LESSWRONG
LW

Comment Permalink

It's true that tiredness is a very common complaint but if it really bothers the person enough that they've come for a visit I'd still do some basic screening even if the person appears healthy. There are enough people with non-existent problems who frequent clinics several times a year that you going for a visit for the first time are unlikely to be put in the whiner category.

Even here in Finland where we have long dark winters and we have mostly national health care that is trying to be cost effective tiredness is a good enough reason to go visit a doctor.

See in context

23 Things to consider when optimizing: Sleep

by [anonymous]

28th Oct 2014

1 min read

23

I'd like to have a series of discussion posts, where each post is of the form "Let's brainstorm things you might consider when optimizing X", where X is something like sleep, exercise, commuting, studying, etc. Think of it like a specialized repository.

In the spirit of try more things, the direct benefit is to provide insights like "Oh, I never realized that BLAH is a knob I can fiddle. This gives me an idea of how I might change BLAH given my particular circumstances. I will try this and see what happens!"

The indirect benefit is to practice instrumental rationality using the "toy problem" provided by a general prompt.

Accordingly, participation could be in many forms:

* Pointers to scientific research
* General directions to consider
* Personal experience
* Boring advice
* Intersections with other community ideas, biases
* Cost-benefit, value-of-information analysis
* Related questions
* Other musings, thoughts, speculation, links, theories, etc.

This post is on sleep and circadian rhythms.

Life ImprovementsPractical

Personal Blog

23

Mentioned in

3Things to consider when optimizing: Commuting, Transportation

New Comment

49 comments, sorted by

top scoring

Click to highlight new comments since: Today at 6:06 AM

[-]Metus11y170

A brain-dump:

Have a bed-time ritual like changing into sleeping clothes, meditation, writing in a diary, ... anything that is more complicated than "Oh it's 3 and I have to be up at 7"
Eat something sweet a quarter or half hour before lying down. This seems to help people. Of course, don't gorge on that.
Speaking of food, people are advised not to eat too much before bed. I don't have that problem aside from usual overfeeding and associated discomfort, so YMMV.
If you have trouble with sleeping through the night or falling asleep, Melatonin can help. Recommended doses vary widely, 1mg should do the trick.
People report falling asleep better on days they've exercised. Strength training seems to be more helpful than endurance.
Generally fixing whatever bothers you while falling asleep helps. Too loud? Fix any noise sources, wear ear plugs. Too bright? Cover any light sources, shut the blinds, wear a sleep mask.
Have a set schedule. Apparently a set waking time is more important than a set time to sleep. Personally I find it only helps if you are really strict with your schedule and do not party as young people tend to do.
Apparently blue and blue-ish light in the evening disrupts sleep. Try installing f.lux or redshift if you absolutely have to look at a screen, else try to avoid screens altogether.

The general problem is that "having issues with sleeping" in any way (too much, too little, difficulty falling asleep, difficulty waking up, difficulty sleeping through, drowsiness, nightmares, restless leg syndrome, sleep walking, ...) belong to the category of symptoms "well this happens when you have any kind of problem" like headaches, lack of motivation, discomfort, feeling a little sick. If you have tried a number of the things listed above with no success consider seeing a medical professional to rule out an underlying medical issue.

[-]A1987dM11y20

Speaking of food, people are advised not to eat too much before bed. I don't have that problem aside from usual overfeeding and associated discomfort, so YMMV.

Similarly, many people claim that you're not supposed to drink alcohol before going to bed if you want to sleep well, but IME (based on both subjective feelings, what smartphone accelerometer-based sleep trackers tell me, and my performance on stuff like Quantified Mind or Lumosity the following day) the reverse applies to me.

[-]TrE11y100

I limit my daily internet usage with LeechBlock (for Firefox; compare StayFocus'd for Chrome). Until a few months ago, I had allowed myself to access all of the internet only from 8pm to 10pm. LessWrong, Wikipedia and similar sites are freely accessible. This has led to me always going to bed after 10pm, and often much later than that.

A few weeks ago, I shifted my "allowed internet time" to the morning hours, to 6-8AM. Then even further back, and now I wake up at 4:30 and may then browse the internet for an hour.

I now reliably get up at 4:30, and I go to bed when I feel tired - typically around 8 to 9 pm. Getting up at a regular time really has helped my sleep, and I have an incentive to not just turn around and nap for another half hour. Aligning my goals and incentives made it easy.

Additionally, I installed several really bright LED bulbs I switch on in the morning. About 40$, but effortless once installed. No habits to remember, no willpower to fail.

[-]Emily11y50

(Minor English language note: "stand up" can't be used as a direct synonym for "get out of bed". Try "get up" instead. Hope you don't mind my pointing this out! Thought it might be helpful.)

[-]TrE11y50

Edited. Thanks. I remember thinking about it, and noticing that it doesn't quite match.

[-]RomeoStevens11y70

Forehead cooling: http://www.scientificamerican.com/article/putting-insomnia-on-ice/

[-]NancyLebovitz11y40

I tried sleeping with a damp slow-release sponge on my forehead. I'll need to try more nights, but my sleep quality may have been better.

[-]Gunnar_Zarncke11y40

Sleeping a cooler room also seems to be recommended, 18°C is not unusual.

http://www.webmd.com/sleep-disorders/features/cant-sleep-adjust-the-temperature

[-]hyporational11y50

How sleep clears the brain.

"Dr. Maiken Nedergaard and her colleagues at the University of Rochester Medical Center recently discovered a system that drains waste products from the brain. Cerebrospinal fluid, a clear liquid surrounding the brain and spinal cord, moves through the brain along a series of channels that surround blood vessels. The system is managed by the brain’s glial cells, and so the researchers called it the glymphatic system. [...] The scientists also reported that the glymphatic system can help remove a toxic protein called beta-amyloid from brain tissue. Beta-amyloid is renowned for accumulating in the brains of patients with Alzheimer's disease."

A human study: Sleep Quality, Not Quantity, Linked to Amyloid Deposition

"Low levels in the cerebrospinal fluid of βamyloid 42 (Aβ 42), which signifies the presence of amyloid plaques, are associated with poor sleep efficiency, although not sleep quantity, a new study has found."

Disruption of the sleep-wake cycle and diurnal fluctuation of β-amyloid in mice with Alzheimer's disease pathology.

"We report a normal sleep-wake cycle and diurnal fluctuation in ISF Aβ in the brain of the APPswe/PS1δE9 mouse model of AD before Aβ plaque formation. After plaque formation, the sleep-wake cycle markedly deteriorated and diurnal fluctuation of ISF Aβ dissipated."

[-][anonymous]11y50

I've successfully shifted my sleep timing earlier over the past year. Here's my notes on that:

I had being an extreme night person as part of my identity. Realizing that waking up like a normal person would actually improve my life was step one.
You have more hooks available to wake yourself up than make yourself fall asleep. If you can adjust waking time, bed time may be easier to change.
What do you think about when falling asleep? I found that "free-association" thinking and non-verbal visualizations help me fall asleep faster than my default, which is to think verbally about a single topic.
I shifted other rhythmic activities earlier in the day: I eat breakfast earlier, exercise in the morning instead of night, try to do social things in the morning, and I open my blinds as soon as I wake up.

Some other notes:

Wash your pillowcases. They add very little to a laundry load. This is recommended if you have acne problems.
If you have a cheap bed, you can get a foam pad to put on top. Some people really like this, the pad is cheap, and you can store and transfer the foam pad easily.

[-]adrien011y30

Red tinted glasses.

[-]hyporational11y30

I use bright lamps with a timer in the socket and set them to turn on 0.5-1 hours before wake up time. I often dream about sleeping in bright sunlight before waking up to the cold reality of the Scandinavian climate. I don't need alarm clocks with this approach at all.

If I wake up groggy I take a few caffeine pills and continue sleeping. Alertness is guaranteed in 15-20 minutes.

[-][anonymous]11y20

Is there a way to turn the lights on gradually?

[-]hyporational11y20

As Richard pointed out there is, but the sunrise alarms I've seen are not bright enough for my taste and are more expensive. Of course you could combine the two approaches. I don't wake up the moment when the lights turn on so nothing feels abrupt about it.

[-]Richard_Kennaway11y10

Yes. I sometimes use one of these, although when it's really important to get up at a certain time, I set other alarms as well.

[-]Gunnar_Zarncke11y30

Link: polyphasic sleep society has a lot about sleep, not only the polyphasic variety.

[-]Metus11y30

[Meta]

This thread is a great idea. But with all these repositories we almost need a repository repository. Or a book summarising all of the stuff on this site. It is starting to be too much.

[-]DeterminateJacobian11y140

The Repository Repository.

[-][anonymous]11y30

See also: Special Threads

I share the concern about navigation and size, although lesswrong is far more legible than most long-running blogs, forums, and community projects of a similar size.

[-][anonymous]11y20

Since this is the Meta comment:

Brainstorming topics (in very loose order of this-is-interesting and hasnt-been-talked-about-too-much)

Commuting/Transportation
Chores/Household tasks/Cleaning
Personal Appearance/Hygiene/Fashion
Cooking and food (health, taste, time, money, social aspects)
Parenting/Understanding and interacting with children
Family relationships
Non-Romantic Relationships
Nuts-and-bolts of traditional employment (e.g. finding work, interviewing, bosses and coworkers, workspaces)
Use of mobile devices, normal computers, internet
Information diets (finding information, filtering information)
Stress/Mental health
Finding and doing music, art, cultural events
Tourism/How to visit places/Long-distance travel.
Formal education topics?
Dating/Romantic Relationships
Exercise/Posture/Physical injuries
Studying/Learning/Reading
Productivity, organization

[-]Gunnar_Zarncke11y20

I take the above to be the Meta Comment.

I think this is thread is a good idea. Thoughts:

Maybe you could bring it into a more general form. With tags, standard comments, a template. Then other people can suggest further topics without fearing interference with your schedule.
Sleep is possibly not the best starter as I think this has been discussed a lot. I would have liked commuting more. Other ideas for next topics could be people skills, daily chores, dating, reading techniques, parenting, programming.
A comment (possibly with a poll) about the next topics might be a good idea.

[-][anonymous]11y30

What would "standard comments, a template" mean?

I like your list of ideas. I think commuting/travel/transportation would be good next. I suspect that programming is too niche.

[-]Gunnar_Zarncke11y10

What would "standard comments, a template" mean?

Have a look at the thread listed in http://wiki.lesswrong.com/wiki/Special_threads

Most have a 'rules' section and follow some common format.

[-][anonymous]11y00

The Repository Repository.

[This comment is no longer endorsed by its author]Reply

[-]roystgnr11y20

Like many people here I often have a problem with being too wakeful at night and too sleepy in the morning.

Getting lots of exercise early in the day seems to be most helpful for fixing my sleep schedule. That's not always possible (the best I can do with computer work is a standing desk) and I've found melatonin in the night and caffeine in the morning to be barely-adequate substitutes.

A college roommate had good experiences with light therapy in the mornings; I haven't tried a "light box" myself but this may be a confounding factor with my experience with exercise; was the exercise helping me directly or was it the additional time outdoors in the sunlight?

The best solution to the problem has often been "don't solve the problem". I've been lucky enough to have a career that lets me get my best work done at 1am at home, as well as supervisors who are too smart to try and cut open the goose to get more golden eggs out. Unfortunately this is now only an option a few months out of the year; my kid's school is not so flexible about scheduling.

[-]James_Miller11y20

I have been using an inversion table to help myself relax before bed time. While I haven't done a proper experiment, it does seem to help.

I have been taking PQQ for about 25 days, and it seems to have greatly improved the quality of my sleep.

[-][anonymous]11y10

Here is a PDF of 40 sleep mindhacks: https://www.goodreads.com/ebooks/download/8114179-40-sleep-hacks

To be honest, I found the list rather simplistic, but it may be a good starting point for others. The one bit of advice that I found useful was waking up to the sound of pleasant music (via mp3 alarm), rather than the screeching of an alarm clock.

[-]Emily11y10

My main problem with sleep is that I can't ever seem to get quite enough of it, the last couple of years. By this I don't mean that I'm too busy and don't have time to sleep: in fact I sleep quite a lot, averaging probably more than 8 hours per night. I mean that the more I sleep, the more I seem to want to sleep. As an undergrad I got along pretty happily on what I think was a much lower average at the time, and I'm sure many people sleep a lot less than I do currently. But now I can't manage with less at all, and am often extremely dozy by mid-afternoon as it is.

I don't think it's that my sleep quality is bad: I fall asleep quickly (usually within 10 minutes or so of turning the light out) and don't often wake up during the night. I don't usually remember dreams or have a sense that my sleep was disturbed. In the mornings I have a bit of a struggle to wake up, but it's not that bad really, and if I'm aware that there's a fixed time I need to be up by that morning, then I can get up straight away. I just... feel tired when I do so. And during the day. And really, really tired at night.

Maybe the undergrad years were a bit of an illusion and I made up for lost sleep during terms by sleeping excessively during the holidays, or something. But I can't shake the feeling that I should be able to get by on at least a bit less sleep than I do, and certainly shouldn't need more sleep than I get, despite feeling tired quite a lot.

[-]hyporational11y30

I don't think it's that my sleep quality is bad: I fall asleep quickly (usually within 10 minutes or so of turning the light out) and don't often wake up during the night. I don't usually remember dreams or have a sense that my sleep was disturbed.

For example in sleep apnea it's possible to wake up dozens of times per night and not remember anything about it. These people also fall asleep quickly because they're exhausted. I'm not saying that you have sleep apnea, just saying that not remembering waking up or falling asleep quickly aren't great indicators of healthy sleep.

As a side note some sleep medications (benzodiazepines, z-drugs) also impair short term memory, and people who use these might not remember if they wake up in the middle of the night, which makes these drugs even more popular.

[-]Lumifer11y20

Sleep requirements are personal. I know someone who needs about 5 hours of sleep per night, and I know someone who needs 9+ hours to feel well-rested. Do not assume that your own sleep requirements match the average -- maybe your body just needs to sleep a lot.

On the other hand, if a lot of sleep does not fix your tiredness during the day, I'd probably run a bunch of medical tests to make sure you don't have any hidden health problems.

[-]Emily11y10

Yeah, that's my assessment of the most likely reason, too - I just need a bit more sleep than some people do. I wish I didn't, though! I think the tiredness levels probably aren't bothersome enough to be worth mentioning to a doctor - I'm not really prevented from doing anything by it.

[-]Lumifer11y10

I wish I didn't, though!

I am quite envious of the 5-hours-is-enough guy :-/

the tiredness levels probably aren't bothersome enough

The question isn't really whether they are bothersome, the question is whether the tiredness is a symptom of a serious underlying problem.

[-]Emily11y30

I suppose so. There's a small chance I could be a bit anaemic. I'm a vegetarian, and the onset of the tiredness thing miiiight have occurred at around the same time as I drastically reduced my consumption of (fortified-with-iron) breakfast cereal. I should go and give blood! Haven't done so for a couple of years, and they check your iron levels when you do that.

[-]Lumifer11y20

A full blood panel would probably be better :-/ Think about it this way: if there turns out to be some fixable problem, fixing it might reduce your sleep requirements which would be a very useful thing for you.

[-]Emily11y30

I should give blood anyway, though. If I get round to doing that and it turns out I'm not anaemic, I suppose I'd consider investigating a bit further. Seems to me I've got a much better chance of checking that one thing by doing that than by going to my doctor and whining "So, sometimes I feel a bit tired..." (Like every other grad student / adult human on the planet, right?)

(It's possible that this is a difference between the UK, where I am, and America. As far as I'm aware, it's not a thing to go to the doctor and request various tests, here. Doctors run tests iff they think they're warranted. I gather from things that I've noticed Americans say that you can ask for particular things to be done, over there? But I suppose you then have to pay for it.)

[-]Lumifer11y30

it's not a thing to go to the doctor and request various tests, here.

Well, it's a function of the relationship between you and your doctor. You certainly can ask for tests and while it could be true that an NHS doctor will be less likely to agree to them than a US doctor, you don't lose anything by asking.

Of course, saying "sometimes I feel a bit tired" is one thing, and saying (still quoting you) "...am often extremely dozy by mid-afternoon ... I just... feel tired when I do so. And during the day. And really, really tired at night." is quite a different thing.

The tired-by-mid-afternoon feeling, by the way, could indicate sugar control problems. I'd add fasting glucose test to the general blood panel -- if you are pre-diabetic, you really want to know this.

[-]hyporational11y30

The tired-by-mid-afternoon feeling, by the way, could indicate sugar control problems.

The normal circadian rhythm has two low points, the other one in the afternoon. A dip in alertness at that time is probably normal.

[-]Emily11y10

Sure, you're correct about asking. The reason for the discrepancy in the two ways I phrased the issue is that I think the former is what the doctor will "hear" - perhaps I'm completely wrong about that! But given that I don't have an objective point of comparison, it seems quite plausible to me that in fact I am no more tired than your average busy-ish, active person. The only reason I'm even wondering if I should be less tired is because it seems like I used to be able to get by on less sleep - a subjective impression that I'm not very confident in.

I do sometimes feel like I have a bit of a blood sugar issue, though I'd be extremely surprised if I was pre-diabetic. I'm young and fit, no risk factors remotely present. Maybe that would be worth getting checked out some time in any case.

Thanks for the input, incidentally. :)

[-]hyporational11y20

Even here in Finland where we have long dark winters and we have mostly national health care that is trying to be cost effective tiredness is a good enough reason to go visit a doctor.

[-][anonymous]11y10

Blood donation will (almost certainly) not check things like thyroid function, which is a common enough problem, and easy to check.

[-]Emily11y10

Eh. This problem is nowhere near bad enough that I want to end up on medication or something. In general, I'm very healthy and do a lot of sports and stuff. The less medicine that gets near me the better; if it's something simple like iron deficiency, I can fix that easily through diet. More likely, there's not even an actual problem, I just need to sleep a bit more.

[-]Eneasz11y10

1-2 mg of Melatonin ~20min before you wish to fall asleep

[-]9eB111y20

Alternatively, according to Eliezer's experience, it could be taken much more than 20 minutes in advance. I take .3mg about 3 hours before sleeping.

[-]hyporational11y10

In my experience small doses regulate the sleep schedule whereas bigger doses have a mild sedative effect. I take 0.25mg 1-3 hours before going to sleep and 1-3mg straight before going to bed for staying asleep.

[-][anonymous]11y10

Meta: Space in discussion is limited. Would people like to see more of these posts? Contingent on community interest, I might plan to post a topic and some notes every week or two.

EDIT: I'll have to think more about organizing this sensibly.

[-]ChristianKl11y100

Space in discussion is limited.

No, it isn't. Karma voting is good enough to be trusted with managing space concerns.

If you find that your posts get a negative karma score, then stop making those posts. Otherwise the community appreciates the posts and the amount of karma tells you for threads roughly how much.

On the other hand I have the feeling that weekly would be a bit too much to get optimal participation. There no reason to start with weekly. It's better to have a slower pace and keep up the project for longer.