Most active commenters
  • incone123(3)

←back to thread

239 points giuliomagnifico | 48 comments | | HN request time: 0.483s | source | bottom
1. ZFleck ◴[] No.36212917[source]
I've read a bit into this subject before; Matthew Walker's book 'Why We Sleep'[0] discusses it at length.

A lot of it boils down to blood pressure. High blood pressure is a serious contributing factor to cardiovascular incidents (as well as a slew of other negative health risks), and getting a good night's sleep will help keep blood pressure down. This is also why the amount of heart attacks are up around 24% after daylight savings[1]; an hour less sleep means higher blood pressure means higher risk of heart attack (relative to any other 'normal' day).

I can definitely see how the same logic could apply to Mondays. Less sleep, more stress = higher blood pressure = higher risk of heart attacks.

[0] https://www.goodreads.com/book/show/34466963-why-we-sleep

[1] https://pubmed.ncbi.nlm.nih.gov/18971502/

replies(6): >>36213190 #>>36214711 #>>36214962 #>>36219491 #>>36220245 #>>36220452 #
2. ◴[] No.36213190[source]
3. kulahan ◴[] No.36214711[source]
The important consideration here is that these people are on the cusp of death already, and this is typically just the straw that broke the camel's back. You don't get a heart attack from one bad night of sleep, of course, unless there are significant underlying conditions.
replies(4): >>36214985 #>>36215739 #>>36218056 #>>36221464 #
4. pushcx ◴[] No.36214962[source]
This book has serious issues. https://guzey.com/books/why-we-sleep/ The only mention of daylight savings time in Why We Sleep is:

> In the Northern Hemisphere, the switch to daylight savings time in March results in most people losing an hour of sleep opportunity. Should you tabulate millions of daily hospital records, as researchers have done, you discover that this seemingly trivial sleep reduction comes with a frightening spike in heart attacks the following day. Impressively, it works both ways. In the autumn within the Northern Hemisphere, when the clocks move forward and we gain an hour of sleep opportunity time, rates of heart attacks plummet the day after.

I don't see a specific study cited, but my ebook copy doesn't seem to have all the footnotes.

I pulled up the article you linked on sci-hub: https://sci-hub.se/https://pubmed.ncbi.nlm.nih.gov/18971502/ The only use of the number "24" refers to hours in the day, and its summary doesn't seem to match your claim:

> The incidence of acute myocardial infarction was significantly increased for the first 3 week-days after the transition to daylight saving time in the spring (Fig. 1A). The incidence ratio for the first week after the spring shift, calculated as the incidence for all 7 days divided by the mean of the weekly incidences 2 weeks before and 2 weeks after, was 1.051 (95% confidence interval [CI], 1.032 to 1.071). In contrast, after the transition out of daylight saving time in the autumn, only the first weekday was affected significantly (Fig. 1B); the incidence ratio for the whole week was 0.985 (95% CI, 0.969 to 1.002

replies(1): >>36216107 #
5. sramam ◴[] No.36214985[source]
On the flip side, isn't it also likely that repeating the same stressful behavior pattern over years (decades?) results in this outcome?

However, parsing signal from noise does seem a very difficult proposition.

replies(2): >>36215706 #>>36219781 #
6. marcosdumay ◴[] No.36215706{3}[source]
This is where an intervention-based study shines. It's just basically impossible to design an intervention for this one.

(But then, this also means that knowing it for sure would be useless.)

7. gtop3 ◴[] No.36215739[source]
High blood pressure is often refereed to as the "silent killer". It's not like these individuals present sick/ill in their daily lives. Basically the only symptoms of high blood pressure are sudden traumatic events like Heart Attack and Stroke. If you meet one of these people hours before their heart attack you often wouldn't describe them as 'on the cusp of death'.
replies(4): >>36216953 #>>36217810 #>>36221454 #>>36225465 #
8. quenix ◴[] No.36216107[source]
Personal anecdote--I fucking hate this book.

For many reasons, I slept just fine until I read it.

replies(1): >>36218700 #
9. kulahan ◴[] No.36216953{3}[source]
Yep! You're correct. I didn't mean to imply that they look sickly or anything, just that their body is literally on the verge of failing, even if it looks perfectly fine.
10. sublinear ◴[] No.36217810{3}[source]
> If you meet one of these people hours before their heart attack you often wouldn't describe them as 'on the cusp of death'.

I disagree. It's not that the symptoms aren't there, but that they have become normalized due to obesity, smoking, etc. being commonplace. Shortness of breath, sleep apnea, feeling weak, upper body tension/pain, etc. are usually present for quite a while in most people before it finally happens. People don't check their blood pressure often enough despite it being so cheap and easy to do.

replies(7): >>36217892 #>>36219207 #>>36219294 #>>36219516 #>>36220136 #>>36220667 #>>36221665 #
11. 2devnull ◴[] No.36217892{4}[source]
You’re wrong. A young person with borderline hypertension (130/80) can present in perfect health. Blacks for instance have a genetic predisposition to hypertension, obesity and diet don’t have to be involved. Besides genetics, other health conditions like insomnia or other medications can cause hypertension. Some people are just salt sensitive.
replies(2): >>36219168 #>>36226813 #
12. Retric ◴[] No.36218056[source]
While presumably true in the general case, there are many drugs etc that drastically lower peoples risks of dying from a heart attack.

So many people must get quite close to a heart attack only to live a long life and die of something else.

13. NilsIRL ◴[] No.36218700{3}[source]
Would love to hear more
replies(1): >>36219049 #
14. quenix ◴[] No.36219049{4}[source]
Sure. I'll start by prefacing that I'm not necessarily wholly attributing these as faults of Walker's book. I don't doubt I have a higher propensity for certain anxious responses, or perhaps my personality made me more susceptible to the sort of thinking I'll discuss.

Walker's book—and his accompanying Ted talks and podcasts—instilled a deep sense of sleep anxiety in me, which led to episodes of chronic insomnia (still occurs today). I had never experienced these issues before reading the book. Unfortunately, his message ensures that the insomnia is self-exacerbating, causing a vicious cycle.

Essentially, I find it very wrong for Walker to focus on and overhype the negative aspects of sleep loss as much as he does. Guzey's article [0], also linked above, goes through much of this. Why We Sleep turns into a horror book if you aren't able to sleep for whatever reason. It implies that, from just one bad night's sleep,

    1. your immune system will deteriorate significantly

    2. the chance that you develop a cancer will increase

    3. your mental health will suffer 

    4. you are more likely to develop anxiety or depression

    5. the probability you hurt yourself will increase

    6. your mental faculties will be destroyed, you will be unable to reason well

    7. you are at higher risk of mortality (!)

    8. you are literally closer to death, which the book supports by mentioning fatal familial insomnia (FFI)... a flawed analogy
... and much more.

I was initially ok after reading the book, but the problems really started after I had a bad nights' sleep. I was absolutely terrified the following night, remembering all the awful things that will happen to my body and mind if I do not recuperate the next night. And we all know how easy it is to lose sleep when you are worried. I stayed up until 6 AM that night. Every passing hour made it harder to sleep.

Naturally, this started a cycle. Grumpy and even more anxious the next day ("two days? wow, am I now DOUBLE the chance of cancer and depression?"), sleep began evading me more and more often. The bed became a place of anxiety. Every minute I spent awake, I remembered Walker's book and the terrible things he told me was happening to my body due to the insomnia. This caused an infernal, unending loop of insomnia. Morning birdsong became hell to my ears.

I still sometimes suffer from it to this day, but Guzey's essay really helped. I think some quotes can do my point more justice:

> Your essay on Why we sleep - I can’t thank you enough. I’m a sleep doctor in Oregon and have seen many many patients who have developed severe sleep anxiety and insomnia. Two friends in the sleep field and myself weekly have talked about people that slept well until reading this book.

> I wanted to drop you a line to thank you for all the time and effort involved in debunking Matthew Walker’s book. As someone who works with individuals with insomnia on a daily basis, I know from firsthand experience the harm that Walker’s book is causing. I have many stories of people who slept well on less than eight hours of sleep, read Walker’s book, tried to get more sleep and this led to more time awake, frustration, worry, sleep-related anxiety, and insomnia.

> My patients are coming to me after reading this alarmist book, with insomnia that they did not have before, and worse, harder to treat because although the book has caused these anxieties - they can’t shake their newly built alarmist beliefs they learnt from the very same book.

> Scott slept well his entire life until he listened to a podcast that led him to worry about how much sleep he was getting and the health consequences of insufficient sleep. That night, Scott had a terrible night of sleep and this triggered a vicious cycle of ever-increasing worry about sleep and increasingly worse sleep that lasted for ten months.

[0]: https://guzey.com/books/why-we-sleep

replies(4): >>36219190 #>>36219534 #>>36219718 #>>36222365 #
15. moneywoes ◴[] No.36219168{5}[source]
What makers can I check?
replies(1): >>36220975 #
16. moneywoes ◴[] No.36219190{5}[source]
If it helps I have heard that his book is poorly researched
17. avgcorrection ◴[] No.36219207{4}[source]
Here’s a spectrum:

- “on the cusp of death already”

- Normalized ill-health

There are some things in between those two.

18. jahewson ◴[] No.36219294{4}[source]
No this is completely wrong. Over the age of 40, a perfectly healthy, functioning and complaint-free individual can have alarmingly high blood pressure. Often it's hereditary. They can even have an obese sibling who's just fine.
replies(1): >>36221023 #
19. m463 ◴[] No.36219491[source]
I feel really good with a sleep rhythm going to bed later each day and getting up later the next day.

I think many people do the same sort of thing, and then monday -- they have to cut their sleep short to get up early and sync with the rest of the world.

I can see how this would be the stressor you allude to.

replies(2): >>36219539 #>>36219741 #
20. outworlder ◴[] No.36219516{4}[source]
I see your point, although some of the symptoms are quite subtle. Most people with sleep apnea don't know they have it until they get tested. Same for other symptoms.

What's really normalized is metabolic syndrome. 88% of adult americans have some degree of metabolic dysfunction. High blood pressure, obesity and other ailments are very often a direct result of that. So much so, that the 'normal' range of indicators such as uric acid has been revised and adjusted over the years, because "normal" people had higher levels and still appeared to be fine. Thankfully, we are starting to question that (eg. https://pubmed.ncbi.nlm.nih.gov/24867507/)

First order of business for anyone watching their blood pressure creeping up over the years (even more so if A1C, triglycerides, liver enzymes and uric acid are rising too): cut sugar in all forms. Not just the sugar you personally add to food, not only what's specified as 'added sugar', but all food containing sugar - which is basically all ultra processed foods. It does include sliced bread which is easily broken down into sugar( and is often laced with additional sugar, check ingredients). Leave your sugar 'allowance' to be used by a reasonable amount of fruits.

That may not reverse the problem (although, in my case, it did) but should help tremendously.

replies(2): >>36220474 #>>36222035 #
21. chearon ◴[] No.36219534{5}[source]
I had the same experience. Very often, I couldn't fall asleep until 6-7am. I felt like I was losing my mind. I got professional help from sleep psychologists but it didn't do much. They told me all the same stuff that comes up when you google it, and it terrified me even more that even professionals didn't know why I couldn't sleep. I never had this much of a problem sleeping before I read the book.

After a year of this, a therapist pointed out that you can have bad days on good sleep and good days on bad sleep. That finally made it click that it wasn't logical to worry about bad sleep so much. I just stopped caring and that mostly got me over it, but I still have more bad nights than I ever used to.

If I see people reading the book, I warn them about it even though it feels a bit rude to tell someone not to read something.

22. samtho ◴[] No.36219539[source]
This is because our circadian rhythms are naturally found to be about 25 hours absent external stimuli or timekeeping devices.
23. NilsIRL ◴[] No.36219718{5}[source]
Thanks for the write-up
24. asdfman123 ◴[] No.36219741[source]
It's so much better going to sleep and waking up the same time every day.

The only problem is it's often incompatible with a social life when you're in your 20s, but thankfully I'm not in my 20s anymore.

25. asdfman123 ◴[] No.36219781{3}[source]
It's actually not very hard to know at all, at least if your question is "what kind of lifestyle will generally lead to the best longterm health outcomes?" Sure, there's minor distinctions to be made and important medical questions, but generally it's pretty clear.

Everyone knows it, I don't need to list it: eating clean, getting good sleep, plenty of exercise, etc.

And furthermore, though our healthcare system seems only configured to deal with things once they become emergencies, metabolic disorder takes your whole life to take root. The time to start making positive changes is now.

26. samstave ◴[] No.36220136{4}[source]
I have high BP due to my insomnia coupled with sleep apnea.

I have insomnia ~5 nights a week. and for some reason I can no longer take naps in my older age. I used to be able to Nap-on-command when I was younger. It SUCKS

27. bbarnett ◴[] No.36220452[source]
This is also why the amount of heart attacks are up around 24% after daylight savings[1]; an hour less sleep means higher blood pressure

There is no proof of this as to why. Only that it happens. For example:

* the hour of lost sleep does not happen on Monday, but on Sunday morning

* people could sleep in on Monday, then get hyper stressed that they are late

* type A personalities could get mad at an office of sluggish people

* people could get upset at everyone complaining about DST again, my blood pressure went up at your post!

28. mr_toad ◴[] No.36220474{5}[source]
What makes sugar different from other carbohydrates?
replies(2): >>36220706 #>>36225638 #
29. ◴[] No.36220667{4}[source]
30. Raidion ◴[] No.36220706{6}[source]
It's really quick fuel that leads to an insulin spike that triggers more fat storage and eventually leads to insulin resistance.
31. gtop3 ◴[] No.36220975{6}[source]
The #1 marker you should be checking is blood pressure.

Cholesterol, Fasting Insulin levels, and (if male) free Testosterone are other good ones. Cholesterol and Insulin should be checked by all adults annually, and BP should be checked at least annually. T isn't checked as routinely, but it's worth knowing where you fit and has an impact on your metabolics and the test isn't a big deal.

replies(1): >>36221545 #
32. eek2121 ◴[] No.36221023{5}[source]
Unsure why folks are hating on you. I have had hereditary high BP since I was 13. I was underweight at that point. I was never overweight until COVID. COVID launched me from a normal weight into 'obese' territory pretty fast, but I am now a 'normal' BMI with 9.5% body fat.
replies(1): >>36226737 #
33. dghughes ◴[] No.36221454{3}[source]
My cousin ran marathons, ate well, etc. and died in his sleep of a heart attack or more likely cardiac arrest.
34. p1necone ◴[] No.36221464[source]
This is a very important thing to consider when interpreting this statistic.

"Heart attack rates go up 24% after daylight savings changes" is not the same thing as "There are 24% more heart attacks due to daylight savings". You can't really know the weight of magnitude vs distribution without actually stopping daylight savings.

replies(1): >>36221963 #
35. mikenew ◴[] No.36221545{7}[source]
Buying a cheap little glucose meter is really valuable IMO. You can get them for close to nothing, and you can use them to check your fasting glucose, or your glucose response after meals.

Also, resting heart rate is very easy to measure, especially if you have any kind of fitness/smart watch, and that's a good marker of health too.

I'm a fan of getting lab work done, but it's definitely more of a hassle.

36. NovaDudely ◴[] No.36221665{4}[source]
I have to agree, while there is a lot of people who say there were no symptoms - it generally was normalized over decades of decline.

It was once I lost 100lb that it became apparent just how bad condition I was in even though at the time I thought I felt fine. It doesn't help when you mention a lack of energy, or poor sleep to the doctor and they just say "Everyone is tired!".

37. clircle ◴[] No.36221963{3}[source]
or by conducting some causal inference with a load of identification assumptions
38. Dalewyn ◴[] No.36222035{5}[source]
>First order of business for anyone watching their blood pressure creeping up over the years: cut sugar in all forms.

No, first order of business is consulting your doctor and/or a nutritionist and otherwise adhering to common sense of having a reasonably balanced nutritional diet.

If your first order of business is taking random advice from the intertubez, you have bigger problems than high blood pressure.

replies(2): >>36222093 #>>36222546 #
39. dcow ◴[] No.36222093{6}[source]
I mean I get what you're saying. But most doctors have normalized refined sugar intake. Cutting out refined sugar and simple carbs is not harmful at all and carries not risk whatsoever. So I don't see how listening to some modern wisdom in a HN comment is dangerous. Our understanding of nutrition in the western medical theatre is woefully incomplete and outdated.
40. stank345 ◴[] No.36222365{5}[source]
I went through a similar thing where I had some trouble sleeping due to external stressors and then started to get freaked out that I was having trouble sleeping, having always been a great sleeper. I developed a lot of anxiety around it and it was pretty awful, though I'm mostly over it now. To me, the key was accepting that I might sleep poorly and being okay with that. That true acceptance allowed me to relax. (The larger context for me fwiw is trying to overcome my perfectionism.)
41. unmole ◴[] No.36222546{6}[source]
> a nutritionist

In most places, any bozo can claim to be a nutritionist. From what I can tell, a large proportion of them are deranged crackpots.

So, no. Absolutely do not consult a self-described nutritionist.

42. peoplefromibiza ◴[] No.36225465{3}[source]
> High blood pressure is often refereed to as the "silent killer".

True but checking your blood pressure is painless, basically free and so easy that one can do it at home with no loss of precision.

Speaking as someone with mild high blood pressure, I see people obsess over diets, physical activity, looks, that never go to the doctor or check for their health conditions and "cure" every discomfort/pain with painkillers or ibuprofen.

And they of course all have some advice to give to me to improve my condition based, of course, on some diet they read online or to try yoga or acupuncture (or whatever is fashionable at the moment) and totally ignore the fact that I've been checking my blood pressure for over 20 years, I know a thing or two about it, because doctors. Yeah... I am that crazy! I see doctors!

Once a year is more than enough for people that have never been diagnosed with anything and yet very few people regularly do it, even here in my Country where medical checkups are virtually free.

IMO the real silent killer is indolence.

43. TurboHaskal ◴[] No.36225638{6}[source]
Sugar is 50% fructose and 50% glucose. The user you mention advocates for a higher amount of fruit which has mostly fructose so my take on this is that he prefers his pancreas over his liver.
replies(1): >>36226736 #
44. incone123 ◴[] No.36226736{7}[source]
Eating whole fruit means you consume fiber at the same time as the sugar, so the latter is metabolized more safely.
replies(1): >>36227901 #
45. fantasticshower ◴[] No.36226737{6}[source]
This is entirely unrelated to this article and discussion, but something I've been wondering: what makes you say folks are hating on them? Is there a mechanism for downvoting that I'm unaware of?
46. incone123 ◴[] No.36226813{5}[source]
Black African Americans seem to have that predisposition, but not all Black populations do. There is a theory that ability to retain salt improved your odds of surviving a slave ship journey.
47. TurboHaskal ◴[] No.36227901{8}[source]
Eating whole cake means you consume fat at the same time as the sugar, so the latter is metabolized more safely.
replies(1): >>36239423 #
48. incone123 ◴[] No.36239423{9}[source]
Could you liquidize the cake and still get that benefit?