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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Dodging Dengue In The US
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Dengue On The Rise
We wrote recently about dengue outbreaks in the Americas, with Puerto Rico declaring an epidemic. Cases are now being reported in Florida too, and are likely to spread, so it’s good to be prepared, if your climate is of the “warm and humid” kind.
If you want to catch up on the news first, here you go:
- UN health agency cites tenfold increase in reported cases of dengue over the last generation
- Puerto Rico has declared an epidemic following a spike in dengue cases
- Dengue fever confirmed in Florida Keys as US on watch for rise in mosquito illness
Note: dengue is far from unheard of in Florida, but the rising average temperatures in each year mean that each year stands a good chance of seeing more cases than the previous. It’s been climbing since at least 2017, took a dip during the time of COVID restrictions keeping people at home more, and then for the more recent years has been climbing again since.
What actually is it?
Dengue is a viral, mosquito-borne disease, characterized by fever, vomiting, muscle pain, and a rash, in about 1 in 4 cases.
Which can sound like “you’ll know if you have it”, but in fact it’s usually asymptomatic for a week or more after infection, so, watch out!
What next, if those symptoms appear?
The good news is: the fever will usually last less than a week
The bad news is: a day or so after that the fever subsided, the more serious symptoms are likely to start—if they’re going to.
If you’re unlucky enough to be one of the 1 in 20 who get the serious symptoms, then you can expect abdominal cramps, repeat vomiting, bleeding from various orifices (you may not get them all, but all are possible), and (hardly surprising, given the previous items) “extreme fatigue and restlessness”.
If you get those symptoms, then definitely get to an ER as soon as possible, as dengue can become life-threatening within hours of such.
Read more: CDC | Symptoms of Dengue and Testing
While there is not a treatment for dengue per se, the Emergency Room will be better able to manage your symptoms and thus keep you alive long enough for them to pass.
If you’d like much more detail (on symptoms, seriousness, at-risk demographics, and prognosis) than what the CDC offers, then…
Read more: BMJ | Dengue Fever
Ok, so how do we dodge the dengue?
It sounds flippant to say “don’t get bitten”, but that’s it. However, there are tips are not getting bitten:
- Use mosquito-repellent, but it has to contain >20% DEET, so check labels
- Use mosquito nets where possible (doors, windows, etc, and the classic bed-tent net is not a bad idea either)
- Wear clothing that covers your skin, especially during the day—it can be light clothing; it doesn’t need to be a HazMat suit! But it does need to reduce the area of attack to reduce the risk of bites.
- Limit standing water around your home—anything that can hold even a small amount of standing water is a potential mosquito-breeding ground. Yes, even if it’s a crack in your driveway or a potted bromeliad.
Further reading
You might also like to check out:
Stickers and wristbands aren’t a reliable way to prevent mosquito bites. Here’s why
…and in case dengue wasn’t bad enough:
Mosquitoes can spread the flesh-eating Buruli ulcer. Here’s how you can protect yourself
Take care!
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Hot And Sour Shiitake Soup
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This is a popular, easy, and delicious soup that nonetheless is not found in many western kitchens, despite being enjoyed in restaurants/take-out. Best of all, making it at home means that you know all the ingredients, can account for quality, and also can customize it per your preferences (i.e. how much heat/sourness you like).
You will need
- 3 cups shiitake mushrooms, sliced
- 3 cups bok choy, chopped
- 2 cups cherry tomatoes, quartered
- 1 cup carrot, grated
- 3 spring onions, chopped
- 2 shallots, sliced lengthways
- 2 serrano chilis (or similar), sliced thinly
- 2 tbsp apple cider vinegar
- 1 tbsp lemon juice
- 1 tbsp fresh ginger, sliced into 1″ strips
- 1 tsp black pepper, coarse ground
- ½ bulb garlic, crushed
- 6 cups low-sodium vegetable stock. Ideally you will have made it yourself from vegetable cuttings that you saved in the freezer until you had enough to make stock from, but if that’s not an option, then low-sodium vegetable stock cubes can be purchased and used.
- Garnish: ¼ cup (or 4 tbsp) cilantro, chopped, or if you have the soap gene, then this time we recommend chopped basil as the subsitution
Method
(we suggest you read everything at least once before doing anything)
1) Put the ginger in a big pot with the stock; cover and simmer for about 20 minutes (otherwise the ginger flavor will remain mostly concentrated in the ginger strips).
2) Bring it to a boil and add the bok choy, mushrooms, shallots, chili peppers, and the carrot; simmer for another 5 minutes
3) Add the remaining ingredients except for the garnish, and simmer for another 5 minutes
4) Serve, adding the garnish
Enjoy!
Want to learn more?
For those interested in some of the science of what we have going on today:
- The (Longevity) Magic of Mushrooms
- Our Top 5 Spices: How Much Is Enough For Benefits?
- An Apple (Cider Vinegar) A Day…
- Enjoy Bitter/Hot/Sour/Pungent Foods For Your Heart & Brain
- Brain Food? The Eyes Have It!
- Some Surprising Truths About Hunger And Satiety
Take care!
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The Big Book of Kombucha – by Hannah Crum & Alex LaGory
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If you’ve been thinking “I should get into kombucha”, then this is the universe prompting you, because with in this book’s 400 pages is all the information you need and more.
Because, it’s understandable to be wary when starting out, from “what if my jar explodes” to “what if I poison my family”, but the authors (and photographer) take every care to ensure that everything goes perfectly, guiding us through everything from start to finish, including very many high-quality color photos of what things should (and shouldn’t) look like.
On which note, that does mean that to enjoy the color you should get a physical copy or Kindle Fire, not a Kindle e-ink version (as then it’d be black and white).
There’s also a comprehensive section on troubleshooting, as well as hundreds of recipes for all kinds of flavors and occasions.
Bottom line: in the category of books that could reasonably be called “The Bible of…”, this one’s the “The Bible of Kombucha”.
Click here to check out The Big Book Of Kombucha, and get brewing!
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How we can prepare for future public health emergencies
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The U.S. is experiencing an increasing number of disease outbreaks and extreme weather events. While state and national preparedness for public health emergencies has improved in some areas, dangerous gaps remain, says a recent report from Trust for America’s Health.
Titled, “Ready or Not 2024: Protecting the Public’s Health from Diseases, Disasters, and Bioterrorism,” the report identifies gaps in national and state preparedness for public health emergencies and provides recommendations for improvement.
Using nine key indicators, the report categorizes all U.S. states and the District of Columbia into three readiness levels: high, medium, and low. The writers hope the report will help policymakers in under-performing states improve public health infrastructure.
Read on to learn more about what the research found and how we can individually prepare for future public health emergencies.
There’s work to be done
The report highlights areas with strong performance as well as those that need improvement.
Some areas with strong performance:
- State public health funding: Most states and the District of Columbia either maintained or increased their public health funding during the 2023 fiscal year.
- Health care labor force preparedness: Most states have started expanding the health care labor force for improved emergency response. As of 2023, 39 states participated in the Nurse Licensure Compact, which allows nurses to work in multiple member states without the need for additional state licenses.
Some areas that need improvement:
- Hospital safety scores: Only 25 percent of acute care hospitals earned the highest patient safety grade in fall 2023. These scores measure health care-associated infection rates, intensive care unit capacity, and other metrics. More high-scoring hospitals would improve preparedness for future public health emergencies.
- Access to paid time off: From March 2018 to March 2023, only 55 percent of U.S. workers used paid time off. Access to paid time off is important for reducing the spread of infectious diseases.
We can all do our part by staying up to date on vaccines
While the report focuses on policy changes that would improve emergency preparedness, Trust for America’s Health’s research identifies one way that we can individually prepare for future public health emergencies: staying up to date on vaccines.
The report found that during the 2022-2023 flu season, only 49 percent of those eligible for the flu vaccine received it. Public health experts are concerned that false claims about COVID-19 vaccines have resulted in overall vaccine hesitancy.
A decline in vaccination rates has led to an uptick in life-threatening, vaccine-preventable diseases, such as measles. Increasing vaccine uptake would prevent the spread of vaccine-preventable diseases and reduce strain on hospital systems during public health crises.
Make sure that you and your children have received all recommended vaccines to prevent severe illness, hospitalization, and death. Learn more about recommended vaccines for adults and children from the CDC.
For more information, talk to your health care provider.
This article first appeared on Public Good News and is republished here under a Creative Commons license.
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The Fast-Mimicking Diet
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Live, Fast, Live Long
This is Dr. Valter Longo. He’s a biogerontologist and cell biologist, whose work has focused on fasting and nutrient response genes, and how we can leverage them against diseases and aging in general.
We reviewed his book recently:
What does he want us to know?
What to eat
Dr. Longo recommends a mostly plant-based diet (especially vegetables, whole grains, and legumes), but also having some fish. The bulk of our dietary fats, however, he says are best coming from olive oil and nuts.
He also advises aiming for nutritional density of vitamins and minerals in our diet, and/but supplementing with a multivitamin once every few days to cover any gaps.
If in doubt choosing between plant-based whole foods, he recommends that we choose those our ancestors will have eaten.
Read more: Longevity Diet For Adults
When to eat
Dr. Longo recommends time-restricted eating within a 12-hour window per day.
See also: Intermittent Fasting: We Sort The Science From The Hype
However, he also recommends (additionally or separately; it’s up to us; additionally is better but the point is it still has excellent benefits separately too) his “fast-mimicking diet” (FMD), which involves eating according to what we said in “What to eat”, but restricting it to 750 kcal per day, 5 days in a row, but not necessarily 5 days per week.
For example, the following was a 3-month study that involved doing this for only one 5-day cycle per month:
❝Three FMD cycles reduced body weight, trunk, and total body fat; lowered blood pressure; and decreased insulin-like growth factor 1 (IGF-1). No serious adverse effects were reported.
A post hoc analysis of subjects from both FMD arms showed that body mass index, blood pressure, fasting glucose, IGF-1, triglycerides, total and low-density lipoprotein cholesterol, and C-reactive protein were more beneficially affected in participants at risk for disease than in subjects who were not at risk.
Thus, cycles of a 5-day FMD are safe, feasible, and effective in reducing markers/risk factors for aging and age-related diseases.❞
~ Dr. Min Wei et al. ← Dr. Longo was
Note: the introduction mentions FMD in mice, but this is just referencing previous studies. This study is about FMD in humans!
Read in full: Fasting-mimicking diet and markers/risk factors for aging, diabetes, cancer, and cardiovascular disease
Want to know more?
You might like this (text-based) interview with Dr. Longo, with the Health Sciences Academy:
Eat, fast and live longer? Interview with Professor Valter Longo
Take care!
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7 Invisible Eating Disorders
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It’s easy to assume that anyone with an eating disorder can be easily recognized by the resultantly atypical body composition, but it’s often not so.
Beyond the obvious
We’ll not keep them a mystery; the 7 invisible eating disorders discussed by therapist Kati Morton in this video are:
- OSFED (Other Specified Feeding or Eating Disorder): a catch-all diagnosis for those who don’t meet the criteria for more specific eating disorders but still have significant eating disorder behaviors.
- Atypical Anorexia: characterized by all the symptoms of anorexia nervosa (especially: intense fear of gaining weight, and body image distortion) except that the individual’s weight remains in a normal range.
- Atypical Bulimia: similar to bulimia nervosa, but the frequency or duration of binge-purge behaviors does not meet the usual diagnostic criteria and thus can fly under the radar.
- Atypical Binge-Eating Disorder: has episodes of consuming large amounts of food without compensatory behaviors (e.g. purging), but the episodes are less frequent and/or intense than typical binge-eating disorder.
- Purging Disorder: purging behaviors such as self-induced vomiting or laxative abuse without having binge-eating episodes (thus, this not being binging, and nothing obvious is happening outside of the bathroom).
- Night Eating Syndrome: consuming excessive amounts of food during the night while being fully aware of the nature of the eating episodes, which disrupts sleep and leads to guilt.
- Rumination Disorder: repeatedly regurgitating food, which may be rechewed, reswallowed, or spat out, without nausea or involuntary retching, often as a self-soothing mechanism.
For more on each of these, along with a case study-style example of each, enjoy:
Click Here If The Embedded Video Doesn’t Load Automatically!
Want to learn more?
You might also like to read:
Eating Disorders: More Varied (And Prevalent) Than People Think
Take care!
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