5 ms·

> It's hard to argue a causative effect between one week of bad sleep and death potentially 10+ years out. Statistically—absolutely, I agree with you, but cont

> It's hard to argue a causative effect between one week of bad sleep and death potentially 10+ years out. Statistically—absolutely, I agree with you, but controls and sample sizes can always be improved. Narratively—it's also not difficult to see: "gunk builds up in brain; gunk requires regular removal; sleep removes gunk; stable sleep removes gunk better than unstable sleep" It's difficult to blame people for emotionally attaching more to the latter than the former.

geysersam 2y ago
It seems easier to see: "some people have lots of difficulties in their lives that makes them have an irregular sleep schedule; some people have lots of difficulties in their lives that makes them die early"
- kimixa 2y ago
  I agree - an obvious connection would be "Lower income jobs tend to have less control over their schedule", be it shift workers, hourly service jobs or similar. There also may be links to worse healthcare due to lack of insurance in those jobs. It might just be another "Poorer people don't live as long" correlation.
  - kaonwarb 2y ago
    They at least tried: "Results were adjusted for age, sex, ethnicity, and sociodemographic, lifestyle, and health factors."
    - lazyasciiart 2y ago
      I wonder if lifestyle or sociodemographic includes having specifically young children. That seems like a specific known temporary sleep disruption.
      - EVa5I7bHFq9mnYK 2y ago
        The cogort was 40-69 yo.
        lazyasciiart 2y ago
        I am 40 and it's very common for people my age to be having babies. I would wild-ass guess that 10% of American 40-somethings have babies these days. https://www.nbcnews.com/news/motherhood-deferred-us-median-age-giving-birth-hits-30-rcna27827 https://www.nbcnews.com/news/motherhood-deferred-us-median-a...
      - rcyeh 2y ago
        Interesting, I initially thought this factor was probably negligible, because the cohort was aged "62.8 ± 7.8 years" (either before or after the 7-year observation period). I still think it's small, but perhaps not negligible. I estimate that some 2-4% of the group could be heavily involved in caring for grandchildren, sorting themselves into the irregular category. It's well-known that school-aged children pass flu to grandparents [2], and then grandparents die, just in time for the 7-year post-birth observation window. The absolute death rate due to flu is 10^-4 to 10^-3 per year, which would be visible on the paper's mortality time course chart. Estimation details: * some 20% are grandparents (and very few are parents) of young children [0] * 20-50% of grandparents care for grandchildren regularly [1] So maybe 4-10% of the cohort as an upper bound. If the birth rate is 12 per 1000 per year, and babies cause sleep disruption for about two years to two persons, then that's about 4% also, but perhaps mostly not the same age group. [0]: https://assets.publishing.service.gov.uk/media/5eeb975b86650c2d26963b4d/S0409_Age_distributions_of_grandparents_and_parents_of_primary_school_aged_children.pdf https://assets.publishing.service.gov.uk/media/5eeb975b86650... [1]: https://www.ageuk.org.uk/latest-news/articles/2017/september/five-million-grandparents-take-on-childcare-responsibilities/ https://www.ageuk.org.uk/latest-news/articles/2017/september... [2]: https://www.sciencedirect.com/science/article/abs/pii/S0025556412001721 https://www.sciencedirect.com/science/article/abs/pii/S00255... Going to sleep now.
  - sahmeepee 2y ago
    The source data is from the UK so it has nothing to do with the health insurance attached to specific jobs. Healthcare is covered via general taxation in the UK.
    - kimixa 2y ago
      I'm aware of the UK system, having been born and lived there for over 25 years :) I didn't note that the data was from UK persons, but the general point likely remains, if not as strongly. While true health insurance isn't attached to jobs in the same way, there's still uneven access - the town I grew up in closed it's local surgery a decade or so ago, so it's about a 30 minute drive, or over 2 hours on a rather indirect bus. Not everyone has a car, or can afford to take pretty much an entire day off work to get there. Assuming you can actually get an appointment, too. Richer areas often are better served, and richer people have better access to transport and time flexibility. And my job came with BUPA membership, which can also make some things easier, it's not the hard barrier to any care in the same way as the American system. And while the paper said that it corrected for Socioeconomic status, knowing the /scale/ (and possible error) in that correction relative to the claimed meaningful difference would be useful in studies like this. It feels like the sort of correction should be detailed more than just saying they did it. But I guess the paper isn't really claiming causation, merely correlation in that it's a predictor of mortality. Though many commenters here seem to assume.
    - geysersam 2y ago
      Interestingly enough, even in countries with tax funded healthcare people with lower income and socioeconomic status tend to receive worse healthcare (fewer expensive interventions, etc).
- hackernewds 2y ago
  I would presume that they somehow controlled for this most obvious confounding factor. almost every experiment I find that they are naysayers (as important as they are) that assume someone just simply plotted a chi-squared distribution.
  - mcmcmc 2y ago
    > presume Okay
- jdietrich 2y ago
  Also: "people in poor health don't sleep well". That's really hard to fully control for, because a lot of problems will affect mortality at sub-clinical levels that don't satisfy diagnostic criteria and won't appear on your medical records.
danparsonson 2y ago
Sure, but things that make narrative sense can easily fall down when examined - that's why the statistics are important and not just a rubber stamp. See for example https://en.m.wikipedia.org/wiki/Regression_toward_the_mean https://en.m.wikipedia.org/wiki/Regression_toward_the_mean
- PittleyDunkin 2y ago
  No disagreement here, but equally you can't be surprised when people can grapple with the narrative easier than statistics. If you want the statistical understanding to propagate you need a narrative.
meindnoch 2y ago
99% of people die from causes other than "brain gunk".
- 7e 2y ago
  Brain gunk could accelerate those causes, no?
  - seba_dos1 2y ago
    ...or those causes could accelerate brain gunk buildup.
  - saalweachter 2y ago
    Eh, you gotta be careful with One Weird Trick medicine. Once you get past painfully obvious problems, everything not currently easily fixed by modern medicine tends to be "well it's really complicated" sets of problems; there's not one Cancer, your blood pressure can be elevated for many reasons, syndromes like chronic fatigue are almost certainly a mix of dozens of problems binned together by common symptoms but will have different causes and treatments. Anyone saying they have one treatment to fix dozens of problems is a huckster, and trying to come up with a medical Theory of Everything to explain large swaths of disease is your origin story for how you become a huckster.
    - TZubiri 2y ago
      The difference between panaceas and this is that the idea for extending life isn't to add something, but not to fuck an essential part of life. If you think of life as the careful coordination of millions of parts, then there will be a million of things that if you fuck up you will die.
      - lanstin 2y ago
        Which is the model that matches acceleration of death rates as we age.
njtransit 2y ago
The issue is that almost all human behavior is correlated and, even if you have an easy-to-see [sic] method of action, e.g. “brain gunk”, that doesn’t automatically negate a nearly-infinite set of other possible causes from correlated behavior. Just a random example: those with high stress probably sleep poorly. You can think of a number of possible explanations that link high stress to shorter lifespans: more likely to commit suicide, more fat retention, less time for healthy activities, etc.

geysersam 2y ago

It seems easier to see: "some people have lots of difficulties in their lives that makes them have an irregular sleep schedule; some people have lots of difficulties in their lives that makes them die early"

kimixa 2y ago
I agree - an obvious connection would be "Lower income jobs tend to have less control over their schedule", be it shift workers, hourly service jobs or similar. There also may be links to worse healthcare due to lack of insurance in those jobs. It might just be another "Poorer people don't live as long" correlation.
- kaonwarb 2y ago
  They at least tried: "Results were adjusted for age, sex, ethnicity, and sociodemographic, lifestyle, and health factors."
  - lazyasciiart 2y ago
    I wonder if lifestyle or sociodemographic includes having specifically young children. That seems like a specific known temporary sleep disruption.
    - EVa5I7bHFq9mnYK 2y ago
      The cogort was 40-69 yo.
      - lazyasciiart 2y ago
        I am 40 and it's very common for people my age to be having babies. I would wild-ass guess that 10% of American 40-somethings have babies these days. https://www.nbcnews.com/news/motherhood-deferred-us-median-age-giving-birth-hits-30-rcna27827 https://www.nbcnews.com/news/motherhood-deferred-us-median-a...
    - rcyeh 2y ago
      Interesting, I initially thought this factor was probably negligible, because the cohort was aged "62.8 ± 7.8 years" (either before or after the 7-year observation period). I still think it's small, but perhaps not negligible. I estimate that some 2-4% of the group could be heavily involved in caring for grandchildren, sorting themselves into the irregular category. It's well-known that school-aged children pass flu to grandparents [2], and then grandparents die, just in time for the 7-year post-birth observation window. The absolute death rate due to flu is 10^-4 to 10^-3 per year, which would be visible on the paper's mortality time course chart. Estimation details: * some 20% are grandparents (and very few are parents) of young children [0] * 20-50% of grandparents care for grandchildren regularly [1] So maybe 4-10% of the cohort as an upper bound. If the birth rate is 12 per 1000 per year, and babies cause sleep disruption for about two years to two persons, then that's about 4% also, but perhaps mostly not the same age group. [0]: https://assets.publishing.service.gov.uk/media/5eeb975b86650c2d26963b4d/S0409_Age_distributions_of_grandparents_and_parents_of_primary_school_aged_children.pdf https://assets.publishing.service.gov.uk/media/5eeb975b86650... [1]: https://www.ageuk.org.uk/latest-news/articles/2017/september/five-million-grandparents-take-on-childcare-responsibilities/ https://www.ageuk.org.uk/latest-news/articles/2017/september... [2]: https://www.sciencedirect.com/science/article/abs/pii/S0025556412001721 https://www.sciencedirect.com/science/article/abs/pii/S00255... Going to sleep now.
- sahmeepee 2y ago
  The source data is from the UK so it has nothing to do with the health insurance attached to specific jobs. Healthcare is covered via general taxation in the UK.
  - kimixa 2y ago
    I'm aware of the UK system, having been born and lived there for over 25 years :) I didn't note that the data was from UK persons, but the general point likely remains, if not as strongly. While true health insurance isn't attached to jobs in the same way, there's still uneven access - the town I grew up in closed it's local surgery a decade or so ago, so it's about a 30 minute drive, or over 2 hours on a rather indirect bus. Not everyone has a car, or can afford to take pretty much an entire day off work to get there. Assuming you can actually get an appointment, too. Richer areas often are better served, and richer people have better access to transport and time flexibility. And my job came with BUPA membership, which can also make some things easier, it's not the hard barrier to any care in the same way as the American system. And while the paper said that it corrected for Socioeconomic status, knowing the /scale/ (and possible error) in that correction relative to the claimed meaningful difference would be useful in studies like this. It feels like the sort of correction should be detailed more than just saying they did it. But I guess the paper isn't really claiming causation, merely correlation in that it's a predictor of mortality. Though many commenters here seem to assume.
  - geysersam 2y ago
    Interestingly enough, even in countries with tax funded healthcare people with lower income and socioeconomic status tend to receive worse healthcare (fewer expensive interventions, etc).
hackernewds 2y ago
I would presume that they somehow controlled for this most obvious confounding factor. almost every experiment I find that they are naysayers (as important as they are) that assume someone just simply plotted a chi-squared distribution.
- mcmcmc 2y ago
  > presume Okay
jdietrich 2y ago
Also: "people in poor health don't sleep well". That's really hard to fully control for, because a lot of problems will affect mortality at sub-clinical levels that don't satisfy diagnostic criteria and won't appear on your medical records.

danparsonson 2y ago

Sure, but things that make narrative sense can easily fall down when examined - that's why the statistics are important and not just a rubber stamp. See for example https://en.m.wikipedia.org/wiki/Regression_toward_the_mean https://en.m.wikipedia.org/wiki/Regression_toward_the_mean

PittleyDunkin 2y ago
No disagreement here, but equally you can't be surprised when people can grapple with the narrative easier than statistics. If you want the statistical understanding to propagate you need a narrative.

meindnoch 2y ago

99% of people die from causes other than "brain gunk".

7e 2y ago
Brain gunk could accelerate those causes, no?
- seba_dos1 2y ago
  ...or those causes could accelerate brain gunk buildup.
- saalweachter 2y ago
  Eh, you gotta be careful with One Weird Trick medicine. Once you get past painfully obvious problems, everything not currently easily fixed by modern medicine tends to be "well it's really complicated" sets of problems; there's not one Cancer, your blood pressure can be elevated for many reasons, syndromes like chronic fatigue are almost certainly a mix of dozens of problems binned together by common symptoms but will have different causes and treatments. Anyone saying they have one treatment to fix dozens of problems is a huckster, and trying to come up with a medical Theory of Everything to explain large swaths of disease is your origin story for how you become a huckster.
  - TZubiri 2y ago
    The difference between panaceas and this is that the idea for extending life isn't to add something, but not to fuck an essential part of life. If you think of life as the careful coordination of millions of parts, then there will be a million of things that if you fuck up you will die.
    - lanstin 2y ago
      Which is the model that matches acceleration of death rates as we age.

njtransit 2y ago

The issue is that almost all human behavior is correlated and, even if you have an easy-to-see [sic] method of action, e.g. “brain gunk”, that doesn’t automatically negate a nearly-infinite set of other possible causes from correlated behavior. Just a random example: those with high stress probably sleep poorly. You can think of a number of possible explanations that link high stress to shorter lifespans: more likely to commit suicide, more fat retention, less time for healthy activities, etc.