7 ms·

I understand this is correlation not causation, but we have tons and tons of evidence for the negative effects of sleep deprivation. Color me highly skeptical

I understand this is correlation not causation, but we have tons and tons of evidence for the negative effects of sleep deprivation. Color me highly skeptical that there are negative effects associated with sleeping 8.5+ hours, up to say, 11 hours. Beyond 11 hours of sleep, I can see an argument being made for physical morbidity from lack of movement etc. But 8-9 hours of sleep nightly - my guess would be that people who get only 7 hours of sleep tend to be more successful, have jobs and families, and access to health care. Whereas those sleeping 10 hours a night are less likely to have the income to get health care when necessary. In other words, I'd be interested to see studies which test the hypothesis that sleep deprivation has a causal effect on morbidity, while excessive sleep only has a correlation.

keerthiko 7y ago
I know that most forms of clinical depression and the treatment associated with it has the side effect of a desire to sleep longer. 10 hours is a normal amount of time sleeping for people on anti-depressants. I'm not entirely certain whether sleeping closer to 8 would be any better for their mental or physical well being.
- abakker 7y ago
  This reminded me of this article - https://mosaicscience.com/story/staying-awake-surprisingly-effective-way-treat-depression/ https://mosaicscience.com/story/staying-awake-surprisingly-e... - which discusses treating depression by purposely putting patients into extremely sleep deprived states.
  - qwsxyh 7y ago
    Note that this is for bipolar sufferers rather than unipolar depression sufferers.
- hackerbabz 7y ago
  When I finally got medical treatment for severe anxiety the sleepiness side effect from my medication was a godsend. I really think it helped me recover just knowing that no matter how horrible I was feeling, I would be asleep in an hour.
gshdg 7y ago
Isn't there also an argument that excessive sleep may be caused by health issues that end up affecting longevity as well?
- WhompingWindows 7y ago
  Every single causal link made in epidemiologic studies will have potential confounders that need to be adjusted for. I'd be shocked if anyone could think of a causal link without a potential confounder, never mind that we may have unknown/unmeasured confounders that aren't even top of mind.
- joshvm 7y ago
  Matt Walker makes this point in his book (at the risk of sounding like a shill). One group of people who sleep abnormally long hours are those suffering from various illnesses - they sleep more either as a result of the illness or while in recovery. Some of them may die. This group potentially skews results and increases the mortality rate of long sleepers. There is no evidence I'm aware of (nor does the book give any) that oversleeping is harmful in itself.
  - LeonB 7y ago
    That book is so good that I feel like a shill when I recommend because I recommend it so enthusiastically.
elipsey 7y ago
This is exactly what I started writing before I saw your post. :) (Does that make this a discouraged “me too” post…?) TFA correlates _more_ sleep with increased mortality, but barely speculates on cause, and lumps too much, and not enough sleep together in discussion. With respect to the question of how more sleep might be bad, the article states: "[...]one can speculate that these folk, who have lower moods and more worry, might struggle to get to sleep or to get up promptly in the morning. Lower scores on extraversion were indirectly linked with increased risk of death, thanks to an association with greater daytime feelings of fatigue (perhaps extraverts’ greater daytime activity levels makes it easier for them to get a satisfying night’s sleep, but this is speculation)." Anecdotally, I think sleep deprivation increases my neuroticsism and decreases my extroversion, so I feel like positive feedback could exist. This makes it harder to do the things that seem to me to improve sleep and mood, like aerobic exercise, exposing oneself to natural light cycles, and other people, and keeping a consistent personal routine. I feel like I have spent periods in a meta-stable state of insomnia after pushing myself too hard because of crunch time, international travel, etc. I suspect that "excess" sleep may be correlated with chronic health problems like mood disorders (like depression), or auto-immune disorder. These problems are known to be suggestively correlated with each other, and also with sleep problems. This stuff seems complicated enough to be pretty hard to figure out, and I think you are right to be skeptical about the direction of causality. Pretty sure not sleeping enough is still bad though. (edit: flow/clarity)
datastoat 7y ago
It's worth pointing out that the study cited in the article does use an analysis that looks for causality. The study says "To formally test mediation [...] calculate indirect effects similar to the Sobel method." I think this refers to a paper "Direct and indirect effects in linear structural equation models" by Michael Sobel. I don't understand enough to say what the limitations are of this method -- but it does sound like rather more advanced causal analysis than you typically see in a medical paper. I'm guessing that the limitation of the Sobel method is "garbage model in, garbage causal inferences out". It'd be interesting to hear from someone who knows the field, who can say whether the model used in this paper was rich enough to test your ideas (about excess sleep versus insufficient sleep).
- chewyshine 7y ago
  Mediation tests don't support causal inference. Sobel method is fine but rarely used now in the social sciences.
WillPostForFood 7y ago
Also, could the relationship be reversed. They suggest high anxiety -> less sleep -> higher mortality. But it seems possible high anxiety would also directly link to higher mortality (e.g., high blood pressure), and sleep would be a side effect, not the cause of higher mortality. Same with low conscientiousness (exercise less, eat junk food).
thatfrenchguy 7y ago
> my guess would be that people who get only 7 hours of sleep tend to be more successful, have jobs and families, and access to health care. Whereas those sleeping 10 hours a night are less likely to have the income to get health care when necessary. I think you may be having a selection bias here: there is a lot of people who sleep 8-9 hours at night who are in high income brackets (I think that’s what you mean by “successful”, even though that’s a debatable metric). The healthcare problem is a US-specific one, although probably if you are in a union job you’re likely to be getting decent healthcare while working hours that let you sleep.
- oarabbus_ 7y ago
  >I think you may be having a selection bias here: there is a lot of people who sleep 8-9 hours at night who are in high income brackets (I think that’s what you mean by “successful”, even though that’s a debatable metric). I'd disagree. Numerous studies with large sample sizes show the average sleep in America is 6 hours and change. I'd need to see some hard evidence that there are "a lot" of people, that is, a statistically significant number of high-earners, who sleep 8-9 hours. In fact, there is evidence to the contrary of your claim: >Turns out, the difference is pretty negligible — the "successful" people get 12 minutes less than the average American. According to this 2013 Gallup poll, the average American gets 6.8 hours of sleep every night. https://www.npr.org/sections/thetwo-way/2015/12/24/460929475/how-do-successful-peoples-sleep-patterns-compare-to-the-average-american https://www.npr.org/sections/thetwo-way/2015/12/24/460929475...
  - samatman 7y ago
    This may sound like pedantry, but I would call 6.8 "almost seven hours" not "6 hours and change". I track my sleep as best I can, and nearly-seven is sustainable, while a bit more than six on a consistent basis leaves me feeling pretty wrung out. The extra 45 minutes we're talking about here are likely to be mostly REM, given how intensely I dream when I start napping to make up a deficit.
ummonk 7y ago
It's also possible that those who sleep 8-9 hours are people who need 10+ hours of sleep but settle for 8-9. Whereas those who sleep 7 hours are those who only need 7 hours.
- rconti 7y ago
  From everything I've read, it's exceedingly uncommon to need more or less than the range of 7.5-9 hours a night.
  - tempestn 7y ago
    As long as you're getting quality sleep, yes. But if you have sleep apnea or another condition that is affecting quality of sleep, greater quantity might be required to feel rested.
magnamerc 7y ago
If you haven't already, I highly suggest reading the book Why We Sleep by Matthew Walker, a google sleep scientist and director of the Center for Human Sleep at Berkeley. The book is mainly focused on the causal effects of sleep deprivation, but he also mentions excessive sleep.
JamesBarney 7y ago
Also there's probably an issue with sleep quality. For instance I bet people who sleep deeper require less sleep, not to mention illness and increase sleep requirements.
darpa_escapee 7y ago
> But 8-9 hours of sleep nightly - my guess would be that people who get only 7 hours of sleep tend to be more successful, have jobs and families, and access to health care. Whereas those sleeping 10 hours a night are less likely to have the income to get health care when necessary. I'd hope that such studies on sleep control for income, employment, education and what not.
maerF0x0 7y ago
Came here to write similar causal / correlation point . If you currently sleep <7 or >9 hours dont take this as a prescription to change your sleep pattern. I would assume there is an underlying cause to your sleep needs and that solving the underlying cause is the true path to longevity. For example if you're sleeping more because you're recovering from burnout or a major surgery. Then taking the sleep to speed recovery is (i presume) a better choice than artificially restricting sleep in the name of "longevity" ...
- newswriter99 7y ago
  If you currently sleep <7 or >9 hours dont take this as a prescription to change your sleep pattern. So if you sleep 7, 8 or 9 hours you DO need to take this as a prescription to change your sleep pattern?
  - tempestn 7y ago
    That's not logically implied by the parent's statement.
dragontamer 7y ago
Let me reveal some of my personal health for this discussion. I was diagnosed with minor sleep apnea, and my doctor prescribed an anti-snoring mouthguard (a $1000 device that is basically a mouthguard with a screw in it... ugghhh). Costs aside, the device works, and I've been getting LESS sleep recently. Why? Because 7ish hours of sleep is all I need now... because I'm not getting minor "self-wakeup events" during night. Before this mouthguard, I needed 9ish hours of sleep to feel rested. The mouthguard definitely works (for my case anyway. I did some research and its apparently because I've got a large tongue or something, which means my snoring / sleep apnea could be cured by a mouth-guard forcing my jaw into a different position). Apparently, other cases of sleep apnea can only be solved with a CPAP, while still other cases of sleep apnea can be solved with a simple "sleeping backpack" (to prevent sleeping on your back). --------- Undiagnosed Sleep Apnea is associated with longer sleep, less-restful sleep, and a variety of ailments like obesity and high-blood pressure. I don't think cause-and-effect has been figured out yet (maybe obesity causes sleep apnea, or maybe vice versa). It is quite possible that excessive sleep is correlated with a variety of sleep-issues, like Sleep Apnea. People who fix their sleeping issues may live longer, higher quality lives.
- ccvannorman 7y ago
  I suspect I may have a condition similar to yours. I googled anti-snoring mouth guard and came back with $50-100 solutions, but no "bolt" inside that I could see. What differs between these and yours? Can you give more details eg a brand, a picture, or better description? Thanks!
  - dragontamer 7y ago
    The doctor gave me a Somnoguard AP2. I'm not entirely sure why it cost me $1000 from them... but that's what it cost from the doctor. Its clearly cheaper online. Perhaps I should have asked for a prescription from them and ordered online... but its too late now. I also had a take-home sleep study, consultation fees, etc. etc. on there. I think that maybe I just didn't understand my options as a consumer and I did this suboptimally from a financial point of view. In any case, the overall industry and regulations DON'T want you to be self-diagnosing things. I think it makes sense to go into a sleep doctor, and first order a take-home sleep study. You pretty much get some weird device hooked up into your nose and a few sensors on your head, and they'll take... some kind of sleep measurements. (Brainwaves? The nose thing probably was recording my breathing patterns, I dunno, I'm not a doctor. They did say a microphone was in the device too, so I guess they're recording the noises I make when I sleep). I know some people with more extreme conditions may need to do a full-scale sleep study in a specific room. But these are more expensive. Its pretty much a hotel-room, except doctors are measuring all sorts of things while you sleep. After those measurements, the sleep doctor probably will try and figure out which device is appropriate for you. Its pretty clear that the Somnoguard AP2 can only solve minor sleep apnea issues caused by tongue blocking during sleep: it just shifts the jaw forward by about 3mm to 5mm or so and holds it there during sleep. ---------- In any case, I'm overall happy that I've got my problem fixed. My only regrets is that I'm not really used to interacting with doctors. So I'm pretty sure I could have optimized my gameplan better and possibly negotiated a cheaper bill. But at least I've gained experience... I'll know what to do when my next health issue comes up.

keerthiko 7y ago

I know that most forms of clinical depression and the treatment associated with it has the side effect of a desire to sleep longer. 10 hours is a normal amount of time sleeping for people on anti-depressants. I'm not entirely certain whether sleeping closer to 8 would be any better for their mental or physical well being.

abakker 7y ago
This reminded me of this article - https://mosaicscience.com/story/staying-awake-surprisingly-effective-way-treat-depression/ https://mosaicscience.com/story/staying-awake-surprisingly-e... - which discusses treating depression by purposely putting patients into extremely sleep deprived states.
- qwsxyh 7y ago
  Note that this is for bipolar sufferers rather than unipolar depression sufferers.
hackerbabz 7y ago
When I finally got medical treatment for severe anxiety the sleepiness side effect from my medication was a godsend. I really think it helped me recover just knowing that no matter how horrible I was feeling, I would be asleep in an hour.

gshdg 7y ago

Isn't there also an argument that excessive sleep may be caused by health issues that end up affecting longevity as well?

WhompingWindows 7y ago
Every single causal link made in epidemiologic studies will have potential confounders that need to be adjusted for. I'd be shocked if anyone could think of a causal link without a potential confounder, never mind that we may have unknown/unmeasured confounders that aren't even top of mind.
joshvm 7y ago
Matt Walker makes this point in his book (at the risk of sounding like a shill). One group of people who sleep abnormally long hours are those suffering from various illnesses - they sleep more either as a result of the illness or while in recovery. Some of them may die. This group potentially skews results and increases the mortality rate of long sleepers. There is no evidence I'm aware of (nor does the book give any) that oversleeping is harmful in itself.
- LeonB 7y ago
  That book is so good that I feel like a shill when I recommend because I recommend it so enthusiastically.

elipsey 7y ago

This is exactly what I started writing before I saw your post. :) (Does that make this a discouraged “me too” post…?) TFA correlates _more_ sleep with increased mortality, but barely speculates on cause, and lumps too much, and not enough sleep together in discussion. With respect to the question of how more sleep might be bad, the article states: "[...]one can speculate that these folk, who have lower moods and more worry, might struggle to get to sleep or to get up promptly in the morning. Lower scores on extraversion were indirectly linked with increased risk of death, thanks to an association with greater daytime feelings of fatigue (perhaps extraverts’ greater daytime activity levels makes it easier for them to get a satisfying night’s sleep, but this is speculation)." Anecdotally, I think sleep deprivation increases my neuroticsism and decreases my extroversion, so I feel like positive feedback could exist. This makes it harder to do the things that seem to me to improve sleep and mood, like aerobic exercise, exposing oneself to natural light cycles, and other people, and keeping a consistent personal routine. I feel like I have spent periods in a meta-stable state of insomnia after pushing myself too hard because of crunch time, international travel, etc. I suspect that "excess" sleep may be correlated with chronic health problems like mood disorders (like depression), or auto-immune disorder. These problems are known to be suggestively correlated with each other, and also with sleep problems. This stuff seems complicated enough to be pretty hard to figure out, and I think you are right to be skeptical about the direction of causality. Pretty sure not sleeping enough is still bad though. (edit: flow/clarity)

datastoat 7y ago

It's worth pointing out that the study cited in the article does use an analysis that looks for causality. The study says "To formally test mediation [...] calculate indirect effects similar to the Sobel method." I think this refers to a paper "Direct and indirect effects in linear structural equation models" by Michael Sobel. I don't understand enough to say what the limitations are of this method -- but it does sound like rather more advanced causal analysis than you typically see in a medical paper. I'm guessing that the limitation of the Sobel method is "garbage model in, garbage causal inferences out". It'd be interesting to hear from someone who knows the field, who can say whether the model used in this paper was rich enough to test your ideas (about excess sleep versus insufficient sleep).

chewyshine 7y ago
Mediation tests don't support causal inference. Sobel method is fine but rarely used now in the social sciences.

WillPostForFood 7y ago

Also, could the relationship be reversed. They suggest high anxiety -> less sleep -> higher mortality. But it seems possible high anxiety would also directly link to higher mortality (e.g., high blood pressure), and sleep would be a side effect, not the cause of higher mortality. Same with low conscientiousness (exercise less, eat junk food).

thatfrenchguy 7y ago

> my guess would be that people who get only 7 hours of sleep tend to be more successful, have jobs and families, and access to health care. Whereas those sleeping 10 hours a night are less likely to have the income to get health care when necessary. I think you may be having a selection bias here: there is a lot of people who sleep 8-9 hours at night who are in high income brackets (I think that’s what you mean by “successful”, even though that’s a debatable metric). The healthcare problem is a US-specific one, although probably if you are in a union job you’re likely to be getting decent healthcare while working hours that let you sleep.

oarabbus_ 7y ago
>I think you may be having a selection bias here: there is a lot of people who sleep 8-9 hours at night who are in high income brackets (I think that’s what you mean by “successful”, even though that’s a debatable metric). I'd disagree. Numerous studies with large sample sizes show the average sleep in America is 6 hours and change. I'd need to see some hard evidence that there are "a lot" of people, that is, a statistically significant number of high-earners, who sleep 8-9 hours. In fact, there is evidence to the contrary of your claim: >Turns out, the difference is pretty negligible — the "successful" people get 12 minutes less than the average American. According to this 2013 Gallup poll, the average American gets 6.8 hours of sleep every night. https://www.npr.org/sections/thetwo-way/2015/12/24/460929475/how-do-successful-peoples-sleep-patterns-compare-to-the-average-american https://www.npr.org/sections/thetwo-way/2015/12/24/460929475...
- samatman 7y ago
  This may sound like pedantry, but I would call 6.8 "almost seven hours" not "6 hours and change". I track my sleep as best I can, and nearly-seven is sustainable, while a bit more than six on a consistent basis leaves me feeling pretty wrung out. The extra 45 minutes we're talking about here are likely to be mostly REM, given how intensely I dream when I start napping to make up a deficit.

ummonk 7y ago

It's also possible that those who sleep 8-9 hours are people who need 10+ hours of sleep but settle for 8-9. Whereas those who sleep 7 hours are those who only need 7 hours.

rconti 7y ago
From everything I've read, it's exceedingly uncommon to need more or less than the range of 7.5-9 hours a night.
- tempestn 7y ago
  As long as you're getting quality sleep, yes. But if you have sleep apnea or another condition that is affecting quality of sleep, greater quantity might be required to feel rested.

magnamerc 7y ago

If you haven't already, I highly suggest reading the book Why We Sleep by Matthew Walker, a google sleep scientist and director of the Center for Human Sleep at Berkeley. The book is mainly focused on the causal effects of sleep deprivation, but he also mentions excessive sleep.

JamesBarney 7y ago

Also there's probably an issue with sleep quality. For instance I bet people who sleep deeper require less sleep, not to mention illness and increase sleep requirements.

darpa_escapee 7y ago

> But 8-9 hours of sleep nightly - my guess would be that people who get only 7 hours of sleep tend to be more successful, have jobs and families, and access to health care. Whereas those sleeping 10 hours a night are less likely to have the income to get health care when necessary. I'd hope that such studies on sleep control for income, employment, education and what not.

maerF0x0 7y ago

Came here to write similar causal / correlation point . If you currently sleep <7 or >9 hours dont take this as a prescription to change your sleep pattern. I would assume there is an underlying cause to your sleep needs and that solving the underlying cause is the true path to longevity. For example if you're sleeping more because you're recovering from burnout or a major surgery. Then taking the sleep to speed recovery is (i presume) a better choice than artificially restricting sleep in the name of "longevity" ...

newswriter99 7y ago
If you currently sleep <7 or >9 hours dont take this as a prescription to change your sleep pattern. So if you sleep 7, 8 or 9 hours you DO need to take this as a prescription to change your sleep pattern?
- tempestn 7y ago
  That's not logically implied by the parent's statement.

dragontamer 7y ago

Let me reveal some of my personal health for this discussion. I was diagnosed with minor sleep apnea, and my doctor prescribed an anti-snoring mouthguard (a $1000 device that is basically a mouthguard with a screw in it... ugghhh). Costs aside, the device works, and I've been getting LESS sleep recently. Why? Because 7ish hours of sleep is all I need now... because I'm not getting minor "self-wakeup events" during night. Before this mouthguard, I needed 9ish hours of sleep to feel rested. The mouthguard definitely works (for my case anyway. I did some research and its apparently because I've got a large tongue or something, which means my snoring / sleep apnea could be cured by a mouth-guard forcing my jaw into a different position). Apparently, other cases of sleep apnea can only be solved with a CPAP, while still other cases of sleep apnea can be solved with a simple "sleeping backpack" (to prevent sleeping on your back). --------- Undiagnosed Sleep Apnea is associated with longer sleep, less-restful sleep, and a variety of ailments like obesity and high-blood pressure. I don't think cause-and-effect has been figured out yet (maybe obesity causes sleep apnea, or maybe vice versa). It is quite possible that excessive sleep is correlated with a variety of sleep-issues, like Sleep Apnea. People who fix their sleeping issues may live longer, higher quality lives.

ccvannorman 7y ago
I suspect I may have a condition similar to yours. I googled anti-snoring mouth guard and came back with $50-100 solutions, but no "bolt" inside that I could see. What differs between these and yours? Can you give more details eg a brand, a picture, or better description? Thanks!
- dragontamer 7y ago
  The doctor gave me a Somnoguard AP2. I'm not entirely sure why it cost me $1000 from them... but that's what it cost from the doctor. Its clearly cheaper online. Perhaps I should have asked for a prescription from them and ordered online... but its too late now. I also had a take-home sleep study, consultation fees, etc. etc. on there. I think that maybe I just didn't understand my options as a consumer and I did this suboptimally from a financial point of view. In any case, the overall industry and regulations DON'T want you to be self-diagnosing things. I think it makes sense to go into a sleep doctor, and first order a take-home sleep study. You pretty much get some weird device hooked up into your nose and a few sensors on your head, and they'll take... some kind of sleep measurements. (Brainwaves? The nose thing probably was recording my breathing patterns, I dunno, I'm not a doctor. They did say a microphone was in the device too, so I guess they're recording the noises I make when I sleep). I know some people with more extreme conditions may need to do a full-scale sleep study in a specific room. But these are more expensive. Its pretty much a hotel-room, except doctors are measuring all sorts of things while you sleep. After those measurements, the sleep doctor probably will try and figure out which device is appropriate for you. Its pretty clear that the Somnoguard AP2 can only solve minor sleep apnea issues caused by tongue blocking during sleep: it just shifts the jaw forward by about 3mm to 5mm or so and holds it there during sleep. ---------- In any case, I'm overall happy that I've got my problem fixed. My only regrets is that I'm not really used to interacting with doctors. So I'm pretty sure I could have optimized my gameplan better and possibly negotiated a cheaper bill. But at least I've gained experience... I'll know what to do when my next health issue comes up.