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"as a serious health debt" Except, sleep isn't a debt because the loss can't be repaid. This is one of many important things I have picked up from Dr. Matthew

"as a serious health debt" Except, sleep isn't a debt because the loss can't be repaid. This is one of many important things I have picked up from Dr. Matthew Walker who wrote "Why We Sleep" and has been doing the podcast rounds lately. Not to pick on you at all. It sounds like you have made some big realizations and are making fantastic changes. Realizing I can't make up sleep to pay off the "debt" has been eye opening.

BeeBoBub 8y ago
I’d say the same, but it’s been more eye-closing for me
leesec 8y ago
This book, and "The Case Against Sugar" have been, by far, the two most impactful books in my life in recent years. They've genuinely changed my life for the better.
- FrojoS 8y ago
  What is your opinion on this, quite damning review? http://www.stephanguyenet.com/bad-sugar-or-bad-journalism-an-expert-review-of-the-case-against-sugar/ http://www.stephanguyenet.com/bad-sugar-or-bad-journalism-an... as well as this one https://nutritionsciencefactcheck.com/2017/07/20/the-case-against-the-case-against-sugar/ https://nutritionsciencefactcheck.com/2017/07/20/the-case-ag...
  - whatshisface 8y ago
    >Rather, I say this book doesn’t need to exist for the following reasons: All of the reasons that follow boil down to, essentially, "this book is so obviously true that there's no need to read it." That's hardly a damning review, it's a bit closer to the most vehement agreement possible.
    - FrojoS 8y ago
      Did you read the rest of the review? Here is an example quote: "Scientifically, The Case Against Sugar suffers from a condition Steven Pinker has called the “Igon Value Problem”. This term describes the tendency of certain science journalists to arrive at obtuse conclusions due to a superficial understanding of their subject matter" and later "Taubes argues that sugar is the only factor that reliably shows up when a culture develops Western noncommunicable diseases, supporting the point with examples of cultures that adopted sugar-rich diets and became ill. Yet he makes no effort to look for a counterexample that could refute his argument: a traditionally-living culture that has a high intake of sugar and does not suffer from Western noncommunicable diseases." These are just two examples. My understanding (from those two reviews only!), is that you will come away LESS well informed when reading this book. Now, if you provide me with an expert opinion in favour of the book, I'm happy to change my mind. FYI Apart from moments where I try to recover fast (1-60min) from a near max physical effort, I avoid sugar anyway. I do NOT promote eating sugar.
- Chazprime 8y ago
  If you haven’t read it, check out The Hacking of the American Mind by Robert Lustig. It might be right up your alley; it opened my eyes as to what influences my dietary choices.
  - heymijo 8y ago
    Dr. Lustig has some good insights. Two caveats on him: 1) He is an evangelist about the dangers of fructose, which is ubiquitous in the Standard American Diet (SAD) 2) I gather that he has a few positions that are not unreasonable but are also not fully supported by research, yet Having said that, I learned a lot from him about fructose metabolism, how it has to be metabolized by the liver, and what happens to excess. The analogy that sticks in my head is that excess fructose consumption is like foie-grasing ourselves. We get Non-alocoholic fatty liver and it's happening to children at unprecedented numbers. He too was on Peter Attia's podcast (I mentioned in a comment above) and it has some good show notes. https://podcastnotes.org/2018/09/11/lustig/ https://podcastnotes.org/2018/09/11/lustig/
lr4444lr 8y ago
I don't know if you have children yet, but I regret to inform you if you don't that significant sleep deprivation is in your future unless you plan to extensively involve caregivers outside of you and your spouse.
- rimliu 8y ago
  No necessary. We were lucky, but our daugher gave us very little trouble in this regards. She was breastfed, so feeding her at night was a minimum hassle at night and wife barely had to wake up for it. Not sure where on the rule-exception continuum this expierience falls, but my point is that having a newborn does not guaranty you an miserable existance in the zombie mode.
  - bluejekyll 8y ago
    Based on my personal experience with two kids, it’s completely random what type of kid you’ll get. My first would wake every hour at night and require a lot of effort to get back to sleep, this lasted until he was at least a year. My second was far better, but still created sleep deprived parents for the first four months. Having at least 3-4 months of an infant after birth (the forth trimester) be difficult to sleep and calm down is quite normal. And based on the anecdotal data from my friends in similar points of their lives, even average. The outliers are the ones who sleep through the night immediately (which can be dangerous) and those who wake up every sleep cycle.
    - virgilp 8y ago
      I was sure that SOME things you can control, but now I believe you just have some variable amount of influence - in the end, luck matters a lot. E.g. we managed to "train" our first two kids to eat well, but the third broke us. At some point, we were begging her, "eat this cupcake, it has chocolate!". Taught me to refrain from judging other parents.
      - sbov 8y ago
        Yeah, every kid is different, and every parent is different. Our first actually taught us this lesson. We have friends with really, really easy kids. Our oldest - 4 years old now - is... tough. She has always been very hard headed. She has always stood up for herself and what she wants. She is persistent. My friends joke about how someday she is going to conquer the world. Our twins are much easier. And much "better" behaved at similar ages. Sometimes you get what you get.
deleted 8y ago
[deleted]
gubbrora 8y ago
It can be repaid in the sense that we stop being tired. This is what people mean by repaid. But the lost productivity from when we were tired can not be recovered.
- d0mine 8y ago
  The book "why we sleep" as I understand suggests the increase in probability of dementia if you don't sleep enough i.e., lack of sleep leads to brain damage that is not fixed by sleeping longer later.
  - beenBoutIT 8y ago
    It's more about the quality of sleep as perfect sleep seems to be able to reverse Alzheimer's in mice . Without some kind of chemical intervention there's no way a complex system like the brain will fix itself, the bad sleep further deteriorates the brain's ability to get good sleep and each day the problem gets exponentially worse. https://www.ncbi.nlm.nih.gov/m/pubmed/25457559/ https://www.ncbi.nlm.nih.gov/m/pubmed/25457559/
- wozer 8y ago
  Also possible long-term health consequences.
Ntrails 8y ago
> Except, sleep isn't a debt because the loss can't be repaid. sort of? The impact of missed sleep has a half life. A single night of 4 hours sleep, followed by a year of normal nights sleep will lead to a me that is indistinguishable from the me that slept 8 hours that same night. I'm all for sleeping properly, but lets not suggest that it is the end of the world any time someone doesn't get their standard n hours
- heymijo 8y ago
  Sure. And please note, I'm not prescribing or suggesting anything about the end of the world regarding a single missed night of sleep. I am commenting about the world of ignorance I had regarding sleep prior to a very recent education. If you or other people reading this are unaware of the depth of what sleep research has learned in the past 15 or so years I will point you to this six hour conversation that Dr. Matthew Walker had with Peter Attia on his podcast. Part 1 https://podcastnotes.org/2019/04/02/sleep-4/ https://podcastnotes.org/2019/04/02/sleep-4/ Part 2 https://podcastnotes.org/2019/04/17/sleep-5/ https://podcastnotes.org/2019/04/17/sleep-5/ Part 3 https://podcastnotes.org/2019/04/18/sleep-6/ https://podcastnotes.org/2019/04/18/sleep-6/
  - illirik 8y ago
    I don't want to be dismissive, but is there a good TLDR on this, preferably in written form, or any other resources you'd recommend? I'd love to catch up on the science, but listening to six hours of podcast might cut into my sleep!
    - jacobolus 8y ago
      You could read Walker’s 2017 book, Why We Sleep, https://amzn.com/1501144316 https://amzn.com/1501144316 https://www.sleepdiplomat.com/author https://www.sleepdiplomat.com/author He’s the director of UC Berkeley’s Center for Human Sleep Science, so you could also look up his lab’s scholarly publications https://www.humansleepscience.com/p-u-b-l-i-c-a-t-i-o-n-s https://www.humansleepscience.com/p-u-b-l-i-c-a-t-i-o-n-s
graeme 8y ago
So naps the same day catch it up? I will often wake up and be unable to get back to sleep. I am able to sleep later in the day after I have walked, and had food. I finished most of the book, but don’t remember seeing what he wrote on this.
- heymijo 8y ago
  Walker seems to say no, it doesn't catch it up. "Can naps help with sleep debt? Walker: And the answer, unfortunately, is no. Sleep is actually not like the bank. You can't accumulate a debt and then hope to pay it off at some later point in time. So sleep is an all-or-nothing event in that sense. So you can't short sleep during the week and then try to binge and oversleep at the weekend." https://www.businessinsider.com/sleep-expert-naps-dangerous-health-science-matthew-walker-science-2017-12 https://www.businessinsider.com/sleep-expert-naps-dangerous-...
- heymijo 8y ago
  That's not to say naps have no benefit for people who don't have trouble sleeping at night. Walker's research shows that naps can help boost memory and learning. https://news.berkeley.edu/2010/02/22/naps_boost_learning_capacity/ https://news.berkeley.edu/2010/02/22/naps_boost_learning_cap...
gonational 8y ago
> ... because the loss can’t be repaid. It’s repaid all at the end.
baxtr 8y ago
This seems to contradict a recent study that I came across [1]: The mortality rate among participants with short sleep during weekdays, but long sleep during weekends, did not differ from the rate of the reference group. Among individuals ≥65 years old, no association between weekend sleep or weekday/weekend sleep durations and mortality was observed. In conclusion, short, but not long, weekend sleep was associated with an increased mortality in subjects <65 years. In the same age group, short sleep (or long sleep) on both weekdays and weekend showed increased mortality. Possibly, long week- end sleep may compensate for short weekday sleep. [1] https://onlinelibrary.wiley.com/doi/pdf/10.1111/jsr.12712 https://onlinelibrary.wiley.com/doi/pdf/10.1111/jsr.12712
- copperx 8y ago
  That study might be reassuring regarding mortality. But what about cognition and memory? are they affected?
fossuser 8y ago
Yeah, but the reasoning I heard from him on that made no sense and was not clarified. From what I remember he said if you stay up all night you don't sleep 16 hours the next night to make up for the missing 8 hours (you may only sleep 12) therefore you never make up that 4. I'd suspect that it doesn't work that way and you can catch up without requiring double the amount of time (there's probably a consistent overhead). If I'm missing some core of his argument please let me know, but from what I heard it made me dismiss the rest as probably bad.
worldvoyageur 8y ago
A good night sleep is required for your mind to process the previous day. Lessons learned get cemented. You can miss a good night's sleep and make it up later in terms of being rested, but whatever lessons and growth from the day prior to the lack of sleep will never be processed. They are lost, even if you sleep enough on a later night. It's sort of like saying there is 'eat healthy debt' where you binge on junk food for a day and try to cancel it by eating super healthy the next day. That healthy eating is a good thing, but it doesn't un-eat the unhealthy food. Edit: to incorporate the valid suggestion below
- vageli 8y ago
  > A good night sleep is required for your mind to process the previous day. Lessons learned get cemented. > You can miss a good night's sleep and make it up later in terms of being rested, but whatever lessons and growth from the day prior to the lack of sleep will never be processed. They are lost, even if you sleep enough on a later night. > It's sort of like saying there is 'eat healthy debt' where you eat junk food all week and then try to cancel it by eating super healthy on the weekend. That healthy eating on the weekend is a good thing, but it doesn't un-eat the unhealthy food. Your two examples are not equivalent. In the first you mention missing _a_ good night's sleep. In the second you are not missing a night of healthy eating but intentionally engaging in the opposite consistently. A more accurate comparison would be something like a "cheat day" in a diet, to follow the logic of the first example.
- deleted 8y ago
  [deleted]
JudgeWapner 8y ago
if you want to nitpick, then the debt must be paid, just not necessarily repaid in an equivalent currency if the debt runs too high. You will pay for it via [diminished immune system, irritability/depression, impaired congnition, other health deficits].
krilly 8y ago
> sleep isn't a debt because the loss can't be repaid Are you saying that there are significant health repurcussions even after bad sleep habits have been fixed? Do you have a source for that? I have... er... a vested interest
jm__87 8y ago
So I've read "Why We Sleep" and my understanding of Walker when he says "sleep loss is not a debt that can be repaid" simply meant that sleep does not work like an accounting system - if you slept for 3 hours less last night, sleeping for 3 hours more tonight will not "catch you up" and bring you back to baseline. You're just going to have to sleep your regular number of hours for a while until your body recovers. The damage done by one night of poor sleep is not going to be irreversible. People lose sleep all the time and are fine after they have had enough consecutive nights of normal sleep.
krageon 7y ago
Short-term sleep deprivation can be mediated to some degree with "catchup" sleep. It's the chronic sleep deprivation that will destroy you with absolutely no recourse.

BeeBoBub 8y ago

I’d say the same, but it’s been more eye-closing for me

leesec 8y ago

This book, and "The Case Against Sugar" have been, by far, the two most impactful books in my life in recent years. They've genuinely changed my life for the better.

FrojoS 8y ago
What is your opinion on this, quite damning review? http://www.stephanguyenet.com/bad-sugar-or-bad-journalism-an-expert-review-of-the-case-against-sugar/ http://www.stephanguyenet.com/bad-sugar-or-bad-journalism-an... as well as this one https://nutritionsciencefactcheck.com/2017/07/20/the-case-against-the-case-against-sugar/ https://nutritionsciencefactcheck.com/2017/07/20/the-case-ag...
- whatshisface 8y ago
  >Rather, I say this book doesn’t need to exist for the following reasons: All of the reasons that follow boil down to, essentially, "this book is so obviously true that there's no need to read it." That's hardly a damning review, it's a bit closer to the most vehement agreement possible.
  - FrojoS 8y ago
    Did you read the rest of the review? Here is an example quote: "Scientifically, The Case Against Sugar suffers from a condition Steven Pinker has called the “Igon Value Problem”. This term describes the tendency of certain science journalists to arrive at obtuse conclusions due to a superficial understanding of their subject matter" and later "Taubes argues that sugar is the only factor that reliably shows up when a culture develops Western noncommunicable diseases, supporting the point with examples of cultures that adopted sugar-rich diets and became ill. Yet he makes no effort to look for a counterexample that could refute his argument: a traditionally-living culture that has a high intake of sugar and does not suffer from Western noncommunicable diseases." These are just two examples. My understanding (from those two reviews only!), is that you will come away LESS well informed when reading this book. Now, if you provide me with an expert opinion in favour of the book, I'm happy to change my mind. FYI Apart from moments where I try to recover fast (1-60min) from a near max physical effort, I avoid sugar anyway. I do NOT promote eating sugar.
Chazprime 8y ago
If you haven’t read it, check out The Hacking of the American Mind by Robert Lustig. It might be right up your alley; it opened my eyes as to what influences my dietary choices.
- heymijo 8y ago
  Dr. Lustig has some good insights. Two caveats on him: 1) He is an evangelist about the dangers of fructose, which is ubiquitous in the Standard American Diet (SAD) 2) I gather that he has a few positions that are not unreasonable but are also not fully supported by research, yet Having said that, I learned a lot from him about fructose metabolism, how it has to be metabolized by the liver, and what happens to excess. The analogy that sticks in my head is that excess fructose consumption is like foie-grasing ourselves. We get Non-alocoholic fatty liver and it's happening to children at unprecedented numbers. He too was on Peter Attia's podcast (I mentioned in a comment above) and it has some good show notes. https://podcastnotes.org/2018/09/11/lustig/ https://podcastnotes.org/2018/09/11/lustig/

lr4444lr 8y ago

I don't know if you have children yet, but I regret to inform you if you don't that significant sleep deprivation is in your future unless you plan to extensively involve caregivers outside of you and your spouse.

rimliu 8y ago
No necessary. We were lucky, but our daugher gave us very little trouble in this regards. She was breastfed, so feeding her at night was a minimum hassle at night and wife barely had to wake up for it. Not sure where on the rule-exception continuum this expierience falls, but my point is that having a newborn does not guaranty you an miserable existance in the zombie mode.
- bluejekyll 8y ago
  Based on my personal experience with two kids, it’s completely random what type of kid you’ll get. My first would wake every hour at night and require a lot of effort to get back to sleep, this lasted until he was at least a year. My second was far better, but still created sleep deprived parents for the first four months. Having at least 3-4 months of an infant after birth (the forth trimester) be difficult to sleep and calm down is quite normal. And based on the anecdotal data from my friends in similar points of their lives, even average. The outliers are the ones who sleep through the night immediately (which can be dangerous) and those who wake up every sleep cycle.
  - virgilp 8y ago
    I was sure that SOME things you can control, but now I believe you just have some variable amount of influence - in the end, luck matters a lot. E.g. we managed to "train" our first two kids to eat well, but the third broke us. At some point, we were begging her, "eat this cupcake, it has chocolate!". Taught me to refrain from judging other parents.
    - sbov 8y ago
      Yeah, every kid is different, and every parent is different. Our first actually taught us this lesson. We have friends with really, really easy kids. Our oldest - 4 years old now - is... tough. She has always been very hard headed. She has always stood up for herself and what she wants. She is persistent. My friends joke about how someday she is going to conquer the world. Our twins are much easier. And much "better" behaved at similar ages. Sometimes you get what you get.

deleted 8y ago

[deleted]

gubbrora 8y ago

It can be repaid in the sense that we stop being tired. This is what people mean by repaid. But the lost productivity from when we were tired can not be recovered.

d0mine 8y ago
The book "why we sleep" as I understand suggests the increase in probability of dementia if you don't sleep enough i.e., lack of sleep leads to brain damage that is not fixed by sleeping longer later.
- beenBoutIT 8y ago
  It's more about the quality of sleep as perfect sleep seems to be able to reverse Alzheimer's in mice . Without some kind of chemical intervention there's no way a complex system like the brain will fix itself, the bad sleep further deteriorates the brain's ability to get good sleep and each day the problem gets exponentially worse. https://www.ncbi.nlm.nih.gov/m/pubmed/25457559/ https://www.ncbi.nlm.nih.gov/m/pubmed/25457559/
wozer 8y ago
Also possible long-term health consequences.

Ntrails 8y ago

> Except, sleep isn't a debt because the loss can't be repaid. sort of? The impact of missed sleep has a half life. A single night of 4 hours sleep, followed by a year of normal nights sleep will lead to a me that is indistinguishable from the me that slept 8 hours that same night. I'm all for sleeping properly, but lets not suggest that it is the end of the world any time someone doesn't get their standard n hours

heymijo 8y ago
Sure. And please note, I'm not prescribing or suggesting anything about the end of the world regarding a single missed night of sleep. I am commenting about the world of ignorance I had regarding sleep prior to a very recent education. If you or other people reading this are unaware of the depth of what sleep research has learned in the past 15 or so years I will point you to this six hour conversation that Dr. Matthew Walker had with Peter Attia on his podcast. Part 1 https://podcastnotes.org/2019/04/02/sleep-4/ https://podcastnotes.org/2019/04/02/sleep-4/ Part 2 https://podcastnotes.org/2019/04/17/sleep-5/ https://podcastnotes.org/2019/04/17/sleep-5/ Part 3 https://podcastnotes.org/2019/04/18/sleep-6/ https://podcastnotes.org/2019/04/18/sleep-6/
- illirik 8y ago
  I don't want to be dismissive, but is there a good TLDR on this, preferably in written form, or any other resources you'd recommend? I'd love to catch up on the science, but listening to six hours of podcast might cut into my sleep!
  - jacobolus 8y ago
    You could read Walker’s 2017 book, Why We Sleep, https://amzn.com/1501144316 https://amzn.com/1501144316 https://www.sleepdiplomat.com/author https://www.sleepdiplomat.com/author He’s the director of UC Berkeley’s Center for Human Sleep Science, so you could also look up his lab’s scholarly publications https://www.humansleepscience.com/p-u-b-l-i-c-a-t-i-o-n-s https://www.humansleepscience.com/p-u-b-l-i-c-a-t-i-o-n-s

graeme 8y ago

So naps the same day catch it up? I will often wake up and be unable to get back to sleep. I am able to sleep later in the day after I have walked, and had food. I finished most of the book, but don’t remember seeing what he wrote on this.

heymijo 8y ago
Walker seems to say no, it doesn't catch it up. "Can naps help with sleep debt? Walker: And the answer, unfortunately, is no. Sleep is actually not like the bank. You can't accumulate a debt and then hope to pay it off at some later point in time. So sleep is an all-or-nothing event in that sense. So you can't short sleep during the week and then try to binge and oversleep at the weekend." https://www.businessinsider.com/sleep-expert-naps-dangerous-health-science-matthew-walker-science-2017-12 https://www.businessinsider.com/sleep-expert-naps-dangerous-...
heymijo 8y ago
That's not to say naps have no benefit for people who don't have trouble sleeping at night. Walker's research shows that naps can help boost memory and learning. https://news.berkeley.edu/2010/02/22/naps_boost_learning_capacity/ https://news.berkeley.edu/2010/02/22/naps_boost_learning_cap...

gonational 8y ago

> ... because the loss can’t be repaid. It’s repaid all at the end.

baxtr 8y ago

This seems to contradict a recent study that I came across [1]: The mortality rate among participants with short sleep during weekdays, but long sleep during weekends, did not differ from the rate of the reference group. Among individuals ≥65 years old, no association between weekend sleep or weekday/weekend sleep durations and mortality was observed. In conclusion, short, but not long, weekend sleep was associated with an increased mortality in subjects <65 years. In the same age group, short sleep (or long sleep) on both weekdays and weekend showed increased mortality. Possibly, long week- end sleep may compensate for short weekday sleep. [1] https://onlinelibrary.wiley.com/doi/pdf/10.1111/jsr.12712 https://onlinelibrary.wiley.com/doi/pdf/10.1111/jsr.12712

copperx 8y ago
That study might be reassuring regarding mortality. But what about cognition and memory? are they affected?

fossuser 8y ago

Yeah, but the reasoning I heard from him on that made no sense and was not clarified. From what I remember he said if you stay up all night you don't sleep 16 hours the next night to make up for the missing 8 hours (you may only sleep 12) therefore you never make up that 4. I'd suspect that it doesn't work that way and you can catch up without requiring double the amount of time (there's probably a consistent overhead). If I'm missing some core of his argument please let me know, but from what I heard it made me dismiss the rest as probably bad.

worldvoyageur 8y ago

A good night sleep is required for your mind to process the previous day. Lessons learned get cemented. You can miss a good night's sleep and make it up later in terms of being rested, but whatever lessons and growth from the day prior to the lack of sleep will never be processed. They are lost, even if you sleep enough on a later night. It's sort of like saying there is 'eat healthy debt' where you binge on junk food for a day and try to cancel it by eating super healthy the next day. That healthy eating is a good thing, but it doesn't un-eat the unhealthy food. Edit: to incorporate the valid suggestion below

vageli 8y ago
> A good night sleep is required for your mind to process the previous day. Lessons learned get cemented. > You can miss a good night's sleep and make it up later in terms of being rested, but whatever lessons and growth from the day prior to the lack of sleep will never be processed. They are lost, even if you sleep enough on a later night. > It's sort of like saying there is 'eat healthy debt' where you eat junk food all week and then try to cancel it by eating super healthy on the weekend. That healthy eating on the weekend is a good thing, but it doesn't un-eat the unhealthy food. Your two examples are not equivalent. In the first you mention missing _a_ good night's sleep. In the second you are not missing a night of healthy eating but intentionally engaging in the opposite consistently. A more accurate comparison would be something like a "cheat day" in a diet, to follow the logic of the first example.
deleted 8y ago
[deleted]

JudgeWapner 8y ago

if you want to nitpick, then the debt must be paid, just not necessarily repaid in an equivalent currency if the debt runs too high. You will pay for it via [diminished immune system, irritability/depression, impaired congnition, other health deficits].

krilly 8y ago

> sleep isn't a debt because the loss can't be repaid Are you saying that there are significant health repurcussions even after bad sleep habits have been fixed? Do you have a source for that? I have... er... a vested interest

jm__87 8y ago

So I've read "Why We Sleep" and my understanding of Walker when he says "sleep loss is not a debt that can be repaid" simply meant that sleep does not work like an accounting system - if you slept for 3 hours less last night, sleeping for 3 hours more tonight will not "catch you up" and bring you back to baseline. You're just going to have to sleep your regular number of hours for a while until your body recovers. The damage done by one night of poor sleep is not going to be irreversible. People lose sleep all the time and are fine after they have had enough consecutive nights of normal sleep.

krageon 7y ago

Short-term sleep deprivation can be mediated to some degree with "catchup" sleep. It's the chronic sleep deprivation that will destroy you with absolutely no recourse.