[HN Gopher] Lack of sleep, stress can lead to symptoms resemblin...
       ___________________________________________________________________
        
       Lack of sleep, stress can lead to symptoms resembling concussion
        
       Author : rustoo
       Score  : 288 points
       Date   : 2021-01-24 13:00 UTC (10 hours ago)
        
 (HTM) web link (news.osu.edu)
 (TXT) w3m dump (news.osu.edu)
        
       | greysteil wrote:
       | If you haven't already read it and are interested in sleep
       | research, I found "Why we sleep" was a wonderful, accessible
       | summary of the literature.
        
       | quichelorraine wrote:
       | I remember reading the results of a study a few years ago that
       | said people in poverty suffered something like a drop in
       | cognitive ability. I wonder if the effect reported here is
       | related.
        
       | m3kw9 wrote:
       | No mention what consists of "lack" of sleep.
        
       | the_only_law wrote:
       | Now I just need a concussion to compare.
        
       | sradman wrote:
       | Many of us are wearing devices with continuous optical heart rate
       | monitors. Heart rate variability at rest is one of the best
       | indicators of stress and these devices are pretty good at
       | estimating sleep duration and sleep cycles.
       | 
       | Regulators need to recognize that continuous tracking devices are
       | a new tool for establishing a health baseline and they should not
       | be expected to match the performance of single-test medical
       | devices. Apple, Garmin, and Fitbit need to build standards to
       | share this baseline data with medical professionals and offer
       | analytics to determine when changes occur.
       | 
       | Questionnaire based medicine seems backwards given the digital
       | tools available.
        
         | nitrogen wrote:
         | There's a DIY-ish service that can be self hosted (not sure if
         | it's still maintained) that tracks all kinds of data in a way
         | that you can share with a physician. It's called Fluxtream, and
         | might take a few extra keywords to find. Written in
         | Java+Spring. I haven't used it myself.
         | 
         | Putting more and more of our data, especially health data, in
         | the hands of others is the wrong direction to be moving IMO.
        
           | kiddico wrote:
           | Oh boy, you're not wrong. People apparently love using that
           | to name projects.
           | 
           | Found it though: https://github.com/fluxtream
        
         | gedy wrote:
         | I will say that learning about and monitoring my HRV after
         | getting a smart watch has been useful to monitor stress and
         | trends. Like with anything though, I've had to try and not
         | self-induce more stress watching this number continuously ha.
        
         | klyrs wrote:
         | > Many of us are wearing devices with continuous optical heart
         | rate monitors.
         | 
         | I don't know how representative you folks are. I know a few
         | people who invest time, money, and effort into tracking and
         | measuring every aspect of their health. It looks like
         | neuroticism to me. Especially when they look for explainations
         | of every blip on every chart.
        
       | graeme wrote:
       | I'll never be sure, but I may have had this to a high degree. I
       | got hit on the ehad by a frisbee two years back, was diagnosed
       | with a concussion, and had post concussive symptoms for about
       | nine months until I found a therapist who did vestibular and
       | visual rehab.
       | 
       | Funny thing was, I had some of the symptoms to a lesser degree
       | _before_ the blow. So was it brain damage, or did the blow merely
       | worsen my visual and vestibular systems and cause more fatigue?
       | I'll never know.
       | 
       | But a key thing is that in the two years prior to the blow I had
       | some burnout, seasonal cashflow issues in my business (thankfully
       | resolved), and worse sleep. I fixed those and I have my old
       | energy back. But for months leading up to the blow I hardly felt
       | able to go to the gym, and old tasks felt tiring. Fatigue, some
       | headaches, etc
        
       | tombert wrote:
       | I used to have really bad insomnia in my early 20s, and
       | throughout my 20s I have always been that guy who could push off
       | sleeping for long periods of time, and it was something I was
       | bizarrely proud of.
       | 
       | In the last couple years I've come to realize how idiotic that
       | position is; just because I don't immediately collapse from
       | exhaustion every time I get insufficient sleep doesn't mean that
       | my body doesn't need it, and that it won't have long term effects
       | if I push it off too much.
       | 
       | For the last couple years, and even more since COVID, I've been
       | making a point of getting regular exercise, and trying to get at
       | least 7 hours of sleep a night (usually 8 or 9). I feel
       | healthier, and I do think it has helped a lot with my depression.
        
       | raghuveerdotnet wrote:
       | Stress resilience is one of the most important things when it
       | comes to knowledge work, also one of the most neglected aspect.
       | Mindfulness, stoicism, exercise help, but nothing helps as much
       | as a good night sleep. Also the other thing people usually fail
       | to note is the vicious stress-sleep cycle (lack of sleep induced
       | stress <-> stress induced lack of sleep). It took me years to
       | realize that so much of my problems with bedtime revenge,
       | burnout, non-clinical depression, permastress was basically just
       | lack of quality sleep. FWIW, it helps to think of productivity in
       | terms of sleep and stress when you are working in the knowledge
       | economy. Just like sleep debt, you can also accumulate
       | productivity debt due to lack of stress resilience, lack of
       | sleep, which can eventually lead to things like burnout.
        
         | hyperpallium2 wrote:
         | > revenge bedtime procrastination: a phenomenon in which people
         | who don't have much control over their daytime life refuse to
         | sleep early in order to regain some sense of freedom during
         | late night hours.
        
           | hnick wrote:
           | For me, it started as more of a reverse-Christmas situation -
           | if I go to sleep, the next thing I know I'll be having to got
           | to work and I really don't want that!
           | 
           | Which sometimes lead to the strange situation of going to bed
           | earlier on weekends.
        
         | einpoklum wrote:
         | Wow, "revenge bedtime procrastination" is such an apt term (not
         | being cynical).
         | 
         | In Chinese, it's a single, uhm, guess you could call it a word:
         | Bao Fu Xing Ao Ye
         | 
         | See also:
         | 
         | https://www.scmp.com/yp/discover/advice/living/article/31130...
        
         | Spooky23 wrote:
         | The other thing is that if you're not an individual
         | contributor, trust your people and let go of things.
         | 
         | I once made the mistake of absorbing lots of accountability for
         | things under the misguided instinct of "protecting" people. My
         | role changed quickly as a result of a crisis and the world
         | seemed to change. The reality was that it was really a type of
         | selfishness and pride. After a few weeks I got to a point where
         | I thought I had a physical problem -- I basically had no short
         | term memory.
         | 
         | Took me a bit for my thick skull to grasp, but once it clicked
         | it ended up being fairly easy to fix.
        
         | reedf1 wrote:
         | I think it goes beyond resilience, at least for me. Sleep is
         | _required_ to experience a state without stress.
        
         | hutzlibu wrote:
         | The thing is, that when you have a high level of stress, you
         | will find it hard to sleep well.
         | 
         | "Mindfulness, stoicism, exercise help, but nothing helps as
         | much as a good night sleep"
         | 
         | So those are very connected. If you practice mindfulness and
         | work out in a healthy way. And be conscious when and how you go
         | to sleep ... things will improve.
        
           | johnnujler wrote:
           | I think this is an issue of interpretation.OP does say that
           | mindfulness/exercise/stoicism are helpful and also talks
           | about the sleep-stress deadlock. I think what they are saying
           | is that although these activities help, you need your mind to
           | be in a decent shape to sustain these practices, which can
           | only be achieved through quality sleep. This is to say that
           | even if you have a good meditation practice or an exercise
           | routine, if you don't focus on getting your sleep back on
           | track, you'll never be able to handle stress in the long run.
        
         | koheripbal wrote:
         | During a very difficult time in my life recently, I found it
         | impossible to sleep. I would have stress nightmares and even
         | when i did fall asleep, I would soon wake myself up with
         | specific scenarios my mind was trying to work out.
         | 
         | I was incapacitated by this, which exacerbated my situation.
         | 
         | I eventually noticed that I could fall asleep if I sat with my
         | daughters while they watched TV. This evolved to me falling
         | asleep with the TV on. ...but the light, noise, and discomfort
         | of the couch made this poor quality sleep.
         | 
         | Which then evolved to me falling asleep in bed with earphones
         | on just listening to old tv, not watching. But I noticed that
         | as soon as the tv show stopped, I would have nightmares again.
         | 
         | This evolved into me selecting 8 hours of movies that, on low
         | volume, keep me asleep all night and I've essentially solved my
         | sleep problem - despite this stressful situation persists.
         | 
         | My colleagues has instead started taking prescription sleeping
         | pills.
         | 
         | I have found that selection of audio is important. It cannot be
         | interesting or novel. It cannot be sound only - there must be
         | speech. It must be content you enjoy, but have seen multiple
         | times before. ...and it must have peaceful audio without
         | screaming, shooting, abrupt sounds.
         | 
         | Interestingly, I no longer dream at all. The audio has
         | essentially supplanted dreaming. I know this because on the
         | occasions that the audio fails, my dreams return and are a
         | notable experience.
         | 
         | I have been doing this for over 6 months now. 8 solid hours of
         | sleep per night on the same programming all night. No ill
         | effects noted. It has been instrumental in coping.
         | 
         | Food for thought. It seems stress caused insomnia can be cured
         | without drugs, and dreams are optional for humans.
        
           | __jf__ wrote:
           | This very difficult time in your life you appear to have in
           | common with your collegues if I'm reading you right. Can you
           | elaborate a little bit on your work and maybe other novel
           | coping strategies you and your collegues evaluated?
        
           | jjtheblunt wrote:
           | My wife has tried very similar things for years: having an
           | Alexa Echo (or similar) play rainstorm sounds all night seems
           | to work fantastically for all here.
        
           | DenisM wrote:
           | A possible explanation is that when you are "watching tv"
           | you're not obligated to do anything else, hence you loosen up
           | and stop thinking about those other things. A safe space of
           | sorts.
        
           | steverb wrote:
           | I went through a similar phase, but I solved it with audio
           | books. You might want to give it a try.
        
           | [deleted]
        
           | drewg123 wrote:
           | I had similar issues, and tried to solve them with a similar
           | method. I fell asleep to an audiobook about the roman empire
           | many nights. I finally realized that the reason I was having
           | trouble falling to sleep, and trouble getting back to sleep
           | after a noise, etc.
           | 
           | I turns out that the only time when I was not doing
           | _something_ that occupied my mind was when I was trying to
           | sleep. Eg, I 'm either working, consuming media such as
           | Netflix or podcasts, talking with people, etc. I'd even
           | listen to podcasts while taking walks. So when trying to
           | sleep, I'd be stressing out over my problems, and trying to
           | work through them.
           | 
           | For me the solution was to find a better time to remove
           | distractions and think about my problems. Eg, taking walks
           | without podcasts, driving without the radio on.
        
             | MetalGuru wrote:
             | This resonates with me. I've noticed an absolute dependence
             | on mental stimulation. I think your solutions is the same
             | conclusion I came to. Cheers!
        
           | leandot wrote:
           | This is very interesting, this is the easiest way to fall
           | asleep for me - reading a book or watching/listening to a
           | comedy series. For some reason my brain prefers it to a dark
           | & quiet room.
        
           | banana_giraffe wrote:
           | I've found a similar solution to my sleep problems.
           | 
           | I used to fall asleep listening to audio books. I eventually
           | found audio books that are barely interesting, with certain
           | narration styles to put me to sleep faster.
           | 
           | I now have a series of audio books, mostly gumshoe detective
           | novels, that I use to sleep on nights when I'm dealing with
           | stress. I set the sleep timer for 6 hours, and invariably get
           | a good night of sleep.
        
           | dsego wrote:
           | When I get to sleep with sound in the background it usually
           | gets incorporated in my dreams. Recently fell asleep while
           | listening to a podcast about file systems and in my dreams
           | all my family members were talking about files systems and
           | B-trees. Didn't feel well rested in the morning. But
           | something like white-noise or different nature sounds could
           | be much better. There are apps that play different droning
           | sounds like train or plain noises, forest sounds, seaside
           | waves etc.
        
             | koheripbal wrote:
             | In my case, non-speech background sounds allow me to dream
             | - which wakes me up because the crisis I'm currently going
             | through changes these dreams into nightmares.
             | 
             | The key for me is that the background sound must contain
             | speech. Podcasts don't work either because their is no
             | visual component. I need to be able to _imagine_ the
             | visual, even if I 'm not watching it. Somehow, that's
             | important. Maybe it stimulates that part of my brain to
             | prevent it from creating visual dreams. I suppose there's a
             | general rule in the brain that when you're listening and
             | watching something, that part of your brain goes into
             | input-mode rather than compute-mode.
             | 
             | There are two important takeaways here.
             | 
             | 1. I've (for myself) obviated the need for sleeping pills
             | (the solution my colleagues have taken).
             | 
             | 2. There are seemingly no ill effects to preventing my
             | brain from dreaming naturally for over six months.
             | 
             | If you really think about that 2nd point, this means that
             | it would be possible to create sleep specific programming.
             | One could use it to incorporate messages to ones self.
             | 
             | Many in this sub-thread are thinking they can use it to
             | learn new things - typical HN! ...but since novel content
             | wakes your mind, I think it would be more valuable to
             | program motivational content. Content that reinforces your
             | core principles and might help you focus yourself in the
             | subsequent day. It might even be possible to have a small
             | portfolio of programming if you're expecting/planning a
             | different type of day.
             | 
             | Obviously, I'm going through a temporary crisis, so I
             | cannot pursue this, but someone should.
        
           | PKop wrote:
           | Sounds similar to why many watch these types of videos: [0]
           | 
           | I can attest to it being very effective at inducing
           | sleepiness. Here's a representative type that seems to work
           | very well at making me fall asleep: [1]
           | 
           | As a sibling comment mentions, the old Joy of Painting videos
           | by Bob Ross were early forms of this. He's kind of the
           | unofficial godfather of ASMR
           | 
           | [0] https://en.wikipedia.org/wiki/ASMR
           | 
           | [1] https://www.youtube.com/watch?v=jomUOcwqchA
        
           | xyzelement wrote:
           | I am a little surprised that so many responses suggested
           | optimization to your technique but not how to solve the
           | problem at root.
           | 
           | I am neither a shrink nor your shrink but I think it's
           | probably safe to say that whatever is affecting your sleep is
           | probably affecting other parts of your life too, and while
           | you mentioned a very difficult time - our bodies and brains
           | don't by default react in most helpful says (eg - keeping you
           | up with nightmares isn't helping anything)
           | 
           | In my experience what helps is a real way to "look within" to
           | understand what's really going on. Ideally, this is done with
           | the help of a real psychiatrist - someone willing to do real
           | deep work of therapy and analysis, not just boredly write a
           | prescription.
           | 
           | The other thing is developing self insight techniques
           | yourself. For me, a diligent yoga practice and yoga study
           | into the meditative aspects has been immensely helpful. But
           | even on the purely physical practice level, learning to "look
           | within" to understand why a pose is hard or painful teaches
           | you the same process that I am talking about.
           | 
           | This all may sound wishy washy but if you are a software
           | person you can relate to this - it's often easy to fix
           | problems once you understand them. It's impossible to fix
           | problems until you do, at best you can manage symptoms.
        
             | dudeman13 wrote:
             | The very best way of dealing with stress isn't internal, it
             | is making the source of stress go away.
             | 
             | Unless the internal changes fundamentally change how you
             | view the world ( i.e. the source of stress no longer causes
             | stress, which is the kind of change you'll very rarely see
             | in adults ) it will only be a paliative measure.
             | 
             | Being better able to cope with crap is useful, but I don't
             | think it can be considered solving the root of the problem
             | ( due to lack of neuroplasticity in adults ).
        
               | xyzelement wrote:
               | I couldn't disagree with you more, fortunately. You can
               | never remove all stressors but you have way more control
               | over your reaction than you think.
               | 
               | One example - people's natural emotional reaction to work
               | deadlines is something like "I'll die if I don't make it"
               | which is almost never literally true, but your body and
               | mind torment you as if it was. Everyone can learn to
               | reframe it to something more healthy like "I am a hard-
               | working processional and I am driving myself to achieve
               | this deadline as a matter of achievement and pride". Then
               | you can engage with it fully and then still go to sleep
               | at night.
               | 
               | Here's the key thing: whether you are able to change how
               | you react depends on whether you try, and whether you try
               | depends on whether you believe that you can. So at the
               | start, you must believe that introspection will empower
               | you to make changes, or you are doomed to be stuck
               | forever.
               | 
               | The pit that many people fall into is that they take
               | themselves very seriously and believe that how they feel
               | about something is an objective representation of the
               | severity of that thing. My example with deadlines above
               | is one example. Another simple one is social anxiety.
               | Someone can really believe and feel that "if I go to
               | drinks with coworkers, they will judge and laugh at me
               | and I will make an ass out of myself somehow" - that
               | feels super real to them but objectively it's not real at
               | all. So they spend hours of torment and lots of sleepless
               | nights fearing and dreading and avoiding something that
               | objectively is nothing. If they can reframe it (over the
               | course of years, with a lot of help and work) the whole
               | thing reduces to "it's just drinks who cares.". Same
               | situation, but the person turner a stressor into a
               | neutral or maybe even positive.
               | 
               | Don't be stuck where you are, and don't think you can't
               | change or feel differently unless the world does. And
               | then expect the change to be hard work but worth it.
        
               | treeman79 wrote:
               | Having a large rainy day fund is something a lot of
               | people are missing.
               | 
               | Paycheck to paycheck drastically increases stress level,
               | yet so many won't get away from it.
               | 
               | When I ran an Airbnb, it was shocking to see how cheap
               | other cultures would eat. Every meal home made. Despite
               | no kitchen access label on listing.
        
             | koheripbal wrote:
             | I specifically did not want to describe my specific crisis
             | because I didn't want to distract from the conversation of
             | my solution to the sleep-impacting aspect of the stress.
             | 
             | We are _also_ dealing with the source of my /our stress,
             | and it should be resolved one way or another in the next
             | few months. It's a 24x7 crisis for us that's complex and
             | we're all working on it. This isn't routine work stress.
             | 
             | I have also used some stoic phrases and slow breathing to
             | help me during the day. https://iamthemaninthedarkroom.com/
             | 
             | My above comment is strictly about this one technique that
             | I stumbled upon.
        
               | kiddico wrote:
               | Is that darkroom site a reference to, or pulled from,
               | something? A quick search for that string only turned up
               | that site, and this ( https://brill.com/view/book/edcoll/
               | 9781848880528/BP000023.xm... ) which seems unrelated.
               | 
               | Anyways, thanks for the link, I bookmarked it. Might also
               | make a local version of it and set it as my homepage.
        
           | baby wrote:
           | Two things that work great with me: smoking weed & wearing a
           | sleeping mask (a bit of light can really fuck w/ my sleep and
           | for some reasons no US apartments seems to have real blinds).
        
           | vinni2 wrote:
           | Reminds of days when I could only sleep with the Air crash
           | investigations show running in the background. It was
           | something about the narrator's voice that put me to sleep.
        
           | luos wrote:
           | For anyone who is suffering from this, or on some days finds
           | it hard to sleep I recommend Science and Futurism With Isaac
           | Arthur podcast.
           | 
           | It has "Narration Only" versions of all episodes and it is
           | very interesting, so if you can't sleep you can listen to it
           | but it will not have harsh noises.
           | 
           | Also Philosophize This has the same properties (very old
           | episodes have some loud music).
           | 
           | Let me know if you know similar podcasts.
        
             | yoz-y wrote:
             | +1 to Isaac Arthur videos as lullabies. The only thing I
             | regret is that then I also need to rewind each episode
             | multiple times because I'm genuinely interested in what's
             | said.
             | 
             | Recently I've also started to listen to luetin09's
             | Warhammer 40k lore videos. They are in similar vein that
             | they could also be podcasts. Skeptoid is another one I've
             | used.
        
           | skylanh wrote:
           | I had a critical acute stressor a few years ago, I wont
           | describe the situation, but the symptoms were:
           | 
           | - panic attacks
           | 
           | - waking up into a panic attack; imagine sleeping, then
           | waking hyperventilating, shivering, and for lack of a better
           | word "freaking out"
           | 
           | - sleep disturbances
           | 
           | - periodic severe emotional disturbance
           | 
           | - inability to remove the stressors, and critically, I had to
           | increase the stressors involved as it was time critical
           | 
           | I was able to take two weeks off from work, and I took
           | escitalopram.
           | 
           | I didn't find escitalopram to be ... a game changer, but it
           | did allow me to "decide" how I was going to feel, and if I
           | felt I was going to have a panic attack, I could head that
           | off through feedback and self aware thinking.
        
           | sedgjh23 wrote:
           | I am sorry you are going through this. Thank you for sharing.
        
           | andreygrehov wrote:
           | I wonder if taking melatonin supplements for a week or two
           | could resolve your issue. A very small dose (0.3 mg) of
           | melatonin is usually sufficient to restore nighttime plasma
           | melatonin levels to those characteristic of young people.
        
             | dageshi wrote:
             | Having suffered recently from randomly waking up in the
             | middle of the night and not being able to get to sleep
             | again I found 2mg time release melatonin the way to go. If
             | you do wake up it's much much easier to fall back to sleep
             | again.
        
           | erikpukinskis wrote:
           | I have used a similar coping strategy in stressful times. Put
           | a YouTube video on that's "the right amount of boring" in my
           | headphones and just let the auto play play me out.
        
           | raghuveerdotnet wrote:
           | Take whatever I say with a grain of salt, but I feel
           | intentions(not to be confused with intentionality) help a lot
           | here. They play a distinctive role in the etiology of
           | attention(and the subsequent process of resilience building),
           | one of the fundamental aspect of dealing with psychological
           | issues. For eg, Whenever you become aware of these
           | nightmares, try to observe the casual chain, eventually your
           | mind will be inured to these episodes and will become much
           | better at threat detection. Something like a
           | mindfulness(Vipassana) retreat can help with this a lot.
           | 
           | My experience has been that most of the psychological issues
           | can be resolved to a great extent by employing the
           | "redundancy of potential command a.k.a Self-Organization"(See
           | McCulloch). Meditation does this by asking you to bring back
           | the wandering mind again and again. But you can also do this
           | voluntarily by repeatedly observing the stress inducing
           | conditions such as nightmare(in your case), which can help
           | your brain better adjust and detect patterns.
        
             | koheripbal wrote:
             | This makes more sense for someone who might suffer general
             | anxiety or "work stress" or relationships stress.
             | 
             | In my case, we're facing a crisis - so we know the source,
             | and that it's temporary (one way or another).
        
               | johnnujler wrote:
               | What do you mean by we know the source? At best, you can
               | track the functional(mri) and structural(pet) aspects
               | your brain if you take the neuroscience route, and the
               | behavioural(cbt) aspect when you take the route of
               | psychology. It seems to me that the unique experience
               | i.e., the unwelt is out of reach without some form of
               | mindful confrontation/adaptation.
        
           | stephen_cagle wrote:
           | I imagine you are still dreaming, but likely you are sleeping
           | deeply enough that you don't have the time to "recover" your
           | dream upon waking.
        
           | stephen_cagle wrote:
           | Putting on my armchair psychologist/anthropologist/whatever
           | hat, I find the fact that you can sleep better with people
           | speaking around you very interesting. I wonder if we are
           | built to feel comfortable when we can hear people whom we
           | trust (your background conversations in this case) speaking
           | as we sleep? Means someone else we trust is awake and can be
           | observant of dangers while we nod off.
        
             | coldtea wrote:
             | Isn't that what cats who trust their human do all the time?
             | Come to sleep on their lap for protection?
        
             | hnick wrote:
             | I have struggled with sleep at night for at least 15 years
             | now. I get very sleepy in food courts (general hubbub in a
             | safe feeling surrounding) and as a child who hated cricket
             | I dozed off on the couch more than once when it was on.
             | There's something calming about a low level of crowd noise.
        
             | newsclues wrote:
             | Sounds about right.
             | 
             | Also, teenagers, adults and elderly people have different
             | sleep schedules that would allow for a tribe to have
             | constant fire watch.
        
         | closeparen wrote:
         | I get a lot more done as a knowledge worker than I ever did in
         | college, because in the real world nobody cares if something is
         | a day or three later than the nominal deadline, and "this
         | turned out to be harder than I anticipated" is a legitimate
         | excuse. Consequently I never start the cycle of staying up to
         | meet a deadline and then blowing the next deadline because I
         | was trying to work on it sleep deprived.
         | 
         | This is easy to recognize from outside but at the time I did
         | not really understand the problem, I thought it was just my
         | capability/identity and the inherent difficulty of the work.
        
           | mcbuilder wrote:
           | In the real world, 2 or 3 days doesn't mean a failing grade
           | most of the time. However, when you start to get 2 to 3 weeks
           | behind the deadline in the real world there is no escape
           | hatch.
           | 
           | Worst case in college, you submit the later assignment,
           | settle for a D, and vow to study hard for the final. In the
           | real world, you manager calls you to his office, asks you why
           | you're weeks behind, it's going down now in your evaluation.
           | Maybe you're in a start up, you loose that crucial client,
           | now you're wondering how to pay your expenses as well. You
           | have a family, kids, the stress compounds, pretty soon you're
           | a mess at home and at work.
           | 
           | And, I've got 12 years of higher education under my belt.
           | When I made the final push for my PhD thesis corrections, I
           | stayed up 4 days straight right before the deadline dotting
           | my 'i's and crossing my 't's. 6 years into the "real world",
           | I often look back on that time as the good ole days.
        
       | EamonnMR wrote:
       | Anecdotally, the symptoms of a concussion resemble feeling sleep
       | deprived and even the slightest adverse situation will lead to
       | excessive stress.
        
       | kzrdude wrote:
       | Anyone have tips for managing sleep in the winter months? It
       | seems like I can stay up forever (until 02-04) and don't get so
       | tired. I need to be in bed by 23 actually.
        
         | jusssi wrote:
         | I got plenty of help from a wake-up light, set up so that it
         | reaches full brightness by the time the alarm sounds. I didn't
         | want an extra gadget in the bedroom so I just replaced all the
         | lights in the bedroom with Hue bulbs.
        
         | graeme wrote:
         | I had this, now much improved:
         | 
         | * have an early dinner. I eat at 4 or 5 pm. This is extreme,
         | but _earlier_ will probably help if possible. No snacks after
         | dinner
         | 
         | * Get light exposure as early as possible after waking. A
         | morning walk is good
         | 
         | * Exercise close to waking. In practice I do a 7 min workout,
         | eat and walk
         | 
         | * blue light blocking glasses help
         | 
         | * A sleep mask can help. I use a manta mask + their glasses. I
         | don't actually sleep with the mask as I side sleep, but I wear
         | it for 10 min or so while laying in bed and I fall asleep, then
         | shift to my side to continue. (For whatever reason I can't
         | sleep on my back)
         | 
         | * Fewer household lights in evening. Lamps are good.
         | 
         | * Decide to get ready for bed even if you're not sleepy. If you
         | start a wind down routine by dimming lights, brushing teeth,
         | reading, whatever you do before bed, you'll start to get
         | sleepier. It sounds dumb, but if you are, say, staring at your
         | phone for three hours waiting to get tired you won't get tired.
         | 
         | * Keep a log. You may identify changes or factors specific to
         | you that help improve things
        
           | kzrdude wrote:
           | > Decide to get ready for bed even if you're not sleepy.
           | 
           | Thank you for reminding me of this.
           | 
           | Two years ago I had a sleeping revolution and I had success
           | with a barrage of efforts I did, most notably giving up
           | caffeine and having this routine, and ensuring 100% darkness.
           | But I have to recognize that I lost the routine now.
        
             | graeme wrote:
             | Oh I forgot, I stopped caffeine too. That helped I think, I
             | just drink decaf now.
             | 
             | But yeah simply deciding to start each night is the
             | stupidest yet most effective thing. I think it's easy to
             | forget this as sleep sort of feels like a non activity vs.
             | say working out or reading etc where deciding to do the
             | thing is obviously the first step.
        
         | toast0 wrote:
         | There's lots of good tips in replies, but some things that work
         | for me that I didn't see mentioned.
         | 
         | Avoid caffeine. If not entirely, at least don't have any after
         | noon. Everytime I have a really hard time falling asleep it'a
         | because I had a (delicious) coffee or cola after lunch. Enough
         | times that I've almost learned my lesson. ;)
         | 
         | Go to bed quickly if you're feeling drowsy in the evening, even
         | if it's before your preferred time. I often feel sleepy just
         | before 21; and if I get into bed then, I usually sleep through
         | the night and wakeup rested; but if I push through it, for
         | whatever reason, I'm no longer drowsy in 30 minutes, and I will
         | have a hard time sleeping until much later.
        
         | Ericson2314 wrote:
         | - Exercise, not too late in the day.
         | 
         | - Do not eat or drink anything but water at least 3 hours
         | before when you are going to bed.
         | 
         | - Do not have screens in the bedroom.
         | 
         | - No screens 1 hour before before bed.
         | 
         | (That last one I utterly fail at, but I am mainly doing textual
         | things not from an attention-economy leach on the screen so,
         | and it works out. Either the other 3 is enough or that screen
         | time is sufficiently less stimulating.)
        
           | kzrdude wrote:
           | Excercise is maybe the most important, but it's hard when
           | it's cold outside (and gyms are shut) :)
           | 
           | I've figured lately that working "hard" at chores at home can
           | replace some of it, the point is to not be too lazy.
        
             | watwut wrote:
             | > Excercise is maybe the most important, but it's hard when
             | it's cold outside (and gyms are shut) :
             | 
             | Good quality sports cloth are not that expensive anymore
             | and make winter outside exercising possible and pleasant.
             | Really, buy merino shirt and sport pants.
             | 
             | The other option is fast wall outside, but that have to be
             | longer to amount to exercise.
             | 
             | Third option is to have a look at bodyweight exercising.
             | Most of it you can do at home with zero equipment and don't
             | require much space. Some of it requires stomping, so you
             | may have to skip those is someone lives under you.
        
             | bloodorange wrote:
             | I found that (for me) the key to making a habit out of some
             | things is to eliminate as much friction as possible in just
             | getting started. If I were you, I'd look at the simplest
             | things like "7 minute workout" to just get started with
             | something easy enough to fit into my routine and once it
             | becomes a habit, one could consider making it more intense.
             | There are interesting challenges like the "100 pushups" or
             | "200 squats" challenge for which you only need a bit of
             | free space on the floor.
        
         | watwut wrote:
         | For me, colder room makes me more sleepy. So take down heater
         | in the evening and then more for sleep. Open window to get cold
         | fresh air into room before sleeping and if you can, have it
         | little open whole night.
        
       | seibelj wrote:
       | I have anxiety / stress / depression issues and when it gets
       | really bad I toss and turn all night, unable to sleep. By day 3
       | all of my muscles and joints ache terribly. During sleep your
       | body is clearing itself of waste and healing. So not only are you
       | a miserable zombie, your body itself is falling apart! I have
       | enormous empathy for anyone who suffers from mental health
       | issues.
       | 
       | I take Lexapro daily, have a low-dose benzo for situational
       | anxiety that I try never to take except it true emergencies,
       | practice mindfulness / meditation, see a therapist off and on.
       | You get better at managing it but it's a problem that never truly
       | goes away.
        
         | posix_me_less wrote:
         | I experienced similar things and eventually I concluded they
         | were due to lack of sleep and taking "being active/productive"
         | too seriuosly. If you work a lot I recommend trying to get more
         | vegetative time. Lots of guilty pleasure meals (sugar can be
         | helpful here), take work less seriously and get a lot of
         | relaxation/rest or doing only activities you enjoy. Got rid of
         | the symptoms and SSRIs that way.
        
       | Tade0 wrote:
       | Whenever I'm showing symptoms of sleep deprivation my SO, who at
       | a certain point in her life spent a few weeks helping a young man
       | regain basic communication skills after a stroke, asks me if I'm
       | having one at the moment.
       | 
       | One sign, which I observed in a few other sleep-deprived people
       | as well, is the inability to form a coherent sentence - or even
       | say a single word sometimes.
        
       | ZacharyPitts wrote:
       | And with that... I'm going to go take a nap
        
       | snappieT wrote:
       | Sorry to hear you're suffering through this experience. I can
       | emperically recommend Moana (the pixar movie) for perfect
       | familiar background noise - it was my go-to on red-eye flights
       | for a long time.
        
       | gedy wrote:
       | One challenge I've found is it gets harder to sleep long as you
       | get older. That coupled with knowledge work stress staring at a
       | screen all day makes things doubly hard.
        
       | waihtis wrote:
       | I had great success picking up a consistent meditation habit with
       | the greasing the groove-approach[1].. in essence, every time I
       | would feel a bit foggy in the head, I would take a 3-15 minute
       | meditation session. It usually results to 3-5 sessions per day.
       | It's such a great mental reset, and I haven't since experienced
       | the kind of complete depletion that you get from pushing yourself
       | hard through the day.
       | 
       | I bet some Zen master would reprimand me for this being the wrong
       | approach, but I found it quite difficult to get into the habit of
       | doing, say, a single 30-60 minute session per day. Now I can
       | consistently drop into the meditation session with no urge for
       | procrastination and have also successfully experimented with
       | longer ones.
       | 
       | [1] refers to the method of increasing your pull-up capability by
       | installing a pull-up bar in your office / bedroom doorway and
       | doing a set every time you pass through the doorway
        
         | amirs wrote:
         | Highly doubt any Zen master would reprimand you. Any habit you
         | want to keep needs to be sustainable, if it doesn't fit the way
         | your life works, you probably won't keep it. They would however
         | most likely encourage you to challenge yourself from time to
         | time when possible to see if you can get comfortable doing a
         | longer session once in a while.
        
           | pedalpete wrote:
           | Seriously... a zen master who reprimands doesn't sound very
           | zen. :)
        
         | hh3k0 wrote:
         | > ... every time I would feel a bit foggy in the head, I would
         | take a 3-15 minute meditation session.
         | 
         | Hey, that's what I do too! I've never read anything meditation-
         | related and consequently do not know any of those approaches
         | but I once realized that lying in bed/on the couch/on the floor
         | for a few minutes while freeing my head of all thoughts really
         | helps with mental fog (I have ADHD and fog tends to build up
         | even with meds). I tend to jokingly refer to the process as
         | 'clearing my cache'.
        
       | zackmorris wrote:
       | This mirrors what I experienced when I went through a severe
       | burnout 2 years ago. I had some health issues like sleep apnea
       | and digestive problems converge before I knew about them, so even
       | though I was working out heavily 5 times per week, I was fat and
       | unhealthy and had lost my resilience.
       | 
       | My work put us on call at night 1 week out of 3 to monitor an
       | ailing server and my productivity fell precipitously almost
       | immediately. That was the last straw, so even though I thought I
       | had the discipline to handle it, my body thought otherwise and I
       | started crashing (falling asleep at my desk, having so much brain
       | fog that I struggled with basic chores, etc). I miss that job
       | often, but the writing was on the wall at least a year before
       | that when I noticed that nobody listened to my expertise, they
       | just wanted output. That's the surest route to burnout that I
       | know of so far.
       | 
       | I did have a lot of concussions in elementary school, but all I
       | remember is the nausea and laying in bed for days. Severe
       | burnout/depression feels similar in that one loses their
       | executive function. To me, burnout felt like what I imagine
       | having a stroke might feel like. My problem-solving faculties
       | shut down, so it was like my mental muscle memory of everything I
       | had learned was no longer there so I was consciously aware of
       | every single step I had to perform (which left me frequently
       | overwhelmed). It also felt like maybe the left and right sides of
       | my brain weren't talking. When I thought about doing any task at
       | all, no matter how minor, I felt low grade pain over my entire
       | body like the feeling you get as you walk slowly into a cold body
       | of water. Where there used to be excitement at the anticipation
       | of doing things I enjoyed, there was now only a void of
       | apprehension and dread. Everything felt like work, even
       | recreation.
       | 
       | I had to start from the beginning and relearn how to write todo
       | lists, journal about what I wanted out of life, address all of
       | the physical issues I could, etc etc etc. The self-help stuff is
       | all true. The only part they are missing is that IMHO as much as
       | 80% of our mood is derived from physical sources. The science of
       | vegetarianism isn't quite there yet. So for example, I was eating
       | more beans (legumes) and nightshades each day than most people
       | probably eat all week. The anti-nutrients had lowered my
       | absorption of iron, zinc and I'm pretty sure iodine, not to
       | mention that I wasn't taking enough of the basics like B
       | vitamins. Each time I reintroduced traditional foods like bacon,
       | I received outsized returns because of things like tryptophan
       | turning into serotonin. Nutrition is huge.
       | 
       | Anyway, when it's all said and done, the best treatment for me
       | was to slow down and emphasize things like how priceless
       | consciousness is (dignity), and deemphasize artificial human
       | constructs like worth/productivity (materialism). Also I learned
       | that habits take about 2 weeks to form, so it was helpful to list
       | 1 or 2 things I was struggling with, then perform them manually
       | and dispassionately until the habit stuck. Negative self-talk is
       | huge too. I adopted a continuous mindfulness as a set of rules so
       | that whenever my inner monologue is critical, I note it and file
       | it away without engaging. Over time, the positive thoughts grew
       | as my inner child learned that positive reinforcement works.
       | 
       | I'll stop there since I could talk about this literally forever,
       | but I highly recommend talking to someone and seeing a doctor or
       | nutritionist and trying some integrative and holistic approaches.
       | Don't lose years like I did.
        
       | KMag wrote:
       | Working from home, needing to log in to work with 2FA, if I'm
       | very tired, I find it difficult to keep the 6 pseudorandom digits
       | in memory simultaneously for long enough to log in.
       | 
       | Also, I should learn to touch-type the digits. It's funny that
       | I've been touch-typing Dvorak for 20 years, but still haven't
       | picked up the digits.
        
         | wongarsu wrote:
         | Number pads are a bit out of fashion, but they are awesome for
         | touch-typing digits.
         | 
         | That being said, if you can't remember 6 digits, just imagine
         | how the rest of your work suffers at that point. Everyone is
         | better served by you taking a nap first
        
         | toast0 wrote:
         | Finding a way to get better sleep is, of course, the proper
         | answer to this problem, however there are mant situations where
         | better sleep is elusive, so...
         | 
         | As a former sender of six digit codes, I worked hard to make
         | them visually (and auditorially) appear to be two three digit
         | codes; we thought that would make it easier for people to
         | process. If you make a habit of processing the codes as two
         | three digit codes, it might help when you're over tired.
        
       | uppsalax wrote:
       | Thank you so much for sharing, this is a really insightful
       | article!
       | 
       | By the way, a friend of mine is doing a Master's thesis in work
       | psychology at the University of Turin on this subject.
       | 
       | I am a bit ignorant about this topic since I have a business
       | background + work in tech-startups. But I am genuinely passionate
       | about this kind of thing.
       | 
       | The gist of the thesis is that all these dynamic and
       | interdependent aspects (e.g. lack of sleep, stress, social
       | pressures, even for athletes before, after and during a race,
       | even if we think about the influence on self-perception in
       | relation to other people and related expectations on personal
       | performance) can lead to somatization which can come in the form
       | of concussion, but also to burnout or multiple injuries (as my
       | friend is researching on the thesis) and as it happened to me
       | too, in my life.
       | 
       | Practicing yoga or simply going for a walk daily, helped me a lot
       | along that path... and helped many friends of mine as well. But
       | some people can argue that it is the natural outcome of a
       | "placebo effect".
       | 
       | All of these are very interesting talking points and the inherent
       | dynamics behind vicious cycles (echoing @raghuveerdotnet's
       | comment) is still not crystal clear and needs further research
       | and experimentation.
       | 
       | What are your thoughts?
        
         | wongarsu wrote:
         | > But some people can argue that it is the natural outcome of a
         | "placebo effect".
         | 
         | What would a placebo effect even be when talking about lack of
         | sleep, stress, etc.?
         | 
         | In medicine the size of the placebo effect seems to depend on
         | the procedure. A placebo surgery is more effective than a
         | placebo injection, which is more effective than a placebo pill.
         | So if you want to test if an injection is better than a placebo
         | you compare it to a placebo injection like saline water,
         | something where there's no way it can have a medical effect
         | beyond the psychological effect. But that would mean that to
         | evaluate meditation you would have to compare it to some kind
         | of fake meditation, maybe breathing exercises that have no
         | viable way to be effective beyond the placebo effect. But we
         | don't know nearly enough about neuroscience to come up with
         | such a thing.
        
       | markc wrote:
       | I wake up after about 4.5 hours of sleep "no matter what".
       | Bedtime of 10pm or 2am, exercise or no, light exposure or no,
       | late eating or no - always the same result. Then I'm awake for a
       | few hours, then get my "second sleep" of 1 to 2 hours. I've been
       | going like this for a decade without daytime sleepiness (a few oz
       | of coffee and I'm charged up for the day), but these kinds of
       | articles really worry me.
       | 
       | I have light sleep apnea, but a CPAP didn't help either. I'm old
       | (60) so I'm considering trying melatonin to replace what I'm no
       | longer producing, but I'm also wondering if I'm missing some
       | other potential "staying asleep" lifestyle factors. Anyone here
       | successfully dealt with the "stay asleep"issue other than with
       | the variables I listed?
        
         | porcc wrote:
         | This seems perfectly healthy:
         | https://en.wikipedia.org/wiki/Biphasic_and_polyphasic_sleep
        
           | markc wrote:
           | I had not heard of this. Reading now - thanks!
        
         | carlmr wrote:
         | You probably have a very natural sleep rhythm.
         | https://www.psychologytoday.com/us/blog/sleepless-in-america...
        
           | markc wrote:
           | Good read, really interesting. Thanks!
        
         | loceng wrote:
         | If you're overweight at all, even by a little, losing that
         | weight that greatly impact your sleep and health overall. Also
         | if you eat any inflammatory foods - sugar, carbohydrates,
         | dairy, etc - then that inflammation can cause issues with
         | sleep, especially for brain related inflammation, sleep time
         | when brain channels are meant to open up to clear waste;
         | inflammation is linked to Alzheimer's now because of this
         | process.
        
           | sandstrom wrote:
           | The science behind "inflammatory foods" is pretty shaky:
           | 
           | https://www.scientificamerican.com/article/the-messy-
           | facts-a...
           | 
           | https://www.acsh.org/news/2019/05/05/closer-look-anti-
           | inflam...
        
             | markc wrote:
             | Interesting. I've been interested in anti-inflammation
             | unrelated to the sleep stuff. Sad if there's not much to
             | it, since it seemed like a hopeful no-drugs way of
             | improving health.
        
           | markc wrote:
           | Skinny guy, no obvious source of airway obstruction. Maybe
           | that's why the cpap doesn't work. I think I literally hold my
           | breath (some variant of so-called "central" apnea?) and foil
           | the cpap that way.
           | 
           | I'll consider the inflammation stuff. I've been trying to cut
           | out down on sugar anyway.
        
         | Balgair wrote:
         | Try cutting the caffeine intake and see if that helps?
        
           | markc wrote:
           | It's literally at 3oz a day though, so "cutting" would
           | effectively be zero. Maybe I could try decaf since I seem to
           | need a bit of coffee for, ahem, regularity.
        
             | Balgair wrote:
             | Yeah, that's pretty small as is.
             | 
             | Anecdata: I cut out all caffeine during quarantine and I've
             | never slept better. But I was drinking ~12oz a day prior to
             | that. And I also cut out all the other drugs in my life
             | too. And the commute due to WFH. Honestly, trying to say it
             | was one thing that made my sleep better isn't really
             | possible, it's all entangled. But the SO says that caffeine
             | was the major culprit.
        
         | e40 wrote:
         | Dude, this is exactly me. Same age. 4.5 hours. Read for a
         | while. 1-2 hours more.
         | 
         | Just this morning, I think I finally diagnosed my central sleep
         | apnea. I was laying there and just as I fell asleep I started
         | awake because I wasn't breathing. My diary has notes about this
         | happening all the way back to last March. This happened to me
         | after my first sleep.
         | 
         | To add to that, I've become hyper-sensitive to caffeine. It
         | causes palpitations (started in late 2019).
         | 
         | I don't snore, but I have been using Breathe Right strips to
         | make sure I have adequate air flow, and so I'm really sure I
         | don't snore. Curiously, I haven't used them for a couple of
         | weeks (long story).
         | 
         | EDIT: if you want to contact me, my info is in my profile
        
       | dsego wrote:
       | Sleep seems so essential to our lives and yet we understand very
       | little. I had two car accidents due to lack of sleep the night
       | before. Whenever I don't get my sleep I can't focus, my
       | recollection is poor and I have trouble doing basic stuff. You
       | can find texts online about people literally dying from chronic
       | insomnia. I always wonder how some people can function well with
       | little sleep and almost everybody seems to do better than me. And
       | I'm convinced that lack of sleep accumulates because I can sleep
       | till noon if I have no obligations that day.
       | 
       | For my schizophrenic sibling one of the most troubling aspects of
       | his condition is bad irregular sleep. Sometimes he can't sleep
       | all night and then he sleeps the whole next day. But it's never
       | enough sleep, nothing but constant drowsiness and lack of energy.
       | Psychosis sure does resemble dreaming while awake, you accept
       | weird ideas, things just happen etc, same as in a dream. And once
       | medication kicks in, seems like slowly waking up and dream fades
       | out.
       | 
       | Somehow it's all connected and whoever figures out the puzzle of
       | sleep will make the world a much happier place.
        
       | hntrader wrote:
       | Related (on how to fall asleep quickly):
       | https://news.ycombinator.com/item?id=16671944
        
         | hnick wrote:
         | Thanks for this, I learned the word Hypnagogia from the
         | discussion. Now I know what to say without sounding as crazy
         | when I mention seeing things to a doctor next time. For some
         | reason it's always spiders.
        
       | thrwyoilarticle wrote:
       | I once had a seizure because of sleep deprivation. I try to keep
       | a better hold of it now - if nothing else, I want to be allowed
       | to keep on driving - but I'm far from comfortable telling my
       | employer I'll be late because I want to sleep in.
        
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