Could Just Two Hours Sleep Per Day Be Enough?

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Polyphasic Sleep… Super-Schedule Or An Idea Best Put To Rest?

What is it?

Let’s start by defining some terms:

  • Monophasic sleep—sleeping in one “chunk” per day. For example, a good night’s “normal” sleep.
  • Biphasic sleep—sleeping in two “chunks” per day. Typically, a shorter night’s sleep, with a nap usually around the middle of the day / early afternoon.
  • Polyphasic sleep—sleeping in two or more “chunks per day”. Some people do this in order to have more hours awake per day, to do things. The idea is that sleeping this way is more efficient, and one can get enough rest in less time. The most popular schedules used are:
    • The Überman schedule—six evenly-spaced 20-minute naps, one every four hours, throughout the 24-hour day. The name is a semi-anglicized version of the German word Übermensch, “Superman”.
    • The Everyman schedule—a less extreme schedule, that has a three-hours “long sleep” during the night, and three evenly-spaced 20-minute naps during the day, for a total of 4 hours sleep.

There are other schedules, but we’ll focus on the most popular ones here.

Want to learn about the others? Visit: Polyphasic.Net (a website by and for polyphasic sleep enthusiasts)

Some people have pointed to evidence that suggests humans are naturally polyphasic sleepers, and that it is only modern lifestyles that have forced us to be (mostly) monophasic.

There is at least some evidence to suggest that when environmental light/dark conditions are changed (because of extreme seasonal variation at the poles, or, as in this case, because of artificial changes as part of a sleep science experiment), we adjust our sleeping patterns accordingly.

The counterpoint, of course, is that perhaps when at the mercy of long days/nights at the poles, or no air-conditioning to deal with the heat of the day in the tropics, that perhaps we were forced to be polyphasic, and now, with modern technology and greater control, we are free to be monophasic.

Either way, there are plenty of people who take up the practice of polyphasic sleep.

Ok, But… Why?

The main motivation for trying polyphasic sleep is simply to have more hours in the day! It’s exciting, the prospect of having 22 hours per day to be so productive and still have time over for leisure.

A secondary motivation for trying polyphasic sleep is that when the brain is sleep-deprived, it will prioritize REM sleep. Here’s where the Überman schedule becomes perhaps most interesting:

The six evenly-spaced naps of the Überman schedule are each 20 minutes long. This corresponds to the approximate length of a normal REM cycle.

Consequently, when your head hits the pillow, you’ll immediately begin dreaming, and at the end of your dream, the alarm will go off.

Waking up at the end of a dream, when one hasn’t yet entered a non-REM phase of sleep, will make you more likely to remember it. Similarly, going straight into REM sleep will make you more likely to be aware of it, thus, lucid dreaming.

Read: Sleep fragmentation and lucid dreaming (actually a very interesting and informative lucid dreaming study even if you don’t want to take up polyphasic sleep)

Six 20-minute lucid-dreaming sessions per day?! While awake for the other 22 hours?! That’s… 24 hours per day of wakefulness to use as you please! What sorcery is this?

Hence, it has quite an understandable appeal.

Next Question: Does it work?

Can we get by without the other (non-REM) kinds of sleep?

According to Überman cycle enthusiasts: Yes! The body and brain will adapt.

According to sleep scientists: No! The non-REM slow-wave phases of sleep are essential

Read: Adverse impact of polyphasic sleep patterns in humans—Report of the National Sleep Foundation sleep timing and variability consensus panel

(if you want to know just how bad it is… the top-listed “similar article” is entitled “Suicidal Ideation”)

But what about, for example, the Everman schedule? Three hours at night is enough for some non-REM sleep, right?

It is, and so it’s not as quickly deleterious to the health as the Überman schedule. But, unless you are blessed with rare genes that allow you to operate comfortably on 4 hours per day (you’ll know already if that describes you, without having to run any experiment), it’s still bad.

Adults typically need 7–9 hours of sleep per night, and if you don’t get it, you’ll accumulate a sleep debt. And, importantly:

When you accumulate sleep debt, you are borrowing time at a very high rate of interest!

And, at risk of laboring the metaphor, but this is important too:

Not only will you have to pay it back soon (with interest), you will be hounded by the debt collection agents—decreased cognitive ability and decreased physical ability—until you pay up.

In summary:

  • Polyphasic sleep is really very tempting
  • It will give you more hours per day (for a while)
  • It will give the promised lucid dreaming benefits (which is great until you start micronapping between naps, this is effectively a mini psychotic break from reality lasting split seconds each—can be deadly if behind the wheel of a car, for instance!)
  • It is unequivocally bad for the health and we do not recommend it

Bottom line:

Some of the claimed benefits are real, but are incredibly short-term, unsustainable, and come at a cost that’s far too high. We get why it’s tempting, but ultimately, it’s self-sabotage.

(Sadly! We really wanted it to work, too…)

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  • Dr. Dean Ornish’s Program For Reversing Heart Disease – by Dr. Dean Ornish

    10almonds is reader-supported. We may, at no cost to you, receive a portion of sales if you purchase a product through a link in this article.

    We’ve previously reviewed Dr. Ornish’s “Undo It!” which is about reversing many kinds of chronic diseases (not all, alas, but quite a few) by undercutting their common etiologies, such as inflammation, insulin resistance, and so forth.

    This book is entirely consistent with that one, but the focus here is (as the title says) specifically on reversing heart disease.

    Of course, it does not require you to already have heart disease—if you do, well, getting onto this is better sooner than later. If you don’t, and are “merely” in a risk zone, or even just want to be proactive about your heart health, then this book will stand you in good stead.

    The book covers all the lifestyle things you’d expect it to (especially diet, but also exercise, and not just “quit smoking” but also how, things like that), and possibly some things you might not expect (chapters on more psychological factors that have a big impact on heart health).

    There are recipes (157 pages of them; they are plant-based and good) and there is a 21-day meal plan to get you going.

    The style is a little dated (written in the 90s), but the content doesn’t suffer for it, having been updated over the years in any case.

    Bottom line: if you want a holistic approach to taking care of your heart that’s not extreme and/but is very effective, then well, you’ve found it.

    Click here to check out Dr. Dean Ornish’s Program For Reversing Heart Disease, and reverse heart disease!

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  • Mung Beans vs Black Beans – Which is Healthier?

    10almonds is reader-supported. We may, at no cost to you, receive a portion of sales if you purchase a product through a link in this article.

    Our Verdict

    When comparing mung beans to black beans, we picked the black beans.

    Why?

    Both are great! But…

    In terms of macros, black beans have more protein, carbs, and fiber, as well as the lower glycemic index (although both are already low). So, a clear win for black beans here.

    In the category of vitamins, mung beans have more of vitamins A, B5, B9, and C, while black beans have more of vitamins B1, B6, E, K, and choline. Thus, a slight win for black beans this time.

    When it comes to minerals, mung beans have more selenium and zinc, while black beans have more calcium, copper, iron, magnesium, manganese, phosphorus, and potassium. An easy win for black beans.

    Of course, enjoy either or both—but if you’re going to pick one, we say black beans win the day.

    Want to learn more?

    You might like to read:

    Plant vs Animal Protein: Head-to-Head

    Take care!

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  • Intermittent Fasting, Intermittently?

    10almonds is reader-supported. We may, at no cost to you, receive a portion of sales if you purchase a product through a link in this article.

    It’s Q&A Day at 10almonds!

    Have a question or a request? We love to hear from you!

    In cases where we’ve already covered something, we might link to what we wrote before, but will always be happy to revisit any of our topics again in the future too—there’s always more to say!

    As ever: if the question/request can be answered briefly, we’ll do it here in our Q&A Thursday edition. If not, we’ll make a main feature of it shortly afterwards!

    So, no question/request too big or small 😎

    ❝Have you come across any research on alternate-day intermittent fasting—specifically switching between one day of 16:8 fasting and the next day of regular eating patterns? I’m curious if there are any benefits or drawbacks to this alternating approach, or if the benefits mainly come from consistent intermittent fasting?❞

    Short and unhelpful answer: no

    Longer and hopefully more helpful answer:

    As you probably know, usually people going for approaches based on the above terms either

    • practise 16:8 fasting (fast for 16 hours each day, eat during an 8-hour window) or
    • practise alternate-day fasting (fast for 24 hours, eat whenever for 24 hours, repeat)

    …which latter scored the best results in this large meta-analysis of studies:

    Effects of different types of intermittent fasting on metabolic outcomes: an umbrella review and network meta-analysis

    There is also the (popular) less extreme version of alternate-day fasting, sometimes called “eat stop eat”, which is not a very helpful description because that describes almost any kind of eating/fasting, but it usually refers to “once per week, take a day off from eating”.

    You can read more about each of these (and some other variants), here:

    Intermittent Fasting: What’s The Truth?

    What you are describing (doing 16:8 fasting on alternate days, eating whenever on the other days) is essentially: intermittent fasting, just with one 16-hour fast per 48 hours instead of per the usual 24 hours.

    See also: International consensus on fasting terminology ← the section on the terms “STF & PF” covers why this gets nudged back under the regular IF umbrella

    Good news: this means there is a lot of literature into the acute (i.e., occurring the same day, not long-term)* benefits of 16:8 IF, and that means that you will be getting those benefits, every second day.

    You remember that meta-analysis we posted above? While it isn’t mentioned in the conclusion (which only praised complete alternate-day fasting producing the best outcomes overall), sifting through the results data discovers that time-restricted eating (which is what you are doing, by these classifications) was the only fasting method to significantly reduce fasting blood glucose levels.

    (However, no significant differences were observed between any IF form and the reference (continuous energy restriction, CER, i.e. calorie-controlled) diets in fasting insulin and HbA1c levels)

    *This is still good news in the long-term though, because getting those benefits every second day is better than getting those benefits on no days, and this will have a long-term impact on your healthy longevity, just like how it is better to exercise every second day than it is to exercise no days, or better to abstain from alcohol every second day than it is to abstain on no days, etc.

    In short, by doing IF every second day, you are still giving your organs a break sometimes, and that’s good.

    All the same, if it would be convenient and practical for you, we would encourage you to consider either the complete alternate-day fasting (which, according to a lot of data, gives the best results overall),or time-restricted eating (TRE) every day (which, according to a lot of data, gives the best fasting blood sugar levels).

    You could also improve the TRE days by shifting to 20:4 (i.e., 20 hours fasting and 4 hours eating), this giving your organs a longer break on those days.

    Want to learn more?

    For a much more comprehensive discussion of the strengths and weaknesses of different approaches to intermitted fasting, check out:

    Complete Guide To Fasting: Heal Your Body Through Intermittent, Alternate-Day, and Extended Fasting – By Dr. Jason Fung

    Enjoy!

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Related Posts

  • AI: The Doctor That Never Tires?
  • Can You Gain Muscle & Lose Fat At The Same Time?

    10almonds is reader-supported. We may, at no cost to you, receive a portion of sales if you purchase a product through a link in this article.

    It’s Q&A Day at 10almonds!

    Have a question or a request? We love to hear from you!

    In cases where we’ve already covered something, we might link to what we wrote before, but will always be happy to revisit any of our topics again in the future too—there’s always more to say!

    As ever: if the question/request can be answered briefly, we’ll do it here in our Q&A Thursday edition. If not, we’ll make a main feature of it shortly afterwards!

    So, no question/request too big or small 😎

    ❝Is it possible to lose fat and gain muscle at the same time, or do we need to focus on one and then the other, and if so, which order is best?❞

    Contrary to popular belief, you can do both simultaneously! However, it’s not as easy as doing just one or the other, which is why most bodybuilders, for example, have a “building phase” and a “cutting phase”.

    The reason it’s difficult is because of the diet. Growing muscle doesn’t just take protein and micronutrients; it takes energy as well, which must come from carbohydrates and/or fats. Therefore, it is tricky to eat enough to build muscle and to fuel the workouts that are required to build the muscle (you can’t hit the gym in a state of rabbit starvation* and expect to perform well at your workout), while at the same time not eating enough carbs/fats to have any excess to store as fat.

    *So-called because rabbit-meat is very lean, such that when during times of famine, European peasants tried to subsist off mostly rabbits, their health quickly plummeted for lack of energy. It’s also been called “salmon starvation”, apparently, for the same reason:

    How ancestral subsistence strategies solve salmon starvation and the “protein problem” of Pacific Rim resources

    In French it’s called “Mal de caribou” (caribou sickness), by the way. But you get the idea: eat too much lean protein without enough carbs/fats, and woe shall befall.

    So, if you want to do both at once, you need to be incredibly on top of your macros, and the bad news is, only you (or a coach working directly with you) can work out what precise macros requirements your body has, because it depends on your body and your activities.

    The easier “half-way house”

    We will get to the “building phase” and “cutting phase” of bodybuilders, but first, here’s an option that’s very worthy of consideration, and it is: forget about your weight and just focus on health while incidentally doing regular resistance exercises and HIIT.

    What will happen if you do this (assuming a healthy balanced diet, nothing special and without counting anything, but we’re talking at least mostly whole-foods, and at least mostly plants; the Mediterranean diet is great for this, as it is for most things) is:

    • The dietary approach described will gradually improve your metabolic health if it wasn’t already good. If it was already good, it’ll likely just maintain it, rather than improve it.
    • The resistance exercises will, if engaged with seriously (it has to be difficult to do, or your muscles won’t have any reason to grow), gradually build muscle. This will be very gradual, because you’re not eating for bodybuilding, nor optimizing your general lifestyle for same. Historically many women have feared lifting weights because they don’t want to “look like a weightlifter”, but the kinds of bodies that word brings to mind are not the kind that happen by accident (especially for women, with our different hormones guiding our bodies to a different composition); it takes a lot of single-minded dedication to specifically optimize size gains, for a long time.
    • The high-intensity interval training (HIIT) will more rapidly improve your metabolic health, and unlike most forms of exercise, it will actually result in a gradual reduction of fat, if you have superfluous fat to lose. This is because whereas most forms of cardio exercise increase the heartrate for a while but then have a corresponding metabolic slump afterwards to make up for it, HIIT confuses the heart (in a good way) which results in it having to grow stronger, and not doing any compensatory metabolic slump:

    How To Do HIIT (Without Wrecking Your Body) ← as well as the “how to”, this also gives some of the science behind it, too

    This will, thus, result in gradual gain of muscle and loss of fat—or if you take it easier with the exercise, then you can easily settle into just maintaining your body composition as it is, but that wasn’t the question today.

    So, there you have it, that’s how to do both at once! Now, if you want more dramatic results, then more dramatic methods are called for:

    What bodybuilders (mostly) do

    Matters of genetic predisposition and commonplace use of steroids aside, here’s how bodybuilders get that “lots of muscle, no fat” figure:

    1. First, get into “moderate” shape if not already there.
    2. Bulk up: eat amounts of food that will seem unreasonable to a non-bodybuilder; eating 2x or even 3x the “recommended” daily calorie amount is common; focus is typically on getting adequate (for bodybuilding purposes) protein while also carb-loading for workouts and getting at least enough fats for fat-soluble vitamins to work. In the gym, focus on doing sets of very few reps with the heaviest weights one can safely lift, while doing minimal cardio, and also sleeping a lot (9–12hrs per day), which is essential because this is putting a huge strain on the body and it needs a chance to recover and rebuild.
    3. Cut down: maintain protein intake (to at least mostly maintain muscles) while keeping carbs and fats low, doing cardio work (HIIT is still ideal) and running a calorie deficit for a short while (there is no use in trying to maintain a long-term calorie deficit; your body will try to save you from starvation by storing any fat it can and slowing your metabolism).

    Phases 2 and 3 are then cycled, alternating every month, or every 6 weeks, or every 2 months or so, depending on personal preferences and scheduling considerations (bodybuilders will often have competitions they are working towards, so they need to time things to be at the end of a cutting phase to look their “best” by bodybuilder standards).

    Disclaimer: bodybuilding is complex, and can be ruinous to the health if practised inexpertly, because of its extreme nature. We don’t recommend serious bodybuilding per se in general, but if you are going to do it, please consult with a professional bodybuilding coach, and do not rely on a few paragraphs from us that are intended only to give the most basic overview of how bodybuilders can approach the “gain muscle, lose fat” problem.

    Want to know more?

    We’ve written on some related topics previously; here’s a three-part series:

    1. How To Lose Weight (Healthily!)
    2. How To Build Muscle (Healthily!)
    3. How To Gain Weight (Healthily!) ← this one’s specifically about gaining healthy levels of fat, for any who want/need that

    And also:

    Can We Do Fat Redistribution? ← yes we can, but there are caveats

    Take care!

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  • Statistical Models vs. Front-Line Workers: Who Knows Best How to Spend Opioid Settlement Cash?

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    MOBILE, Ala. — In this Gulf Coast city, addiction medicine doctor Stephen Loyd announced at a January event what he called “a game-changer” for state and local governments spending billions of dollars in opioid settlement funds.

    The money, which comes from companies accused of aggressively marketing and distributing prescription painkillers, is meant to tackle the addiction crisis.

    But “how do you know that the money you’re spending is going to get you the result that you need?” asked Loyd, who was once hooked on prescription opioids himself and has become a nationally known figure since Michael Keaton played a character partially based on him in the Hulu series “Dopesick.”

    Loyd provided an answer: Use statistical modeling and artificial intelligence to simulate the opioid crisis, predict which programs will save the most lives, and help local officials decide the best use of settlement dollars.

    Loyd serves as the unpaid co-chair of the Helios Alliance, a group that hosted the event and is seeking $1.5 million to create such a simulation for Alabama.

    The state is set to receive more than $500 million from opioid settlements over nearly two decades. It announced $8.5 million in grants to various community groups in early February.

    Loyd’s audience that gray January morning included big players in Mobile, many of whom have known one another since their school days: the speaker pro tempore of Alabama’s legislature, representatives from the city and the local sheriff’s office, leaders from the nearby Poarch Band of Creek Indians, and dozens of addiction treatment providers and advocates for preventing youth addiction.

    Many of them were excited by the proposal, saying this type of data and statistics-driven approach could reduce personal and political biases and ensure settlement dollars are directed efficiently over the next decade.

    But some advocates and treatment providers say they don’t need a simulation to tell them where the needs are. They see it daily, when they try — and often fail — to get people medications, housing, and other basic services. They worry allocating $1.5 million for Helios prioritizes Big Tech promises for future success while shortchanging the urgent needs of people on the front lines today.

    “Data does not save lives. Numbers on a computer do not save lives,” said Lisa Teggart, who is in recovery and runs two sober living homes in Mobile. “I’m a person in the trenches,” she said after attending the Helios event. “We don’t have a clean-needle program. We don’t have enough treatment. … And it’s like, when is the money going to get to them?”

    The debate over whether to invest in technology or boots on the ground is likely to reverberate widely, as the Helios Alliance is in discussions to build similar models for other states, including West Virginia and Tennessee, where Loyd lives and leads the Opioid Abatement Council.

    New Predictive Promise?

    The Helios Alliance comprises nine nonprofit and for-profit organizations, with missions ranging from addiction treatment and mathematical modeling to artificial intelligence and marketing. As of mid-February, the alliance had received $750,000 to build its model for Alabama.

    The largest chunk — $500,000 — came from the Poarch Band of Creek Indians, whose tribal council voted unanimously to spend most of its opioid settlement dollars to date on the Helios initiative. A state agency chipped in an additional $250,000. Ten Alabama cities and some private foundations are considering investing as well.

    Stephen McNair, director of external affairs for Mobile, said the city has an obligation to use its settlement funds “in a way that is going to do the most good.” He hopes Helios will indicate how to do that, “instead of simply guessing.”

    Rayford Etherton, a former attorney and consultant from Mobile who created the Helios Alliance, said he is confident his team can “predict the likely success or failure of programs before a dollar is spent.”

    The Helios website features a similarly bold tagline: “Going Beyond Results to Predict Them.”

    To do this, the alliance uses system dynamics, a mathematical modeling technique developed at the Massachusetts Institute of Technology in the 1950s. The Helios model takes in local and national data about addiction services and the drug supply. Then it simulates the effects different policies or spending decisions can have on overdose deaths and addiction rates. New data can be added regularly and new simulations run anytime. The alliance uses that information to produce reports and recommendations.

    Etherton said it can help officials compare the impact of various approaches and identify unintended consequences. For example, would it save more lives to invest in housing or treatment? Will increasing police seizures of fentanyl decrease the number of people using it or will people switch to different substances?

    And yet, Etherton cautioned, the model is “not a crystal ball.” Data is often incomplete, and the real world can throw curveballs.

    Another limitation is that while Helios can suggest general strategies that might be most fruitful, it typically can’t predict, for instance, which of two rehab centers will be more effective. That decision would ultimately come down to individuals in charge of awarding contracts.

    Mathematical Models vs. On-the-Ground Experts

    To some people, what Helios is proposing sounds similar to a cheaper approach that 39 states — including Alabama — already have in place: opioid settlement councils that provide insights on how to best use the money. These are groups of people with expertise ranging from addiction medicine and law enforcement to social services and personal experience using drugs.

    Even in places without formal councils, treatment providers and recovery advocates say they can perform a similar function. Half a dozen advocates in Mobile told KFF Health News the city’s top need is low-cost housing for people who want to stop using drugs.

    “I wonder how much the results” from the Helios model “are going to look like what people on the ground doing this work have been saying for years,” said Chance Shaw, director of prevention for AIDS Alabama South and a person in recovery from opioid use disorder.

    But Loyd, the co-chair of the Helios board, sees the simulation platform as augmenting the work of opioid settlement councils, like the one he leads in Tennessee.

    Members of his council have been trying to decide how much money to invest in prevention efforts versus treatment, “but we just kind of look at it, and we guessed,” he said — the way it’s been done for decades. “I want to know specifically where to put the money and what I can expect from outcomes.”

    Jagpreet Chhatwal, an expert in mathematical modeling who directs the Institute for Technology Assessment at Massachusetts General Hospital, said models can reduce the risk of individual biases and blind spots shaping decisions.

    If the inputs and assumptions used to build the model are transparent, there’s an opportunity to instill greater trust in the distribution of this money, said Chhatwal, who is not affiliated with Helios. Yet if the model is proprietary — as Helios’ marketing materials suggest its product will be — that could erode public trust, he said.

    Etherton, of the Helios Alliance, told KFF Health News, “Everything we do will be available publicly for anyone who wants to look at it.”

    Urgent Needs vs. Long-Term Goals

    Helios’ pitch sounds simple: a small upfront cost to ensure sound future decision-making. “Spend 5% so you get the biggest impact with the other 95%,” Etherton said.

    To some people working in treatment and recovery, however, the upfront cost represents not just dollars, but opportunities lost for immediate help, be it someone who couldn’t find an open bed or get a ride to the pharmacy.

    “The urgency of being able to address those individual needs is vital,” said Pamela Sagness, executive director of the North Dakota Behavioral Health Division.

    Her department recently awarded $7 million in opioid settlement funds to programs that provide mental health and addiction treatment, housing, and syringe service programs because that’s what residents have been demanding, she said. An additional $52 million in grant requests — including an application from the Helios Alliance — went unfunded.

    Back in Mobile, advocates say they see the need for investment in direct services daily. More than 1,000 people visit the office of the nonprofit People Engaged in Recovery each month for recovery meetings, social events, and help connecting to social services. Yet the facility can’t afford to stock naloxone, a medication that can rapidly reverse overdoses.

    At the two recovery homes that Mobile resident Teggart runs, people can live in a drug-free space at a low cost. She manages 18 beds but said there’s enough demand to fill 100.

    Hannah Seale felt lucky to land one of those spots after leaving Mobile County jail last November.

    “All I had with me was one bag of clothes and some laundry detergent and one pair of shoes,” Seale said.

    Since arriving, she’s gotten her driver’s license, applied for food stamps, and attended intensive treatment. In late January, she was working two jobs and reconnecting with her 4- and 7-year-old daughters.

    After 17 years of drug use, the recovery home “is the one that’s worked for me,” she said.

    KFF Health News is a national newsroom that produces in-depth journalism about health issues and is one of the core operating programs at KFF—an independent source of health policy research, polling, and journalism. Learn more about KFF.

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    Subscribe to KFF Health News’ free Morning Briefing.

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  • ‘I keep away from people’ – combined vision and hearing loss is isolating more and more older Australians

    10almonds is reader-supported. We may, at no cost to you, receive a portion of sales if you purchase a product through a link in this article.

    Our ageing population brings a growing crisis: people over 65 are at greater risk of dual sensory impairment (also known as “deafblindness” or combined vision and hearing loss).

    Some 66% of people over 60 have hearing loss and 33% of older Australians have low vision. Estimates suggest more than a quarter of Australians over 80 are living with dual sensory impairment.

    Combined vision and hearing loss describes any degree of sight and hearing loss, so neither sense can compensate for the other. Dual sensory impairment can occur at any point in life but is increasingly common as people get older.

    The experience can make older people feel isolated and unable to participate in important conversations, including about their health.

    bricolage/Shutterstock

    Causes and conditions

    Conditions related to hearing and vision impairment often increase as we age – but many of these changes are subtle.

    Hearing loss can start as early as our 50s and often accompany other age-related visual changes, such as age-related macular degeneration.

    Other age-related conditions are frequently prioritised by patients, doctors or carers, such as diabetes or heart disease. Vision and hearing changes can be easy to overlook or accept as a normal aspect of ageing. As an older person we interviewed for our research told us

    I don’t see too good or hear too well. It’s just part of old age.

    An invisible disability

    Dual sensory impairment has a significant and negative impact in all aspects of a person’s life. It reduces access to information, mobility and orientation, impacts social activities and communication, making it difficult for older adults to manage.

    It is underdiagnosed, underrecognised and sometimes misattributed (for example, to cognitive impairment or decline). However, there is also growing evidence of links between dementia and dual sensory loss. If left untreated or without appropriate support, dual sensory impairment diminishes the capacity of older people to live independently, feel happy and be safe.

    A dearth of specific resources to educate and support older Australians with their dual sensory impairment means when older people do raise the issue, their GP or health professional may not understand its significance or where to refer them. One older person told us:

    There’s another thing too about the GP, the sort of mentality ‘well what do you expect? You’re 95.’ Hearing and vision loss in old age is not seen as a disability, it’s seen as something else.

    Isolated yet more dependent on others

    Global trends show a worrying conundrum. Older people with dual sensory impairment become more socially isolated, which impacts their mental health and wellbeing. At the same time they can become increasingly dependent on other people to help them navigate and manage day-to-day activities with limited sight and hearing.

    One aspect of this is how effectively they can comprehend and communicate in a health-care setting. Recent research shows doctors and nurses in hospitals aren’t making themselves understood to most of their patients with dual sensory impairment. Good communication in the health context is about more than just “knowing what is going on”, researchers note. It facilitates:

    • shorter hospital stays
    • fewer re-admissions
    • reduced emergency room visits
    • better treatment adherence and medical follow up
    • less unnecessary diagnostic testing
    • improved health-care outcomes.

    ‘Too hard’

    Globally, there is a better understanding of how important it is to maintain active social lives as people age. But this is difficult for older adults with dual sensory loss. One person told us

    I don’t particularly want to mix with people. Too hard, because they can’t understand. I can no longer now walk into that room, see nothing, find my seat and not recognise [or hear] people.

    Again, these experiences increase reliance on family. But caring in this context is tough and largely hidden. Family members describe being the “eyes and ears” for their loved one. It’s a 24/7 role which can bring frustration, social isolation and depression for carers too. One spouse told us:

    He doesn’t talk anymore much, because he doesn’t know whether [people are] talking to him, unless they use his name, he’s unaware they’re speaking to him, so he might ignore people and so on. And in the end, I noticed people weren’t even bothering him to talk, so now I refuse to go. Because I don’t think it’s fair.

    older woman looks down at table while carer looks on
    Dual sensory loss can be isolating for older people and carers. Synthex/Shutterstock

    So, what can we do?

    Dual sensory impairment is a growing problem with potentially devastating impacts.

    It should be considered a unique and distinct disability in all relevant protections and policies. This includes the right to dedicated diagnosis and support, accessibility provisions and specialised skill development for health and social professionals and carers.

    We need to develop resources to help people with dual sensory impairment and their families and carers understand the condition, what it means and how everyone can be supported. This could include communication adaptation, such as social haptics (communicating using touch) and specialised support for older adults to navigate health care.

    Increasing awareness and understanding of dual sensory impairment will also help those impacted with everyday engagement with the world around them – rather than the isolation many feel now.

    Moira Dunsmore, Senior Lecturer, Sydney Nursing School, Faculty of Medicine and Health, University of Sydney, University of Sydney; Annmaree Watharow, Lived Experience Research Fellow, Centre for Disability Research and Policy, University of Sydney, and Emily Kecman, Postdoctoral research fellow, Department of Linguistics, University of Sydney

    This article is republished from The Conversation under a Creative Commons license. Read the original article.

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