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I've read a bit into this subject before; Matthew Walker's book 'Why We Sleep'[0] discusses it at length. A lot of it boils down to blood pressure. High blood

• deleted 3y ago
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• kulahan 3y ago
  The important consideration here is that these people are on the cusp of death already, and this is typically just the straw that broke the camel's back. You don't get a heart attack from one bad night of sleep, of course, unless there are significant underlying conditions.
  • sramam 3y ago
    On the flip side, isn't it also likely that repeating the same stressful behavior pattern over years (decades?) results in this outcome? However, parsing signal from noise does seem a very difficult proposition.
    • marcosdumay 3y ago
      This is where an intervention-based study shines. It's just basically impossible to design an intervention for this one. (But then, this also means that knowing it for sure would be useless.)
    • asdfman123 3y ago
      It's actually not very hard to know at all, at least if your question is "what kind of lifestyle will generally lead to the best longterm health outcomes?" Sure, there's minor distinctions to be made and important medical questions, but generally it's pretty clear. Everyone knows it, I don't need to list it: eating clean, getting good sleep, plenty of exercise, etc. And furthermore, though our healthcare system seems only configured to deal with things once they become emergencies, metabolic disorder takes your whole life to take root. The time to start making positive changes is now.
  • gtop3 3y ago
    High blood pressure is often refereed to as the "silent killer". It's not like these individuals present sick/ill in their daily lives. Basically the only symptoms of high blood pressure are sudden traumatic events like Heart Attack and Stroke. If you meet one of these people hours before their heart attack you often wouldn't describe them as 'on the cusp of death'.
    • kulahan 3y ago
      Yep! You're correct. I didn't mean to imply that they look sickly or anything, just that their body is literally on the verge of failing, even if it looks perfectly fine.
    • sublinear 3y ago
      > If you meet one of these people hours before their heart attack you often wouldn't describe them as 'on the cusp of death'. I disagree. It's not that the symptoms aren't there, but that they have become normalized due to obesity, smoking, etc. being commonplace. Shortness of breath, sleep apnea, feeling weak, upper body tension/pain, etc. are usually present for quite a while in most people before it finally happens. People don't check their blood pressure often enough despite it being so cheap and easy to do.
      • 2devnull 3y ago
        You’re wrong. A young person with borderline hypertension (130/80) can present in perfect health. Blacks for instance have a genetic predisposition to hypertension, obesity and diet don’t have to be involved. Besides genetics, other health conditions like insomnia or other medications can cause hypertension. Some people are just salt sensitive.
        • moneywoes 3y ago
          What makers can I check?
          • gtop3 3y ago
  • Retric 3y ago
    While presumably true in the general case, there are many drugs etc that drastically lower peoples risks of dying from a heart attack. So many people must get quite close to a heart attack only to live a long life and die of something else.
  • p1necone 3y ago
    This is a very important thing to consider when interpreting this statistic. "Heart attack rates go up 24% after daylight savings changes" is not the same thing as "There are 24% more heart attacks due to daylight savings". You can't really know the weight of magnitude vs distribution without actually stopping daylight savings.
    • clircle 3y ago
      or by conducting some causal inference with a load of identification assumptions
• pushcx 3y ago
  This book has serious issues. https://guzey.com/books/why-we-sleep/ https://guzey.com/books/why-we-sleep/ The only mention of daylight savings time in Why We Sleep is: > In the Northern Hemisphere, the switch to daylight savings time in March results in most people losing an hour of sleep opportunity. Should you tabulate millions of daily hospital records, as researchers have done, you discover that this seemingly trivial sleep reduction comes with a frightening spike in heart attacks the following day. Impressively, it works both ways. In the autumn within the Northern Hemisphere, when the clocks move forward and we gain an hour of sleep opportunity time, rates of heart attacks plummet the day after. I don't see a specific study cited, but my ebook copy doesn't seem to have all the footnotes. I pulled up the article you linked on sci-hub: https://sci-hub.se/https://pubmed.ncbi.nlm.nih.gov/18971502/ https://sci-hub.se/https://pubmed.ncbi.nlm.nih.gov/18971502/ The only use of the number "24" refers to hours in the day, and its summary doesn't seem to match your claim: > The incidence of acute myocardial infarction was significantly increased for the first 3 week-days after the transition to daylight saving time in the spring (Fig. 1A). The incidence ratio for the first week after the spring shift, calculated as the incidence for all 7 days divided by the mean of the weekly incidences 2 weeks before and 2 weeks after, was 1.051 (95% confidence interval [CI], 1.032 to 1.071). In contrast, after the transition out of daylight saving time in the autumn, only the first weekday was affected significantly (Fig. 1B); the incidence ratio for the whole week was 0.985 (95% CI, 0.969 to 1.002
  • quenix 3y ago
    Personal anecdote--I fucking hate this book. For many reasons, I slept just fine until I read it.
    • NilsIRL 3y ago
      Would love to hear more
      • quenix 3y ago
        Sure. I'll start by prefacing that I'm not necessarily wholly attributing these as faults of Walker's book. I don't doubt I have a higher propensity for certain anxious responses, or perhaps my personality made me more susceptible to the sort of thinking I'll discuss. Walker's book—and his accompanying Ted talks and podcasts—instilled a deep sense of sleep anxiety in me, which led to episodes of chronic insomnia (still occurs today). I had never experienced these issues before reading the book. Unfortunately, his message ensures that the insomnia is self-exacerbating, causing a vicious cycle. Essentially, I find it very wrong for Walker to focus on and overhype the negative aspects of sleep loss as much as he does. Guzey's article [0], also linked above, goes through much of this. Why We Sleep turns into a horror book if you aren't able to sleep for whatever reason. It implies that, from just one bad night's sleep, 1. your immune system will deteriorate significantly 2. the chance that you develop a cancer will increase 3. your mental health will suffer 4. you are more likely to develop anxiety or depression 5. the probability you hurt yourself will increase 6. your mental faculties will be destroyed, you will be unable to reason well 7. you are at higher risk of mortality (!) 8. you are literally closer to death, which the book supports by mentioning fatal familial insomnia (FFI)... a flawed analogy ... and much more. I was initially ok after reading the book, but the problems really started after I had a bad nights' sleep. I was absolutely terrified the following night, remembering all the awful things that will happen to my body and mind if I do not recuperate the next night. And we all know how easy it is to lose sleep when you are worried. I stayed up until 6 AM that night. Every passing hour made it harder to sleep. Naturally, this started a cycle. Grumpy and even more anxious the next day ("two days? wow, am I now DOUBLE the chance of cancer and depression?"), sleep began evading me more and more often. The bed became a place of anxiety. Every minute I spent awake, I remembered Walker's book and the terrible things he told me was happening to my body due to the insomnia. This caused an infernal, unending loop of insomnia. Morning birdsong became hell to my ears. I still sometimes suffer from it to this day, but Guzey's essay really helped. I think some quotes can do my point more justice: > Your essay on Why we sleep - I can’t thank you enough. I’m a sleep doctor in Oregon and have seen many many patients who have developed severe sleep anxiety and insomnia. Two friends in the sleep field and myself weekly have talked about people that slept well until reading this book. > I wanted to drop you a line to thank you for all the time and effort involved in debunking Matthew Walker’s book. As someone who works with individuals with insomnia on a daily basis, I know from firsthand experience the harm that Walker’s book is causing. I have many stories of people who slept well on less than eight hours of sleep, read Walker’s book, tried to get more sleep and this led to more time awake, frustration, worry, sleep-related anxiety, and insomnia. > My patients are coming to me after reading this alarmist book, with insomnia that they did not have before, and worse, harder to treat because although the book has caused these anxieties - they can’t shake their newly built alarmist beliefs they learnt from the very same book. > Scott slept well his entire life until he listened to a podcast that led him to worry about how much sleep he was getting and the health consequences of insufficient sleep. That night, Scott had a terrible night of sleep and this triggered a vicious cycle of ever-increasing worry about sleep and increasingly worse sleep that lasted for ten months. [0]: https://guzey.com/books/why-we-sleep https://guzey.com/books/why-we-sleep
• m463 3y ago
  I feel really good with a sleep rhythm going to bed later each day and getting up later the next day. I think many people do the same sort of thing, and then monday -- they have to cut their sleep short to get up early and sync with the rest of the world. I can see how this would be the stressor you allude to.
  • samtho 3y ago
    This is because our circadian rhythms are naturally found to be about 25 hours absent external stimuli or timekeeping devices.
  • asdfman123 3y ago
    It's so much better going to sleep and waking up the same time every day. The only problem is it's often incompatible with a social life when you're in your 20s, but thankfully I'm not in my 20s anymore.
• aaron695 3y ago
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• b112 3y ago
  This is also why the amount of heart attacks are up around 24% after daylight savings[1]; an hour less sleep means higher blood pressure There is no proof of this as to why. Only that it happens. For example: * the hour of lost sleep does not happen on Monday, but on Sunday morning * people could sleep in on Monday, then get hyper stressed that they are late * type A personalities could get mad at an office of sluggish people * people could get upset at everyone complaining about DST again, my blood pressure went up at your post!