[HN Gopher] Association of sleep duration in middle and old age ...
       ___________________________________________________________________
        
       Association of sleep duration in middle and old age with incidence
       of dementia
        
       Author : gmays
       Score  : 288 points
       Date   : 2021-04-21 16:08 UTC (6 hours ago)
        
 (HTM) web link (www.cnn.com)
 (TXT) w3m dump (www.cnn.com)
        
       | Tycho wrote:
       | I wonder if there is a very simple effect involving blood flow to
       | the head. When you sleep, you lie horizontally, and so presumably
       | it's easier for blood to circulate through your entire body.
       | Maybe if you don't get enough horizontal time, it leads to head
       | related problems like dementia and hair loss.
        
         | TheBlight wrote:
         | Possibly related:
         | https://www.scientificamerican.com/article/deep-sleep-gives-...
        
         | tinyhouse wrote:
         | Many people who don't sleep enough at night do spend the same
         | time laying down as one with a full night sleep. Many people
         | would spend like 5 hours sleeping and another 2 hours laying
         | down resting.
        
       | overcast wrote:
       | Unless it's an emergency, I've ALWAYS prioritized sleep. It's
       | just too important for health regardless of these latest
       | findings. I'd call in to work if I didn't get a full nights rest
       | in the past, it's not worth feeling like shit for the rest of the
       | day. The culture of glamorizing working longer and harder till
       | early hours of the mornings on zero sleep, has always been
       | nonsense. Musk is notorious for bragging about this, and the dude
       | is a rough looking 49.
        
         | rubicon33 wrote:
         | Some people are willing to trade health for fortune and fame.
         | There's been interviews with Musk where he describes being
         | unable to turn his brain off. He's probably just leaning hard
         | into the cards that life dealt him - a wildly productive brain
         | that wants to go go go. I don't blame him for taking what he
         | was dealt, and running with it.
        
           | rednerrus wrote:
           | He's leaning hard into the stimulants...
        
             | tachyonbeam wrote:
             | People with amphetamine habits typically look very skinny
             | and unhealthy because amphetamines suppress appetite. Same
             | for cocaine, ritalin and all other dopaminergic stimulants.
             | They can also have facial scabs because of obsessive
             | picking/scratching, and tend to be very twitchy and hyper.
             | He doesn't come off that way at all during interviews.
             | 
             | My personal experience leads me to believe that there is no
             | way Elon Musk could have been dosing stimulants for the
             | last 10-20 years and look as good and as relatively calm as
             | he does. You build a tolerance very quickly, and any edge
             | that you thought the stimulants were giving you will fade
             | away fast. Then, if you increase the dose, your life will
             | spiral off the rails as you become more manic, impulsive
             | and irrational (eg: gambling, sex, spending sprees,
             | irritability, violence, paranoia). Just Google John McAfee
             | if you want to see what this can look like.
             | 
             | IMO Elon Musk just has lucky genetics and doesn't need much
             | sleep, always has high energy. There are people who are
             | fortunate to be born like that.
        
               | germinalphrase wrote:
               | I know - quite literally - at least a dozen people who
               | take amphetamines daily and display few or none of the
               | visible descriptions you list above. None of us know what
               | EM ingests.
        
               | 74d-fe6-2c6 wrote:
               | Your reasoning might hold for an average user but not for
               | a billionaire like Musk. He'll obviously have very smart
               | people research and design a cycle for him that mitigates
               | the usual side effects. With calorie intake monitoring,
               | vitamins and anything you can remotely think of. A guy
               | like Musk will also react more controlled with regard to
               | amphetamines.
               | 
               | Whether he actually uses amphetamines I have no idea. But
               | I'd not be surprised to learn that he has his own RC lab.
        
               | spurgu wrote:
               | ^^ Agreed.
               | 
               | > IMO Elon Musk just has lucky genetics and doesn't need
               | much sleep, always has high energy.
               | 
               | I remember him explaining that 6 hours was just a sweet
               | spot (not the highest energy spot), that he would have
               | more energy with more sleep but it wouldn't be enough to
               | compensate for the lack of hours available in a day. Or
               | something to this effect.
        
               | paulpauper wrote:
               | I dunno what his schedule is. Maybe he just seems busier
               | than he actually is.
        
               | tachyonbeam wrote:
               | There's no way you can run all these companies, be an
               | international celebrity, and not be busy.
        
               | retrac wrote:
               | Sporadic, restricted use of amphetamine tends to retain
               | full effect over the long-term. With regular use, the
               | subtle change in perception it causes tends to persist
               | longer than the physical stimulation. The appetite issue
               | can sometimes be addressed simply by actively choosing to
               | eat more.
               | 
               | I do think that, in the long run, it at best averages out
               | between the unavoidable highs and lows. Some people
               | benefit from being able to time when those periods
               | happen. Probably net loss in many cases. Still, the
               | behaviour you're describing represents the end stages of
               | escalating use and loss of control where they have fallen
               | into dependency and/or addiction. That's not inevitable.
               | Some people do seem to be able to self-regulate their use
               | of strong stimulants.
               | 
               | But you're right. It's clear some people are just
               | innately more driven. In the worst case they're like Elon
               | Musk, always flitting around, perpetually alternating
               | between chipper and enraged, and always with coffee in
               | hand and at most four hours of sleep the night before. I
               | find such people infuriating, but that is probably just
               | envy.
        
               | majoram wrote:
               | >My personal experience leads me to believe that there is
               | no way Elon Musk could have been dosing stimulants for
               | the last 10-20 years and look as good and as relatively
               | calm as he does.
               | 
               | Looks can be deceiving :P Years ago Elon was balding hard
               | and now he has a full head of hair.
        
               | novok wrote:
               | the man is overweight
        
               | majoram wrote:
               | Nah he's just bulking. It's all muscle under there.
        
         | crocsarecool wrote:
         | Heck yes. When I first started in tech, I was all about the
         | working into the wee hours. I wanted to be hardcore. I was
         | listening to a podcast and someone mentioned what you just
         | said, "A major culture problem in the tech industry is
         | glamorizing lack of sleep." Hearing that gave me the slap of
         | reality I needed. Just because I'm present at the computer
         | doesn't mean I'm doing my best work. There would be times I was
         | so tired, I'd open an application to do something then sit
         | staring at it for a few moments because I couldn't remember
         | what I was going to do. Now, I evangelize sleep to all my
         | friends and coworkers. Especially the younger ones. I want to
         | break that cycle.
        
         | nradov wrote:
         | I wonder if Elon Musk has the "short sleep" genes?
         | 
         | https://www.ucsf.edu/news/2019/08/415261/after-10-year-searc...
        
         | tinyhouse wrote:
         | Well, many people don't sleep enough because they cannot.
         | Insomnia is common in midlife.
        
           | nradov wrote:
           | Most cases of insomnia in midlife are caused by lifestyle
           | problems: lack of exercise, substance abuse, and obesity-
           | induced apnea.
        
         | decafninja wrote:
         | I think Elon Musk looks his age, and looks pretty ok for a 49
         | year old. Granted he has money, and he's had hair transplants,
         | but I've seen many late 40s early 50s people in much worse
         | shape.
        
           | maxerickson wrote:
           | He's approaching the Brimley/Cocoon Line.
        
             | benatkin wrote:
             | Passed the Wendt/Cheers Line two years after Tesla was
             | founded and three years before he became CEO.
        
           | mywittyname wrote:
           | He's had a lot of cosmetic...improvements. Plus he can afford
           | personal chefs, trainers, doctors, stylists, etc.
        
           | paulpauper wrote:
           | those are alot of caveats though. excpet for blah blah blah
           | blahb, yeah he looks good.
           | 
           | Compared to his earlier pictures, it looks like he 'filled
           | out' in terms of mody mass and skull growth. That sometimes
           | happens when you take GH for long periods.
        
           | matwood wrote:
           | IME, the biggest predictor for people looking younger than
           | their age is exercising and avoiding alcohol. I'm sure sleep
           | is in there since people who do the other 2 normally also
           | sleep ok.
        
             | paulpauper wrote:
             | i think genes are a bigger factor
        
             | burade wrote:
             | Sleep is in there, trust me. I'm 29 and look 40.
        
             | bradford wrote:
             | I'd add tobacco use and UV exposure to that list (anecdotal
             | of course).
        
               | ethbr0 wrote:
               | Constant stress seems the biggest ager. Intermittent
               | stress (even at high levels), punctuated by periods of
               | relexation, doesn't seem as bad.
               | 
               | See: US presidents before-and-after vs corporate CEOs
        
           | teawrecks wrote:
           | Elon looked 50 when he was 30. It's definitely the money.
        
             | decafninja wrote:
             | Probably the hair transplants.
        
       | dmje wrote:
       | It's irritating how these articles always position stuff as if us
       | insomniacs have a choice. I'd chew my own arm off to get a solid
       | 8 hours a night but it just doesn't happen.
        
         | ronyeh wrote:
         | I am still terrible at sleeping, but a small dose of melatonin
         | and moving my phone away from my bed has helped me a bit. Does
         | melatonin help you any?
        
           | dmje wrote:
           | Never tried, but thanks, will give it a go!
        
       | arisAlexis wrote:
       | Maybe a bit extreme conclusions? One day or one week of bad sleep
       | detrimental? So people that have more than one kid and had bad
       | sleep for years are all doomed? Like all humanity?
        
       | fencepost wrote:
       | I think reading the entire article is important here.
       | 
       | My initial response was that the headline writer was sloppy about
       | risk, correlation and causation, but towards the end it notes
       | some studies where one or more nights of poor sleep appeared to
       | cause measurable increases in substances that are present in
       | elevated levels in dementia patients. If those studies did a
       | reasonable job of showing causation, then this could be an
       | extension of that work.
        
       | andred14 wrote:
       | CNN lied constantly in 2020 and before. People are still watching
       | and reading their stuff?
       | 
       | This is more propaganda - a story to cover up the thousands of
       | vacc1ne reactions that are happening
        
       | daneel_w wrote:
       | Percentage or percentiles?
        
       | gregf wrote:
       | I'm screwed then. Due to a mental issue and my sleep paralysis
       | I'm lucky if I sleep 3-4 hours a night as much as I would like to
       | sleep more.
        
         | pvarangot wrote:
         | That little sleep has way more possible dire consequences that
         | just dementia. There's literature all over the place about it,
         | I don't even know where to start. How old are you? I don't know
         | anyone that can live with getting that little sleep unless they
         | are also on amphetamines.
        
           | gregf wrote:
           | Turning 40 in August. I haven't slept this badly all my life.
           | It's got worse over the years. Specially the last 5 or so.
           | I'm bipolar II, I take my meds as I'm supposed to, but I
           | still seem to frequently cycle with manic episodes that keep
           | me up working on projects all hours of the night. I then
           | refuse to sleep all day, so I'll go to bed at say 3-4am and
           | get up by 9am. Nights I can go to bed, I suffer from horrible
           | sleep paralysis and that will have me waking me up throughout
           | the night. Some of it is pretty disturbing, at least to me.
           | So I end up giving after it happening several times in a
           | night and just not sleeping any longer.
           | 
           | Sleep issues run in the family though. My father is a logger
           | and I have never seen him sleep longer than 5-6 hours my
           | entire life.
           | 
           | *EDIT* not abusing Amphetamine's BTW. Sorry forgot to even
           | talk about that. Just lots of mania I would guess. Like right
           | now, I have been kinda down and depressed all afternoon. It's
           | now 6pm where I'm at, and I just had a switch go off, and now
           | I'm full of energy and will probably end up coding till I
           | drop. I'm my own worst enemy, I know.
        
         | eurasiantiger wrote:
         | Worrying about sleeping enough is certainly more detrimental to
         | one's health and well-being than getting too little sleep.
        
       | abledon wrote:
       | nurses and doctors, the 'health' workers, and other erratic
       | schedule-shifting shift workers... RIP
        
         | gumby wrote:
         | This is well known, and there is a movement to change this for
         | residents, at least. So far nothing has changed.
         | 
         | More proximally: the level of care you can receive / number of
         | errors committed is seriously affected by the loss of sleep by
         | your carer.
        
       | slt2021 wrote:
       | do investment bankers have dementia later in their lifes?
       | 
       | i heard they work 9-5 (9am-5am next day)
        
       | Tenoke wrote:
       | ~6 hours or just above it in general seems to be the sweetspot.
       | Most negative effects (especially broad ones like all-cause
       | mortality) only really start showing up under 6 (or over 7
       | hours)[0].
       | 
       | Too bad the majority of reporting exaggerates and starts scaring
       | people for going under 8 (and sometimes 9!) when yet again it
       | seems like 6-7 is likely best, with very little 'loss' between 7
       | and 6. Just don't go much lower than that for long unless you
       | need exceptionally less.
       | 
       | 0. https://cdnsciencepub.com/doi/full/10.1139/apnm-2020-0034
        
         | balfirevic wrote:
         | > Most negative effects (especially broad ones like all-cause
         | mortality) only really start showing up under 6
         | 
         | Most - maybe. But one very important negative effect is that
         | waking up without enough sleep is, quite literally, torturous.
        
         | fulafel wrote:
         | Your linked consensus statement recommends against under 7 or
         | over 9 hours, and says 7-8 is "most favourable".
        
           | Tenoke wrote:
           | I already edited and answered in another comment. The actual
           | studies (especially large meta-analyses) show very good
           | results between 6 and 7, I was just thinking of linking this
           | for the overrecomendation of 8-9 and copied it by mistake.
           | 
           | Though even here they try to reccomend more in the abstract
           | than what their results suggest, so look at the actual
           | results e.g. all-cause mortality.
        
         | matwood wrote:
         | Yeah, I naturally sleep around 7 hours. If I get < 6 I really
         | notice it the next day. 6+ is a normal day. But it is weird
         | just how much I notice going less than 6 though.
         | 
         | Another thing that my wife hates (ie, is jealous of), is my
         | head hits the pillow and I'm out. Also, during that 6 hour
         | sweet spot, I can sleep through almost anything.
        
           | serpix wrote:
           | My dad is like this. Please tell me as I am curious, do you
           | tend to self-reflect or have a vivid inner world? I'm trying
           | to understand how my dad does this and my current theory is
           | that he simply does not dwell on things and runs mostly on
           | instinct.
        
             | IneffablePigeon wrote:
             | Fwiw, I can also usually do this and I would consider
             | myself a world class dweller.
             | 
             | For me, it's about
             | 
             | - consistent bedtime
             | 
             | - doing as little as possible involving a screen in bed
             | 
             | - consistent bedtime routine
             | 
             | - consistent bedtime
             | 
             | Screwing any of these up can quite easily cause me to start
             | worrying about things instead of falling asleep.
             | 
             | But I also think in part I'm just lucky and I can't really
             | explain what causes it. I was always able to fall asleep in
             | the car when I was younger, almost instantly. I can't fall
             | asleep on public transport or planes at all though unless
             | I'm really shattered.
        
             | matwood wrote:
             | I self reflect a lot, but don't dwell on things outside of
             | my control. How an interaction with a co-worker went I
             | might think about for days and even journal about, but I
             | can't tell you what I read on HN yesterday unless it fit
             | into something I'm working on.
             | 
             | I exercise almost every day and have for over 20 years. It
             | definitely helps.
             | 
             | I do have a basic bedtime routine. I go to bed at a
             | consistent time, but I don't avoid screens or anything. I
             | do avoid games and any news type things when I'm winding
             | down for bed, but will read and watch part (it's always a
             | part b/c I'm asleep before it's over heh) of a show on my
             | phone. Also, DnD kicks on about an hour before bed so a
             | random work email doesn't derail me.
             | 
             | Finally, if there is something I'm worried about I take
             | care of it. This goes back to not dwelling on things
             | outside of my control, and dealing with the things that
             | are.
        
         | cinntaile wrote:
         | That's not what your source says though. The consensus is less
         | than 7 hours has adverse health outcomes and more than 9 hours
         | has an unknown effect for most people and is beneficial for
         | certain groups of people.
        
           | Tenoke wrote:
           | My bad, I copied the wrong link (edited now). I meant to link
           | to the largest systematic review I could find[0]. Instead I
           | had linked to the US recommendation which I was initially
           | thinking of linking for the part where most over-recommend
           | 8-9.
           | 
           | Relevant part:
           | 
           | >that compared with 7 h of sleep per day, a 1-h decrease in
           | sleep duration was associated with 6% increased risk of all-
           | cause mortality and a 1-h increase in sleep duration was
           | associated with a 13% increased risk of all-cause mortality
           | (N = 241 107 adults in 43 articles).
           | 
           | With again, the bigger effects being under 6 but even with an
           | per-hour average the risk from 7 to 8 is higher than 7 to 6.
           | 
           | 0. https://cdnsciencepub.com/doi/full/10.1139/apnm-2020-0034
        
       | ineedasername wrote:
       | Why assume lack of sleep is the cause? Why not reverse it, that
       | dementia causes people to sleep less?
       | 
       | The study makes it clear that it's an association. It never says
       | it's an assertion of directional causality.
        
       | datavirtue wrote:
       | Typical mainstream click bait.
        
       | [deleted]
        
       | kazinator wrote:
       | We must avoid using causal words like "raises" when a statistical
       | relationship is found. To raise something is to cause something
       | lower to become something higher.
       | 
       | What the study found is that the pattern of sleeping less than
       | six hours _is seen_ more in people who develop dementia.
       | 
       | The study's own discussion states: "There is evidence of a
       | bidirectional association between sleep dysfunction and
       | pathophysiological changes in dementia{citations given},
       | highlighting the need for a longer time frame in studies."
        
       | sokoloff wrote:
       | I always wonder about the direction of causality (if any) in
       | these studies.
       | 
       | I'm fortunate to mostly live without an alarm clock. I naturally
       | get up before any scheduled activities, only early morning
       | flights (previously) or EU time zone meetings require an alarm.
       | Even without an alarm, I typically wake up feeling fully
       | refreshed after 5-6 hours, rarely more than 7.
       | 
       | If I end up with dementia (family history indicates likely), is
       | the same root cause of dementia _causing_ the 5-6 hours of sleep
       | now, the other way around, or neither?
        
         | tinyhouse wrote:
         | Not an expert. But if you're fully refreshed I think you're
         | fine. Many people would take it, that's for sure. Research is
         | useful. But nothing is more useful than listening to your own
         | body. When something is wrong there are usually signs.
        
       | k__ wrote:
       | Good to know.
       | 
       | Five years ago I stopped setting an alarm and now I get about
       | 8-9h of sleep every night.
       | 
       | Let's see how this plays out in the long run, haha.
        
       | JCM9 wrote:
       | There are lots of stories of the "I can work harder and longer
       | than others because I require very little sleep" types having
       | serious issues later in life. This study would seem to put some
       | hard data behind this logic being a really bad idea for ones long
       | term health and well being. The public discourse now seems to be
       | shifting to one where "successful people prioritize sleep."
        
         | eurasiantiger wrote:
         | I think those people already have serious issues and are
         | escaping them through working.
        
       | carbocation wrote:
       | In contrast, a quasi-causal analysis (via Mendelian
       | randomization) found no causal effect of sleep duration on
       | Alzheimer's risk.
       | 
       | > _There was little evidence to support associations of increased
       | sleep duration with ... Alzheimer 's disease risk [OR = 0.89 (95%
       | CI = 0.67-1.18); P = 0.41]. _
       | 
       | https://pubmed.ncbi.nlm.nih.gov/31062029/
        
         | dmicah wrote:
         | The study you cite isn't really in conflict with the parent
         | study. They note that the number of individuals with
         | Alzheimer's Disease in the study was too small to develop a
         | non-linear model relating sleep duration to AD risk:
         | 
         | Pg. 858:
         | 
         | "Similarly, short and long sleep duration and poor sleep
         | quality have also been linked with an increased risk of
         | dementia. Although a similar J-shaped association was observed
         | in our observational analysis, we were limited to performing
         | only the linear MR analysis, as the non-linear MR method
         | requires a large number of cases and individual-level data. In
         | our linear MR analysis, we found no clear evidence that an
         | increased sleep duration was associated with a higher risk of
         | all-cause dementia in UK Biobank or with AD in IGAP. This is
         | unsurprising, as the true association might be non-linear and
         | we were limited with only 1343 dementia cases in UK Biobank.
         | Also, IGAP does not capture non-AD dementia types and comprises
         | an older and more heterogeneous population."
         | 
         | "Results for risks of dementia and AD are still too imprecise
         | to draw any definitive conclusions. Our findings suggest that,
         | in clinical care, attention should be paid to sleep-duration
         | patterns and improved sleep habits could represent a potential
         | therapeutic target for cognition."
        
           | carbocation wrote:
           | It doesn't disprove the parent study, but it certainly is not
           | supportive of some of the causal interpretations of the
           | observational study.
        
         | gumby wrote:
         | There are other forms of dementia than Alzheimer's.
        
           | carbocation wrote:
           | Are there causal analyses of sleep on those other forms of
           | dementia?
        
             | sixstringtheory wrote:
             | I'm not well versed on different kinds of studies... could
             | you explain the differences between "causal analysis" and
             | whatever the study linked in the article is? They mention a
             | longitudinal study and that the "finding was confirmed in
             | analysis using sleep duration measured by an
             | accelerometer."
             | 
             | I assume a causal analysis would also determine the
             | direction of the causality, e.g. if it turns out that
             | people predisposed to dementia have more trouble sleeping
             | in middle age. That definitely seems like a tall order and
             | probably not exactly what the linked study can answer.
        
               | eurasiantiger wrote:
               | Accelerometers tell nothing about the actual sleep
               | duration. Is this another one of that quack sleep
               | doctor's "everyone needs 8 hours of sleep every night"
               | studies?
        
               | carbocation wrote:
               | Correct, the study design in the original article cannot
               | answer causal questions (although of course it can
               | generate hypotheses). For example, if an omniscience
               | informed us "actually, people lose sleep in middle age as
               | a consequence of the early stages of dementia", that
               | would make sense as well.
               | 
               | The best causal analysis is interventional, but many
               | times (such as in this case) it would be both extremely
               | challenging and likely hard to do in any ethical fashion
               | (I can't imagine how it could be done, but perhaps
               | someone could).
               | 
               | Short of that, you're left with instrumental variables.
               | Genetics offers a very nice instrumental variable, since
               | the causal arrow largely goes one way if you setup your
               | study design carefully.
               | 
               | That is generally performed as Mendelian randomization,
               | which has several assumptions but, if met, has nice
               | properties.
               | https://en.wikipedia.org/wiki/Mendelian_randomization
        
             | gumby wrote:
             | Unfortunately such studies are very very hard to conduct
             | and are never well powered
        
       | zapita wrote:
       | Alternative title: people without children have less risk of
       | dementia.
        
       | Jallpowawe wrote:
       | After following nearly 8,000 people for 25 years, the study found
       | a higher dementia risk with a "sleep duration of six hours or
       | less at age 50 and 60" as compared to those who slept seven hours
       | a night.
       | 
       | In addition, persistent short sleep duration between the ages of
       | 50, 60 and 70 was also associated with a "30% increased dementia
       | risk," independent of "sociodemographic, behavioural,
       | cardiometabolic, and mental health factors," including
       | depression, the study said.
        
       | eurasiantiger wrote:
       | Many forms of dementia destroy dopaminergic neurons, and this
       | process begins much earlier than symptoms of dementia itself
       | manifest. From what I've gathered from reading studies across the
       | years, less dopaminergic capacity seems to be associated with
       | less restful sleep.
       | 
       | The conclusions of this study seem to have it backwards. It's not
       | lack of sleep that causes dementia, it's early dementia that
       | causes insomnia.
       | 
       | Edit: it's also possible that a third factor causes both of
       | these. For example, both people low on dopamine and the sleep-
       | deprived are likely to turn to coffee to keep them functional. If
       | they drink too much coffee, they might accidentally poison
       | themselves into dementia, because some of the Harmala alkaloids
       | in coffee are neurotoxic and like to deposit themselves in brain
       | fatty tissues for a long time.
        
         | gundmc wrote:
         | Coffee causing dementia is a pretty shocking claim that I
         | haven't heard previously. Do you have more reading on this?
        
           | nsxwolf wrote:
           | I've always wondered if coffee studies are just something
           | they give bored grad students to do. I've heard about what
           | seems like hundreds of them in my lifetime and they
           | contradict each other in cycles over long stretches of time.
        
             | crocsarecool wrote:
             | Same! One week it's terrible for you. The next week it's
             | curing cancer. I just try not to have any past a certain
             | hour so as to not interrupt my sleep.
        
             | ineedasername wrote:
             | The behavior of drinking coffee or not is also very
             | socially mediated-- portrayal of coffee drinkers in movies,
             | coffee as a common activity for preliminary dates, or to
             | meet someone new at a cafe...
             | 
             | All of this means that coffee drinkers are going to self
             | select for various other features that add confounding
             | factors. Imagine you were doing a study on marriage
             | patterns: I wouldn't be surprised if "Drinks their coffee
             | in the cafe itself" was more highly associated with being
             | single. And the headline will read "Dedicated coffee
             | drinkers less likely to find a partner"
        
           | eurasiantiger wrote:
           | There's something in (1), but it doesn't address the entire
           | spectrum of Harmala alkaloid neurotoxicity (2) (3). It has
           | been shown that heterocyclic aromatic amines (which Harmala
           | alkaloids belong to) indeed damage dopaminergic neurons (4).
           | 
           | (1): https://hammer.purdue.edu/articles/thesis/Identification
           | _of_... (2):
           | https://onlinelibrary.wiley.com/doi/pdf/10.1002/ijc.20703
           | (3): https://www.sciencedirect.com/science/article/pii/S15700
           | 2320... (4): https://academic.oup.com/toxsci/article-
           | abstract/173/1/171/5...
        
         | tartoran wrote:
         | The OP doesn't suggest that coffee may cause dementia but was a
         | possibility for sleep deprived and low on dopamine individuals
         | drinking too much coffee to stay functional, exacerbating their
         | sleep deprivation thus rising the prospects of developing
         | dementia.
        
           | eurasiantiger wrote:
           | No, I was explicitly suggesting that neurotoxic amines in
           | coffee may be building up in some, possibly genetically
           | predisposed heavy coffee drinkers, causing loss of
           | dopaminergic neurons and ultimately dementia, or other
           | neurological disorders.
           | 
           | This exact mechanism has been shown to be the cause of a very
           | common neurological disorder called essential tremor.
           | Patients have a genetic predisposition for building up
           | tremor-inducing Harmala alkaloids due to reduced metabolism.
        
         | JamesBarney wrote:
         | https://pubmed.ncbi.nlm.nih.gov/20182054/#:~:text=In%20the%2...
         | .
         | 
         | this says coffee is associated with a reduced risk of dementia
         | which is pretty much what I've read over and over again
        
           | eloff wrote:
           | Thank you! I was freaking out about my beloved coffee
           | addiction.
        
             | zikzak wrote:
             | Never blame the coffee.
        
           | eurasiantiger wrote:
           | That study conflates caffeine and coffee from the very first
           | word in the abstract. I wouldn't trust it at all -- it's like
           | an article about CPUs but the writer doesn't understand the
           | difference between a processor (called CPU) and the rest of
           | the stuff in the computer case (which, as a whole, is also
           | called CPU).
        
         | jiofih wrote:
         | Please don't upvote this nonsense. Harmala alkaloids are found
         | in tobacco, not coffee.
        
           | eurasiantiger wrote:
           | They are found in both, in high concentrations. Tobacco smoke
           | and coffee are the two most significant sources of Harmala
           | alkaloids in the human diet. (Source: T. Herraiz)
        
           | guerrilla wrote:
           | I'm pretty sure harmine and harmaline are found in coffee
           | too. I thought it was common knowledge but all I found were
           | two papers so maybe not.
           | 
           | 1. https://www.sciencedirect.com/science/article/abs/pii/S002
           | 43...
           | 
           | 2. https://www.sciencedirect.com/science/article/abs/pii/S030
           | 88...
        
         | ckosidows wrote:
         | Just coffee or anything with caffeine?
         | 
         | I'm really curious for a source on this, considering how much
         | coffee I drink weekly.
        
           | pvarangot wrote:
           | If caffeine does it for you and need lots of it, eating just
           | caffeine is probably safer than drinking a lot of coffee.
           | Coffee beans have a lot of of other stuff and it varies from
           | bean to bean and eating a lot of some of that stuff may not
           | be good for your gut/brain/whatever.
           | 
           | If you are "addicted" to coffee sometimes you will crave it
           | if you do just caffeine, but this goes away after a while.
           | 
           | Be aware also that if you want the antioxidants and other
           | stuff in coffee beans eating just caffeine won't give you
           | that.
        
             | eurasiantiger wrote:
             | There's really no evidence that antioxidants are
             | categorically good for you. Studies have found that some
             | benefits of exercise are mediated through oxidative stress,
             | and get impaired by antioxidant intake.
        
           | eurasiantiger wrote:
           | Just coffee. You may have a MAOA VNTR that predisposes you to
           | like coffee.
        
         | ineedasername wrote:
         | In fairness to the study, it's only claiming an association,
         | not a causal link.
        
         | chubot wrote:
         | I agree you have to examine both directions, and a common
         | cause, but the article somewhat addresses that under "chicken
         | or egg?" The headline is misleading.
         | 
         | Big idea: a common cause may be jaw development and the
         | resulting lack of breathing (during the day and during sleep)
         | in large parts of the population.
         | 
         | Jaw development has a strong claim to be the fundamental,
         | common cause of poor breathing and sleep because it's derived
         | from 2 fundamental differences between humans and animals:
         | agriculture and speech.
         | 
         | It's a long chain of causation, and took me awhile to learn
         | about, but it may be what you're looking for.
         | 
         | Of course it could also be the case that some people are just
         | staring at screens too much before bed and getting poor sleep.
         | But bad sleep is an epidemic and there is evidence of this all
         | over the world, and going back hundreds of years. The books I
         | reference tell of orthodontists from the 1800's who noticed
         | this problem, etc. Our diets drastically changed, which caused
         | poor jaw development, which causes bad breathing, which causes
         | bad sleep (I learned about this from my dentist).
         | 
         | There are many factors that restrict airways, including weight.
         | Remember that the average American male is about 30 pounds
         | heavier in 2020 than in 1960 (and similarly for females). It's
         | hard to imagine that not having an effect of breathing and
         | sleep (and thus dementia). But I think animals can be fat and
         | still have plenty of air for breathing; the same isn't true for
         | humans.
         | 
         | Previous comment I wrote on this including recent books
         | (2018-2020): https://news.ycombinator.com/item?id=23435964
         | 
         | That article is "fitful nightly sleep linked to chronic
         | inflammation and hardened arteries". That is another
         | correlation, not a causation. So I would suggest that bad
         | sleep, inflammation, hardened arteries, and dementia have a
         | common cause in jaw and airway development. This is a lot
         | harder to see because it took place over 10,000 years and it
         | takes 30-50 years to kill you. You can have bad breathing your
         | whole life but still be functional. It's very related to tooth
         | grinding/bruxism, which is an epidemic as well.
         | 
         | Other threads on Hacker News:
         | https://news.ycombinator.com/item?id=24247066
        
         | TYPE_FASTER wrote:
         | > it's early dementia that causes insomnia
         | 
         | > If they drink too much coffee, they might accidentally poison
         | themselves into dementia
         | 
         | Oh crap
        
           | didibus wrote:
           | I wouldn't take anyone making a comment on HN a source of
           | accurate and truthful data. The HN bias can be at play. Which
           | is the bias that we believe and trust a random comment on
           | Hacker News more than a linked research study, or the body of
           | experts around a subject (who don't comment on Hacker News).
        
       | The_rationalist wrote:
       | Melatonin intake (300 mcg) is useful for falling asleep faster.
        
       | BugsJustFindMe wrote:
       | "However, this study cannot establish cause and effect" is the
       | only part of this article that matters, and it demonstrates the
       | ineptitude of the article writer.
        
         | gentleman11 wrote:
         | As people age and that their brains change, many end up
         | sleeping less automatically, so it could be a common cause for
         | both
        
         | fighterpilot wrote:
         | Yeah, the headline isn't a conclusion that can be drawn from
         | the study, and is guaranteed to mislead most people who come
         | across it. Shame.
        
         | senux wrote:
         | I agree. This sort of article is partly the reason why we so
         | often here something like "science can't make up its mind" or
         | "x is good now but was bad before, and will be bad again soon".
         | 
         | Instead of sharing accurate information about the findings of
         | these researchers, news organizations use them to write catchy,
         | clickbait-y articles. Needless to say, researchers are often to
         | blame as well, since they participate in interviews using vague
         | language so that they can benefit from the exposure, well aware
         | of the repercussions of their behavior.
         | 
         | This issue goes beyond just researchers and news organizations,
         | though. There have been plenty of discussions here in HN and
         | other places about how scientific research is somewhat broken
         | due to how it rewards quantity versus quality for example.
        
           | zarq wrote:
           | It's really hard to fight this though, because it may take
           | many years, even decades, to thoroughly answer a follow-up
           | question. By then, everyone has forgotten about the original
           | reason something got published.
        
           | tinyhouse wrote:
           | > researchers are often to blame as well, since they
           | participate in interviews using vague language so that they
           | can benefit from the exposure, well aware of the
           | repercussions of their behavior.
           | 
           | I would also add that like everything in life, there's a
           | large distribution of researchers. Some do poor research.
           | This is true for all fields. One example is when a researcher
           | has an hypothesis in mind which they try to force even if the
           | results don't really support it. Doing great science is hard
           | and researchers in the end have pressure to publish papers.
        
           | busyant wrote:
           | > Needless to say, researchers are often to blame as well,
           | since they participate in interviews using vague language so
           | that they can benefit from the exposure, well aware of the
           | repercussions of their behavior.
           | 
           | Universities also have PR departments that tout their faculty
           | research. I imagine these PR groups contribute to the hype.
        
         | scotuswroteus wrote:
         | get some sleep
        
           | coding123 wrote:
           | I will when I finish just one more zombie night in 7 days to
           | die. Just one more I promise.
        
       | roguson wrote:
       | This article makes me question my time management ability. I
       | should tweak it so I can't make the chances worse. I guess I'll
       | sleep right now.
        
       | gyrgtyn wrote:
       | This just stresses me out about sleeping even more and makes
       | sleeping harder than it already is.
        
       | paultopia wrote:
       | I really hate these kinds of news stories. It's like: yes, here
       | are some more ways that not getting enough sleep will kill you.
       | Add dementia to weight gain, worsened immune function, etc. etc.
       | Gee, let's all call the Magic Sleep Fairy and ask her to make it
       | possible to sleep longer, as if jobs, family members, noisy
       | neighbors, and all the rest of actual pieces of human existence
       | that make adequate sleep impossible for many of us don't exist.
        
       | irrational wrote:
       | So, anyone with kids is probably going to have dementia?
        
         | emteycz wrote:
         | Usually parents can't sleep well only for a year at most, even
         | 6 months old children are sleeping whole nights.
        
           | ihaveajob wrote:
           | My coffee addiction says otherwise :).
           | 
           | YMMV but kids have their hangups and it's often not possible
           | to negotiate rationally. They also regress (this past year
           | has been terrible, with no school for extended periods,
           | staying at grandma's every couple of weeks so parents can get
           | work done...), and you're back to square one.
           | 
           | Ours are 2 and 5, and I haven't slept in on a Saturday
           | morning since 2015.
        
           | growt wrote:
           | That's just half of the picture. My kids are older but they
           | have a talent to get up at 6 in the morning on weekends. And
           | need to get up at similar times for school during the week.
        
             | stagger87 wrote:
             | If you have kids getting up at 6 for school and you haven't
             | adjusted your sleep schedule to match, isn't that kind of
             | on you now?
        
               | wonderwonder wrote:
               | How does one do this? Parents get up at 6 to get their
               | kids ready for school. Then take the kids to school,
               | shower, have breakfast and then work until 6. Picking up
               | the kids at some point in there. Then make dinner, family
               | time and then kids go to bed at 8 or 9. Now you have the
               | option of going right to sleep which is fine if you
               | desire no personal time / partner time. But if you have
               | your own hobbies or goals then you spend a couple hours
               | on those and bang you are sleep deprived.
        
               | PragmaticPulp wrote:
               | It's all about priorities, time management, efficiency,
               | and sharing the load.
               | 
               | If you want to have both parents working, stay late at
               | the office, have both parents involved with kids for
               | every activity, and also work on side projects late at
               | night, you're going to struggle until the kids are more
               | self sufficient.
               | 
               | Even without kids, waking up at 6AM, hustling through
               | morning routines and to the office, working to 6PM and
               | then getting home at 6:30PM (assuming commute) leaves
               | about 3.5 hours of free time and 8 hours for sleep. If
               | you're trying to shoe-horn involved hobbies and side
               | projects into those weekdays, something has to give
               | regardless of whether or not you have kids.
               | 
               | The standard parent learning curve usually involves:
               | Becoming more efficient with your routines, becoming more
               | efficient with time management at the office, learning to
               | say no to unnecessary requests, pushing back on jobs that
               | demand long hours (or changing jobs to a more reasonable
               | 8-hour workday company), becoming more efficient with
               | meals and grocery shopping, doing more tradeoff load
               | sharing with partner instead of both people being
               | involved in everything, and letting kids have more
               | independent play time as they age.
               | 
               | That said, you simply won't have as much alone time with
               | kids in the equation. If you're trying to do too much,
               | you have to sacrifice somewhere. It's better to do a few
               | things well than to try to do everything at 75%
               | commitment or being 75% awake.
        
               | SethMurphy wrote:
               | As a parent I need both my own down time and time alone
               | with my spouse to feel mentally healthy too, and that is
               | usually after they are in bed and asleep. Maybe more than
               | 6 hours is easy, but it's usually less than 8 if I manage
               | to do all my normal expected activities. Often I do sleep
               | instead now though as I quickly realized my temperament
               | is only agreeable with enough of it as I age, and the
               | other things I need to do suffer. Others may not make the
               | same choice, and it's not a wrong to prioritize other
               | important aspects of mental and physical well being.
        
           | gumby wrote:
           | Then in their teens they may sleep 10 hours a day but that's
           | the _only_ time you 're not worried.
        
           | hpoe wrote:
           | You say that. I too believed as you did. I looked for the
           | joyous day when I could sleep through the night with our
           | first and second and third.
           | 
           | But it turns out toddlers will get up in the night and ask
           | you to tuck them back in, they will get up because they had a
           | scary dream, because they can't find their stuffed animal,
           | and don't get me started on night terrors.
           | 
           | The point is I don't think this tracks.
           | 
           | I don't think I've had a solid week of uninterrupted sleep
           | since our first came home.
        
             | DoreenMichele wrote:
             | Night terrors are not remotely normal. They are a fairly
             | uncommon and extreme sleep issue.
             | 
             | My experience/understanding: Very bright kids get night
             | terrors when you make sure they are physically tired enough
             | to sleep but fail to make sure they are mentally tired
             | enough to sleep. You need both to sleep deeply and bright
             | kids who can't yet read have trouble reaching a state of
             | being adequately mentally tired.
             | 
             | I suggest you join some parenting lists for people
             | suffering from having made the mistake if giving birth to
             | bright kids. Tagfam.org is probably still a good place to
             | begin trying to find support resources and reliable info.
             | 
             | Edit: Bright kids are known to be prone to a variety of
             | sleep issues. I spent twelve years arranging every minute
             | of every day to make sleep feasible for one of my kids.
        
           | IggleSniggle wrote:
           | Ha! This is not my lived experience at all nor of my friend-
           | group. My older kid, 5, mostly sleeps fine now, but both he
           | and his sibling had middle-of-night issues well into their
           | 2s. Even now, if one of my kids wakes (sometimes many hours
           | before I would choose to wake, sometimes due to things like
           | bed wetting), I'm not going to be finishing my nights sleep,
           | and even if I did, the quality is simply lower.
           | 
           | Pre-6 months, we're talking about a zombie lifestyle where
           | there is no "sleeping at night," just sleeping between
           | feedings.
           | 
           | I acknowledge there are definitely both cultural and
           | hereditary elements to this, but your comment is so starkly
           | different from my experience and the experience of my
           | friends.
        
           | irrational wrote:
           | That's not my experience at all. My oldest woke up screaming
           | with nightmares every night until she was 7 years old. That
           | was 7 solid years of my not sleeping through the night.
        
         | pvarangot wrote:
         | So mid-life in this study is 50 to 60, if you have kids at 35
         | by that age your kids are probably not affecting your sleep
         | schedule. I coudn't find out if the study found a correlation
         | with younger patients sleeping 6 vs. 7 hours.
         | 
         | Also they are at 30% higher risk of something that is already
         | kinda unlikely for most of the population if you follow a
         | healthy lifestyle. Most of the research points towards vascular
         | disease being the most important indicator of heightened
         | dementia risk on an otherwise healthy population, and this
         | study only controlled for severe vascular disease like having
         | had a stroke or infarction.
        
         | PragmaticPulp wrote:
         | Not doubting anyone's personal experience, but to add another
         | anecdotal data point:
         | 
         | Kids weren't as disruptive to sleep as I expected after reading
         | horror stories online. The way the internet talks about child
         | raising sometimes makes it feel like martyrdom, but the
         | internet tends to focus on worst-case stories and people
         | venting about uniquely bad situations. It's almost taboo to
         | share positive stories when other parents are sharing their
         | struggles, so most conversations veer toward discussions from
         | parents who are struggling the most while other parents keep
         | quiet. I've found it helpful to identify parents who are doing
         | well and specifically ask them what they're doing, because most
         | parents are too polite to tell others how to raise their kids.
         | 
         | There are always edge cases and every child is different, so of
         | course we should all be considerate of other parents and cut
         | them slack and/or provide assistance when they are struggling.
         | 
         | However, I and most of my friends have had good results with
         | combinations of sleep training and adjusting our own sleep
         | schedules for additional buffer. The key for me was to go to
         | bed an hour earlier than normal. If I get interrupted in the
         | middle of the night, I use that extra hour to sleep in. If I
         | don't get interrupted (most common case) I simply wake up an
         | hour earlier than normal. It doesn't cover every night and
         | every situation, but it fits most nights.
        
           | everfraid wrote:
           | I'd love to go to sleep an hour earlier, but my 3year old is
           | not asleep at that time :) And he wakes up at 5, so that's
           | great. Maybe when he start skipping his midday nap, we'll
           | start to get some more sleep. Until then, it's dementia I
           | guess.
        
             | PeterisP wrote:
             | The kid still sleeps more than you need over the whole day;
             | so you "just" need to take midday naps as well.
        
           | barbazoo wrote:
           | Same experience here. We were lucky and with just a few
           | adjustments are being able to cope quite well. It does
           | require for me and my partner to go to bed earlier to have
           | more of our sleep overlap with baby's, otherwise it'd be
           | hell. But at the same time we get up earlier, too.
        
           | intergalplan wrote:
           | > However, I and most of my friends have had good results
           | with combinations of sleep training and adjusting our own
           | sleep schedules for additional buffer.
           | 
           | Bingo. Also don't insist on both being awake for every
           | nighttime wake period and use a shift system, plus offset
           | your go-to-bed times, and then, unless you're _very_ unlucky
           | or your newborn has some kind of illness, you 're looking at
           | 6ish hours of sleep a night with at least one night a week of
           | 8+ hours (when you can each give the other a "sleep make-up
           | night" to sleep in basically indefinitely, probably on a
           | weekend).
           | 
           | Sleep train right, and you're gonna be doing this for 3
           | months, tops. They should be down to one feeding a night
           | around IIRC 1 month, so it gets way better then.
           | 
           | 3 for 3 on having our kids sleeping through the night (as in,
           | we only have to wake up and do something if there's an
           | unusual situation, and aren't woken up at all at least 6
           | weeks a night) by no later than 10 weeks. I believe some
           | people do get unlucky and their kids just _won 't_ sleep
           | through the night that early, but it's _quite_ rare (again,
           | unless your kid 's sick, that changes everything).
           | 
           | Everyone we see having trouble with it is one or more of:
           | 
           | 1) keeping their kid in the same room or same bed (no
           | judgement on co-sleeping for other reasons, but continuing it
           | past the first couple weeks seems, anecdotally, strongly
           | correlated with kids who still won't sleep through the night
           | at 6 months and beyond, and have trouble going to sleep in
           | the first place),
           | 
           | 2) pouncing on their baby the second they make a sound at
           | night, even past the first couple weeks, at which point you
           | should _stop_ that and gradually increase your response times
           | to waking /crying unless you want to _train_ your kid to wake
           | up a lot (by rewarding waking with attention, and not letting
           | them learn how to transition between sleep cycles),
           | 
           | 3) unable to handle "cry it out" for the 2-3 nights it'll
           | probably take to finish the process, if you've followed the
           | steps you should have to correctly reduce how often they wake
           | by ~8 weeks or so (if you haven't, it might take a lot
           | longer, but... just don't do that)
        
           | bredren wrote:
           | I'm expecting my first child in June and have sort of been
           | preparing for misery when it comes to sleep. I appreciate you
           | sharing this.
        
             | cpach wrote:
             | It can be rough. But it isn't rough for all parents all the
             | time. And keep this in mind: A period of bad sleep could be
             | followed by a period of good sleep. Kids aren't static,
             | their behavior can vary a lot during different development
             | stages.
             | 
             | Best of luck!
        
               | bredren wrote:
               | Thank you.
        
             | barbazoo wrote:
             | Whatever happens, know that it's ultimately not only up to
             | you. There's quite a bit of luck involved how they are able
             | to cope with the environment and what sleep pattern they
             | prefer.
             | 
             | And OT but relevant for every new parent, sorry for giving
             | unsolicited advice. But always remember, whenever it gets
             | tough: "They're not giving you a hard time, they're having
             | a hard time!". That helped me better understand that it's
             | our job to help them through whatever crazy thing they're
             | going through at any given time.
        
               | bredren wrote:
               | Thanks for this, it is the first time I've shared this
               | here.
               | 
               | This perspective is useful. We have a cat that sometimes
               | does stuff we wish he wouldn't and now when unexpected
               | stuff happens I've come to realize it means something is
               | bothering him, rather than be frustrated by him.
               | 
               | Hopefully that translates.
        
             | david422 wrote:
             | Good luck bud. Better to be prepared for misery just in
             | case.
        
               | bredren wrote:
               | I'm trying to treat it like Burning Man. Where if it's
               | your first time going, you go in with no expectations and
               | as much preparedness as possible.
        
             | werdnapk wrote:
             | 3 kids in, aged 6, 4 and 2... 12 hours a night for all of
             | them. I guess I did the "sleep training" thing, although
             | all I did was what I thought was common sense stuff.
             | 
             | Some things I did off the top of my head:
             | 
             | - 15 min cry buffer. More than that and check diaper, or
             | give a bottle/feeding. Never turn on the lights during
             | these check-in times... always use a dim (soft colored
             | light) night light that's already on to keep things "dark".
             | Changing diapers with little light gets easier the more you
             | do it.
             | 
             | - Burping a newborn/baby is an essential technique. Don't
             | leave the feeding until you get a good burp out of them.
             | More often than not if the diaper is clean and they're fed,
             | and they keep crying, it's trapped air that needs to be
             | burped out.
             | 
             | - I use a sound machine with white noise which drowns out
             | almost all external noises.
             | 
             | - No soothers. I let me kids figure out where their thumbs
             | are and they use that. Too many times with my first kid I
             | was going in to pick up the soother that dropped out of
             | their mouth which made them cry.
             | 
             | - Keep their room "cool". Nobody likes sweating in their
             | sleep.
             | 
             | A newborn will be waking up every 2-3 hours likely, but so
             | far for me, by 3-5 months, the kids get to 12 hours.
             | 
             | Side note, I'm the father of the kids. Breastfeeding was
             | not done by me, so I'd bottle feed from pumped milk.
             | 
             | Good luck!
        
               | bredren wrote:
               | Thank you for these specific points of advice.
        
         | obelos wrote:
         | We co-slept with our kids until they were 3-ish. Made sleeping
         | a pleasant experience for everyone involved.
        
         | TameAntelope wrote:
         | If you are 5%-8% likely to get dementia as a baseline, but
         | don't sleep enough, you're now 6.5%-10.5% likely to get
         | dementia.
         | 
         | Out of 1000 people who live to be over 70 and sleep properly,
         | ~65 of them get dementia.
         | 
         | Out of another 1000 people who live to be over 70 and sleep
         | improperly, ~80 of them get dementia.
         | 
         | So an extra 15 people out of 1000 get dementia in the "sleep
         | improperly" group.
         | 
         | Someone please check my application of natural frequencies!
        
         | pc86 wrote:
         | They paradoxically define "midlife" as "50s and 60s" so for
         | most people, no.
        
           | pmiller2 wrote:
           | Yeah, that seems kind of silly to me as well. I don't claim
           | to speak for them, but what I think the researchers were
           | getting at was "right before Alzheimer's symptoms typically
           | appear," including mild cognitive impairment.
        
         | PeterisP wrote:
         | IIRC there are studies that parenting small kids (not to those
         | giving birth but to those actually raising infants) cuts off
         | 1-2 years of expected lifespan, presumably due to the
         | associated sleep disturbances.
        
       | fish45 wrote:
       | More accurately, middle aged people who get less than 6 hours of
       | sleep a night are 30% more likely to get dementia.
       | 
       | I'd expect that people who get less than 6 hours of sleep are
       | also more stressed and less health concious though.
        
         | CerealFounder wrote:
         | This guy infers. This seems like a tough study given the
         | correlation factors.
        
         | pmiller2 wrote:
         | Sure, I'd agree with the "more stressed and less health
         | conscious" bit. But, the article does give some good reasons to
         | suggest that either midlife insomnia is a very early symptom of
         | dementia, or that sleep deprivation itself leads to dementia.
         | 
         | Nonetheless, we are talking about people who have pre-existing
         | insomnia before being diagnosed with dementia. According to the
         | Mayo Clinic[0], the most common causes of insomnia are:
         | 
         | * Stress.
         | 
         | * Disrupted circadian rhythms due to shift work or frequent
         | travel.
         | 
         | * Poor sleep habits.
         | 
         | * Eating too much late in the day.
         | 
         | Further down the list are:
         | 
         | * Anxiety disorders.
         | 
         | * Medications.
         | 
         | * Other medical conditions.
         | 
         | * Sleep disorders.
         | 
         | * Caffeine, nicotine, and alcohol.
         | 
         | * Age (older people sleep less than younger people).
         | 
         | Of these, anxiety disorders; sleep disorders; and caffeine,
         | nicotine, and alcohol seem the most interesting to me. Anxiety
         | disorders probably have an effect much like that of chronic
         | stress, except that simple chronic stress generally goes away
         | eventually. Sleep disorders seem interesting because we have
         | some evidence that sleep serves a function related to brain
         | health, but, really, we don't know exactly _what_ sleep does
         | for us. And, alcohol, nicotine, and caffeine are interesting
         | because the former two carry their own, independent health
         | risks. Caffeine is interesting because, of course, it is active
         | in the central nervous system, and it actually shows some
         | limited evidence for a _protective_ effect against Alzheimer 's
         | disease. [1]
         | 
         | Cross referencing that with the list of things they control for
         | ("age (timescale), sex, ethnicity, education, marital status,
         | alcohol consumption, physical activity, smoking status, fruit
         | and vegetable consumption, BMI, hypertension, diabetes,
         | cardiovascular disease, GHQ depression, and CNS medications"),
         | we can (lightly) cross age, nicotine, and alcohol off the list
         | of interesting things.
         | 
         | All this makes me wonder if either insomnia is an early
         | dementia symptom, as they suggest, or if one of the causes of
         | insomnia is the instigating factor. And, it seems to me the
         | most interesting causal factors for insomnia left on the board
         | are anxiety and stress.
         | 
         | Oh, and guess what? Anxiety, stress, and PTSD have been
         | independently linked to the development of dementia! [2]
         | 
         | To me, _that_ 's interesting because anxiety is known to impair
         | both working memory and cognitive processes[3], things which
         | are both impaired in dementia.
         | 
         | I don't mean to suggest that anxiety and stress cause dementia
         | all by themselves, but I do think this might point to a more
         | significant role for anxiety and stress than is typically
         | considered these days.
         | 
         | Anyway, these are just some idle thoughts from someone who is
         | neither a doctor, neuroscientist, nor biological researcher of
         | any kind. If anyone has anything else to add, or would care to
         | riff off this, I'd love to see it. ---
         | 
         | [0]: https://www.mayoclinic.org/diseases-
         | conditions/insomnia/symp...
         | 
         | [1]: https://content.iospress.com/download/journal-of-
         | alzheimers-...
         | 
         | [2]: https://www.alzheimers.org.uk/blog/there-link-between-
         | stress...
         | 
         | [3]: https://www.psychologytoday.com/us/blog/anxiety-fear-and-
         | hat...
        
         | kazinator wrote:
         | That's not more accurately at all; you're still insinuating a
         | causal relationship.
         | 
         | "More accurately, people with yellow-stained fingertips are
         | more likely to get lung cancer."
         | 
         | The actual study's own title puts it more accurately:
         | 
         | "Association of sleep duration in middle and old age with
         | incidence of dementia"
        
           | fish45 wrote:
           | I don't think it insinuates a causal relationship.
           | 
           | I interpret "30% more likely" as the same as "associated with
           | a 30% increase," which is what the article claims.
        
             | MauranKilom wrote:
             | I would say that "People who do X are 30% more likely to
             | get X" is commonly understood to imply causation.
        
               | ziml77 wrote:
               | How would you phrase it? Because I did not read that as
               | meaning that less sleep caused dementia.
        
       | TaupeRanger wrote:
       | Reverse causation not ruled out. Typically useless study within
       | this field where no real progress has been made in years.
        
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       (page generated 2021-04-21 23:03 UTC)