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Sleep regularity is a stronger predictor of mortality than sleep duration (2023) (oup.com)
384 points by yamrzou 3 days ago | hide | past | favorite | 245 comments








Interesting, I have a DEC2 mutation and don't need much sleep, but I do sleep very consistently. When I was first working through this discovery, I asked the dr how it was that people who have this have no adverse effects when folks always say not sleeping long enough is bad for your health and he said "well, we don't really know that's true" and kinda shrugged it off.



also things are recommended for the average population, not the individual - with "conditions"/superpowers like yours, it's absolutely the individual that matters, not the mean.

Do you work out? How often, how long and what type of exercises do you do?

5 days a week, Velodrome 1 hour high intensity. 49/14 + :30 each way to work. I'm tall and skinny.

Interesting, I wonder if it's common for people who don't need much sleep.

I need 5ish hours of sleep(usually less) and I feel that regular workouts (7 days a week, 60 min runs) help me clear brain fog a lot.


when you say dont need much sleep, are we talking 6 hours or something more out thre like 4 hours or less?

I go to sleep between 1am and 1:30am naturally and wake up around 6/:30am naturally. Allergy season makes me kinda lethargic, but doesn't change how much sleep I need. 4/5hrs is ok, less than 4 is not ok. I also oddly don't get jet lag.

its a blessing. i think i survive well on 4-5hrs (incl wake up naturally) but def feel suboptimal compared to 7-8hrs.

My problem with regular sleep is that the sum of "good night sleep" + "energy for the day" is > 24 hours. Realistically I think it is about 26 hours on average. If I sleep for a normal amount (7-8 hours) I will generally have about 18 hours of energy. So if I just sleep when I'm tired my schedule is constantly shifting. If I go to bed when not tired I just stair at the ceiling for hours, which feels like a waste.

You might need stronger environmental queues for your body to wake up. The body has both internal and external data to know when you have to wake up - lights, noise levels etc.

If you set up your bedroom “too well” - quiet, light blocking roller blinds etc, then your body can only rely on the internal clock.

I used to have that but since moving to another place without those “niceties” suddenly my body quite easily finds “the correct time” every day.

Also you can experiment with this on long flights to get rid of jet lag. After I land, if I spend the first night drinking and fall asleep, I effectively ruin my internal clock for the night, and then the body has only the environmental queues. Wake up in the morning and my clock is effectively reset. Might not feel great for the day but suffer zero jet lag as I start waking up in the morning at the “correct” time even though I’ve flown halfway across the planet.


My problem isn't really waking up though, it's the going to sleep.

This matches my experience. I think I have a 25 hour circadian rhythm, which has me always wanting to stay up one hour later than the night before.

Whenever I see a study about something that affects longevity, I want to know how much of a difference it makes expressed as a number I can relate to. If you were able to switch from a highly irregular sleep schedule to a very regular schedule, would you live 18 hours longer on average, or 1.5 months, or 5 years? This would be a way to decide how much attention and effort one should to devote to the numerous studies about things that affect mortality.

Looking at the graph in the study, it looks like 0.972 fraction of the very regular sleepers are alive after 7.8 years and 0.945 of the highly irregular sleepers. The difference is 0.027, or in other words 2.7% more of the highly irregular sleepers have died off after 7.8 years. It might be significant in the statistical sense, but it looks like a pretty small difference to me.

I don't know to translate that into a statement like: If you were able to switch from a highly irregular sleep schedule to a very regular schedule, you would live __(x days)__ longer on average. With some hand-wavy reasoning I arrived at something like 10 days longer over a period of 10 years. I.e., a very small amount on average. I'd welcome someone with a statistics background to do a real calculation.


A confounding factor example would be someone who sleeps regularly and someone who sleeps irregularly, two people who both live the same amount of years... but the irregular sleeper lives their last 10 years with greatly impaired capacity after a stroke. [Note: some of my work involves dealing with elderly people and "impaired after a stroke" is an extremely real, and common, thing.] These 'fuzzy' conclusions may be the best we can do.

Sleep is like drinking water. No one says, "I'm gonna get dehydrated right now and then drink a lot more water later so it's OK." But people do this for sleep. You need to sleep right when you're tired, because being tired is a stress that will need more time to heal the longer it goes. Sleep timing is underrated but it is just as important as quality and amount.

> No one says, "I'm gonna get dehydrated right now and then drink a lot more water later so it's OK."

Err yeah they do? That's 'a night out', 'going out for drinks', 'night on the town', etc.

Sort of get the point, but not a brilliant analogy ;)


I think the analogy holds if you consider all these behaviors as negative behaviors which they are.

But you're right, people do say it so he's wrong. You could rephrase it as going on a bender and not eating/drinking as healthy is probably just as bad as lack of regular sleep.

I've walked myself into a circle. You're right


> Sleep regularity was a stronger predictor of all-cause mortality than sleep duration, by comparing equivalent mortality models, and by comparing nested SRI-mortality models with and without sleep duration (p = 0.14–0.20). These findings indicate that sleep regularity is an important predictor of mortality risk and is a stronger predictor than sleep duration.

Not totally disagreeing with you, but this indicates that it is _more_ important than the latter two when concerned with all-cause mortality.


I wish some of the sleeping/eating studies covered the options "sleep when I'm tired" and "eat when I'm hungry."

When remote work is an option, it'd be nice to know the health opportunity cost of RTO. Sadly the cohort is too hard to study outside of nursing home residents.


Related:

How to Train Yourself to Go to Sleep Earlier

https://news.ycombinator.com/item?id=42016904


Ah, fuck.

My exact same sentiment. My day got a little darker after reading this.

My reaction was slightly more humorous:

Baymax: Oh no.


You beat me to it.

One of the best things I ever did was start going to bed and waking up at roughly the same time every day regardless of weekend or weekday.

in what ways was it one of the best things?

I wake up feeling rested everyday around the same time without an alarm. I also go to sleep fairly easily.

The yo yo of late weekends and spending part of the week trying to get back to an earlier time left me tired much of the time.


Irregular weekend sleeping seems to have a knockon effect of hurting weekday sleeping. Just do it the same every time. The weekend shouldn't be different

Does anyone else consistently get 6 to 7 hours of sleep no matter what? It doesn't feel optimal and I feel great on the rare days I get 8 hours, but I can function just fine on less. Also cannot easily fall back asleep if woken up which is really frustrating.

This used to be a problem for me until I stopped drinking alcohol.

I used to think it was related to caffeine or work stress but cutting out drinking seems to have fixed all my sleep issues.


On my days off, I can sleep 12 hours if I don't set an alarm. And I could easily do more, if I didn't force myself out of bed.

Amazing! Without Advil PM I can’t sleep more than 7. Really goes to show how diverse sleep habits/requirements are from person to person.

Hah, I blame my job. Different shift every few days, always tired.

I'd love to try a fixed sleep schedule, but sometimes I don't get home until 2am, other times I have to get up at 7:30am.


> Does anyone else consistently get 6 to 7 hours of sleep no matter what

6 hours is too little IMO. If I sleep 6 hours for more than a few days in a row, I feel like shit and need caffeine to wake up properly. Then I end up sleeping 10-12 hours on my days off to compensate (and to take a break from caffeine). It doesn't feel healthy.

So, I try to get at least 8 hours consistently. That way, I don't need caffeine at all and function just about fine.


I usually get 6 hours dead on. Rarely 7 or more. I'm asleep less than a minute after going to bed, and have such a regular sleep duration that I never have to set an alarm. In fact, I haven't used an alarm clock at all in 20+ years. Well perhaps, less than a dozen times.

I am fully awake and ready to go a few minutes after waking up, too. No coffee needed.

I do occasionally take an hour nap here and there, but that is also rare.


I'm this 100%. Waking up at 5am on a Saturday is such a pain because my brain just won't let me go back to sleep.

I'm a zombie if I have less than 8 hours, that's the absolute minimum. I drank a lot of coffee for years even though that had diminishing returns, until I realized it just concealed my exhaustion instead of helping, so I stopped.

Of course, spending 12-14 hours a day facing brights screens do not help.


I've found that 7 is about ideal for me as a 35 year old male. Anything more or less seems to cause more issues

Same, let me know if you find a solution. My brain just runs wild if I ever wake up leading me to not fall back asleep

I feel like shit any time I get less than 8 hours of sleep. Usually I get 9 or 10. However a day nap of 45-60 min does help a lot when I’m at a deficit.

After having a kid Ive wondered how all these sleep disruption means you'll die studies could actually be true. You'd think evolution would have taken care of it at some point

As far as evolution is concerned, you've already had the kid - you passed on your genes. If you survive long enough to make sure your kid reaches maturity, that's all that matters there.

Evolution can't select for anything that happens significantly past the birth of your progeny.


Maybe, but do other mammals suffer from this? Maybe it woukd have been taken care of with some early human-ish species with shorter life spans or something.

> As far as evolution is concerned, you've already had the kid - you passed on your genes

A second child would help with that too.


Sure but I doubt lack of sleep effects mortality greatly in childbearing years. Assuming you make it to 40-50, that's it. Now you can die whenever and have succeeded

As a parent, you’re underselling the impact of the help of grandparents and siblings on fertility

Sure it can. Knowledge, skills, and wisdom passed on to children and grandchildren well into adulthood significantly increases their chances of successfully passing on their genes to future generations, attract quality mates, and reduce stressors that can be passed down through subsequent generations.

You are thinking in far more modern terms than anything evolutionarily distant enough to affect this issue in a large portion of the population.

Additionally, even if you were looking to predict selection many generations in the future; modern reproduction happens at higher rates the lower in economic disparity you go, so clearly that isn’t the case.


I was responding to the sweeping statement you made about what natural selection can select for, and it can absolutely select for these sorts of advantages. It will play out differently depending on environmental factors such as economic and other disparities but this just becomes a matter of which strategy is chosen to adapt to that landscape.

Can you give an example of evolution selecting for parental survival past the maturity of progeny? I’m curious about this because I’ve never heard of a species that has that trait.

I never said it is selecting for parental survival. I was responding to "Evolution can't select for anything that happens significantly past the birth of your progeny."

The point is that there many valuable things that parents can pass on after the birth of their children that will increase their chances of success in future generations.


long enough to pass on genes also includes living long enough to make sure your child survives, so there is that as well.

Yes, which is why I said that.

Curious to learn which lifestyle factors correlate with extremely regular sleep patterns. Of my friends who have very regular sleep patterns, they tend to be very stable, long termists, career focussed, good in relationships, at least moderately sociable, fit and healthy (although in no way obsessed) and well rounded. Kinda good at everything but not extreme in any way. I'd guess those factors alone would have a noticeable effect on longevity.

There is likely 100 factors that affects longevity and having a 3% better is pretty huge just for one factor

My Oura ring establishes a consistent sleep rhythm and nudges me when it is approaching.

I read that with a lower case O at first and was intrigued!

I sleep when I feel tired and wake up when my body naturally wakes up (never an alarm). However it results in irregularity, although somewhat aligning with a 28-hour cycle. I wonder if that's good or bad.

If you can't help it, this is called Non-24-Hour Sleep-Wake Disorder (N24SWD) [1]. If it's just because you're not exposed to natural light a whole lot, circadian drift is "normal," though my recollection is that ~25 hours is more common. I guess it gets diagnosed if and when you complain to a doctor that you can't help it.

[1] https://en.wikipedia.org/wiki/Non-24-hour_sleep–wake_disorde...


Just consider yourself to not live long, that is the reality anyway

When I was younger I went to clubs every Friday and Saturday, dancing till morning, then continuing the exercises at home. Guess that takes a toll.

This is probably correlated with so many other cofounding factors, like employment/stress/substance abuse

Regardless of that reality, circadian rhythms have been extensively studied, and there is more evidence than just this study to support the claim they're making. Patterns and routines are generally beneficial as a rule.

That being said, there is a lot of diversity amongst us, and I'm quite sure that when you factor in (epi-)genetic variation - particularly in the short to medium term - there are some unexpected advantage/cost ratios to wildly different strategies.


> Results were adjusted for age, sex, ethnicity, and sociodemographic, lifestyle, and health factors.

Whew, glad we covered all 6 of the known possible confounding variables.

You are willfully taking more away from that than was stated. Such a fallacy is a favorite trope among science denialists, and those who would distort the objectivity of research for misinformed (and/or dishonest) ends. I don’t know what, if any, specific motivations you have, but I think it’s worth pointing out.

Their point was, there are other confounding variables, and therefore the parent comment doesn't negate the grandparent comment. I agree, and I am absolutely not a science denialist.

The scientific method explicitly requires peer-review and feedback, in part because methodological flaws may have been overlooked by those who designed and/or performed the original study.

Ad-hominem attacks against a person offering good-faith methodological criticism (such as calling them a "science denialist", or accusing them of being "misinformed" and/or "dishonest") is behavior that seeks to defend the results of a study more strongly than it seeks to discover the truth.

If you have a critique of my methodological criticism itself, by all means, please share it, but the entire scientific community would be better off if we could do away with this kind of emotionally-charged quasi-religious dogma that seeks to suppress legitimate scientific concerns through social ostracism.

--------------- Compare and contrast the above with what follows: ---------------

Your post reminds me of the reaction of the Catholic Church to Copernicus's assertions of a heliocentric solar system.

--------------- Notice how sticking to objective, unemotional, and impersonal language in the first section is more conducive to earnest scientific inquiry than the personal attack in the second section?


What do you mean? The commenter just pointed out (in a joking manner) that, even if some confounding factors were taken into account, the result might still be caused by other confounding factors. That's a serious critique, not a fallacy.

Such a critique is also a favorite refrain among science professionals

Well my sleep is certainly regularly fucked up, so I guess that means I'm dying eventually.

Oh man I took my sleep for granted last month, have been working late and waking up at strange times. Sometimes sleep at 3 am and wake up at 7am then sleep at 11pm and wake up at 6am. Eventually my body totally crashed, interestingly I had a panic attack and heart attack type symptoms at 2am in the morning. Had to rush to ER.

Great, another source of anxiety to make it harder to maintain a consistent sleep schedule.

I know this will not help you, but stressing about sleep is a vicious cycle which does not help.

I used to be much more anxious about sleep — and life in general — but I have leaned that if I don’t sleep that is fine. Life goes on, the body gets what the body needs, and I should focus on living instead of sleeping.

Being active, spending time with friends, going outside for walks, laughing, and taking the world as it comes to me has done more for my sleep than reading studies or buying stuff (outside of a tempurpedic matress and solid oak frame).


Fortunately, I did learn early on that stressing about sleep, especially as I lie awake in bed, was making things worse.

Agree. Every month there’s some new “discovery” about what can make your life shorter. It makes me anxious and definitely doesn’t help at all. I cannot simply manage so many variables. I try to do a little bit of everything, to be in the middle point of everything as much as I can; that’s my strategy.

I think this is a framing problem. You need to let go of the outcome and focus on what you can do. You can't control the result, but you can do the best that you're capsble of in your current situation, which includes not over-extending yourself.

Cat owners are screwed.

What about people with very young children? Like infants?

Well obviously they would have severely impacted sleep? What are you trying to imply?

Consider it a sacrifice. The cause being noble doesn't make it any healthier

As somebody with Non-24 sleep wake disorder i concur.

very cool that dst has been killing us all this time.

I live in an area that observes DST and since most devices does the changeover automatically I've never noticed the switch. Only notice when other people start moaning about it. Wonder if it affects certain people more than others.

It deeply affects me. I’ve lived in places that have it and currently live where there is no DST. If my state implemented it I would try to negotiate with my workplace to keep the same actual hours so my schedule doesn’t change, if they refused I would consider moving, job or state.

It would still happen with or without DST. The winter and summer phases of sunlight adjust people's sleep schedules. It's just more dramatic with DST

when I worked in UK doing shift work work gave me bonuses and pamphlets on the health costs for working through the graveyard shift regularly. The management initially wanted us to do weekly rotations of 3 shifts we tried for a month and it was undeniably sure fire way to die early. So we decided we'd rather do monthly shifts, it worked mostly ok except heading into winter I didn't get to see the sun for a while.

nowadays I still do some kind of on-call hours, and I think being on call should pay a butt load more honestly.


Subtitling: "Graveyard shift is a work shift running through the late hours of the night through the early hours of the morning, typically from midnight until 8 am."

I was wondering if you actually did some job on a graveyard at night or if there was a second meaning there. Good I looked that up...


im checking hacker news in between astrophotography subs.

looks like i'm in danger


This feels like one of those points that go back to our recent history vs the last 100,000 years of evolution.

Before artifical light, alarm clocks, jobs, screens with blue light etc - we presumably woke and slept fairly consistently, no doubt tied partly to sunlight and temperature. Some people probably slept more than others, as they always have, but I wouldn't be surprised if there was a lot more consistency.

Disclaimer: I know nothing, just interested


I think a “correlation is not causation” cautionary note is important here - there are a lot of things that cause fragmented sleep, and also cause death. Stress and underlying disease are two obvious ones.

"Finally, we acknowledge the correlational nature of our findings. Sleep regularity may be both a cause and marker of premature mortality risk."

Shit, I do sleep 8 hrs a day but regularity is out of the question. Fuck

I am so fucked

-

Personal experiences cannot disprove a large scale statistical observation like this.

i forgot the rule that I don't post against the wind in internet. So I can avoid arguments with random peoples at online.

your anecdata is not data. this almost seems like a troll post

i forgot the rule that I don't post against the wind in internet. So I can avoid arguments with random peoples at online.



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