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Yvain comments on Lifestyle interventions to increase longevity - Less Wrong

122 Post author: RomeoStevens 28 February 2014 06:28AM

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Comment author: Yvain 28 February 2014 07:06:26AM *  25 points [-]

This is good stuff!

One addition I would make to your "sleep" section: between 5% and 10% of Americans have moderate or severe sleep apnea, mostly undiagnosed. Untreated sleep apnea more than doubles mortality through a combination of cardiac problems, stroke, and maybe a cancer-promoting effect as well. There are well-known effective treatments for sleep apnea and it is kind of dumb not to get them.

The main symptoms of sleep apnea are excessive snoring, and feeling very tired during the day even if you slept a normal amount the night before. It is most common in obese and older people but sometimes happens in normal-weight and younger people as well. If you think you might have this condition, probably your highest-priority longevity intervention (after quitting smoking, if you do that) is to go to your doctor and get it checked out.

Comment author: Qiaochu_Yuan 28 February 2014 10:37:08PM 7 points [-]

feeling very tired during the day even if you slept a normal amount the night before.

Crap. Alright, I sleep alone so I don't know if I snore or not, but I can test this with an iPhone app. Thanks for giving me the push I need to do this (I had briefly considered the possibility of sleep apnea before but didn't see any easy next actions).

Comment author: Qiaochu_Yuan 04 March 2014 06:58:14AM 7 points [-]

Update: I had some trouble with the app the first two nights (it stops recording if you exit it in any way), but I have audio evidence that I snore now (I don't know what counts as excessive). Time to go see a doctor about a diagnosis.

Comment author: MartinB 28 April 2014 01:33:33PM 2 points [-]

I've got it :-) Actually I read about it before, but delayed going to the doctors for a few years. Afterwards it took about 6month of preliminary testing till I got the appointment in the sleep lab - since it is not an emergency situation. But afterwards the CPAP helped me right away. Its ridiculously effective. (Around the same time I started using f.lux to dim the brigtness of the monitor which is a good idea anyway (redshift for linux), and later got an eye mask to keep lights out.) From the self help group I got some material for the practical questions. And read many sad stories of those who need decades to figure it out. Not all doctors know about sleep apnea. But numbers are rising. One danger ignored is professional drivers who cause accidents by being tired. Might account for 7% of the total traffic accidents. But eitherway if you have it treatment is there. The published papers I read (mostly metastudies) usually deal with compliance rates in combination with some other factor. Medical compliance is stupidly low, many people don't use their CPAP even if it works. But I saw no other treatment options that were seriously explored. A nice feature is that CPAP is purely external, so no changes in your body, no operations and no big problems if you forget it occasionally.

To correct the symptom list above: snoring is a common signal, but not all snoring is from APNEA. You can have it checked out, if its a problem. The mean part is the daytime fatigue, which others will usually assume is due to a lazy lifestyle, partying to long or such. It takes a while to make the leap from daytime fatigue - despite extensive sleeping to an actual problem in the sleep.

And one plus point: you look and sound a bit like Darth Vader while sleeping :-)

Comment author: Eliezer_Yudkowsky 28 February 2014 08:09:35PM 2 points [-]

CPAP (auto-adjusting pressure) didn't work on me. What else is there?

Comment author: Yvain 01 March 2014 01:11:00AM 3 points [-]

Complicated. I think I'm seeing you tomorrow night, I'll talk to you then rather than demand your medical history on a public forum.

Comment author: MarkL 27 May 2014 06:20:15PM *  1 point [-]

Buteyko breathing [1] and high-intensity interval training [2]. YMMV, etc.

[1] http://store.breathingcenter.com/books---in-english/buteyko-breathing-manual-download

[2] e.g. "sprinting" on an elliptical

Sleep apnea is caused by low CO2 tolerance which causes you to breath off too much CO2, and low CO2 levels relax smooth muscle, including the smooth muscle of your throat (which otherwise should actively maintains your airway at all times). The above two practices increase CO2 tolerance.

(Low CO2 tolerance can be caused by many things (e.g. too much mouth breathing from allergies, jobs which require lots of talking or singing or instrument playing, lots and lots of sitting without exercising, chronic anxiety, etc.)

Evidence:

  1. Personal/anecdotal: Intense jaw clenching, tongue soreness, turbinate opening within a few days of starting buteyko breathing, objectively far less moving around during sleep, subjectively deeper more refreshing sleep.
  2. This is how I think (poorly edited rant): http://meditationstuff.wordpress.com/2013/08/05/rant-thought-stopping-truths-e-g-weight-loss/
  3. Clinical trial(s?) show that Buteyko breathing does stuff (e.g. improves asthma symptoms without increasing lung capacity)
Comment author: MartinB 28 April 2014 01:27:03PM 0 points [-]

Did you go to a Sleeplap? They are supposed to fit it, have a pile of different masks to choose from. As far as I know cpap is the way to go with APNEA.

Comment author: michaelcurzi 10 March 2014 09:23:02AM 0 points [-]

I have two relatives that had apnea - one got rid of it by losing weight, the other by having her tonsils removed.

Comment author: Eneasz 28 February 2014 09:12:28PM 0 points [-]

UPPP

Not terribly expensive. The recovery is painful. But the pain is temporary, and the improvements are amazing. It was a major turning point in my life, and I'd strongly recommend it to anyone who is considered a good candidate (consult your specialist)

Comment author: Jonathan_Graehl 28 February 2014 07:28:47PM 1 point [-]

I snore when I'm very tired and sleeping on my back (when my jaw relaxes down in that position it's harder to breathe even through nostrils). Any cheap advice for that (besides don't do it)?

Are there harmless allergy meds that would be worth taking for better sleep when I have mild nasal congestion from seasonal pollen etc?

Comment author: RomeoStevens 28 February 2014 08:20:38AM 1 point [-]

Thanks! I believe it was you who pointed out that longevity is only 20-30% genetics that sent me down this rabbit hole to begin with.

Comment author: TylerJay 28 February 2014 04:40:30PM 1 point [-]

If I remember correctly, Yvain argued for a salt intake lower than 1500mg / day, whereas on your meal squares page, you made an argument for having 3000mg / day. Wy do you think you disagree on that one?

Comment author: RomeoStevens 28 February 2014 08:28:44PM 2 points [-]

Differing takes on which evidence is more valid. Many studies say reducing salt is healthy. A few studies say it is unhealthy, and point to the fact that all the other studies actually say "salt reduces blood pressure" and that it turns out that in this particular case the reduction was not correlated to overall mortality. It would seem that reducing salt has detrimental effects that outweigh the blood pressure effect.

Comment author: [deleted] 02 March 2014 04:12:36AM 0 points [-]

Should people with hereditary low blood pressure ignore most of this advice / do the opposite?

For example it seems processed meats --> increased salt intake --> increased blood pressure --> increased mortality, which doesn't apply to people with low blood pressure.

Comment author: RomeoStevens 02 March 2014 04:18:14AM 0 points [-]

The causal pathway is not necessarily (in fact almost certainly not) exclusively via blood pressure, so I wouldn't do this.

Comment author: [deleted] 02 March 2014 07:15:51AM *  0 points [-]

What proportion of it is through blood pressure and could you elaborate on what the rest of the causal pathway is? Trying to decide whether it's worth cutting down on processed meats even though it may result in less protein intake overall (because I can't be bothered cooking / preparing non-processed meats).

Comment author: RomeoStevens 03 March 2014 05:22:16AM 2 points [-]

I wouldn't venture a quantification. Whey protein and eggs?