Sleep Tracking, For Five Million Nights
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5 Sleep Phenotypes, By Actual Science
You probably know people can be broadly divided into “early birds” and “night owls”:
Early Bird Or Night Owl? Genes vs Environment
…and then the term “hummingbird” gets used for a person who flits between the two.
That’s three animals so far. If you read a book we reviewed recently, specifically this one:
The Power of When – by Dr. Michael Breus
…then you may have used the guide within to self-diagnose your circadian rhythm type (chronotype) according to Dr. Breus’s system, which divides people into bears, lions, wolves, and dolphins.
That’s another four animals. If you have a FitBit, it can “diagnose” you with being those and/or a menagerie of others, such as giraffe, hedgehog, parrot, and tortoise:
How Fitbit Developed the Sleep Profile Experience (Part 2 – Sleep Animals)
Five million nights
A team of researchers recently took a step away from this veritable zoo of 11 different animals and counting, and used a sophisticated modelling system to create a spatial-temporal map of people’s sleep habits, and this map created five main “islands” that people’s sleep habits could settle on, or sometimes move from island to island.
Those “five million nights” by the way? It was actually 5,095,798 nights! You might notice that would take from the 2020s to the 15970s to complete, so this was rather a matter of monitoring 33,152 individuals between January and October of the same year. Between them, they got those 5,095,798 nights of sleep (or in some cases, nights of little or no sleep, but still, they were there for the nights).
The five main phenotypes that the researchers found were:
- What we think of as “normal” sleep. In this phenotype, people get about eight hours of uninterrupted sleep for at least six days in a row.
- As above for half the nights, but they only sleep for short periods of time in bouts of less than three hours the other half.
- As per normal sleep, but with one interrupted night per week, consisting of a 5 hour sleep period and then broken sleep for a few more hours.
- As per normal sleep generally, but with occasional nights in which long bouts of sleep are separated by a mid-sleep waking.
- Sleeping for very short periods of time every night. This phenotype was the rarest the researchers found, and represents extremely disrupted sleep.
As you might suspect, phenotype 1 is healthier than phenotype 5. But that’s not hugely informational, as the correlation between getting good sleep and having good health is well-established. So, what did the study teach us?
❝We found that little changes in sleep quality helped us identify health risks. Those little changes wouldn’t show up on an average night, or on a questionnaire, so it really shows how wearables help us detect risks that would otherwise be missed.❞
More specifically,
❝We found that the little differences in how sleep disruptions occur can tell us a lot. Even if these instances are rare, their frequency is also telling. So it’s not just whether you sleep well or not – it’s the patterns of sleep over time where the key info hides❞
…and, which gets to the absolute point,
❝If you imagine there’s a landscape of sleep types, then it’s less about where you tend to live on that landscape, and more about how often you leave that area❞
In other words: if your sleep pattern is not ideal, that’s one thing and it’d probably be good to address it, by improving your sleep. However, if your sleep pattern changes phenotype without an obvious known reason why, this may be considered an alarm bell warning of something else that needs addressing, which may be an underlying illness or condition—meaning it can be worthwhile being a little extra vigilant when it comes to regular health screenings, in case something new has appeared.
Want to read more?
You can read the paper in full here:
Five million nights: temporal dynamics in human sleep phenotypes
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Hardwiring Happiness – by Dr. Rick Hanson
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Publishers are very excitable about “the new science of…”, and it’s almost never actually a new science of. But what about in this case?
No, it isn’t. It’s the very well established science of! And that’s a good thing, because it means this book is able to draw on quite a lot of research and established understanding of how neuroplasticity works, to leverage that and provide useful guidance.
A particular strength of this book is that while it polarizes the idea that some people have “happy amygdalae” and some people have “sad amygdalae”, it acknowledges that it’s not just a fated disposition and is rather the result of the lives people have led… And then provides advice on upgrading from sad to happy, based on the assumption that the reader is quite possibly coming from a non-ideal starting point.
The bookdoes an excellent job of straddling neuroscience and psychology, which sounds like not much of a straddle (the two are surely very connected, after all, right?) but this does mean that we’re hearing about the chemical structure of DNA inside the nuclei of the neurons of the insula, not long after reading an extended gardening metaphor about growth, choices, and vulnerabilities.
Bottom line: if you’d like a guide to changing your brain for the better (happier) that’s not just “ask yourself: what if it goes well?” and similar CBTisms, then this is a fine book for you.
Click here to check out Hardwiring Happiness, and indeed hardwire happiness!
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Tis To Season To Be SAD-Savvy
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Seasonal Affective Disorder & SAD Lamps
For those of us in the Northern Hemisphere, it’s that time of the year; especially after the clocks recently went back and the nights themselves are getting longer. So, what to do in the season of 3pm darkness?
First: the problem
The problem is twofold:
- Our circadian rhythm gets confused
- We don’t make enough serotonin
The latter is because serotonin production is largely regulated by sunlight.
People tend to focus on item 2, but item 1 is important too—both as problem, and as means of remedy.
Circadian rhythm is about more than just light
We did a main feature on this a little while back, talking about:
- What light/dark does for us, and how it’s important, but not completely necessary
- How our body knows what time it is even in perpetual darkness
- The many peaks and troughs of many physiological functions over the course of a day/night
- What that means for us in terms of such things as diet and exercise
- Practical take-aways from the above
Read: The Circadian Rhythm: Far More Than Most People Know
With that in mind, the same methodology can be applied as part of treating Seasonal Affective Disorder.
Serotonin is also about more than just light
Our brain is a) an unbelievably powerful organ, and the greatest of any animal on the planet b) a wobbly wet mass that gets easily confused.
In the case of serotonin, we can have problems:
- knowing when to synthesize it or not
- synthesizing it
- using it
- knowing when to scrub it or not
- scrubbing it
- etc
Selective Serotonin Re-uptake Inhibitors (SSRIs) are a class of antidepressants that, as the name suggests, inhibit the re-uptake (scrubbing) of serotonin. So, they won’t add more serotonin to your brain, but they’ll cause your brain to get more mileage out of the serotonin that’s there, using it for longer.
So, whether or not they help will depend on you and your brain:
Read: Antidepressants: Personalization Is Key!
How useful are artificial sunlight lamps?
Artificial sunlight lamps (also called SAD lamps), or blue light lamps, are used in an effort to “replace” daylight.
Does it work? According to the science, generally yes, though everyone would like more and better studies:
- The Efficacy of Light Therapy in the Treatment of Seasonal Affective Disorder: A Meta-Analysis of Randomized Controlled Trials
- Blue-Light Therapy for Seasonal and Non-Seasonal Depression: A Systematic Review and Meta-Analysis of Randomized Controlled Trials
Interestingly, it does still work in cases of visual impairment and blindness:
How much artificial sunlight is needed?
According to Wirz-Justice and Terman (2022), the best parameters are:
- 10,000 lux
- full spectrum (white light)
- 30–60 minutes exposure
- in the morning
Source: Light Therapy: Why, What, for Whom, How, and When (And a Postscript about Darkness)
That one’s a fascinating read, by the way, if you have time.
Can you recommend one?
For your convenience, here’s an example product on Amazon that meets the above specifications, and is also very similar to the one this writer has
Enjoy!
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Digital Minimalism – by Dr. Cal Newport
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There are a lot of books that advise “Unplug once in a while, and go outside”. But it doesn’t really take a book to convey that, does it? And it just leaves all the digital catching-up once we get back. Surely there must be a better way?
Rather than relying on a “digital detox”, Dr. Newport offers principles to apply to our digital lives, that allow us to reap the benefits of modern information technology without being obeisant to it.
The book’s greatest strength lies in that; having clear guidelines that can be applied to cut out the extra weight of digital media that has simply snuck in because of The Almighty Algorithm—and even tips on how to engage more mindfully with that if we still want to, for example using social media only in a web browser rather than on our phones, so that we can ringfence the time for it rather than having it spill into every spare moment.
In the category of criticism, the book sometimes lacks a little awareness when it comes to assumptions about the reader and the reader’s social circles; that (for example) nobody has any disabilities and everyone lives in the same town. But for most people most of the time, the advices will stand, and the exceptions can be managed by the reader neatly enough.
Stylistically, the book is not very minimalist, but this is not inconsistent with the advice of the book, if you’re curling up in the armchair with a physical copy, or a single-purpose ereader device.
Bottom line: if you’d like to streamline your use of digital media, but don’t want to lose out on the value it brings you, this book provides an excellent template
Click here to check out Digital Minimalism, and choose focused life in a noisy world!
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Proteins Of The Week
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This week’s news round-up is, entirely by chance, somewhat protein-centric in one form or another. So, check out the bad, the very bad, the mostly good, the inconvenient, and the worst:
Mediterranean diet vs the menopause
Researchers looked at hundreds of women with an average age of 51, and took note of their dietary habits vs their menopause symptoms. Most of them were consuming soft drinks and red meat, and not good in terms of meeting the recommendations for key food groups including vegetables, legumes, fruit, fish and nuts, and there was an association between greater adherence to Mediterranean diet principles, and better health.
Read in full: Fewer soft drinks and less red meat may ease menopause symptoms: Study
Related: Four Ways To Upgrade The Mediterranean Diet
Listeria in meat
This one’s not a study, but it is relevant important news. The headline pretty much says it all, so if you don’t eat meat, this isn’t one you need to worry about any further than that. If you do eat meat, though, you might want to check out the below article to find out whether the meat you eat might be carrying listeria:
Read in full: Almost 10 million pounds of meat recalled due to Listeria danger
Related: Frozen/Thawed/Refrozen Meat: How Much Is Safety, And How Much Is Taste?
Brawn and brain?
A study looked at cognitively healthy older adults (of whom, 57% women), and found an association between their muscle strength and their psychological wellbeing. Note that when we said “cognitively healthy”, this means being free from dementia etc—not necessarily psychologically health in all respects, such as also being free from depression and enjoying good self-esteem.
Read in full: Study links muscle strength and mental health in older adults
Related: Staying Strong: Tips To Prevent Muscle Loss With Age
The protein that blocks bone formation
This one’s more clinical but definitely of interest to any with osteoporosis or at high risk of osteoporosis. Researchers identified a specific protein that blocks osteoblast function, thus more of this protein means less bone production. Currently, this is not something that we as individuals can do anything about at home, but it is promising for future osteoporosis meds development.
Read in full: Protein blocking bone development could hold clues for future osteoporosis treatment
Related: Which Osteoporosis Medication, If Any, Is Right For You?
Rabies risk
People associate rabies with “rabid dogs”, but the biggest rabies threat is actually bats, and they don’t even need to necessarily bite you to confer the disease (it suffices to have licked the skin, for instance—and bats are basically sky-puppies who will lick anything). Because rabies has a 100% fatality rate in unvaccinated humans, this is very serious. This means that if you wake up and there’s a bat in the house, it doesn’t matter if it hasn’t bitten anyone; get thee to a hospital (where you can get the vaccine before the disease takes hold; this will still be very unpleasant but you’ll probably survive so long as you get the vaccine in time).
Read in full: What to know about bats and rabies
Related: Dodging Dengue In The US ← much less serious than rabies, but still not to be trifled with—particularly noteworthy if you’re in an area currently affected by floodwaters or even just unusually heavy rain, by the way, as this will leave standing water in which mosquitos breed.
Take care!
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Taking A Trip Through The Evidence On Psychedelics
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In Tuesday’s newsletter, we asked you for your opinions on the medicinal use of psychedelics, and got the above-depicted, below-described, set of responses:
- 32% said “This is a good, evidence-based way to treat many brain disorders”
- 32% said “There are some benefits, but they don’t outweigh the risks”
- 20% said “This can help a select few people only; useless for the majority”
- 16% said “This is hippie hogwash and hearsay; wishful thinking at best”
Quite a spread of answers, so what does the science say?
This is hippie hogwash and hearsay; wishful thinking at best! True or False?
False! We’re tackling this one first, because it’s easiest to answer:
There are some moderately-well established [usually moderate] clinical benefits from some psychedelics for some people.
If that sounds like a very guarded statement, it is. Part of this is because “psychedelics” is an umbrella term; perhaps we should have conducted separate polls for psilocybin, MDMA, ayahuasca, LSD, ibogaine, etc, etc.
In fact: maybe we will do separate main features for some of these, as there is a lot to say about each of them separately.
Nevertheless, looking at the spread of research as it stands for psychedelics as a category, the answers are often similar across the board, even when the benefits/risks may differ from drug to drug.
To speak in broad terms, if we were to make a research summary for each drug it would look approximately like this in each case:
- there has been research into this, but not nearly enough, as “the war on drugs” may well have manifestly been lost (the winner of the war being: drugs; still around and more plentiful than ever), but it did really cramp science for a few decades.
- the studies are often small, heterogenous (often using moderately wealthy white student-age population samples), and with a low standard of evidence (i.e. the methodology often has some holes that leave room for reasonable doubt).
- the benefits recorded are often small and transient.
- in their favor, though, the risks are also generally recorded as being quite low, assuming proper safe administration*.
*Illustrative example:
Person A takes MDMA in a club, dances their cares away, has had only alcohol to drink, sweats buckets but they don’t care because they love everyone and they see how we’re all one really and it all makes sense to them and then they pass out from heat exhaustion and dehydration and suffer kidney damage (not to mention a head injury when falling) and are hospitalized and could die;
Person B takes MDMA in a lab, is overwhelmed with a sense of joy and the clarity of how their participation in the study is helping humanity; they want to hug the researcher and express their gratitude; the researcher reminds them to drink some water.
Which is not to say that a lab is the only safe manner of administration; there are many possible setups for supervised usage sites. But it does mean that the risks are often as much environmental as they are risks inherent to the drug itself.
Others are more inherent to the drug itself, such as adverse cardiac events for some drugs (ibogaine is one that definitely needs medical supervision, for example).
For those who’d like to see numbers and clinical examples of the bullet points we gave above, here you go; this is a great (and very readable) overview:
NIH | Evidence Brief: Psychedelic Medications for Mental Health and Substance Use Disorders
Notwithstanding the word “brief” (intended in the sense of: briefing), this is not especially brief and is rather an entire book (available for free, right there!), but we do recommend reading it if you have time.
This can help a select few people only; useless for the majority: True or False?
True, technically, insofar as the evidence points to these drugs being useful for such things as depression, anxiety, PTSD, addiction, etc, and estimates of people who struggle with mental health issues in general is often cited as being 1 in 4, or 1 in 5. Of course, many people may just have moderate anxiety, or a transient period of depression, etc; many, meanwhile, have it worth.
In short: there is a very large minority of people who suffer from mental health issues that, for each issue, there may be one or more psychedelic that could help.
This is a good, evidence-based way to treat many brain disorders: True or False?
True if and only if we’re willing to accept the so far weak evidence that we discussed above. False otherwise, while the jury remains out.
One thing in its favor though is that while the evidence is weak, it’s not contradictory, insofar as the large preponderance of evidence says such therapies probably do work (there aren’t many studies that returned negative results); the evidence is just weak.
When a thousand scientists say “we’re not completely sure, but this looks like it helps; we need to do more research”, then it’s good to believe them on all counts—the positivity and the uncertainty.
This is a very different picture than we saw when looking at, say, ear candling or homeopathy (things that the evidence says simply do not work).
We haven’t been linking individual studies so far, because that book we linked above has many, and the number of studies we’d have to list would be:
n = number of kinds of psychedelic drugs x number of conditions to be treated
e.g. how does psilocybin fare for depression, eating disorders, anxiety, addiction, PTSD, this, that, the other; now how does ayahuasca fare for each of those, and so on for each drug and condition; at least 25 or 30 as a baseline number, and we don’t have that room.
But here are a few samples to finish up:
- Psilocybin as a New Approach to Treat Depression and Anxiety in the Context of Life-Threatening Diseases—A Systematic Review and Meta-Analysis of Clinical Trials
- Therapeutic Use of LSD in Psychiatry: A Systematic Review of Randomized-Controlled Clinical Trials
- Efficacy of Psychoactive Drugs for the Treatment of Posttraumatic Stress Disorder: A Systematic Review of MDMA, Ketamine, LSD and Psilocybin
- Changes in self-rumination and self-compassion mediate the effect of psychedelic experiences on decreases in depression, anxiety, and stress.
- Psychedelic Treatments for Psychiatric Disorders: A Systematic Review and Thematic Synthesis of Patient Experiences in Qualitative Studies
- Repeated lysergic acid diethylamide (LSD) reverses stress-induced anxiety-like behavior, cortical synaptogenesis deficits and serotonergic neurotransmission decline
In closing…
The general scientific consensus is presently “many of those drugs may ameliorate many of those conditions, but we need a lot more research before we can say for sure”.
On a practical level, an important take-away from this is twofold:
- drugs, even those popularly considered recreational, aren’t ontologically evil, generally do have putative merits, and have been subject to a lot of dramatization/sensationalization, especially by the US government in its famous war on drugs.
- drugs, even those popularly considered beneficial and potentially lifechangingly good, are still capable of doing great harm if mismanaged, so if putting aside “don’t do drugs” as a propaganda of the past, then please do still hold onto “don’t do drugs alone”; trained professional supervision is a must for safety.
Take care!
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Topping Up Testosterone?
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The Testosterone Drop
Testosterone levels decline amongst men over a certain age. Exactly when depends on the individual and also how we measure it, but the age of 45 is a commonly-given waypoint for the start of this decline.
(the actual start is usually more like 20, but it’s a very small decline then, and speeds up a couple of decades later)
This has been called “the male menopause”, or “the andropause”.
Both terms are a little misleading, but for lack of a better term, “andropause” is perhaps not terrible.
Why “the male menopause” is misleading:
To call it “the male menopause” suggests that this is when men’s menstruation stops. Which for cis men at the very least, is simply not a thing they ever had in the first place, to stop (and for trans men it’s complicated, depending on age, hormones, surgeries, etc).
Why “the andropause” is misleading:
It’s not a pause, and unlike the menopause, it’s not even a stop. It’s just a decline. It’s more of an andro-pitter-patter-puttering-petering-out.
Is there a better clinical term?
Objectively, there is “late-onset hypogonadism” but that is unlikely to be taken up for cultural reasons—people stigmatize what they see as a loss of virility.
Terms aside, what are the symptoms?
❝Andropause or late-onset hypogonadism is a common disorder which increases in prevalence with advancing age. Diagnosis of late-onset of hypogonadism is based on presence of symptoms suggestive of testosterone deficiency – prominent among them are sexual symptoms like…❞
…and there we’d like to continue the quotation, but if we list the symptoms here, it won’t get past a lot of filters because of the words used. So instead, please feel free to click through:
Source: Andropause: Current concepts
Can it be safely ignored?
If you don’t mind the sexual symptoms, then mostly, yes!
However, there are a few symptoms we can mention here that are not so subjective in their potential for harm:
- Depression
- Loss of muscle mass
- Increased body fat
Depression kills, so this does need to be taken seriously. See also:
The Mental Health First-Aid That You’ll Hopefully Never Need
(the above is a guide to managing depression, in yourself or a loved one)
Loss of muscle mass means being less robust against knocks and falls later in life
Loss of muscle mass also means weaker bones (because the body won’t make bones stronger than it thinks they need to be, so bone will follow muscle in this regard—in either direction)
See also:
- Resistance Is Useful! (Especially As We Get Older)
- Protein vs Sarcopenia
- Fall Special (How to Proof Yourself Against Falls)
Increased body fat means increased risk of diabetes and heart disease, as a general rule of thumb, amongst other problems.
Will testosterone therapy help?
That’s something to discuss with your endocrinologist, but for most men whose testosterone levels are lower than is ideal for them, then yes, taking testosterone to bring them [back] to “normal” levels can make you happier and healthier (though it’s certainly not a cure-all).
See for example:
Testosterone Therapy Improves […] and […] in Hypogonadal Men
(Sorry, we’re not trying to be clickbaity, there are just some words we can’t use without encountering software problems)
Here’s a more comprehensive study that looked at 790 men aged 65 or older, with testosterone levels below a certain level. It looked at the things we can’t mention here, as well as physical function and general vitality:
❝The increase in testosterone levels was associated with significantly increased […] activity, as assessed by the Psychosexual Daily Questionnaire (P<0.001), as well as significantly increased […] desire and […] function.
The percentage of men who had an increase of at least 50 m in the 6-minute walking distance did not differ significantly between the two study groups in the Physical Function Trial but did differ significantly when men in all three trials were included (20.5% of men who received testosterone vs. 12.6% of men who received placebo, P=0.003).
Testosterone had no significant benefit with respect to vitality, as assessed by the Functional Assessment of Chronic Illness Therapy–Fatigue scale, but men who received testosterone reported slightly better mood and lower severity of depressive symptoms than those who received placebo❞
Source: Effects of Testosterone Treatment in Older Men
We strongly recommend, by the way, when a topic is of interest to you to read the paper itself, because even the extract above contains some subjectivity, for example what is “slightly better”, and what is “no significant benefit”.
That “slightly better mood and lower severity of depressive symptoms”, for example, has a P value of 0.004 in their data, which is an order of magnitude more significant than the usual baseline for significance (P<0.05).
And furthermore, that “no significant benefit with respect to vitality” is only looking at either the primary outcome aggregated goal or the secondary FACIT score whose secondary outcome had a P value of 0.06, which just missed the cut-off for significance, and neglects to mention that all the other secondary outcome metrics for men involved in the vitality trial were very significant (ranging from P=0.04 to P=0.001)
Click here to see the results table for the vitality trial
Will it turn me into a musclebound angry ragey ‘roidmonster?
Were you that kind of person before your testosterone levels declined? If not, then no.
Testosterone therapy seeks only to return your testosterone levels to where they were, and this is done through careful monitoring and adjustment. It’d take a lot more than (responsible) endocrinologist-guided hormonal therapy to turn you into Marvel’s “Wolverine”.
Is testosterone therapy safe?
A question to take to your endocrinologist because everyone’s physiology is different, but a lot of studies do support its general safety for most people who are prescribed it.
As with anything, there are risks to be aware of, though. Perhaps the most critical risk is prostate cancer, and…
❝In a large meta-analysis of 18 prospective studies that included over 3500 men, there was no association between serum androgen levels and the risk of prostate cancer development
For men with untreated prostate cancer on active surveillance, TRT remains controversial. However, several studies have shown that TRT is not associated with progression of prostate cancer as evidenced by either PSA progression or gleason grade upstaging on repeat biopsy.
Men on TRT should have frequent PSA monitoring; any major change in PSA (>1 ng/mL) within the first 3-6 months may reflect the presence of a pre-existing cancer and warrants cessation of therapy❞
Those are some select extracts, but any of this may apply to you or your loved one, we recommend to read in full about this and other risks:
Risks of testosterone replacement therapy in men
See also: Prostate Health: What You Should Know
Beyond that… If you are prone to baldness, then taking testosterone will increase that tendency. If that’s a problem for you, then it’s something to know about. There are other things you can take/use for that in turn, so maybe we’ll do a feature on those one of these days!
For now, take care!
Don’t Forget…
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