How Regularity Of Sleep Can Be Even More Important Than Duration
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A recent, large (n=72,269) 8-year prospective* observational study of adults aged 40-79 has found an association between irregular sleep and major cardiovascular events.
*this means they started the study at a given point, and measured what happened for the next eight years—as opposed to a retrospective study, which would look at what had happened during the previous 8 years.
As to what qualifies as major cardiovascular events, they counted:
- Heart attack
- Cardiac arrest
- Stroke
- Cardiovascular death (any)
Irregular sleep, meanwhile, was defined per a bell curve of participants. Based on a sleep regularity index (SRI) score, those with a score of 87 or more were on the “regular” side of the curve, and those with a score of 72 or lower were on the “irregular” side of the curve.
What they found is that irregular sleep is associated with major cardiovascular events, regardless of the actual amount of sleep that people got. So in other words, you could be sleeping 9 hours per day, but if it’s a different 9 hours each day, your cardiovascular risk will still be higher.
How much higher?
- For those in the middle of the curve (so, moderate irregularity), it was 8% higher than those on the “regular” side.
- For those on the “irregular” side of the curve, it was 26% higher than those on the “regular” side.
All of the above is after taking into account confounding variables such as age, physical activity levels, discretionary screen time, fruit, vegetable, and coffee intake, alcohol consumption, smoking, mental health issues, medication use, and shift work. Which is quite something, given that shift work is a very common reason for irregular sleep schedules in a lot of people.
Limitations
While, as noted above, they did their best to account for a lot of things, this was an observational study, not an interventional study or a randomized controlled trial, and as such, it cannot truly establish cause and effect.
For example, an observational study in the 90s found that the sport most strongly associated with longevity was polo. For any unfamiliar, it’s a game played on horseback with mallets and balls. Why was this game so much better than, say, swimming? And the answer is most likely that polo is played almost entirely by very rich people. It wasn’t the sport that enhanced longevity—it was the wealth.
So similarly here, it could be for example that people who are predisposed to heart conditions, are prone to having irregular schedules. We won’t know for sure until we have interventional studies (and we probably can’t get RCTs for this, for practical reasons).
Still, it seems likely that the association is indeed causal, in which case, having a regular sleep schedule if at all possible seems like a very good way to look after one’s health.
You can read more about the study here:
Irregular sleep may elevate risk of major cardiovascular events
Practical take-away
This study strongly suggests that sleep regularity is even more important than sleep duration.
This means that there is extra reason to not sleep in past one’s normal getting-up time, even if one had a less restful night.
That’s the end of sleep that’s the most important in practical terms, too, because we can control our getting-up time, whereas we can’t really control our going-to-sleep time, because it’s perfectly possible to just lie there awake.
So, controlling the getting-up time is really the key to the whole thing. See also:
Calculate (And Enjoy) The Perfect Night’s Sleep
And for scope, you might enjoy reading:
Morning Larks vs Night Owls: How Much Can We Control Our Sleep Schedule?
Enjoy!
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Elon Musk says ketamine can get you out of a ‘negative frame of mind’. What does the research say?
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X owner Elon Musk recently described using small amounts of ketamine “once every other week” to manage the “chemical tides” that cause his depression. He says it’s helpful to get out of a “negative frame of mind”.
This has caused a range of reactions in the media, including on X (formerly Twitter), from strong support for Musk’s choice of treatment, to allegations he has a drug problem.
But what exactly is ketamine? And what is its role in the treatment of depression?
It was first used as an anaesthetic
Ketamine is a dissociative anaesthetic used in surgery and to relieve pain.
At certain doses, people are awake but are disconnected from their bodies. This makes it useful for paramedics, for example, who can continue to talk to injured patients while the drug blocks pain but without affecting the person’s breathing or blood flow.
Ketamine is also used to sedate animals in veterinary practice.
Ketamine is a mixture of two molecules, usually referred to a S-Ketamine and R-Ketamine.
S-Ketamine, or esketamine, is stronger than R-Ketamine and was approved in 2019 in the United States under the drug name Spravato for serious and long-term depression that has not responded to at least two other types of treatments.
Ketamine is thought to change chemicals in the brain that affect mood.
While the exact way ketamine works on the brain is not known, scientists think it changes the amount of the neurotransmitter glutamate and therefore changes symptoms of depression.How was it developed?
Ketamine was first synthesised by chemists at the Parke Davis pharmaceutical company in Michigan in the United States as an anaesthetic. It was tested on a group of prisoners at Jackson Prison in Michigan in 1964 and found to be fast acting with few side effects.
The US Food and Drug Administration approved ketamine as a general anaesthetic in 1970. It is now on the World Health Organization’s core list of essential medicines for health systems worldwide as an anaesthetic drug.
In 1994, following patient reports of improved depression symptoms after surgery where ketamine was used as the anaesthetic, researchers began studying the effects of low doses of ketamine on depression.
Researchers have been investigating ketamine for depression for 30 years.
SB Arts Media/ShutterstockThe first clinical trial results were published in 2000. In the trial, seven people were given either intravenous ketamine or a salt solution over two days. Like the earlier case studies, ketamine was found to reduce symptoms of depression quickly, often within hours and the effects lasted up to seven days.
Over the past 20 years, researchers have studied the effects of ketamine on treatment resistant depression, bipolar disorder, post-traumatic sress disorder obsessive-compulsive disorder, eating disorders and for reducing substance use, with generally positive results.
One study in a community clinic providing ketamine intravenous therapy for depression and anxiety found the majority of patients reported improved depression symptoms eight weeks after starting regular treatment.
While this might sound like a lot of research, it’s not. A recent review of randomised controlled trials conducted up to April 2023 looking at the effects of ketamine for treating depression found only 49 studies involving a total of 3,299 patients worldwide. In comparison, in 2021 alone, there were 1,489 studies being conducted on cancer drugs.
Is ketamine prescribed in Australia?
Even though the research results on ketamine’s effectiveness are encouraging, scientists still don’t really know how it works. That’s why it’s not readily available from GPs in Australia as a standard depression treatment. Instead, ketamine is mostly used in specialised clinics and research centres.
However, the clinical use of ketamine is increasing. Spravato nasal spray was approved by the Australian Therapuetic Goods Administration (TGA) in 2021. It must be administered under the direct supervision of a health-care professional, usually a psychiatrist.
Spravato dosage and frequency varies for each person. People usually start with three to six doses over several weeks to see how it works, moving to fortnightly treatment as a maintenance dose. The nasal spray costs between A$600 and $900 per dose, which will significantly limit many people’s access to the drug.
Ketamine can be prescribed “off-label” by GPs in Australia who can prescribe schedule 8 drugs. This means it is up to the GP to assess the person and their medication needs. But experts in the drug recommend caution because of the lack of research into negative side-effects and longer-term effects.
What about its illicit use?
Concern about use and misuse of ketamine is heightened by highly publicised deaths connected to the drug.
Ketamine has been used as a recreational drug since the 1970s. People report it makes them feel euphoric, trance-like, floating and dreamy. However, the amounts used recreationally are typically higher than those used to treat depression.
Information about deaths due to ketamine is limited. Those that are reported are due to accidents or ketamine combined with other drugs. No deaths have been reported in treatment settings.
Reducing stigma
Depression is the third leading cause of disability worldwide and effective treatments are needed.
Seeking medical advice about treatment for depression is wiser than taking Musk’s advice on which drugs to use.
However, Musk’s public discussion of his mental health challenges and experiences of treatment has the potential to reduce stigma around depression and help-seeking for mental health conditions.
Clarification: this article previously referred to a systematic review looking at oral ketamine to treat depression. The article has been updated to instead cite a review that encompasses other routes of administration as well, such as intravenous and intranasal ketamine.
Julaine Allan, Associate Professor, Mental Health and Addiction, Rural Health Research Institute, Charles Sturt University
This article is republished from The Conversation under a Creative Commons license. Read the original article.
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Healing The Modern Brain – by Dr. Drew Ramsey
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We previously reviewed Dr. Ramsey’s Eat To Beat Depression & Anxiety, and this time [it briefly covers that ground again, and then] it’s more about comprehensive brain health and mental fitness.
He tackles this in a methodical fashion, first briefly covering the need for mental fitness, and the obstacles to same, before the main part of the book—which covers the “how”.
The “how” in question is multifaceted, and the “nine tenets” mentioned in the subtitle cover very obvious things like diet, exercise, sleep, etc, as well as less obvious yet very important things like connection, engagement, purpose, and so forth, and some things that don’t get talked about much at all elsewhere, such as the processes of grounding and unburdening, as he describes them.
The style is mostly narrative with many anecdotes to illustrate points, but with practical advice woven throughout also, all very readable. There’s a respectable bibliography at the back.
Bottom line: if you’d like your brain health to get gradually better instead of gradually worse, this book can help set you on the right track.
Click here to check out Healing The Modern Brain, and heal your modern brain!
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Glucose Revolution – by Jessie Inchauspé
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While we all know that keeping balanced blood sugars is important for all us (be we diabetic, pre-diabetic, or not at all), it can be a mystifying topic!
Beyond a generic “sugar is bad”…
- What does it all mean and how does it all work?
- Should we go low-carb?
- What’s the deal with fruit?
- Carbs or protein for breakfast?
- Is “quick energy” ever a good thing?
- How do starches weigh in again?
It’s all so confusing!
Happily, Jessie Inchauspé has the incredible trifecta of qualifications to help us: she’s a biochemist, a keen cook, and a great educator. What we mean by this latter is:
Instead of dry textbook explanations, or “trust me” hand-waives, she explains biochemistry in a clear, simple, digestible (if you’ll pardon the pun) way with very helpful diagrams what things cause (or flatten) blood sugar spikes and how and why. If you read this book, you will understand, without guesswork or gaps, exactly what is happening on a physical level, and why and how her “10 hacks” work.
Her “10 hacks” are explained so thoroughly that each gets a chapter of its own, but we’ll not keep them a mystery from you meanwhile, they are:
- Eat foods in the right order
- Add a green starter to your meals
- Stop counting calories
- Flatten your breakfast curve
- Have any type of sugar you like—they’re all the same
- Pick dessert over a sweet snack
- Reach for the vinegar before you eat
- After you eat, move
- If you have to snack, go savoury
- Put some clothes on your carbs
She then finishes up with a collection of handy cheat-sheets and some of her own recipes.
Bottom line: this isn’t just a “how-to” book. It gives the how-to, yes, but it also gives such good explanations that you’ll never be confused again by what’s going on in your glucose-related health.
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How (And Why) To Train Your Pre-Frontal Cortex
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Dr. Chapman’s Keys For Mental Focus
This is Dr. Sandra Chapman; she’s a cognitive neuroscientist, on a mission to, in her words, further our understanding of:
- what makes the brain stronger, faster and last longer
- what enhances human cognitive capacity, and
- what enhances the underlying brain systems across the lifespan.
To this end, she’s also the founder and Chief Director of the Center For Brain Health, where she has worked on her mission for the past 25 years (clocking up hundreds of peer-reviewed publications to her name), as well as being a professor of Behavioral and Brain Sciences at UT Dallas.
What does she want us to know?
Get your brain into gear
When it comes to your brainpower, it is “use it or lose it”, but it is also perfectly possible to use it and lose it.
Why?
Very often, what we are using our brains for is high-strain, low-yield stuff, such as multitasking, overthinking, or overthinking while multitasking. And to make it worse, we often do it without sufficient rest.
This is the equivalent of owning a Ferrari but trying to drive it in second and third gear at once by switching between the two as rapidly as possible. And doing that for 18 hours each day.
Suffice it to say, you’ll be going nowhere quickly.
An alternative “use” of brainpower is low-strain, low-yield stuff, such as having to pay close attention to a boring conversation. It’s enough to stop your mind from doing anything else, but not enough to actually stimulate you.
This is the equivalent of owning a Ferrari but keeping it idling. The wear and tear is minimal this time, but you’re not actually going anywhere either.
Better, of course, are the other two quadrants:
- low-strain, high-yield: consistently using our brain in relatively non-taxing ways that encourage its development
- high-strain, high-yield: here the Ferrari metaphor definitely fails, because unlike cars, our bodies (including our brains) are machines that benefit from judicious regular progressive overloading (but just by a bit, and with adequate recovery time between overloads).
See also: 12 Weeks To Measurably Boost Your Brain
How to do the “low-strain, low-yield” part
When it comes to “what’s the most important part of the brain to help in the face of cognitive decline?” the usual answer is either to focus on memory (hippocampi) or language (various parts, but for example Wernicke’s area and Broca’s area), since people most fear losing memory, and language is very important both socially and practically.
Those are indeed critical, and we at 10almonds stand by them, but Dr. Chapman (herself having originally trained as speech and language pathologist!) makes a strong case for adding a third brain part to the list.
Specifically, she advocates for strengthening the pre-frontal cortex, which is responsible for inhibition, task-switching, working memory, and cognitive flexibility. If that seems like a lot, do remember it’s a whole cortex and not one of the assorted important-but-small brain bits we mentioned above.
How? She has developed training programs for this, based on what she calls Strategic Memory Advanced Reasoning Tactics (SMART), to support support attention, planning, judgment and emotional management.
You can read more about those programs here:
Center For Brain Health | Our Programs
Participation in those is mostly not free, however, if you join their…
Center For Brain Health | BrainHealth Project
…then they will periodically invite you to join pilot programs, research programs, and the like, which will either be free or they-pay-you affairs—because this is how science is done, and you can read about yourself (anonymized, of course) later in peer-reviewed papers of the kind we often cite here.
If you’re not interested in any of that though, we will say that according to Dr. Chapman, the keys are:
Inhibition: be conscious of this function of your brain, and develop it. This is the function of your brain that stops you from making mistakes—or put differently: stops you from saying/doing something stupid.
Switching: do this consciously; per “I am now doing this task, now I am switching to this other task”, rather than doing the gear-grinding thing we discussed earlier
Working memory: this is effectively your brain’s RAM. Unlike the RAM of a computer (can be enhanced by adding another chip or replacing with a bigger chip), our brain’s RAM can be increased by frequent use, and especially by judicious use of progressive overloading (with rests between!) which we’ll discuss in the high-strain, high-yield section.
Flexibility: this is about creative problem-solving, openness to new ideas, and curiosity
See also: Curiosity Kills The Neurodegeneration
How to do the “high-strain, high-yield” part
Delighting this chess-playing writer, Dr. Chapman recommends chess. Although, similar games such as go (a Chinese game that looks simpler than chess but actually requires more calculation) work equally well too.
Why?
Games like chess and go cause structural changes that are particularly helpful, in terms of engaging in such foundational tasks as learning, abstract reasoning, problem-solving and self-control:
Chess Practice as a Protective Factor in Dementia
Basically, it checks (so to speak) a lot of boxes, especially for the pre-frontal cortex. Some notes:
- Focusing on the game is required for brain improvement; simply pushing wood casually will not do it. Ideally, calculating several moves ahead will allow for strong working memory use (because to calculate several moves ahead, one will have to hold increasingly many possible positions in the mind while doing so).
- The speed of play must be sufficiently slow as to allow not only for thinking, but also for what in chess is called “blunder-checking”, in other words, having decided on one’s move, pausing to consider whether it is a mistake, and actively trying to find evidence that it is. This is the crucial “inhibition habit”, and when one does it reflexively, one will make fewer mistakes. Tying this to dementia, see for example how one of the common symptoms of dementia is falling for scams that one wouldn’t have previously. How did cognitive decline make someone naïve? It didn’t, per se; it just took away their ability to, having decided what to do, pause to consider whether it was a mistake, and actively trying to find evidence that it is.
- That “conscious switching” that we talked about, rather than multitasking? In chess, there is a difference between strategy and tactics. Don’t worry about what that difference is for now (learn it if you want to take up chess), but know that strong players will only strategize while it is their opponent’s turn, and only calculate (tactics) while it is their own turn. It’s very tempting to flit constantly between one and the other, but chess requires players to have the mental discipline be able to focus on one task or the other and stick with that task until it’s the appointed time to switch.
If you feel like taking up chess, this site (and related app, if you want it) is free (it’s been funded by voluntary donations for a long time now) and good and even comes with free tuition and training tools: LiChess.org
Here’s another site that this writer (hi, it’s me) personally uses—it has great features too, but many are paywalled (I’m mostly there just because I’ve been there nearly since its inception, so I’m baked into the community now): Chess.com
Want to know more?
You might like this book by Dr. Chapman, which we haven’t reviewed yet but it did inform large parts of today’s article:
Make Your Brain Smarter: Increase Your Brain’s Creativity, Energy, and Focus – by Dr. Sandra Chapman
Enjoy!
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How Olives Can Help Protect Your Brain
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Olives boast a special molecule that’s neuroprotective in several ways, as well as being structurally identical to dopamine metabolite:
Introducing hydroxytyrosol
Things that start with “hydroxy-” and/or end in “-ol” are often not astonishingly healthy, but this one is!
It’s approved as safe by the FDA, EFSA, and the AESAN at typical dietary levels of up to about 51 mg per day.
Hydroxytyrosol (HXT) is a phenolic compound (polyphenol, specifically a simple phenolic alcohol belonging to the family of secoiridoid-derived polyphenols found in olives and olive oil. It’s one of the key antioxidant compounds responsible for many of the health benefits associated with extra virgin olive oil.
As for its established benefits: it’s antioxidant, anti-inflammatory, anti-cancer, anti-diabetic, antimicrobial, cardio-protective, neuroprotective, cognition-enhancing, and immune-modulatory.
Most recently, a research team from Spain (Dr. Lorena Martínez-Zamora et al.), investigated specifically its neurovascular and neuroimmune effects, in other words, how it relates to the health of the brain’s blood vessels, and the brain’s clean-up crew.
What they found:
❝HXT protects endothelial and neural cells by lowering oxidative stress, maintaining nitric oxide availability, stabilizing the blood-brain barrier, and improving neural connectivity. A key pathway is Keap1-Nrf2-ARE activation, which boosts mitochondrial antioxidant defences and limits oxidative DNA and protein damage. HXT also dampens brain inflammation by reducing microglial cytokine release and suppressing NF-κB/MAPK and NLRP3 inflammasome signalling—mechanisms implicated in Parkinson’s disease.❞
Translating from sciencese:
The cited human trials link HXT or HXT-rich olive oils to better vascular function, reduced inflammation, and improved cerebral blood flow. That’s correlation, though. In terms of causality, what’s been established is that daily intakes around 7–15 mg improve endothelial cell health, while single doses of 30–60 mg improve protection against free radicals.
Furthermore, HXT-rich olive extracts have been shown to improve memory, psychomotor speed, and attention–memory coupling in older adults, and supported mitochondrial health.
And where it mentioned Parkinson’s disease, that bit is because HXT is structurally identical to the dopamine metabolite DOPET, and thus helps regulate healthy dopamine levels.
You can read about this in full, here: Novel Ingredients: Hydroxytyrosol as a Neuroprotective Agent; What Is New on the Horizon?
Protection against stroke?
This is the part that’s not yet proven, but looks very promising.
Hydroxytyrosol might help protect against stroke, due to how it protects the brain’s blood vessels, most notably:
- Boosting the body’s natural antioxidant defences through the aforementioned Nrf2 pathway, helping arteries stay flexible and resilient under stress
- Keeping blood vessels healthy by preserving nitric oxide, which is vital for supporting healthy blood flow, and prevents the buildup of damaging plaque
- Dialing down overactive immune responses in blood vessel walls, reducing the slow-burning inflammation that often leads to stroke
In fewer words: hydroxytyrosol acts like a molecular shield—keeping the brain’s circulation strong, stable, and better protected against both blockages and bleeds.
For how all this ties together, see also the closely related: What’s Your Vascular Dementia Risk? ← includes actual numbers and a risk calculator tool and things like that
Want to learn more?
Check out:
- Black Olives vs Green Olives – Which is Healthier?
- All About Olive Oil (And: Is “Extra Virgin” Worth It?)
- Olive oil is healthy. Turns out olive leaf extract may be good for us too
Enjoy!
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Edamame vs Brussels Sprouts – Which is Healthier?
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Our Verdict
When comparing edamame to Brussels sprouts, we picked the edamame.
Why?
We were curious to see if something could unseat Brussels sprouts from the vegetable throne!
In terms of macros, edamame have more than 3x the protein and and nearly 50% more fiber, for the same amount of carbs. An easy win for edamame.
In the category of vitamins, edamame have more of vitamins B1, B2, B3, B5, B9, and choline, while Brussels sprouts have more of vitamins A, B6, C, E, and K, meaning a marginal 6:5 win for edamame this time.
When it comes to minerals, things are quite one-sided: edamame have more calcium, copper, iron, magnesium, manganese, phosphorus, potassium, and zinc, while Brussels sprouts have more selenium. Another easy win for edamame!
Adding up the sections makes it clear that edamame win the day, but of course, by all means, enjoy either or both; diversity is good!
Want to learn more?
You might like to read:
What Do The Different Kinds Of Fiber Do? 30 Foods That Rank Highest
Enjoy!
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