Hormones in Short Sleeping Obese Individuals.” PLoS ONE.
Matthews, and Fortier. 2013. The Rematee Bumper Belt® Positional Therapy Device for Snoring and Obstructive Sleep Apnea: Positional Effectiveness in Healthy Subjects.” Canadian Journal of Respiratory Therapy: CJRT = Revue Canadienne de La Thérapie Respiratoire : RCTR.
Mograss, Crosetta, Abi-Jaoude, et al. n.d. Exercising Before a Nap Benefits Memory Better Than Napping or Exercising Alone.” Sleep.
Mohtashami, Thiele, Karreman, et al. 2014. Comparing technical dexterity of sleep-deprived versus intoxicated surgeons.” JSLS: Journal of the Society of Laparoendoscopic Surgeons / Society of Laparoendoscopic Surgeons.
O’Leary. 2009. Workplace Stress, Sleep Loss and Well-Being: Implications for Public Health Policy.” Summer School 2009.
Olders. 2003. Average sunrise time predicts depression prevalence.” Journal of Psychosomatic Research.
Permut, Diaz-Abad, Chatila, et al. 2010. Comparison of Positional Therapy to CPAP in Patients with Positional Obstructive Sleep Apnea.” Journal of Clinical Sleep Medicine : JCSM : Official Publication of the American Academy of Sleep Medicine.
Reynolds, and Banks. 2010. Total sleep deprivation, chronic sleep restriction and sleep disruption.” Progress in Brain Research.
Roenneberg, Allebrandt, Merrow, et al. 2012. Social Jetlag and Obesity.” Current Biology.
Roenneberg, Kuehnle, Juda, et al. 2007. Epidemiology of the human circadian clock.” Sleep Medicine Reviews.
Selvi, Aydin, Boysan, et al. 2010. Associations between chronotype, sleep quality, suicidality, and depressive symptoms in patients with major depression and healthy controls.” Chronobiology International.
Stickgold, and Walker. 2005. Memory consolidation and reconsolidation: what is the role of sleep? Trends in Neurosciences.
Takahashi. 2012. Prioritizing Sleep for Healthy Work Schedules.” Journal of Physiological Anthropology.
Terman, and Terman. 2005. Light Therapy for Seasonal and Nonseasonal Depression: Efficacy, Protocol, Safety, and Side Effects.” CNS Spectrums.
van Cauter, Spiegel, Tasali, et al. 2008. Metabolic consequences of sleep and sleep loss.” Sleep Medicine.
van Dongen, Maislin, Mullington, et al. 2003. The cumulative cost of additional wakefulness: dose-response effects on neurobehavioral functions and sleep physiology from chronic sleep restriction and total sleep deprivation.” Sleep.
van Heugten-van der Kloet, Giesbrecht, and Merckelbach. 2015. Sleep loss increases dissociation and affects memory for emotional stimuli.” Journal of Behavior Therapy and Experimental Psychiatry.
Walker, and Stickgold. 2004. Sleep-dependent learning and memory consolidation.” Neuron.
Williamson, and Feyer. 2000. Moderate Sleep Deprivation Produces Impairments in Cognitive and Motor Performance Equivalent to Legally Prescribed Levels of Alcohol Intoxication.” Occupational and Environmental Medicine.