Sleep apnea degrades your quality of life tremendously. Even when treated with CPAP you can still have pretty poor sleep due to the mask shifting around while you sleep and other side effects of the treatment, but it's generally much better than the torture of untreated apnea. It's so bad that even with moderate apnea you wake up more tired than when you went to bed.
Now allow me a preemptive reply: I suffered apnea with a BMI below 20. Plenty of people don't have apnea because they are overweight; instead, they are overweight because they suffer apnea.
jonhohle said a month ago:
As an additional PSA, sleep apnea may not be the cause of exhaustion, even if diagnosed. I was diagnosed with apnea and CPAP did (still does) little if anything for my energy levels. I finally found a sleep doctor who checked my iron levels, and despite being within the normal range suggested I take an iron supplement (iron polypeptide) and within a week felt normal again.
It turns out that people with restless legs, which I’ve had since childhood, experience iron deficiency anemia with much higher blood iron content than the average population.[0]
My primary care didn’t consider this. A pulmonologist had no interest in checking this. An oral sleep doctor had no interest in checking this. I had people suggesting getting an implant to force my tongue to stick out when the issue was low iron.
Definitely get a sleep study (I’d recommend lab over home). I use a sleep tracker (cheap Garmin “smart” watch, but I’ve also tried an Apple Watch) as a reasonable proxy for REM and deep sleep. And if you think a practice is just trying to sell equipment, they probably are. Fortunately I found a good doctor from acquaintances that I would have never otherwise considered (not part of the local medical systems, though did take insurance).
Unfortunately, for many issues it’s not enough to trust the doctor. Do your own due diligence for your health.
My wife had menorrhagia (extremely heavy periods that lasted a week) and extreme lethargy. And restless legs. Not only did her doctor not get her bloods checked, he didn't care about the heavy periods and said (about heavy periods), "go on the pill, and see a shrink" (because presumably he thought she was a hypochondriac or depressed, because she came back several times to see if he could do anything about it). He finally got her iron and B12 checked, and since they were both on the lowest end of the "Ok" range, he didn't do anything further.
It took 2 doctor changes and a lot of goggling to realise that her menorrhagia had a cause, but that she's need scans to prove she might have uterine fibroids. It took 2 procedures to correct them. Once all that was done and she got iron + B12 injections, and got her life back.
On a forum she talked to other women who were left to deal with fibroids for up to a decade because their doctors would just sigh and say, "Yes, women's problems. This is normal. Go on the pill". Unfortunately the fibroids grow so large that there is sometimes no option but a full hysterectomy. This is a common story.
I completely agree, you need to do your own due diligence these days.
throwup238 said a month ago:
> He finally got her iron and B12 checked, and since they were both on the lowest end of the "Ok" range, he didn't do anything further.
This type of mistake infuriates me to no end because there’s no reason it should happen. I was recently looking at blood tests from years back to figure out my usual resting glucose levels (just got a GCM) and stumbled on my testosterone results.
I was in the green, so my doctor (and nurse practitioner) didn’t notice a problem but I had the testosterone levels of a 50 or 60 year old in my late 20s. Since the acceptable range wasn’t adjusted for age by the Quest report, the range is ridiculously huge.
heroprotagonist said a month ago:
It's worth noting that in some cases it might be cheaper to outright purchase a CPAP machine online than to get a diagnosis via a sleep study.
I got a sleep study about a decade ago, having to go in first for diagnosis and then to evaluate the right settings. Even with insurance it cost about $2000 after all was said and done due to limited coverage and out of pocket fees. THen add the ongoing $35/month copay for renting the CPAP machine (they did not offer to sell it) and limited fee for having someone deliver it, which was a scam of an 'in-home medical visit' to set it up by handing me a box and saying where to plug in the hoses.
Meanwhile, the same machine sold for $400 online, wouldn't have required me to spend overnights in a lab or go through doctor visits every couple months for continued 'check-ups' where they read the card data to make sure I'm still using the machine to justify insurance coverage of everything beyond the $35/month fee. With automatic settings (now standard on machines, perhaps not at the time) or simply using materials online to do a few nights trial and error to figure out correct settings.
I felt like I (and my insurance carrier) was getting scammed at every point along the line. But the doctors claimed these were the hoops I had to go through to get tested and treated.
Hopefully it's a lot better today, but.. I doubt it. The CPAP did work when I finally got it, though.
kirse said a month ago:
H.Pylori is well known to impact iron absorption and serum iron/ferritin levels. Most of the world carries this unknowingly (esp. since childhood), and it has all sorts of silent consequences ranging from fatigue (due to iron impact, etc) to GI issues to stomach cancers.
I just wanted to mention how I cope with occasional restless leg syndrome. I find that a wall sit for two minutes right before trying to fall asleep works every time. I have to do it long enough and push hard enough to make my legs really burn from the exertion. The more unpleasant it is, the better it works. Afterwards, I immediately get in bed and try to go to sleep (it doesn’t work unless I do it right before attempting to fall asleep). Usually by the time my heart rate returns to normal, I’m asleep.
sleepskeptic said 19 days ago:
I'm looking into this as of now. For your situation though, from what I've read about iron supplements. A week is too short of a time for anything. So your situation was placebo; in my opinion.
DanielHB said a month ago:
I was sleeping 8.5-10h per day and still feeling extremely tired. Also had a lot of mental problems to the point I was thinking of going to a therapist (I thought it was work related).
My doctor sent me to do sleep apnea tests and blood work, but turns out I was vitamin B12 and B9 anemic AND seems like I have mild sleep apnea as well (I have more tests booked). But taking vitamin supplements cured most of my symptoms in less than a week. I had horrible headaches for the first couple of days of supplements though.
y-c-o-m-b said a month ago:
Isn't iron one of those things you don't want to overdo due to dangerous side effects?
You raise an interesting situation here though because I've also had restless leg forever and my iron tests came back normal. Still, I'm not sure how safe it is to take iron supplements under "normal" conditions.
Did I suggest otherwise? I said I ended up seeing four doctors before one suggested what worked for me. YMMV. Consult a physician, etc., etc.
I need to have my iron levels checked semi regularly. I would imagine any doc suggesting iron supplements would suggest the same.
dathinab said a month ago:
tbh. I generally I don't understand why some people are so insistant to point out "how dangerous supplements are".
For most nutrients there is quite a large area between what the body needs and when it starts to become a problem.
And while you can over a long time accumulate by not only only consume more then you need but also more then your body can disperse it's not really an issue either. Doing semi regular tests in case of knowing you have some nutrition issues is pretty common and stuff like fasting once a year can help you body to flush out accumulations.
And again for a lot of supplement choices people will often not run into this issue at all anyway.
I have seen a lot of people which live quality increased by taking supplements (including non water soluble ones) but yet have to see a single case of overdosing on supplements in my environment.
SamBam said a month ago:
I have occasional restless leg (once every two weeks or so) and low energy. How would one know if one has iron deficiency despite blood work being normal? Is it just a case of popping iron pills and seeing if you feel better?
raffraffraff said a month ago:
What's "normal"? Your results are never just "normal", there is a range that is considered normal. If you're at the low end of normal, that could actually be just "low". Those teams can be a bit too wide.
How is your B12? If you're a vegan or vegetarian and aren't taking those supplements then I would start taking them. It's always safe to take extra B12.
Unless your iron is at the upper end of the band it should be safe to take a low dose. But it won't do anything if you're not really deficient.
I find that sitting at a desk all day makes me tired. I just push past it and go for a run. Always works, and it guarantees me a good night's sleep.
Just remembered, if you walk a lot, like over 25k steps a day, or do a lot of exercise (squats?) that can also cause restless legs.
Also, your diet? Most people are getting more than enough carbs these days, but are you on some weird diet?
dj_mc_merlin said a month ago:
Doesn't hurt to try does it? A bit of extra iron is harmless.
SamBam said a month ago:
That was partly my question. Looking online, iron is definitely something that you don't want to have too much of.
My question is, basically, is having a non-anemic iron deficiency something that can be easily remedied by having low-dose over the counter vitamins, or is it something that requires a higher dose (to make up the difference in what you're missing) and so requires a doctor. And yet it sounds like this is difficult to diagnose.
dj_mc_merlin said a month ago:
Over the counter iron supplements are totally safe to take for the period indicated on them. They contain as much iron as a medium piece of chicken liver.
SamBam said a month ago:
Most of the over the counter ones I see online are 65 mg iron, which is nearly twice the iron in a whole half kilo of chicken liver.
The medical sites say a safe value is no more than 45 mg per day.
There are also low iron pills (or "gentle iron") that are 28 mg.
So not only are many over the counter pills potentially over the safe levels, but it still doesn't even really answer the question, which is whether the low-dose pills that are under the RDA effective in countering an iron deficiency.
Anyway. I think I'll ask my doctor at a once-every-several-years checkup.
dj_mc_merlin said a month ago:
Do you live in America? Supplements tend to be much stronger there. Here in Germany at the local pharmacy you will mostly find in the 10mg-30mg range. I've bought and drank them before to no ill effect, which is why I even started this entire chain.
scaryclam said a month ago:
Same for here in the UK. My iron suppliments are 30mg, which seems pretty usual here.
zhengyi13 said a month ago:
It can indeed hurt[1], and getting medical advice from the Internet can be... fraught.
Similar for me, I thought I would start feeling better after my CPAP. Still had terrible sleep. Still experimenting with solutions (issues started after Covid vax, so I’m experimenting with long Covid protocols and have noticed much better sleep in the last month although I’m not getting my hopes up just yet)
alimjiwa said a month ago:
If you don't mind sharing, what are some of these long-covid protocols that you're trying?
dwallin said a month ago:
Do you have any additional resources you recommend on this topic? I've experienced life long restless legs alongside issues with sleep quality, daytime tiredness and low energy levels so this seems like an interesting avenue to explore.
jonhohle said a month ago:
I don’t, just my personal experience. A few years ago I started getting exhausted to the point I was napping every day and getting 10-12 hours asleep and still felt tired. I’ve never been overweight, don’t have any structural occlusions in my airways, though I do snore (so says my wife).
I did all of the normal things and got regular exercise. I finally went to a specialist, and got an at home sleep study which found moderate apnea (on the low side of moderate). I spent several months using a CPAP and bought a sleep tracking watch. Nothing improved and I was still tired. The pulmonologist suggested one of my medications affected REM. I was able to stop taking it without any significant issue and my REM improved, but I was still tired. I asked them for an in lab study and did that and it found the same as the home study.
I had convinced myself I had narcolepsy or some similar neurological issue.
My wife’s friend coincidentally mentioned he had sleep issues and they had found a sleep doctor they liked. He was the first to ask about restless legs and have any blood work done. He confirmed that I have apnea, but thought trying an iron supplement might help based on recent studies and my iron levels.
The iron helped almost immediately. Within a week I didn’t need to take a nap, which I had done daily for at least two years. I still use the CPAP because apnea can cause heart issues long term, but don’t “feel” like it does anything in the short term.
Usually, the most common thing is the most likely, but when it’s not, it can be really hard to find someone who both believes you and can do something about it. When I was exhausted all of the time, finding that person was even more challenging.
annpierce said a month ago:
So interesting! Thanks for sharing. Do you still take iron every day, or is this the kind of thing one does for a period of time until the body is rebalanced?
tbirdny said a month ago:
Serum iron is a pretty useless test. What was your ferritin?
jonhohle said a month ago:
In August it was 66ng/mL prior to taking any supplement. So above the reference low, but below the adjustment for RLS.
Unfortunately, I just had it tested last week but had given power red a few weeks prior and came in below even the normal range (20ng/mL).
elric said a month ago:
I wish CPAP manufacturers were a bit better. There has been little innovation, and if anything, there's been a downward trend in quality in recent years.
My wishlist:
1. Every CPAP device should be BiLevel.
2. All data they record should be accessible to the user (for tools like oscar).
3. Either more granular pressure controls, or better algorithms (or both). Some people do well on CPAP, others do better when iPAP > ePAP (BiLevel, or EPR), while others do better when ePAP > iPAP (vcom).
4. Better masks. Seriously. It's so hard to find a good mask, and so expensive to experiment with them. A new mask can set you back €150, and if turns you hate it, you're shit out of luck. I've toyed with the idea of personalized 3D printed masks to get a better seal for each unique nose/face shape.
5. Quieter machines. Without the Philips cancer foam.
6. Quieter masks. Some have excellent diffusers in the exhalation port (P10), while others blast out a concentrated jet of air that will wake you up when it hits the pillow, or will lead to divorce faster than your snoring ever did when it hits your bedpartner.
7. Bring back travel cpap devices. The market collapsed post covid. I'd love to keep a small device and super lightweight mask/hose in my bag for sleepover emergencies. I'd pay any price for that, because having to lug a full size cpap around ruins any chance of spontaneity in my bachelor sex life.
None of these are rocket science. But Philips Respironics are a bunch of evil cunts, ResMed are goofing off, and the other brands might as well not exist.
david-gpu said a month ago:
Agreed on all counts, down to having contemplated 3D printing molds to manufacture custom silicone masks. I also wish the tube had a sensor to detect whether you are sleeping on your back to preemptively raise the pressure. Or having better algorithms to detect hypopneas before the air stops flowing altogether.
I don't even understand why purchasing a CPAP machine requires a prescription. I'm scared of the possibility of a doctor denying me a new CPAP machine when the current one inevitably croaks. The device is a glorified fan, for goodness sake.
elric said a month ago:
The prescription thing is probably location specific, but AFAIK you can just buy them online. I have a few spares I bought online from back when I frequently slept in different places.
Masks straps could probably be fitted with an accelerometer to detect positioning. If they can make heated tubing, this isn't such a stretch. Might also be useful in correctly flagging events: my machine often incorrectly marks position switches as periods of hypopnea.
HumblyTossed said a month ago:
> Plenty of people don't have apnea because they are overweight; instead, they are overweight because they suffer apnea.
A lack of sleep means a lack of energy. You're body compensates by getting food energy.
Too much stigma around what should just be understood as a biological mechanism.
sandworm101 said a month ago:
>> A lack of sleep means a lack of energy. You're body compensates by getting food energy.
I saw this ironically during military basic training. Lots of exercise, but very little sleep. The body compensates by keeping blood sugar levels high. I was one of the many that actually gained weight during basic training. The eating routine of three solid meals eaten very quickly also was not healthy.
jerlam said a month ago:
My doctor wore one of those continuous glucose monitors for a while and reports something similar. He considers himself an endurance athlete and his blood sugar levels were always a bit high when he was regularly exercising, but once he took some time off, his blood sugar levels dropped to "normal" levels once his body realized it wasn't under so much stress.
xarope said a month ago:
that concurs with my anecdotal sample size = 1 study, where I have gone for 3.5 days without sleep before, and just keep feeling hungry and snacking every hour or so.
(for those asking what happened after 3.5 days, I basically started getting hysterical - literally just laughing at nothing - and when I was finally able to get to a bed, it took about 2 hours of staring at the ceiling before my body finally decided I was no longer under stress, and allowed me to fall asleep).
alwiejrlai said a month ago:
Absolutely. When I was in the Navy, working 80-100hrs/wk, we were served four meals a day, every six hours, like clockwork. You can substitute sleep with calories for days or weeks at a time. It's terrible for you, I do not recommend it, but it can keep you going.
pc86 said a month ago:
This is stated as biological fact when it's simply not. Sleep apnea doesn't change the laws of thermodynamics - if you are gaining weight you need to eat less or move more. It's not stigma, it's simply the way it is for the vast majority of people (the rest being covered by rare hormonal conditions that require a doctor to treat).
Being tired may cause you to eat more but being tired isn't making you gain weight, it's the overeating that is.
SamBam said a month ago:
People love to think of the body as a simple energy-in->energy-out equation, but it's definitely more complex than that, as the body can change what it's deciding to hold on to and what it's deciding to burn or expel.
I am one of those that stayed skinny as a rake throughout my childhood and mid-adulthood (in my mid-40s I'm starting to become more normal sized). I wasn't particularly active, and I ate voraciously -- third or fourth helpings of pasta bowls. But the food never stuck to my ribs. (And it wasn't a worm or anything -- the whole side of my mother's family is the same, while my dad's side is the opposite.)
No one should look at my body and say "clearly he is exercising more than he is eating" because it wouldn't have been true at all, and yet that's what the simplistic energy-in and energy-out conclusion would say.
nvy said a month ago:
>People love to think of the body as a simple energy-in->energy-out equation, but it's definitely more complex than that, as the body can change what it's deciding to hold on to and what it's deciding to burn or expel.
If calories-in/calories-out didn't work, then it would be impossible to starve to death.
Where people get confused is that the number of calories changes as your metabolism speeds up or slows down.
If you are ingesting fewer calories than your body requires, you will lose some combination of fat and muscle. There is no possible way for this to be false.
SamBam said a month ago:
It's the flip side that is quite possible to be false. You can certainly eat more calories than your body requires and yet not gain weight. Your gut could absorb less, so you excrete otherwise-digestible carbs. You could have a parasite.
Further, you could be burning more calories without doing more exercise or otherwise doing anything "useful" with the energy -- i.e. having a higher basal metabolic rate. These calories can be burned doing all sorts of things that the person has no control over: you could have a higher core body temperature, you could be spending more energy on cellular repair and other cellular processes, you could be synthesizing more hormones, you could be spending more energy metabolizing foods, etc etc.
These latter causes are obviously on the "energy out" side of the equation, but they do not relate to things under our control. Further, they can change with age, stress, and (relevant to TFA) sleep.
So a body that has been coasting by eating 2200 calories per day and never gaining a pound could suddenly change and start putting on weight, even though the person's diet and activities haven't changed.
The point is that two people could eat the exact same calories, and do the exact same exercise, and one of them go up in weight and the other go down. The "calories in vs calories out" idea usually simplistically makes people think this couldn't be true, because "calories out" is simplistically taken as "exercise."
The reason I shared my story is that so many people just quote "calories in vs calories out" as if both sides of the equation were perfectly under control, and those people are also often like me: they find it easy to keep the pounds off (because of a high metabolic rate) and so they look down on people who have trouble shedding weight and figure that those people could live just like them. But those heavier people could well be eating less and doing more exercise than them.
unshavedyak said a month ago:
> It's the flip side that is quite possible to be false. You can certainly eat more calories than your body requires and yet not gain weight. Your gut could absorb less, so you excrete otherwise-digestible carbs. You could have a parasite.
Is the flip-side really debated that much tho? I feel like when people talk about CICO they're primarily talking about reducing CI to lower than your CO. No?
The complexity in CICO of course is measuring your CO. Ie you could estimate your CO, reduce your CI to what you believe your CO is - and still not lose weight. But does that undermine CICO? Because as the other commenters mentioned, it's "impossible" for you to burn more than you take in without losing mass, so our issue in this example is incorrectly asserting the output (assuming of course we're not also underestimating the input).
Note my questions here are generally questions. I am not an expert here, so please correct me if i'm wrong.
> The reason I shared my story is that so many people just quote "calories in vs calories out" as if both sides of the equation were perfectly under control, and those people are also often like me: they find it easy to keep the pounds off (because of a high metabolic rate) and so they look down on people who have trouble shedding weight and figure that those people could live just like them. But those heavier people could well be eating less and doing more exercise than them.
Fwiw, i don't dispute that some people have the wrong ideas with CICO. Perhaps frequently even. But i thought it still stood as a foundational truth nonetheless; that you have to "simply" burn more than you take in. If you gain weight (ignoring water weight for simplicity), then you have ate more then you burned, always.
My takeaway with CICO is that the hardest question seems to be correctly figuring out how much you're burning. Which i feel like usually, especially for overweight people, it's much less than they think. You can't outrun a bad diet, as they say. Rarely do people actually want to exercise enough to truly compensate for the thing they want to eat. Hence why i like CICO, as to me it signals the only effective action is in restricting your CI, since increasing CO is so difficult.
pandaman said a month ago:
I believe you confuse an inequality of Energy(Fat) ≤ Energy(Food) - Energy(Activity) with an equation and are trying to disprove it with a counter-example. People saying "calories in, calories out" don't help with this confusion too. Another variant of your argument is "but different people extract different amounts of energy from the same food so there!". This being an equality, both arguments make no sense. I give you more - the "Energy(Food)" is calculated by burning the food in question and measuring the energy produced. It's guaranteed to be more than most humans could extract from the food as most humans excrete more complex chemicals than carbon dioxide and water, which burning food produces. But it does not matter because this is an inequality and not an equation. E.g. in your example the inequality still holds, you allegedly increased the Energy(Food) but the energy stored in fat did not increase, as asserted in the inequality.
A counter example to disprove this would be somebody gaining more weight in fat than the weight of fat needed to store energy from consumed food. Of course, this would have been broken pretty fundamental laws of nature and would have caused some kind of revolution in physics.
valarauko said a month ago:
In my Indian family, this sort of skinny phenotype with a voracious appetite had a simple folk explanation - you eat so much that the food doesn't have time to be absorbed.
aliasxneo said a month ago:
I can second this. I get routinely mistaken for a runner because of my size. I do strive for 10k steps a day, but generally, my activity levels would not easily reflect my BMI.
Kirby64 said a month ago:
And yet, if you want to lose weight, it’s almost always (outside of medical conditions) as simple as getting into a caloric deficit that matches the deficit necessary to induce weight loss.
If you have a 500cal deficit per day, you lose a pound of weight (fat) per week. It’s literally that simple.
There’s some auto regulation of caloric burn rate, but it’s not some impossible problem to solve.
silverquiet said a month ago:
If you knew your exact metabolic requirements as well as the exact calorie count of every food you ingested, then it would be that simple. But what if you take the elevator one day instead of the stairs and don't burn off the 30 or so calories it might take to go up them? What if someone went a little heavy on the dressing on a salad you ordered and added 100 calories or so?
I've manipulated my body weight a few times and the real world is vastly different from a simple model of CI/CO.
Kirby64 said a month ago:
On average this doesn’t matter. Humans are a whole lot more predictable and pattern based than you seem to be implying.
Also, if you’re trying to aim to a specific deficit, you should be calorie counting your food. If you got fatty dressing, you should be counting that. Even estimating is relatively easy once you do it for awhile. And if you don’t get it quite right, being a little off shouldn’t impact your overall average too much. It keeps you honest, which I think is by and large the main reason people don’t think they can lose weight: dishonest assessments of food consumption.
silverquiet said a month ago:
As I've said, I can absolutley lose weight, but I cannot reliably lose one pound per week; I do not seem to have that resolution in the numbers.
Izkata said a month ago:
I've been tracking my weight weekly and all calories (even with crude estimates in some cases) for a year and a half, and have been experimenting with exactly this: I made a scatter plot and linear regression of average calories per day on the X axis, and weight change for that week on the Y axis.
Week to week weight has extra fluctuations that make it difficult to tell what's going on, but after around 6 months of data it stabilizes, and has been consistent for any 6-month period over the last year and a half: I burn around 2200 - 2300 calories per day on average (way higher than the online estimator tools think I burn, 1600 - 1700).
Knowing this I've also been reliably able to control my weight up or down at the rate I want as long as I'm looking at it for over a month span - because as above, week to week there's too much fluctuation (fullness of stomach and bowels mostly).
silverquiet said a month ago:
That it takes that much data to see the result pretty much proves my point - maintaining a 500 calorie per day deficit is just very difficult for me and I suspect most people. I don’t mean the hunger - when I do lose weight the deficits are easily above 1000, but 500 is too marginal for me to resolve.
Kirby64 said a month ago:
Reliably losing one pound a week (beyond the initial 1-2 week period where your weight is going to go all over the place due to water weight fluctuations) is as simple as cutting calories until you see the weight (on average, ignore fluctuations) drop by 1 lb a week. You have to average extensively. Bodies are very temperamental at this, unfortunately. My scale weight swings 0.5-1 lb quite frequently mainly due to sodium changes in my diet. It’s all about trend weight, though.
brnt said a month ago:
The body is far more complex than simple thermodynamics however, and to pretend the dozens of biological feedback loops are fully under ones control betrays a lack of understanding.
Reducing getting fat to thermodynamics is like reducing computing to adding numbers. While that may be the basic building block, only a fool thinks that merely by comprehension of the add operator, one is also able to debug hugely complicated soft- and hardware stacks.
pc86 said a month ago:
I actually like the computing and adding numbers analogy because "Sleep apnea makes people overweight" is the nutritional equivalent of saying "1 + 1 = hammer."
The root cause of weight gain is either overeating or lack of sufficient exertion in almost every case. Sleep apnea may absolutely cause someone to overeat in part because of those dozens of biological feedback loops you mention. But that doesn't mean that sleep apnea makes people gain weight. It's still too much food at the end of the day.
Modified3019 said a month ago:
>It's still too much food at the end of the day.
The problem with that is you can reach a point were trying to reduce calories further will only further sabotage your metabolism and makes you feel like shit. Which is why treating the symptom repeatedly fails to work long term.
I’m a 5’11” male who gained weight up to ~220 pounds on ~1800 calories eating a very consistent meal rotation. I now maintain ~190 pounds at ~2100 calories. My problem was likely a combination of my food acting as a chemical signal to gain weight (high in branch chain amino acids, polyunsaturated fats from fatty pork and chicken), work stress, bad sleep, and possibly even chronically elevated blood sugar or thyroid effects from essentially what was an almost carnivore one meal a day sort of diet. My body temperature was hitting lows of 96.3 degrees F. It’s now roughly two degrees higher, which seems small, but feels so much better.
balfirevic said a month ago:
> It's still too much food at the end of the day.
It's all four fundamental physical forces actually, if you want to go that route. Which isn't helpful.
david-gpu said a month ago:
> But that doesn't mean that sleep apnea makes people gain weight
I gather that you are unaware of how sleep apnea causes poor sleep, which in turn causes insulin resistance, which in turn causes an elevated production of insulin, which in turn forces glucose into your adipose tissue, which in turn makes the rest of your tissues starved for energy, which in turn causes you to be hungrier, overeat and gain weight.
This is an oversimplification, of course, as there are hormones other than insulin and cortisol involved in the complex process of insulin resistance, but it is at least a starting point that goes beyond the useless truism that "people gain weight because they overeat". Of course they do, but the mechanisms why they are hungrier than they need to be are crucial if you want to address the problem, because in the long run every human being with free access to food will eat precisely until they are no longer hungry, whether or not they are metabolically healthy or not.
jonhohle said a month ago:
But that’s not what he’s saying. Being hungry does not cause you to eat. Regardless of hunger, a caloric deficit will result in weight loss.
There definitely is the issue of how to reliably maintain a caloric deficit when your body is screaming at you to eat more, but the underlying mechanism is much simpler.
At the most basic levels, food choice doesn’t even really matter (specifically for weight loss, not general health), but choosing satiating foods with low calories is going to help with implementation. Eating 2,000 calories of oranges (45) is going to be a lot harder than 2,000 calories of fast food hamburgers (2).
david-gpu said a month ago:
The problem isn't that CICO isn't true, it's that it's not useful. It can't even explain why fat people are still hungry when they have enough calories stored in their bodies to last them for months.
> Being hungry does not cause you to eat
Yes, it does. That's why people eat: to alleviate hunger. You may will power your way to a caloric deficit for some months, maybe a couple of years, but eventually hunger will win and you will eat until satiety.
Metabolically healthy people aren't slim by being hungry all the time. They eat to satiety, and they are lucky enough that their satiety signalling is still working well enough. If you make them chronically hyperinsulinemic, they will be hungrier and they will gain weight -- it happens in humans and in animal models when allowed to eat ad libitum.
> At the most basic levels, food choice doesn’t even really matter (specifically for weight loss, not general health), but choosing satiating foods with low calories is going to help with implementation
As long as you are hyperinsulinemic, you will store a portion of the energy you consume in your adipose tissue, because that is one of the major effects of insulin in the body. The remaining energy left in you will not be sufficient to supply the energy needs of your body, and as a result you will be cold, tired and hungry.*
dgfitz said a month ago:
> Yes, it does. That's why people eat: to alleviate hunger. You may will power your way to a caloric deficit for some months, maybe a couple of years, but eventually hunger will win and you will eat until satiety.
If this is the premise of your argument, it is flawed.
You have no idea if “eventually” happens to everyone. You’re making a wildly strange assumption.
david-gpu said a month ago:
>> You may will power your way to a caloric deficit for some months, maybe a couple of years, but eventually hunger will win and you will eat until satiety.> You have no idea if “eventually” happens to everyone
Have you tried? Are you willing to try? How many people do you know that intentionally remain hungry every day for more than a couple of years, while otherwise having free access to food?
Any weight loss advice that does not adequately address hunger and satiety is naive to the point of ridicule. And any person who advises others to address their weight by telling them to be hungry in perpetuity hasn't given much thought to what they are asking for.
dgfitz said a month ago:
Yeah. Turns out when you eat less your stomach shrinks and you need less food to feel satiated. What are you on about? You’re severely incorrect.
jonhohle said a month ago:
>> Being hungry does not cause you to eat
> Yes, it does.
Nearly 1:10 people in the world are chronically hungry. Being hungry has no impact on their ability to eat. Likewise, those with access to food eat when not hungry and (believe it or not) may not eat when hungry.
I really think you’re missing the point, though. We have a host of signals in our body that can misfire due to various conditions and people cope with them. Hunger is no different and many of us have spent months ignoring it to our own benefit (and some to their own peril).
Caloric intake in excess of expense causes weight gain. What factors lead to that excess do not.
There are certainly those with a variety of issues that make caloric deficit difficult. Fortunately, that’s not most people.
jonhohle said a month ago:
I know you’re being downvoted into oblivion, but I agree. I’m not overweight, but had put on nearly 40lbs more than my historic average. There’s all kinds of advice, but the best I found was: the only way to lose weight is to have a caloric deficit.
That meant measuring calories until I could generally estimate what I was taking in each day. 1000-1500 calories a day sucks at first, but seeing the scale drop is motivating. I dropped 30lbs in about 6 months.
You can’t gain weight if you are taking in less calories than you expend. That’s pretty simple. Not eating that cheesecake, on the other hand, not so easy.
pkoird said a month ago:
I'd like to contribute by saying that even when you are sleeping, body burns calories for various neurobiological processes. That automatically translates to bad sleep equals decreased calorie utilization (than a healthy baseline)
criddell said a month ago:
If overeating has causes, then it's not really a root cause.
dgfitz said a month ago:
By this logic, sleep apena doesn't make people gain weight either.
bnralt said a month ago:
I think one of the issues with this is that most people have pretty terrible diets, most people have pretty terrible diets that can be improved pretty easily, and when dietary improvements are suggested a lot of time the response is “this is just really complicated, it’s not that simple.” Not everything is simple, but, say, giving up soda is something that’s healthy and going to have a positive impact on people’s lives. People who are saying “don’t tell me to give up soda because I have sleep apnea” are looking for excuses for their bad habits.
If someone is eating healthy foods and making a genuine effort to get good exercise, then we can talk about other factors. But too many people use “this is so complex” to avoid the very basics of healthy living.
moritzwarhier said a month ago:
Lack of sleep and stress are associated with overeating, and not only that, they also trigger hormons that promote the body to prioritize building up fat reserves.
I'm on mobile and don't have time to link, but a quick google search should give medical studies on this.
The "energy" thing is a simplification, but as a description of how this feels, it is apt in my view.
This is not about thermodynamics.
Modified3019 said a month ago:
People do not live on a thermodynamic knife edge. There is a very wide leeway of excess intake that allows our body to burn energy “wastefully” or store it based on a hideously complex set of factors.
The idea that everyone is fat because we’re somehow more sinful (gluttonous, slothful) than in the past has repeatedly failed to resolve any problem except for the need for smug people to pat themselves on the back for using thermodynamics in a sentence.
david-gpu said a month ago:
> if you are gaining weight you need to eat less or move more
You could do a little experiment: set up an alarm to wake you up 15-30 times every hour while you try to sleep. That is what moderate sleep apnea does to you. Try this for, say, a year. See what happens to your overall health and your weight in particular. Don't forget to "eat less or move more".
throwaway11460 said a month ago:
Being tired changes how your body uses and stores energy. Your body might be permanently trying to save up for bad times (because the times are always bad) and so you're getting fat even if you eat very little.
vmladenov said a month ago:
By this logic, one could run an army legion without food supplies simply by keeping them sleep deprived.
throwaway11460 said a month ago:
Uh, no? The whole point is that the entire system breaks down. So you get sleep deprived humans who can't process food properly and have no energy as a result. Sounds like a big failure.
serf said a month ago:
can you point to examples of otherwise healthy individuals under moderate to high calorie restriction that gain weight due to chronic poor quality sleep?
it's not something I have ever been made aware of, and I don't understand how it could be the case.
throwaway11460 said a month ago:
A lot of things about your body changes when you're extremely tired.
I don't have anything specific to link - it's just my own personal experience and what the doctor said.
In my own case, I had to eat much more than I theoretically should because my body wasn't able to process the food as well as it should (less than 50% of usual efficiency). And yet I was fat - not obese, but definitely not thin. The body redirected some of my food to storage even though I didn't have enough energy (glucose etc) as measured by blood screening. And it didn't use the reserves properly when I stopped eating.
pc86 said a month ago:
What is mentioned in a couple of these comments about your body's response to external stressors changing how it allocates calories is absolutely true, but it's at the margins. If you're at maintenance caloric intake and ± a couple hundred calories a day, over years this can have an effect. But it's not going to meaningfully impact a 500-1000 calorie/day deficit to the point where you're still gaining weight.
jf22 said a month ago:
I believe there is a study where people ate at a 25% deficit but had high glucose and still gained weight.
> Effects of moderate sleep restriction during 8-week calorie restriction on lipoprotein particles and glucose metabolism
Because the conclusion starts with,
> In this study, 8 weeks of calorie restriction with and without sleep restriction of less than 90 minutes per day on 5 days with 2 days of ad libitum sleep per week, resulted in similar degrees of weight loss
Let me be clear that sleep deprivation doesn’t seem to be good for your circulating lipoprotien levels or insulin sensitivity based on that study, but they didn’t gain weight.
nonameiguess said a month ago:
Not gonna try to find a specific example, but just from having listened so much to the Stronger by Science and Iron Culture podcasts for the past few years, there have at least been numerous studies and metas over the last decade examining the effects of sleep on weight loss and weight gain as it pertains to bodybuilding goals. I don't recall any having showed an impact on the rate of gain or loss but duration of sleep opportunity definitely has an impact on the quality of gain or loss. That is, you lose more muscle and less fat losing weight while sleeping poorly, and gain more fat and less muscle when gaining weight while sleeping poorly.
schwartzworld said a month ago:
> Being tired may cause you to eat more but being tired isn't making you gain weight, it's the overeating that is.
Potato pot-ah-to.
pc86 said a month ago:
Maybe the end result is the same but it's an important distinction. It's too easy to say "oh yeah I'm gaining weight because I have sleep apnea" while you're snacking on donuts at your desk at all. The people who are tricked into believing it think that if they "cure" their apnea they'll be back to a healthy weight when a) they could be at a healthy weight despite their apnea with some effort, and b) they're building habits that even if their apnea disappears a year from now they will stay at the same weight.
unshavedyak said a month ago:
Sidenote, i'm in your camp and agree with you - BUT, hypothetically there's a side to this i've not seen discussed here. That you can lose sleep and it causes a weight gain, with no other change to your CI or CO. Notably, you were previously not processing a portion of your potential CI and it was just passing through you.
In that case you didn't change how much you ate or how many calories passed your lips, but you did change your CI by way of changing your sleep.
Is this a real example or a contrived edge case from a software dev? No clue. I'll let better minds decide that hah.
It's entirely possible to eat less food and have your body decide that food is more scarce and choose to strip more calories from your food than it was when you were eating more.
Thermodynamics is an asinine thing to bring up in a system that can reconfigure its efficiency on the fly to optimize for different environments.
tehjoker said a month ago:
All that does is change the lower limit. The system has a compensation limit, below that you lose weight.
BobaFloutist said a month ago:
Sure, but it's still unhelpful to say that overeating is what makes you gain weight when other people eating the same amount and with the same amount of activity are not gaining weight, especially when eating less could cause you to gain more weight until you hit a threshold.
I don't think many people disagree with "If you starve yourself enough your body will eventually start burning fat", they disagree that it's as simple as "anyone gaining weight is necessarily doing it to themselves by eating more than other people".
And starving yourself isn't easy. It's one of the top like five things your body is designed not to let you do. So how on earth is it helpful when people are talking about factors that can influence your appetite and can literally influence the number of calories your body chooses to extract from the exact same food to say "just eat less lol"?
I might add that overwhelming research suggests that social pressure on people's weight causes people to gain weight. So even if you were right, bringing it up would be counterproductive.
Izkata said a month ago:
> when other people eating the same amount and with the same amount of activity are not gaining weight, especially when eating less could cause you to gain more weight until you hit a threshold
That's part of the "calories out" side of the equation, that few people put in the effort to find (if they even know how). And I've found online estimators aren't very useful here, you need to find it for yourself - they say mine is around 1600 when it's actually more like 2200.
Ignoring half of CICO just because people only like talking about CI doesn't make it false.
tehjoker said 25 days ago:
It's even harder to change CO than CI, that's why people talk about CI. You lose a bit over 100 calories per mile run, and then you have to not compensate by eating them when you're finished. Everyone has a different metabolic set point for how many calories they burn, true.
No one said not eating is easy, especially when there's a lot of food around! I struggle with it. The laws of physics are not kind.
What I will say though, is if I exercise moderate amounts, it makes appetite control easier, at least for me. YMMV. I believe this is because insulin is more level throughout the day.
lr4444lr said a month ago:
He's not entirely wrong, but perhaps not for the stated reason. Sleep deprivation can skew the ghrelin/leptin hormonal balance, which can make appetite control difficult.
nerb said a month ago:
You reference the laws of thermodynamics, but I'm not sure which laws you're applying to the human body? Is it the first which requires the measured system to be closed which a human body is not? Is it the second about entropy always increasing? Or is it the third defining perfect entropy at 0 Kelvin?
Bringing up thermodynamics as a generalization for biological systems is pseudo-intellectual. We aren't all equal machines that take in a fuel stock and output work. How do you account for differences in peoples' resting metabolic rates? How do you account for the difference in available energy in the foods you chose to eat, and in the differences in peoples' biological processes that extract that energy? Stress is a common hormonal modifier that impacts how the body stores fat; no where near a "rare" condition that many people experience nowadays, and yeah caused by things like sleep apnea. You betray your own argument anyway by adding an the "hormonal condition" exception (I don't see any exceptions referenced in the laws of thermodynamics, lol).
Biology has more dimensions than you are choosing to look at, and using thermodynamics as a "gotcha" when it comes to others' bodies reveals your lack of understanding and intuition.
foobarian said a month ago:
Yes the first one. The energy contained in ingested food is far and away the dominant metabolic input.
There is no need to get into the weeds of various details of how that breaks down; the main problem is that calories are way too cheap in the modern day and age, and people's habits and instincts developed in far different eras lead to easily ingesting more than is expended. Yes the OP is not wrong, but it's not a very useful argument unless we're going to roll back the modern civilization.
vikingerik said a month ago:
This is the truth, even if people don't like it so you're receiving downvotes for it. Weight gain or loss is calories in vs calories out. Nobody's body is so special that you're defying thermodynamics and creating mass that you didn't intake as food. And that's definitely not changed by sleep apnea.
That said, there is the point that calories ingested doesn't necessarily equal calories absorbed, and sleep apnea could indeed affect that. But if you're relying on that thin margin for the difference between staying at a healthy weight or not, that's a fragile state of affairs, and you could fix your diet more to be more comfortably on the right side of it.
(My own, unscientific, hypothesis: far too many people are indeed unknowingly relying on that. I think a ton of people cram in 3k calories a day while absorbing 2k because there's just too much mass for the body to process, and then when they do cut ingestion to 2k, that doesn't change absorption and that's why they don't lose weight. (Numbers here are approximate.) It's actually pretty amazing how little food the human body actually needs and how little mass 1500 calories is.)
vmladenov said a month ago:
> and how little mass 1500 calories is
Or how much, depending on what you’re eating. It would be physically impossible for me to eat 1500 calories of lettuce in a day (10kg worth) but it definitely aids in “feeling full” when added to a meal.
lordswork said a month ago:
I thought it was more complex than this, something like lack of sleep disrupting hormones that regulate feelings of hunger and fullness.
HumblyTossed said a month ago:
I'm sure it is. But the point should still stand.
bbatchelder said a month ago:
CPAP has been life changing for me. For my entire life I struggled getting up in the morning, and I never felt "refreshed". Getting up before 9-10AM was super difficult. I also was often in a sort of fugue state when I would first wake up, I'd often have no memory of any interactions, and apparently was often mean.
Now I can easily get up, even at hours that were previously unthinkable, and more often than not feel fully recharged.
I have no doubt that played a part in me being unhealthy - though by no means was it the sole reason.
As an aside, also getting on a dose of Semaglutide has been similarly life changing. The damn near elimination of "food noise" has been incredible.
I know there are a number of folks of the opinion that its somehow cheating. But for me I am left wondering "Is this just how normal people feel?".
phone8675309 said a month ago:
It always bothers me when someone says it’s "cheating" to use a GLP-1 agonist.
It helps but the person losing weight still has to clean up their diet and start an exercise routine. There are still major changes they need to make to become successful. GLP-1 agonists help a lot of people make better decisions due to how they fight hunger. Less hunger means less chances to make bad choices when eating, and weight loss progress is a virtuous mental cycle where you keep doing what you’re doing because you see results.
None of that is cheating. There are still major changes one must make. Taking Ozempic but continuing to eat a trash-tier diet will yield little to no progress.
bbatchelder said a month ago:
Definitely agree, but man, the sheer number of folks who leave just horrible comments on videos/posts people make about how they lost weight on a GLP-1 agonist is so disheartening.
In addition to saying that its cheating, they will actively wish harm to the person by saying "just wait til you get X" where X is some side effect (real or imagined). Or just the "well once you stop taking it you'll just get fat again".
phone8675309 said a month ago:
The people who say "you'll get fat again once you stop taking it" also baffle me.
The most difficult part of losing weight for me personally is changing my routine and habits. Setting myself up with a kitchen that's ready to cook. Figuring out what kind of meals I'm happy to have on a weeknight that don't require a lot of cooking. Preparing parts of meals over an hour or two on the weekend to complete some of the more time consuming parts when I'm not so constrained on time. Learning to deal with the urge I (used to) have to "eat my feelings".
All of those things don't just magically go away when you stop taking a GLP-1 agonist. Losing a lot of weight isn't just about self-control like if you're just trying to lose five pounds to make your pants more comfortable for going to your 20th high school reunion; you have to rewire your habits and mind and make a life long commitment to those changes.
Rewiring your habits and rewiring your brain are things that persist if your intention going into the weight loss was to change your habits instead of just moving the number on the scale. If you are looking to do it only temporarily and are unwilling to lock in those behavioral changes then you're likely going to fail, and that has much more to do with mindset than medication.
glp1guide said a month ago:
Just to add to this, there's data to support the intuition there that there is long term good in taking GLP1s even after you stop:
Now, we need price to go down and availability to go up, but people who think all the weight bounces back as a sort of "gotcha" are silly. It's possible, but is a testament to the difficulty of dealing with obesity -- not some sort of gotcha of the drug.
glp1guide said a month ago:
> As an aside, also getting on a dose of Semaglutide has been similarly life changing. The damn near elimination of "food noise" has been incredible.
>. I know there are a number of folks of the opinion that its somehow cheating. But for me I am left wondering "Is this just how normal people feel?".
Heavily under-weighting (heh) the opinions of people on the internet (and honestly most people in real life) is the way to go.
We generally don't (and shouldn't) ridicule people for taking scientifically proven treatments that can help save/prolong their lives.
Redster said a month ago:
As a fairly thin guy in my 20s (I was about 130lbs and 5'6"), I had years of undiagnosed hypopnea. I would wake up with tears streaming down my face and choking, but couldn't figure out why. I was constantly exhausted and yet, couldn't sleep. I would spend more than 12 hours in bed every night, hoping to get as close to 8 hrs as I could.
Paid for a sleep study and the doctor walked in the room and said, "You don't have sleep apnea." I was like, " I knew that, but what can I do?" The doctor shrugged and said, "You have hypopnea. You could try a mouthguard...?" trailed off and left.
So, with this newfound wisdom I was back at square one.
Some things that dramatically helped me in recovering from years of sleep loss:
- A chinstrap.
- I found a study (n=1, literally) about a patient who didn't fit the typical sleep apnea profile as a thin older man. The doctors treating him wondered if it was "positional sleep apnea" and had him get a chinstrap. This held his mouth shut while sleeping and prevented his tongue from falling back and blocking his airway. I found a chinstrap on Amazon and immediately started sleeping better.
- A blood test
- My doctor knew that I was dealing with adrenal issues due to not sleeping, Lyme disease, and other issues, so he ordered a blood test. This was fantastic. For me, addressing my underlying magnesium and B-12 deficiency made an enormous difference in sleep quality. I found that taking my B-12 right before bed helped my sleep be so much more restorative.
- Andrew Huberman
- Andrew Huberman's podcast Huberman Labs is old news, now, but when I found him a few years ago, it was some of the more actionable advice I had ever gotten about sleep, falling asleep, and circadian rhythm.
Anyway, there were more things across the way, but these are some things I shared with others that they also found helpful. I now am in control of my sleep and feel decades younger. You can get there! It's worth experimenting and finding a doctor who is going to help you find your problem. The mental clarity, focus, and energy has definitely made up for all the the months of trying to find out what was wrong with me.
I hope you sleep well!
cko said a month ago:
I had sleep apnea and got jaw surgery. But I also have a dysfunctional TMJ, so my mouth opens when I sleep. Every chin strap on the market pushes the chin down into the airway, it seems. Which one did you get?
Redster said a month ago:
I got some random generic one. I wouldn't recommend it as the quality could've been better. For you, I also tried tape over the mouth. I got a wide washi tape from a friend and experienced similarly helpful results to the chin-strap. However, I found that comfort-wise, I preferred the chinstrap.
But, if you can breath through your nose well enough, I think some kind of mouth tape can work? I haven't tried the Hostage brand anti-snore tape, but maybe someone here has had experience with that.
Based on the pictures, it obviously pushes the jaw backwards. That obviously wouldn't work for you. I wear mine in such a way that it is helping my jaw close and stay shut. I agree that you don't want something pulling your lower jaw backwards.
cko said a month ago:
Yep I've tried mouth tape and it's pretty good, especially when combined with side sleeping.
Though I have this paranoia that mouth tape will increase my philtrum length, which I know is a vain worry. Another solution is one of those incline pillows - just a 20% gradient should allow me to back sleep, which I prefer.
Post-surgery I had my jaws wired shut and they had this chin strap that was like an ace bandage that around my head and chin. I could replicate that with one of those mouth guard combined with a chin strap, but I read somewhere that this would eventually pull the upper jaw down towards the airway as well (since maxillary plates are not fixed.)
SamBam said a month ago:
Have you tried mouth taping instead? Seems to work better for some people than chin straps, but I don't really know.
dbspin said a month ago:
Thank you for this comment which mirrors my experience. Unfortunately CPAP seems to be considered the be all and end all of treatment, although the mask, tubes and reliance on such a bedtime setup can be enormously disruptive of sleep on its own.
elric said a month ago:
CPAP is by far the best option for very nearly everyone with obstructive sleep apnea (for now).
Unless you have a very specific, isolated problem (such as huge tonsils or a fucked up jaw), surgery is rarely a good option. Results are hit or miss, recovery is unpleasant, and the scar tissue created can result in more obstructions years down the line.
None of the current implants are as good as cpap and few peole qualify for them.
Mouth guards can work, but many don't tolerate them well and they can lead to TMJ issues.
Etc.
PaulHoule said a month ago:
I adapted to it really well but I am used to adapting to the needs of machines. My wife doesn't like it when it blows air on her but my cat is very curious about the mask. My doc told me that most people have a lot more trouble.
giantg2 said a month ago:
I think CPAP is just convenient and inexpensive compared to surgery. If I ever have sleep apnea, I'd want the surgery.
newaccount74 said a month ago:
I talked to a bunch of dudes who had various surgeries to open up their airways. It seems the outcome of the surgeries is kind of hit and miss. Some people had multiple surgeries and still no success.
poulsbohemian said a month ago:
This is a really important comment. Whether for apnea or other sinus related issues, I've met far more people for whom the surgery did nothing than people I've talked to who had good outcomes.
I have heard horror stories about the surgery. Who knows, but I’m skeptical because surgery presumes the precise cause is known. The number of variables for sleep apnea is large to have certainty.
giantg2 said a month ago:
"The number of variables for sleep apnea is large to have certainty."
Clearly they have to know which part of your airway is restricted. Most of the variables for sleep apnea are not related to the surgey, just factors that make it more likely to experience that restricted airway (drinking, weight, etc).
e40 said a month ago:
I have sleep apnea and I use a CPAP. During the diagnosis, there were tests but nothing that would/could finger a physical culprit that could be fixed via surgery.
My question is, what tools are there to narrow, to a certainty, what would need to be done via surgery? In all my research I have found none. Maybe I missed them. If I did not, then it amounts to a guess by a surgeon. And that's what worries me and has fed a lot of the horror stories I've read about.
monktastic1 said a month ago:
In case this helps anybody: I've been using those BreatheRight strips (extra strength) and they've been incredibly helpful. Not nearly as effective as CPAP, I'm sure, but a milder version of the same effect.
hombre_fatal said a month ago:
Tape didn't work for me. What did work were nasal dilators:
I don't understand why, but in my 30s, it's like my nostrils aren't big enough to get the airflow I need, especially when sleeping on my side where a pillow might compress one nostril.
Disclaimer: they are not very comfortable, but far more comfortable than a CPAP mask.
bluefirebrand said a month ago:
I feel the same way, I wish there was some kind of way to permanently expand my sinuses or something because I feel like I can't force air through them.
Sometimes just breathing hard through my nose starts to make my ears pressurize and threaten to pop
toasterlovin said a month ago:
> Sometimes just breathing hard through my nose starts to make my ears pressurize and threaten to pop
I had something similar (ears permanently felt like they needed to be popped, for months). Was diagnosed with a deviated septum + allergic response causing my eustachian tubes to not regulate ear pressure properly. Flonase helped. But cluing in that it was partially due to an allergic response (deviated septum made my nasal passage narrow, allergies closed them all the way), I have found that Benadryl is extremely helpful with both nose breathing and preventing the issue with pressure in my ears. I only take it when I have difficultly nose breathing.
bluefirebrand said a month ago:
I actually had surgery done to fix a deviated septum about 10 years ago, now you mention it
You're probably right it's allergy related. Nothing ever shows up on scratch tests though
I use a nasal steroid I just wish there was a permanent fix
instagib said a month ago:
There’s a metallic device to insert inside your sinuses. It looks like a finger trap with one side going to a point. I remember it lasts a few years then needs to be replaced for $1000 or so.
My grandfather looked into it because the surgery doesn’t last very long and he had it done multiple times.
konfusinomicon said a month ago:
nasal dilators definitely help a lot. I've tried the mute brand you posted and another style that smells of lavender and the mute ones are better. my only problem is I subconsciously mid sleep pull it out because they are a bit uncomfortable like you mentioned, or it falls out at some point of the night and gets lost in the bed. it is amazing how much more air I can breathe through my nose with one in though, and I definitely feel much more rested using them when they stay in. I knew they worked the first time I fell asleep and woke up the next morning in the same position
hombre_fatal said a month ago:
Yeah exactly. I frequently wake up to realize I yanked the sucker out at some point, sometimes even with groggy recollection of it. (Though I do the same to a CPAP mask when I use one)
But it clearly works in the best case scenario. And sometimes it's the only way I can even breathe well enough to fall asleep.
wnolens said a month ago:
That's a little upstream of where in one's anatomy is the common choke point - usually the back of the throat/soft palate relaxes and obstructs all breathing.
But I have nose blockage issues and use nasal strips nowadays, too. It prevents mouth breathing which is nice to prevent dry mouth in the middle of the night (which even a humidifier on my nightstand can't completely solve in my climate)
euroderf said a month ago:
I could not handle the CPAP mask but instead I got a dental appliance (custom) that juts out my lower jaw a bit. Worked great.
QuercusMax said a month ago:
I got a custom dental appliance for like $1000 out of pocket, and it broke within a few months, conveniently when I had moved out of state from my original dentist.
There are a few over-the-counter options that advertise themselves as just for snoring reduction - SnoreRX and ZQuiet are ones I've tried. I've found that wearing a BreatheRight-type strip along with one of these appliances works as well or better than the one I got from my dentist, and it's MUCH cheaper. I also take an anti-allergy nasal spray, as I have pretty bad allergies also interfere with sleep.
euroderf said a month ago:
I got mine thru the city health service, so I only made a token payment.
1000$ ouch.
johnbellone said a month ago:
Those never worked for me (mouth breather) but for some they do work wonders.
flanbiscuit said a month ago:
I have severe apnea and have been skinny most of my life, as I get older (in my mid-40s now) I can gain _some_ weight, but I'm still slim. My apnea is caused by having a narrow airway entrance and thick tongue that just completely blocks the entrance during sleep when my tongue relaxes and falls back. Has nothing to do with my weight, just the genetics I inherited. I use a CPAP that helps. My AHI is really low with it on. Now I just need to make myself go to bed earlier, I definitely have that "revenge nighttime procrastination" thing where I stay up way too late.
hackernoteng said a month ago:
I fixed apnea using MAD night guard (pulls jaw forward using a mouth guard device). Made by dentist. Cost about $2000. But it works.
QuercusMax said a month ago:
You can also try "snore prevention" night guards like ZQuiet and SnoreRX - they're less than $100 and you can buy them online. I find they work just as well as the custom night guard I got from my dentist.
ted_bunny said a month ago:
When you say fixed, do you mean you no longer need the device?
TurkishPoptart said a month ago:
Do you think sleep apnea is a condition caused by civilization? I.e. did medieval people suffer from this? And is this a consequence of the American diet and a sedentary lifestyle, or something else?
on_the_train said a month ago:
If it's not weight, what's the common cause? Such a bad impediment on so many people should have a very clear signal. And apparently it's not weight? O never really looked into it
schwartzworld said a month ago:
With obstructive apnea, it's mostly hereditary. You inherit the shape of nose from your parents, why not the structures in your airway? Weight gain can make it worse as those tissues also can expand, and any weight on your breathing can help turn a partial blockage into a full one. That weight can include muscle weight, and body builders often suffer from apnea.
But the thing to keep in mind is that obstructive sleep apnea isn't so much a condition as a description of what's happening. Apnea means you stop breathing, obstructive means something is blocking it. Maybe it's because your fat belly is weighing you down, maybe it's your tiny nostrils and deviated septum, or maybe the back of your tongue is thick because your dad also had a thick tongue.
That's not even including self-imposed factors like central nervous system depressants (alcohol) and smoking, both of which can make apnea worse. Ever notice how drunk people snore?
hombre_fatal said a month ago:
Beyond physical obstruction, sleep apnea can also be neurological which is the more annoying one since only air pressure seems to fix it. You simply stop breathing.
Obstructive apnea doesn't need to be caused by fat either. I always thought sleep apnea was a fat person's problem until I realized at age 30 that when I slept on my back, the tissue mass at the base of my tongue was dropping into my airway. And I'm fit/slim and also a nasal breather.
(I used to think I always woke up gasping for breath in my 20s because I had frequent nightmares. Ugh, wish I could go back and fix it sooner.)
kkwteh said a month ago:
One theory is poor facial structure that develops due to faulty breathing technique.
One theory blames "modern life" as a supporting factor, that since modern people eat more processed and softer food, that jaw muscles are out of proportion to the bone structure and this contributes to apnea, as well as tooth problems like impacted wisdom teeth.
It's not exactly common, but you can have central sleep apnoea instead of obstructive sleep apnoea. Essentially, rather than your airway being blocked, you just stop attempting to breath for a period of time. I was diagnosed with this a few years ago, and IIRC there are multiple possible causes of it.
wredue said a month ago:
The most common cause of sleep apnea is anything that obstructs your airways. Being overweight does that and is far and away the most common cause of sleep apnea.
elric said a month ago:
This is such an often repeated trope, but it's not at all as clear cut as that. Sleep apnea *causes* weight gain, the arrow of causality can go both ways.
maxglute said a month ago:
Sometimes I wonder if humans need more variability in sleeping positions. Animals sleep in all sorts of positions on all manners of not perfectly even terrain, probably trains nassal to be strong in different orientations. When I had bad heartburn/gerd I'd pass out propped up on the couch or setup a bunch of cushions in the corner of the room, or raise head of my bed up with a few books and getting great sleeps.
johnbellone said a month ago:
I’ve had sleep apnea and CPAP for years. The last several weeks have been grueling because of mask fit, movement, and other factors. My BMI is very high, but I am in minority that will have sleep apnea regardless due to anatomy. That doesn’t mean it won’t help to lose weight.
Fire-Dragon-DoL said a month ago:
I'll throw this out based on the comments I'm reading, it seems like doctors don't personalize medical advice sufficiently.
Glad some people were able to find the good ones that did
MuffinFlavored said a month ago:
How would one know if they had sleep apnea in any shape/form?
instagib said a month ago:
Get a sleep study for accuracy.
If your partner notices you snore or stop breathing when sleeping.
You can record yourself also. You wake with a headache and dry mouth almost daily.
Vaslo said a month ago:
Sleep apnea is not the reason people are overweight.
david-gpu said a month ago:
If you are so confident, try setting up an alarm to wake yo up 15-30 times every hour of every night, for a year. See what happens to your overall health and to your weight in particular.
And that is moderate sleep apnea. Actually, apnea is worse because you wouldn't even be breathing normally while you are "asleep".
mort96 said a month ago:
Nobody is overweight from one reason alone. But do you dispute the idea that it contributes?
anonuser123456 said a month ago:
Sleep deficit drives metabolic changes that may result in obesity (e.g over feeding behavior).
edu said a month ago:
I’m the dad of a 7 month old baby. I think I feel around 100 years older than I actually am.
gambiting said a month ago:
I feel you - our son had about 6 months(from ~4 months old until 10 months old) where he just wouldn't sleep for more than an hour at the time, then would wake up screaming and it took at least 30-40 minutes to put him back to sleep. I think in that period me and my wife were actual zombies, just didn't get any sleep at all, there was a point where I thought to myself I haven't had more than 2 hours of continious unbroken sleep for few months, and that there is no way this can be healthy lol.
Also, I know saying this now doesn't help, because at the moment you are in one of the most "intense" periods of their development where they need all of your attention but give relatively little back - but that will improve. They will eventually sleep better and they will start telling you how much they love you and kiss you goodnight - and then all of those early months are forgotten :-)
tutfbhuf said a month ago:
I can relate, sleep deprivation can have serious health effects. We did night shifts on cycles every other day, where one parent slept through the night on the couch with hearing protection, while the other stayed with the baby in the bedroom. This method worked out quite well. The advantage is that the parent who slept on the couch has more energy during the day for the child and can enjoy the time more, which is also beneficial for the child.
fullstackchris said a month ago:
so... what are you supposed to do if you have a full time job?
n4r9 said a month ago:
I have an 8 month old and am full time while mum's on maternity leave. When the baby was ill recently, at times he wouldn't sleep unless he was being held by a standing person. I'm not kidding - there were nights where sitting or lying down as gently as possible would wake him up. We ended up doing half-night shifts where I'd have him from 8pm to 2am and then mum would take him from 2am-8am. I'd wake up at 8am, put him in the carrier for a nap while mum napped as well (30-60 mins) and then start work.
How parents in the US do it when maternity is only 12 weeks unpaid... I have no idea!
Loughla said a month ago:
I caught shit from my ex-employer when out latest was born because I wanted to take 2 weeks off. 2 weeks. It was part of my review that year before I even took the time off.
I left that company the same day. We lived VERY lean for a year or so while I figured out a new direction. Thank Christ for a supportive family.
n4r9 said a month ago:
That's just awful. As a new parent I'm so much more keenly appreciative of these kinds of struggles. I found 4 weeks of pat leave and a very gentle re-introduction to work very challenging, let alone bringing up an infant without an income. I'm glad that you had family around to support you and that you did indeed find a new direction (which it sounds like you did).
gambiting said a month ago:
As a dad I only had 1 month of paternity leave and I still found it incredibly difficult to go back to work(not because of work, but because my son needed a lot of support and I wasn't able to provide it). 2 weeks would be literally impossible, I think I'd resign.
MrDresden said a month ago:
And coming from the nordics I wonder how the parents in the rest of Europe do it when there is barely any paternity leave.
n4r9 said a month ago:
Yes, I'm very jealous of what you get, "up north". Some companies in the UK are generous - I hear Google (or at least DeepMind) provides 3 months - but some dads in my antenatal class only got a single week off. And some of the mums went back to work after 6 months, putting the baby in nursery at that age.
gambiting said a month ago:
UK is weirdly crap at it compared to other European countries. Dads only get 2 weeks at statutory pay(like £150 a week), mums can take a full year but they get progressively less with time, where if I remember correctly after the first 3 months they only get statutory pay(about £600 a month) then in the last 3 months they get absolutely nothing. So yeah, no surprise women are getting back to work sooner - the financial penalty for staying on maternity leave is huge.
n4r9 said a month ago:
I'm not sure if her company is particularly generous, but my wife is getting 3 months at something like 80 or 90% pay, then 6 months stat pay, then 3 months nothing. Fortunately she still accrues annual leave during the year, which means we do have the option of covering the final month at full pay. We're going to try to tough it out and tack a month of leave on at the end instead.
How old is/are your kid/s now if you don't mind me asking? And did you have another one after the terrible sleeper? I only ask because we're now in that phase of trying to decide whether having another one is what we want.
gambiting said a month ago:
Sorry for the late reply - our kid turns 3 next month.
And nope, I'm very much against having another one, exactly because the first one was such a bad sleeper, every time I start thinking whether to have another child I remember sitting on the floor and literally crying because I was so exhausted and he just wouldn't sleep, or doing something and just knowing that he will wake up in an hour and there is nothing I can do to prevent that. It was absolutely awful and I don't want to take that risk again.
Having said that......he is an absolute angel now. Very bright, very cuddly, loves to play and hug and definitely reciprocates all the love we give him. So I do sometimes think "wouldn't it be great to have another" - and then I remember again.
n4r9 said a month ago:
Thanks for the reply. I think that is a common theme - first kid being a bad sleeper makes a second kid much less likely. We're on the tail end of an illness now and he's rarely going for more than 1-2 hours without attention. And he's never regularly slept for more than 45 mins in a nap. It must be a huge difference in quality of life if you know that they're going down for a 2 hour afternoon nap. You can nap yourself, or get a workout in or something. That said, I've heard nightmare stories even at your daughter's age. One friend couple of ours has a 3 yr old who wakes up between 2 and 4 am every night, and needs playing with and reading to.
> I remember sitting on the floor and literally crying
I feel this, and it's still like that for me sometimes. Last night I shouted "Just go to sleep!" at him, I got so frustrated and upset because he kept taking his own dummy out of his mouth and waking himself up. I'm really hoping that once he starts either crawling or walking he'll burn off that energy and sleep better.
mcntsh said a month ago:
This is why I love Germany, because you don't have to ask questions like this. You have the right to take a year off (or more) as a father and mother and the state pays you.
jcul said a month ago:
What the parent comment is suggesting is every second night one person gets a solid night sleep.
It's a great strategy for survival. We did this a lot with our second child and still so sometimes if there is a patch of disrupted sleep.
The person with the child is not getting zero sleep. A small baby can't stay awake for an entire night. So you could get two or three hours in small batches.
You are exhausted the next day, but at least you have the following night to recover.
If you have a full time job you just do your job. You are really tired and not operating at 100℅ but you get through and it is better than having 2 or 3 hours broken sleep every night.
tutfbhuf said a month ago:
It will be a challenge for a few months, but as other parents pointed out, it will improve over time. My advice is, if you plan to have kids, then try to reduce any other factors of stress, such as work-related, as much as possible, because your kid requires full attention, especially in the beginning.
a_e_k said a month ago:
My experience as a working parent has been that you just have to muddle through some days one way or the other. (But taking longer shifts like GP mentioned works way better than trying to split the difference within a single night.)
InitialLastName said a month ago:
Answer A (because capitalism is for sociopaths): Sleep train
Answer B: Work harder on the days you have energy.
PaulHoule said a month ago:
We just slept with our son in bed and didn't have a fraction of the problems in this department.
lolinder said a month ago:
This should be obvious, but you also had a different child.
Our oldest child wouldn't sleep until we got him not only out of the bed but the bassinet all the way out of the room.
Our second child slept like a baby pretty much whenever.
Our third did fine in the bassinet, but now that she's older and transferred to the nursery she wakes up if even the slightest bit of light comes in through her door.
Kids are wildly different from one another from a very young age. I wouldn't assume that your cosleeping is the cause of your having fewer sleep troubles. If anything it might be the reverse.
skrbjc said a month ago:
Makes you wonder where "sleep like a baby" comes from, because it definitely seems like only some babies are great sleepers.
edmundsauto said a month ago:
It could also mean that you wake up every 2 hours and crap your pants crying! That’s why it’s such a great term - it can mean almost anything.
yayitswei said a month ago:
Older babies do tend to sleep very soundly though!
gambiting said a month ago:
One thing I learnt a while ago is that every child is different and that everyone(me included!) love to extrapolate their own experiences on everyone else.
But yes, in hindsight I would probably try some form of co-sleeping, even though everyone around us was advising against it(too much of a risk).
Balgair said a month ago:
I've dug into the studies on the co-sleeping risks.
It turns out that co-sleeping is a risky thing if you are on drugs or are drunk.
If you are 100% sober, then it's perfectly fine. If you are high, or have had a drink, or are on some sort of flu medication (NyQuil, then the risks start ratcheting up.
So, since we're most worried about the parents that do drugs and drink around their infants, the common advice is to no co-sleep. It makes sense, I totally agree with that tack, but if you are willing to be 100% sober of all drugs and alcohol, then try co-sleeping and see how it goes.
nineplay said a month ago:
I didn't co-sleep with my first because of the warnings about co-sleeping. Instead I'd fall asleep in my office chair with my feet propped up on the coffee table.
Finally realized that I was going to fall asleep somewhere and did the same research. Co-sleeping sober ( and with a healthy BMI ) is safe and often better than sleeping somewhere else. We don't all have the money and space for cutesy recliners.
hzay said a month ago:
I also have always slept with our child in our bed. This hasn't done much for my sleep.
jcul said a month ago:
First child was terrible, she preferred having a bit of space I think, and she would flip around in the bed so you'd be constantly woken up with a foot in the face etc.
Second child did like to sleep in the bed and still does, though now we are trying to break the habit.
Each child is different and even one child can change a lot through different developmental stages.
hzay said a month ago:
> there was a point where I thought to myself I haven't had more than 2 hours of continious unbroken sleep for few months
Omg same, but for more than 2 years, because I'm a breastfeeding mom. Idk how this is healthy or normal!
UniverseHacker said a month ago:
People who haven't been through this often underestimate the severity of it... they often think that because they've pulled all-nighters for school or something that they understand but weeks or months of chronic sleep deprivation is a totally different thing.
It was living hell for me- my son wouldn't sleep during the night for more than 10-20m at a time, and my partner was having severe postpartum mental health issues (psychosis/rage/depression) so I was parenting solo, and up all night every night by myself with a crying baby. I eventually started hallucinating, and had a short temper and made very poor decisions. I couldn't get advice, help, or sympathy from anyone- usually something along the lines of "parenting is so easy for dads, why are you complaining?" Visiting family would expect me to serve meals to them, and not help either.
I almost lost my job also because I couldn't focus or code anymore. Once I started sleeping in a separate room from my son, I could finally think/code/work again. Understanding in the workplace for a struggling new dad was non-existant: everyone assumed the mother was doing all of the work, and I would perform like normal.
If anyone is reading this and can relate, don't do what I did- pay for help. Pay for a nanny- take out a loan if you have to. If you or your partner is struggling, get them professional mental health support. Prioritize your sleep, bodily, and mental health needs: you need to "put the mask on yourself first" or you can't help anyone else. Don't be afraid to set a crying baby in a safe crib and go sleep for a while if you need it.
chasd00 said a month ago:
To you and the others, just hang in there it gets better. You’ll get through and come out the other side better, stronger, and full of more love than you thought existed.
/father of a 14 and 12 year old boys
garrickvanburen said a month ago:
^ fully agree. I blinked an my youngest was suddenly 10yrs old. The kids all being in double digits is really awesome and far less labor intensive than the early months.
jrussino said a month ago:
A lot of people here will say "it gets better", and it does, but be sure to take your health seriously and not let yourself normalize that feeling for the long-term. Mine are 7 and 4 now and we're well past the sleep-deprived early years, but I realized recently that I had grown accustomed to that feeling and my new baseline is significantly worse, largely due to bad sleep habits. I'm a lot busier now, juggling the needs of 2 kids and my other responsibilities, and for too long I've coasted on ~5-7 hours of sleep thinking it's OK to sacrifice 1-3 hours of sleep in favor of squeezing in extra work or some low-quality leisure time at the end of the day because, "hey, it's still better than it was when they were babies, and I made it through that".
jmacd said a month ago:
Posting this here, because it was advice given to me by one of the founders we all look up to on HN when I had my first child (on our 4th now).
"If you are going to have kids and run a company, you all need to sleep." and then he introdued me to a sleep trainer/coach.
"No way, we are not sleep training" was my thought, but I quickly realized that there is a difference between sleep normalization and what we know as sleep training.
The sleep coach gave us a completely customized regime for 2 weeks. Once the baby is 6 months or so, you can start. (up until 6 months, I just slept with the kids in my arms every night. Oh my god I miss those nights now. It makes me cry to think about how wonderful it felt.)
We've done it 4 times now and all our children gladly sleep from 7pm to 6:30am every single night. (The older ones now go to sleep more like 9pm). Everyone in the house is rested every day and it makes a big difference. Those two weeks are a lot of work for one of the parents (it is specified that one person should be focused on it) but in our experience it works by the 3rd night or so.
The main takeaway from the aproach is to disassociate eating and interaction from the act of sleeping. It created buffers between feeding times and play times and when you finally put them down in their crib to sleep. If they do wake up during the night they don't think "oh, if I cry I will get to eat right away." and they self-soothe and go back to sleep. If they do wake up hungry, it's a failure of the parent to have ensured they've eaten properly. You adjust as they grow. (A hungry cry is totally different from a discomfort or bored cry. You learn them pretty quickly.)
When I put my 10 month old in his crib to sleep now he looks back at me briefly and then turns over and gets in his sleeping position and he's asleep before I leave the room. It's such a relief knowing that no matter how badly a day goes, you can sleep that night.
I've had a lot of friends think this isn't for them, but 100% of the ones I have convinced to do it (and in some cases have just paid for) have been successful.
I'll also add that 2 of our kids were "colicky" and were very unfcomfortable during the day for their first year. Even still we were able to have them sleeping the entire night most nights after 6 months.
Again, there is no "cry it out". In fact, the baby almost never cries at all in this process in my experience.
cblum said a month ago:
> "oh, if I cry I will get to eat right away."
This kinda matches what I’ve read recently in a parenting book.
I’m currently reading Bringing Up Bébé, a book written by an American journalist who lived (maybe still lives?) in Paris and had her kids there. She wrote it after she started observing that French parents don’t seem to have the myriad of exhausting issues American parents have, or at least not with the same intensity and for the same duration.
When it comes to sleep, she writes that most French babies sleep through the night by the time they’re 6 months old.
According to her, what a lot of American parents (and from my experience as an expat, parents from several other countries too) do wrong is to immediately tend to the baby the moment they make any noise at night, in the first months few of their lives (this apparently doesn’t apply to the very first month though). That trains the baby to do exactly what you wrote, to get what they want as soon as they wake up in the middle of the night.
According to the author, French parents typically wait a few minutes whenever the baby wakes up at night. Most of the time the baby goes back to sleep.
The explanation she offers is that babies’ brains don’t know how to link one sleep cycle to the next, so they wake up between cycles and typically cry or fuss for a bit. By leaving them alone for a few minutes instead of instantly reacting, parents can help their brains learn to connect sleep cycles more efficiently. If they’re immediately picked up though, they’re actually being trained to do the exact opposite and to stay awake instead.
I really like your post btw, going to look up what you wrote about as it sounds invaluable in case the French method doesn’t work :)
mreezie said a month ago:
Can you point me in the direction of this trainer/method?
thehappypm said a month ago:
Taking Cara Babies, by Cara Dumaplin, is an excellent resource for sleep training that works super well.
misiti3780 said a month ago:
who is this coach?
inference-lord said a month ago:
100% having the same experience. It's mind bending how tired you can get.
We recently all had the flu, 2 nights of the baby having a fever and both of us being sick and also having a fever was one of the most testing things in my life.
verisimi said a month ago:
Best advice I heard on this, is for partners to take turns to get sleep if possible. Perhaps it's obvious, but we didn't do that initially. You really only need 3 hours or so (in my experience) and the insanity starts to subside.
david422 said a month ago:
My wife and I had a spare bedroom - we used to alternate nights down there when our child would scream all night.
objektif said a month ago:
Try having a kid with febrile seizures. Mine runs 105 fevers casually for 5 to 7 days. We have to check her very often to make sure she is not going into a seizure.
2024throwaway said a month ago:
Sorry.
But it’s not a contest.
objektif said a month ago:
Oh no did not mean it that way. Not that I want a trophy for sleeping less lol. My point was as a new parent things can get a lot worse in terms of sleep deprivation. I was not prepared for it.
meindnoch said a month ago:
I'm in the same shoes, and I often wonder why evution haven't solved this yet... Like, babies' chance of survival should drop if their parents are sleep deprived. There should be a selection pressure for well-sleeping babies.
Or is it about ensuring that mom and dad don't make a sibling that takes away the baby's resources?
dgfitz said a month ago:
I think that is part of the "it takes a village" saying. Communities/grandparents (of the baby) were all either in the same abode or most likely very close.
Having run the same gamut three times, the best advice I ever got was: chunk sleep. Let the wife sleep for 4 straight hours, and then tag out, where the awake person sleeps if/when they can. I know nursing can gum this up, but either pumping, or just doing the formula thing, it's worth it.
pfannkuchen said a month ago:
The current situation of 2 parents alone in a box (“house”) with baby is severely unnatural. I don’t think there is an evolutionary explanation because in this regard we are out of spec.
lr4444lr said a month ago:
It did: live in extended family dwellings. The modern nuclear family (with 2 working spouses to boot) is the problem.
HumblyTossed said a month ago:
> I'm in the same shoes, and I often wonder why evution haven't solved this yet
It did! But we, in our infinite wisdom, got selfish and we now live alone. Fight nature and she fights back!
PaulHoule said a month ago:
It is our own damn fault. Back in the day people slept with their kids and being close to their parents meant they felt secure and would (1) sleep through the night, and (2) if they needed any attention it would be easy to give it to them.
Somebody invented the crib, got rich at our expense, and now people can't imagine life any other way.
lordswork said a month ago:
It's more of the fact that we discovered the scientific method and measured that cosleeping is statistically more likely to kill your child. Even if that increase % is small, it's enough for most (western) parents to make the tradeoff and suffer through sleep deprivation.
And the tradeoff makes sense -- as a parent, you are biologically programmed to go through great lengths to keep your children safe.
marbartolome said a month ago:
Recent take of science is that co-sleeping is actually safer (reduces SIDS) if taking a couple of precautions.
Parent under drugs/medications (including smoking) is mainly what drove the death statistics in cosleeping.
Don't have links to studies but is what is teached in official parental education courses in spain atm.
lordswork said a month ago:
Would love to see the sources if you have the time to share them.
PaulHoule said a month ago:
Some have made the case that “cry it out” is preparation for sitting there and suffering while you get bullied in school, while your group gets discriminated against, when employers treat you like a thing, or when politicians scapegoat and steal.
lordswork said a month ago:
This has nothing to do with the scientific method informing our parenting choices.
robocat said a month ago:
> biologically programmed
You mean Socially programmed.
Instincts are biological programming.
lordswork said a month ago:
I'd say you have instincts to protect your child.
n4r9 said a month ago:
All I can say is that doesn't jibe with our experience.
We co-slept for the first 2-3 months, then had baby in a "next-to-me" for a few months, then moved baby to a crib in his own room at 6.5 months. Prior to being in their own room, the baby would usually wake up every 2-4 hours, with the very occasional 6-7 hour stretch. After going in his own room, his sleep began to consolidate and he would regularly last from 7-8pm to 4am without needing resettling.
We have friends with a 4 year old daughter who co-slept until now and have just moved her to her own room. She wakes up screaming and needing attention most nights around midnight.
alex_duf said a month ago:
Isn't co-sleeping a significant cause of death though? So maybe our society traded sleep to get a higher survival rate
PaulHoule said a month ago:
There are two versions of this story.
"It's very safe to sleep with your baby unless you sleep with your baby drunk or on a small couch", and
"It's very dangerous to sleep with your baby especially if you sleep with your baby drunk or on a small couch"
That last bit is right and a study found "The risk associated with being found in the parental bed was not significant for older infants (>14 weeks) or for infants of parents who did not smoke and became non-significant after adjustment for recent maternal alcohol consumption..."
Anyone who has shared a bed with a cat or small dog would note that you never roll over and crush it.
arkey said a month ago:
Thank you for this.
xyzelement said a month ago:
As others are saying, how tired you are as a parent is a direct inverse function of: how far away your parents/inlaws live, how much they prioritize their grandchildren over boomer pastimes, and your relationship with them.
forgotmyinfo said a month ago:
I've never seen a more zombified human being than when a friend had a fussy baby who simply would not sleep. Two hours a night was her and her husband's norm, sometimes. Godspeed, I hope you can get some rest soon. (Also, congratulations on the new baby! :))
bicepjai said a month ago:
It felt good to read the stories that we can relate to, we have a a 2.5 year old; literally sleep deprived and these stories woke me up, thank you and good morning. I can see aging process is definitely faster with sleep deprivation. We can physically see it in our photos timeline and feel it in our workouts that we work so hard to keep up. Grey hair and baldness surged in this 2 years. We use to have so much energy in the evening for personal projects after work, not anymore. It’s so hard to deal with this both mentally and physically. Sleep training definitely helped us, but again every experience is unique.
Hold on and it will pass.
silveira said a month ago:
2 years and 5 months here. He never slept well, wakes up during the night, makes all sorts of sounds while sleeping, and wakes up early (5~6 am). Doctor said some kids are like this and it may get better over the years. The lack of sleep took a lot of my concentration, energy, and memory.
pdxandi said a month ago:
Same here. 3.5 year old and one year old twins. Poor sleep and just general fatigue most days. It’s hard to convey to those who sleep well how challenging it is to be constantly sleep deprived.
caporaltito said a month ago:
Keep in mind: this period does end at some point. All the best!
chasebank said a month ago:
For the love of god, sleep train your baby. There are coaches online if you need help.
ActionHank said a month ago:
Ask your doctor about Modafinil, my GP prescribed it for me when my son was born and it was a life saver.
xyzelement said a month ago:
I found myself feeling "old" during north east winters, I would wake up exhausted and crabby.
Recently I tracked this down to indoor air quality, installed an ERV (basically, introduces fresh outside air into the house) and I feel much better.
There's a lot of talk about (obesity related etc) sleep apnea that's due to how the person breathes, it seems to me that there's a version of it related to WHAT you breathe.
Granted I think I am more sensitive to indoor air quality than an average person or maybe just more aware of the effect, but this seems to have been a game changer in a way.
chankstein38 said a month ago:
I'm having a very similar experience with indoor air quality in winter. Googling ERV doesn't deliver anything. What would I look up to find what you're talking about?
xyzelement said a month ago:
It stands for "energy recovery ventilator" - in a nutshell it just blows fresh air into your house and exhausts stale air, but uses the heat in the exhaust air to warm up the incoming air so it's more comfortable and energy efficient compared to an open window with a fan in it.
Before you go too far that route (a multi-thousand dollar install) I recommend getting an indoor air quality meter to get a sense of what might be the problem. I recommend the Airthings View Plus, which is about $300 but is comprehensive and reliable and since (in my case) I made a multi-thousand dollar decision based on it, it was worth the investment.
In my house it was obvious there's a massive CO2 buildup, CO2 itself isn't as big a deal itself but an indicator of stale air (ie, it's not being vented out by itself) and somewhat elevated radon. The ERV isn't the "prescribed" solution for radon but since it ends up venting it out it's fine.
One last thing - for me, the connection between energy and indoor air quality was obvious in retrospect. I could wake up early and be miserable, but once I stepped outside to take my son to school I'd feel better. Or vice versa - I could be full of energy running around all day, then come home and immediately get drowsy.
It only took about 15 years to realize indoor air was the cause.
gilbertbw said a month ago:
This is called MVHR (mechanical ventillation with heat recovery) in the UK. We're looking at putting it in, but have a fairly poorly insulated house, so it's not clear if the heat recovery is worthwhile. There is also PIV (positive input ventillation), which blows fresh air into a property (normally the hallways), but does not recover heat, or duct air from the rooms. So it's much simpler and cheaper to buy and install. It relies on the natural 'leakiness' of the property to vent stale air out.
xyzelement said a month ago:
// This is called MVHR (mechanical ventillation with heat recovery) in the UK.
These are actually two subtly different things. ERV (what I am talking about) recovers some of the moisture content along with heat, while an HRV (heat recovery ventilator and probably what you're talking about) does the heat but not the moisture. Depending on where you live this matters or doesn't matter (eg, if your winters are really dry and/or your summers are really humid, you want the ENERGY recovery ventilator to keep the house humidity closer to what you want vs equalizing with the outside.
// We're looking at putting it in, but have a fairly poorly insulated house, so it's not clear if the heat recovery is worthwhile
This doesn't make sense to me at all. First, if your house is "leaky" then why do you need mechanical ventilation at all, versus just relying on the natural air exchange (I can think of a valid reason but just curious how you think about it.) Second, if you DO put it in, your house is obviously better conditioned inside compared to outside so why wouldn't you want to recover that heat, at least for comfort if not economy?
// There is also PIV (positive input ventillation), which blows fresh air into a property (normally the hallways)
Yut but I think your hallway is then going to be as cold as the outside in the winter?
goalieca said a month ago:
I find having kids in my late 30s hits really hard because of this. Biologically, I can see it being best having kids in your early 20s when you're made of rubber and can bounce back after lack of sleep.
lolinder said a month ago:
I had my first in my mid twenties and there wasn't a lot of bouncing back happening.
In college you can bounce back after an all nighter not just because you're younger but also because it's an opt-in single event and you can opt out of the next one when you recognize that you're sleep deprived. You can also do what my brother does and regularly sleep in till 10 to make up for the late nights.
Once you have kids there's no opt out mechanism, and sleeping in isn't an option any more. There's not really an opportunity to bounce back from the sleep loss, even for a younger adult.
hipjiveguy said a month ago:
but your body is more resilient when you're young - you will learn this eventually, but hopefully not :D, in that you are healthy forever !
silverquiet said a month ago:
I hear this all the time regarding bouncing back after lack of sleep when younger, but I have to say that I never really experienced it - I was always completely shot after a (rare) night of not sleeping. To the point where I actually essentially lost consciousness involuntarily for a few hours on one occasion. Then, when I was in my 30's I suffered a bout of sleeplessness for a bit and found I could actually "function" to some extend during the day, though it was a bit dicey.
It really gave me a fear of situations that might involve sleep deprivation - one reason among many I never thought I could handle medical school for instance.
yosito said a month ago:
I'm in my late 30s, and physically healthy. Mentally, I can function better on low sleep than I could in my 20s. But two weeks ago, I had five nights in a row of 4 hours of sleep. By the end of the week, I ended up in the hospital with chest pains and doctors were concerned it was a heart attack. In the end, things checked out fine, but my body definitely can't handle the stress of lack of sleep like it used to.
QuercusMax said a month ago:
I had 4 kids in my 20s, and I dealt with a lot of lost sleep.
Since I hit about 36, I've found that a poor night of sleep, such as from a red-eye flight, will wreck me for about 2 days.
hackernoteng said a month ago:
Yeah have the young kids in your 20s. Thats why you dont need sleep in your 20s. Also has benefit kids are grown and moved out by the time you hit 50...
nadermx said a month ago:
A thing I noticed had a dramatic effect on my sleeping was forcing myself to keepy my mouth closed while doing any sort of excersize, be it running or calisthenics. It forces my entire nasal cavity to empty all the mucus, and I can breath significantly better and my sleep improved dramatic.
globular-toast said a month ago:
I was having problems breathing through my nose too. It led to snoring and I felt like a had a blocked nose more often than not. Other than forcing myself to breathe through my nose I also got one of those sinus rinse bottles and did some salt rinses.
It's made such a huge difference. After years of having a blocked nose I sometimes just take a moment to enjoy the fact I can breathe through my nose at last. I've also gone from being a snorer to a "very quiet sleeper" according to my girlfriend.
Waterluvian said a month ago:
A week of broken sleep is enough to change my whole personality. I end up hopeless, self-destructive, and convinced that I’m going to die imminently for some reason. Just this conviction that my heart is going to wear out any day now. It’s such a bizarre experience, especially to finally get sleep and wake up with such energy and positivity.
eqmvii said a month ago:
Classic symptoms of anxiety from the sleep deprivation, no?
I've also found that there's a lag on recovering from sleep deprivation, where the first night of good sleep often leaves me feeling foggy and lethargic the next day. After 2 or 3, that energy and positivity returns - not sure if that's idiosyncratic or not.
maksum said a month ago:
I feel exactly the same way. The first night of real rest feels as if my body “caught up” to how sleep deprived I was and I often don’t accomplish much that day.
donatj said a month ago:
The first two months after my wife had my daughter about a year ago, I was a walking zombie.
I wasn’t really here. I tripped and fell down so many times. I had not fallen down since I was in my teens and I am in my late 30’s.
I really had no idea how bad lack of sleep was going to mess me up. Of the things I had planned for in having a child, I was absolutely not prepared for this.
failrate said a month ago:
One of the hardships of sleeping rough is that poor sleep quality can rapidly degenerate your cognitive function. Simply put, being homeless hurts your ability to escape homelessness.
diggan said a month ago:
> Simply put, being homeless hurts your ability to escape homelessness.
Same with sleep surely, where bad sleep leads to worse sleep...
jmpman said a month ago:
This is why I need to work from home. I have random periods of chronic insomnia. If I’m able to get a nap in, it breaks the cycle. If not, after 2 days, I begin to spiral down. When in the office, I could only recover on the weekends, leaving a productive Monday and Tuesday.
galdosdi said a month ago:
If only your job let you have a real office with a door, you'd have no problem working from the office.
A lot of the benefit of WFH is just undoing the damage of open office.
Not long ago Google was famous for having nap rooms (supposedly -- I never found it at the NYC office when I worked there in the mid teens).
But in the days of private offices, this was just normal.
rcbdev said a month ago:
Semi-agree. I have my own office, my boss would still say something if I dragged a couch in here. This was the case before open office took over in the private sector as well.
Couches were always reserved for managerial class, since the 80s.
chankstein38 said a month ago:
I also work from home and take lunchtime naps most days! I have been chronically deprived of sleep for a while by an old dog who doesn't relax for more than 5hrs at a time and I think I'd be dead without my lunchtime naps.
bdw5204 said a month ago:
I've found that my body can tolerate one day in a row of waking up via an alarm clock instead of at my natural wakeup time. The second day, I'm completely exhausted and can't think straight.
The way to sleep effectively and be most alert is to sleep when your body tells you to not when society tells you to.
ActionHank said a month ago:
I hate the fact that I must sleep everyday. I have always tried to get around 6 - 7 hours a night as a result.
Through my 20s it wasn't an issue, but I stopped gyming a few years back and it has been hard if I lose any sleep.
I started working out again and I am back to 6.5 hrs a night, no problem.
bibliotekka said a month ago:
Almost 50, working out more than ever, super clean diet and it really is the key to maintaining all kinds of energy and stamina, good sleep, focus, all that stuff.
pjc50 said a month ago:
I'm hoping that someone will ""solve"" poor sleep, in the sense of working out how to determine what's actually causing it. What's the state of the art in affordable home sleep analysis? Smartwatches?
RattlesnakeJake said a month ago:
> ...what's actually causing it.
I'm not sure a smartwatch could do anything with my chronic diagnosis of "Having a toddler kicking my ribs at night."
yosito said a month ago:
The good news is that condition usually resolves on its own with time!
diggan said a month ago:
Anecdote, but I've found that the less I analyze and try to "mold" my sleeping, the better I sleep. The times I sleep worst is when I'm worried about sleeping too little, so whatever I can do to take my mind off how poor my sleep is, the better rested I feel when I wake up.
Some nights are still horrible though, and it's a hard loop to exit when you lie there at 03:43 in the morning and panicking about getting too little hours this night...
doubled112 said a month ago:
I know that feeling. You're probably onto something. If you worry about something, I think you always make it worse.
There was a point where even other people worried about me sleeping, and that made me worry about my sleep.
Eventually I decided I would go to bed when I was tired and see how it went. Been doing that half my life now. I go to bed when I'm tired (about 12-1am) and I usually wake up at 7AM feeling fine.
Forcing a whole 8 hours often makes me feel worse. YMMV
ambicapter said a month ago:
Yes, I've had terrible sleep most of my life, and a period of good sleep recently. Felt stupid, but I realized during that good period that I just needed to "chill" when going to bed. My brain has a tendency to WANT to focus, and actually slowing down is almost a foreign state at this point, and it's exactly the state you need to get in to naturally fall into sleep.
schnuri said a month ago:
For me it’s the same. The moment I accept that I’ll be super tired the next day is the moment I finally fall asleep.
eszed said a month ago:
Listening to podcasts helps me. It gives my brain something else to focus on, and I drift off much more quickly.
QuercusMax said a month ago:
I like listening to podcasts as well, but the ones I like when trying to fall asleep are different than those I listen to recreationally when doing chores. For falling asleep, I need to make sure whatever I listen to is something I'm OK with missing, so call-in shows often are a good fit, as there's infinite content in a call-in type show.
forgotmyinfo said a month ago:
Sleep studies exist, and they're fairly advanced, is my understanding. For most people, though, it'll be possibly difficult lifestyle changes, like reducing light in the room, better bedding, less noise, not sleeping with a partner, winding down before bed without screens (big one), better diet, etc. The solutions are there, they're just unpalatable, like everything else you should do that's good for you.
0xcde4c3db said a month ago:
Sleep studies collect a lot of data, but that may or may not translate into an actual intervention depending on the situation. As I understand it, they're mostly useful for detecting when sleep is disrupted, which can then potentially fit a profile for e.g. sleep apnea or be correlated to some other physiological indicator.
As for lifestyle changes, I'm not an expert in sleep science, but I've tried to read some of the literature to understand what works, since I struggle with sleep quality. As far as I can tell, a lot of the specific suggestions that often get thrown around (even by otherwise reputable sources, sadly) are somewhere between speculative and pseudoscience. There is some evidence that "sleep hygiene" interventions as a whole might have some kind of effect, but the individual components aren't typically tested, the studies usually aren't adequately controlled, and the effect is often exaggerated (e.g. by highlighting questionable measures like "sleep efficiency").
CBT-I has better evidence, although it's also not entirely clear which components are really worth the trouble (the evidence for sleep restriction seems pretty strong; the "CBT" elements less so, but it may be that they help different subpopulations), and clinicians who actually have experience delivering CBT-I are not readily available in many places.
thibaut_barrere said a month ago:
I have followed a distilled version of CBT-i remotely via SleepReset (a HN company), because I discovered CBT-i but it wasn’t indeed readily available in my country and region.
It has helped me tremendously (together with other tooling like sport and meditation).
monktastic1 said a month ago:
I suspect it will only be "solved" once the problems of existential angst and ennui are. It's remarkable how powerful our primal emotions can be at overriding even the strongest of drugs.
ramon156 said a month ago:
I've seen DIY gadgets before that cost around the same, seems very interesting. I'm wondering if there is a gap in the market in sleep quality analysis
vundercind said a month ago:
Electronics and very bright nighttime lighting are a ton of it.
Cutting those out would turn a hell of a lot of “night owls” or people who “can’t sleep” into people who sleep on a normal schedule just fine.
It’s obvious when you consider what all that stuff really means. Obviously it’s hard to sleep when you spend your hours after sunset in hundreds-of-candle-power lighting and have hyper-stimulation of a hundred kinds available at the press of a button.
Of course there’s also apnea and kids and such, but that’s a large proportion of the problem, overall.
randerson said a month ago:
Color temperature is more of a factor than brightness. Blue/white light disrupts Melatonin production. Changing your lightbulbs to be below 2700K (more of a yellow light or even red light) won't disrupt Melatonin.
jackallis said a month ago:
that's why it is imperative that you squeeze in some amount/level of workout. does not have to at the gym, even 5 mintues of jumping jack at your home helps. Granted if you have are exhuasted from lack of sleep, workout is the last thing you want to do; but through out your weekly routine -- to quote immortal bard Eddie -- go ahead jump <https://www.youtube.com/watch?v=SwYN7mTi6HM>.
sleepskeptic said 19 days ago:
I get bad sleep all the time, and I look younger than all my friends my age...
jdawg777 said a month ago:
I would be curious as to how they are measuring the subject's perception of their age. Are they just asking them how old they feel? How do they get meaningful results?
> Subjective age was assessed using a single-item question: ‘On some days you may feel older or younger than your calendar age. What age do you feel right now?
akira2501 said a month ago:
How would any of these people _know_ what older actually "feels like?" It's hard to believe they felt this surrogate question would reveal anything useful, let alone, that the numeric values associated with it were worth averaging.
francisofascii said a month ago:
Good point. The study would be better if they tracked actual biomarkers like HRV, RHR, blood pressure, etc. rather than asking the question, how old do you feel.
begueradj said a month ago:
Some martial artists of the UFC say that sleeping is the best PED (performance enhancer drug)
chikitabanana said a month ago:
*when the cameras are on
uoaei said a month ago:
I like to set an alarm for 9 hr 30 min before sunrise. This gives me 30 min to get ready for bed, and to go to bed with time for 6 full REM cycles of 1.5hr each. The rest of the timing (the timing of my rest?) is up to my body and how much sleep it wants.
When I do it this way, vs setting alarms, I'm always surprised by the sleep debt I've accrued and am now paying back.
Modern (especially urban) society demands a lot more of us than many of our bodies can sustain.
EPWN3D said a month ago:
I'm sorry, but this is clickbait junk science.
> Psychologists in Sweden found that, on average, volunteers felt more than four years older when they were restricted to only four hours of sleep for two consecutive nights, with some claiming the sleepiness made them feel decades older.
The average was four years older, with some people claiming they felt "decades" older. This should be enough to tell you how useless this methodology is. People cannot reliably estimate how much "older" they feel because it's their subjective interpretation of an experience they don't have. By definition they don't know what being 4 years older feels like.
You might as well ask them whether sleep deprivation made them feel like they'd been waterboarded for 4 hours or 4 days.
andai said a month ago:
Has anyone experimented with polyphasic sleep? There was a very interesting blog on "Uberman" sleep cycle (nap every 4 hours) in the 2000s, called Puredoxyk. The author tried it due to insomnia and found it very helpful. Later she developed Everyman (short "core sleep" plus several flexible naps), which works better with work and family.
I tried Uberman a few times but I seem quite nap resistant... I only ever have those catastrophic 5 hour naps, which isn't very helpful here.
I'd spend the first few days of adaptation completely sleep deprived, then finally pass out and sleep through all the alarms.
Steve Pavlina wrote about his experiences with Uberman. Says the most useful thing he got out of it was that now (back to normal sleep) he can instantly nap anytime he wants to.
Also related and fascinating: N24, zeitgebers, etc.
pedalpete said a month ago:
You don't just "feel" older, the subjective response is only a small part of it. Insulin response decreases, and there is a direct relationship between diabetes and sleep.
Cortisol levels increase, which can harm sleep the following night.
Memory and reaction times are measurably worse.
The older I've gotten the earlier I wake up, probably due to my bladder going down the drain. I usually pop awake 4-6am and just begrudgingly stay awake, I don't work until 9-10am.
When I DO go back to bed after waking up like this and manage to actually sleep until 8-9am I feel more drained and tired by far. I did that last night/this morning and I am way more tired than I've been all week getting up as soon as I wake up.
I don't really go to bed late, 10-11 probably. My doc complains all the time that I'm not sleeping enough but that's why.
tschumacher said a month ago:
My sleep is very irregular but I always get enough. I tend to have trouble falling asleep but once I'm asleep nothing can wake me up. Some days I sleep until noon or I have to get up early but then take a nap later. I wonder if all the bad consequences that are associated with "broken" sleep apply to irregular but plenty sleep as well.
I was just sick for 2 days and spent about 1.5 days sleeping (like I literally slept 18-19 hours on one day, and probably 12-13 hours the next) - I am now recovered and I feel a couple of years younger...so I guess it goes both ways
Redster said a month ago:
To your point, I had a season of extremely hard work (for me) where I was on two timezones (one in Europe and one in the US) and ended up in a situation where, due to severe jet lag, I would go to bed at the right time for the timezone I was in, sleep for 12hrs, and wake up *more exhausted* than when I went to sleep. Very demoralizing, but this continued for weeks. Eventually I decided to take a sleep-cation. I went to a friend's house who generously offered a private room. I prepared a couple of meals in the fridge and proceeded to sleep as much as I could for the next three days. I probably slept more than 20 hrs per day, although I didn't necessarily have very long stretches. I only needed like 4-5 meals over that time. It really took me out of a negative spiral and got me back on track. If you actually can sleep, I've seen this approach help people "reset" on their sleep and then get more regular benefits from their sleep hygiene.
sarasasa28 said a month ago:
I have very very poor deep sleep, but no apneas. Anyone in the same boat?
ngai_aku said a month ago:
How did you discover you have poor deep sleep? Wearables?
I’ve been discussing my issue with (for lack of a better term) chronic fatigue. He suspects it might be an issue with my sleep, but
- I fall asleep really quickly
- no obvious signs of apnea
- I wake up feeling pretty good
My issue is that by 10:30am I’m dragging.
sarasasa28 said a month ago:
apple watch first then confirmed with a proper study
monroewalker said a month ago:
Yes
sarasasa28 said a month ago:
Did you do anything?
I Have recently done a sleep study and that was the result mainly. Haven't seen the doc yet but no idea
I can think of a much more fitting headline for that article. The international community not reacting to the blatant human rights violations proudly performed by the U.S. speaks volumes about opression and bullying tactics. How did the comedian I heard just yesterday express it: "You lend money to the USA, because if you dont, they come and get it."
froyolobro said a month ago:
Validated. I exercise, eat well, don't drink, don't consume caffeine after noon, and my sleep is still terrible. I get four good hours, that's it.
duderific said a month ago:
Same here! I'm in my 50's, so I often have to wake up to pee at anywhere from 3 - 5 AM. Sometimes I go right back to sleep but sometimes not. Then it's up at 6:15 AM to get the kids going for school (I had kids really late.)
I've just become accustomed to being in a semi-groggy state much of the time. I know it's not ideal, but I'm just not gifted with being a good sleeper. Conversely, my wife can sleep 10 hours in a row if given the opportunity.
In the rare situation where I get 6 to 7 hours of unbroken sleep, I feel fantastic.
Edited for clarity
johnbellone said a month ago:
Last night my kid slept with us because he is sick. At 2am woke up to screaming and alligator death rolls. I feel like ass after one night.
IncreasePosts said a month ago:
Maybe a coincidence but I got the first gray hair of my life 4 months after getting a newborn(and waking up like 4 times per night)
seanhunter said a month ago:
This is incredible. I can't remember the last time I had a night of unbroken sleep. It's literally months ago.
aronhegedus said a month ago:
Recommend the book "Why we sleep" for people who want to learn a bit more about effects of sleep deprivation
307 Comments:
Sleep apnea degrades your quality of life tremendously. Even when treated with CPAP you can still have pretty poor sleep due to the mask shifting around while you sleep and other side effects of the treatment, but it's generally much better than the torture of untreated apnea. It's so bad that even with moderate apnea you wake up more tired than when you went to bed.
Now allow me a preemptive reply: I suffered apnea with a BMI below 20. Plenty of people don't have apnea because they are overweight; instead, they are overweight because they suffer apnea.
As an additional PSA, sleep apnea may not be the cause of exhaustion, even if diagnosed. I was diagnosed with apnea and CPAP did (still does) little if anything for my energy levels. I finally found a sleep doctor who checked my iron levels, and despite being within the normal range suggested I take an iron supplement (iron polypeptide) and within a week felt normal again.
It turns out that people with restless legs, which I’ve had since childhood, experience iron deficiency anemia with much higher blood iron content than the average population.[0]
My primary care didn’t consider this. A pulmonologist had no interest in checking this. An oral sleep doctor had no interest in checking this. I had people suggesting getting an implant to force my tongue to stick out when the issue was low iron.
Definitely get a sleep study (I’d recommend lab over home). I use a sleep tracker (cheap Garmin “smart” watch, but I’ve also tried an Apple Watch) as a reasonable proxy for REM and deep sleep. And if you think a practice is just trying to sell equipment, they probably are. Fortunately I found a good doctor from acquaintances that I would have never otherwise considered (not part of the local medical systems, though did take insurance).
Unfortunately, for many issues it’s not enough to trust the doctor. Do your own due diligence for your health.
0 - https://www.frontiersin.org/journals/neurology/articles/10.3...
My wife had menorrhagia (extremely heavy periods that lasted a week) and extreme lethargy. And restless legs. Not only did her doctor not get her bloods checked, he didn't care about the heavy periods and said (about heavy periods), "go on the pill, and see a shrink" (because presumably he thought she was a hypochondriac or depressed, because she came back several times to see if he could do anything about it). He finally got her iron and B12 checked, and since they were both on the lowest end of the "Ok" range, he didn't do anything further.
It took 2 doctor changes and a lot of goggling to realise that her menorrhagia had a cause, but that she's need scans to prove she might have uterine fibroids. It took 2 procedures to correct them. Once all that was done and she got iron + B12 injections, and got her life back.
On a forum she talked to other women who were left to deal with fibroids for up to a decade because their doctors would just sigh and say, "Yes, women's problems. This is normal. Go on the pill". Unfortunately the fibroids grow so large that there is sometimes no option but a full hysterectomy. This is a common story.
I completely agree, you need to do your own due diligence these days.
> He finally got her iron and B12 checked, and since they were both on the lowest end of the "Ok" range, he didn't do anything further.
This type of mistake infuriates me to no end because there’s no reason it should happen. I was recently looking at blood tests from years back to figure out my usual resting glucose levels (just got a GCM) and stumbled on my testosterone results.
I was in the green, so my doctor (and nurse practitioner) didn’t notice a problem but I had the testosterone levels of a 50 or 60 year old in my late 20s. Since the acceptable range wasn’t adjusted for age by the Quest report, the range is ridiculously huge.
It's worth noting that in some cases it might be cheaper to outright purchase a CPAP machine online than to get a diagnosis via a sleep study.
I got a sleep study about a decade ago, having to go in first for diagnosis and then to evaluate the right settings. Even with insurance it cost about $2000 after all was said and done due to limited coverage and out of pocket fees. THen add the ongoing $35/month copay for renting the CPAP machine (they did not offer to sell it) and limited fee for having someone deliver it, which was a scam of an 'in-home medical visit' to set it up by handing me a box and saying where to plug in the hoses.
Meanwhile, the same machine sold for $400 online, wouldn't have required me to spend overnights in a lab or go through doctor visits every couple months for continued 'check-ups' where they read the card data to make sure I'm still using the machine to justify insurance coverage of everything beyond the $35/month fee. With automatic settings (now standard on machines, perhaps not at the time) or simply using materials online to do a few nights trial and error to figure out correct settings.
I felt like I (and my insurance carrier) was getting scammed at every point along the line. But the doctors claimed these were the hoops I had to go through to get tested and treated.
Hopefully it's a lot better today, but.. I doubt it. The CPAP did work when I finally got it, though.
H.Pylori is well known to impact iron absorption and serum iron/ferritin levels. Most of the world carries this unknowingly (esp. since childhood), and it has all sorts of silent consequences ranging from fatigue (due to iron impact, etc) to GI issues to stomach cancers.
[1] https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8513126/
[2] https://pubmed.ncbi.nlm.nih.gov/11218379/
I just wanted to mention how I cope with occasional restless leg syndrome. I find that a wall sit for two minutes right before trying to fall asleep works every time. I have to do it long enough and push hard enough to make my legs really burn from the exertion. The more unpleasant it is, the better it works. Afterwards, I immediately get in bed and try to go to sleep (it doesn’t work unless I do it right before attempting to fall asleep). Usually by the time my heart rate returns to normal, I’m asleep.
I'm looking into this as of now. For your situation though, from what I've read about iron supplements. A week is too short of a time for anything. So your situation was placebo; in my opinion.
I was sleeping 8.5-10h per day and still feeling extremely tired. Also had a lot of mental problems to the point I was thinking of going to a therapist (I thought it was work related).
My doctor sent me to do sleep apnea tests and blood work, but turns out I was vitamin B12 and B9 anemic AND seems like I have mild sleep apnea as well (I have more tests booked). But taking vitamin supplements cured most of my symptoms in less than a week. I had horrible headaches for the first couple of days of supplements though.
Isn't iron one of those things you don't want to overdo due to dangerous side effects?
You raise an interesting situation here though because I've also had restless leg forever and my iron tests came back normal. Still, I'm not sure how safe it is to take iron supplements under "normal" conditions.
EDIT: this is just one source, but it doesn't sound like a great idea to be taking iron supplements with normal iron levels, at least not on your own: https://ods.od.nih.gov/factsheets/Iron-Consumer/#h11
Did I suggest otherwise? I said I ended up seeing four doctors before one suggested what worked for me. YMMV. Consult a physician, etc., etc.
I need to have my iron levels checked semi regularly. I would imagine any doc suggesting iron supplements would suggest the same.
tbh. I generally I don't understand why some people are so insistant to point out "how dangerous supplements are".
For most nutrients there is quite a large area between what the body needs and when it starts to become a problem.
And while you can over a long time accumulate by not only only consume more then you need but also more then your body can disperse it's not really an issue either. Doing semi regular tests in case of knowing you have some nutrition issues is pretty common and stuff like fasting once a year can help you body to flush out accumulations.
And again for a lot of supplement choices people will often not run into this issue at all anyway.
I have seen a lot of people which live quality increased by taking supplements (including non water soluble ones) but yet have to see a single case of overdosing on supplements in my environment.
I have occasional restless leg (once every two weeks or so) and low energy. How would one know if one has iron deficiency despite blood work being normal? Is it just a case of popping iron pills and seeing if you feel better?
What's "normal"? Your results are never just "normal", there is a range that is considered normal. If you're at the low end of normal, that could actually be just "low". Those teams can be a bit too wide.
How is your B12? If you're a vegan or vegetarian and aren't taking those supplements then I would start taking them. It's always safe to take extra B12.
Unless your iron is at the upper end of the band it should be safe to take a low dose. But it won't do anything if you're not really deficient.
I find that sitting at a desk all day makes me tired. I just push past it and go for a run. Always works, and it guarantees me a good night's sleep.
Just remembered, if you walk a lot, like over 25k steps a day, or do a lot of exercise (squats?) that can also cause restless legs.
Also, your diet? Most people are getting more than enough carbs these days, but are you on some weird diet?
Doesn't hurt to try does it? A bit of extra iron is harmless.
That was partly my question. Looking online, iron is definitely something that you don't want to have too much of.
My question is, basically, is having a non-anemic iron deficiency something that can be easily remedied by having low-dose over the counter vitamins, or is it something that requires a higher dose (to make up the difference in what you're missing) and so requires a doctor. And yet it sounds like this is difficult to diagnose.
Over the counter iron supplements are totally safe to take for the period indicated on them. They contain as much iron as a medium piece of chicken liver.
Most of the over the counter ones I see online are 65 mg iron, which is nearly twice the iron in a whole half kilo of chicken liver.
The medical sites say a safe value is no more than 45 mg per day.
There are also low iron pills (or "gentle iron") that are 28 mg.
So not only are many over the counter pills potentially over the safe levels, but it still doesn't even really answer the question, which is whether the low-dose pills that are under the RDA effective in countering an iron deficiency.
Anyway. I think I'll ask my doctor at a once-every-several-years checkup.
Do you live in America? Supplements tend to be much stronger there. Here in Germany at the local pharmacy you will mostly find in the 10mg-30mg range. I've bought and drank them before to no ill effect, which is why I even started this entire chain.
Same for here in the UK. My iron suppliments are 30mg, which seems pretty usual here.
It can indeed hurt[1], and getting medical advice from the Internet can be... fraught.
[1] https://www.ncbi.nlm.nih.gov/books/NBK557376/#:~:text=The%20....
Similar for me, I thought I would start feeling better after my CPAP. Still had terrible sleep. Still experimenting with solutions (issues started after Covid vax, so I’m experimenting with long Covid protocols and have noticed much better sleep in the last month although I’m not getting my hopes up just yet)
If you don't mind sharing, what are some of these long-covid protocols that you're trying?
Do you have any additional resources you recommend on this topic? I've experienced life long restless legs alongside issues with sleep quality, daytime tiredness and low energy levels so this seems like an interesting avenue to explore.
I don’t, just my personal experience. A few years ago I started getting exhausted to the point I was napping every day and getting 10-12 hours asleep and still felt tired. I’ve never been overweight, don’t have any structural occlusions in my airways, though I do snore (so says my wife).
I did all of the normal things and got regular exercise. I finally went to a specialist, and got an at home sleep study which found moderate apnea (on the low side of moderate). I spent several months using a CPAP and bought a sleep tracking watch. Nothing improved and I was still tired. The pulmonologist suggested one of my medications affected REM. I was able to stop taking it without any significant issue and my REM improved, but I was still tired. I asked them for an in lab study and did that and it found the same as the home study.
I had convinced myself I had narcolepsy or some similar neurological issue.
My wife’s friend coincidentally mentioned he had sleep issues and they had found a sleep doctor they liked. He was the first to ask about restless legs and have any blood work done. He confirmed that I have apnea, but thought trying an iron supplement might help based on recent studies and my iron levels.
The iron helped almost immediately. Within a week I didn’t need to take a nap, which I had done daily for at least two years. I still use the CPAP because apnea can cause heart issues long term, but don’t “feel” like it does anything in the short term.
Usually, the most common thing is the most likely, but when it’s not, it can be really hard to find someone who both believes you and can do something about it. When I was exhausted all of the time, finding that person was even more challenging.
So interesting! Thanks for sharing. Do you still take iron every day, or is this the kind of thing one does for a period of time until the body is rebalanced?
Serum iron is a pretty useless test. What was your ferritin?
In August it was 66ng/mL prior to taking any supplement. So above the reference low, but below the adjustment for RLS.
Unfortunately, I just had it tested last week but had given power red a few weeks prior and came in below even the normal range (20ng/mL).
I wish CPAP manufacturers were a bit better. There has been little innovation, and if anything, there's been a downward trend in quality in recent years.
My wishlist:
1. Every CPAP device should be BiLevel.
2. All data they record should be accessible to the user (for tools like oscar).
3. Either more granular pressure controls, or better algorithms (or both). Some people do well on CPAP, others do better when iPAP > ePAP (BiLevel, or EPR), while others do better when ePAP > iPAP (vcom).
4. Better masks. Seriously. It's so hard to find a good mask, and so expensive to experiment with them. A new mask can set you back €150, and if turns you hate it, you're shit out of luck. I've toyed with the idea of personalized 3D printed masks to get a better seal for each unique nose/face shape.
5. Quieter machines. Without the Philips cancer foam.
6. Quieter masks. Some have excellent diffusers in the exhalation port (P10), while others blast out a concentrated jet of air that will wake you up when it hits the pillow, or will lead to divorce faster than your snoring ever did when it hits your bedpartner.
7. Bring back travel cpap devices. The market collapsed post covid. I'd love to keep a small device and super lightweight mask/hose in my bag for sleepover emergencies. I'd pay any price for that, because having to lug a full size cpap around ruins any chance of spontaneity in my bachelor sex life.
None of these are rocket science. But Philips Respironics are a bunch of evil cunts, ResMed are goofing off, and the other brands might as well not exist.
Agreed on all counts, down to having contemplated 3D printing molds to manufacture custom silicone masks. I also wish the tube had a sensor to detect whether you are sleeping on your back to preemptively raise the pressure. Or having better algorithms to detect hypopneas before the air stops flowing altogether.
I don't even understand why purchasing a CPAP machine requires a prescription. I'm scared of the possibility of a doctor denying me a new CPAP machine when the current one inevitably croaks. The device is a glorified fan, for goodness sake.
The prescription thing is probably location specific, but AFAIK you can just buy them online. I have a few spares I bought online from back when I frequently slept in different places.
Masks straps could probably be fitted with an accelerometer to detect positioning. If they can make heated tubing, this isn't such a stretch. Might also be useful in correctly flagging events: my machine often incorrectly marks position switches as periods of hypopnea.
> Plenty of people don't have apnea because they are overweight; instead, they are overweight because they suffer apnea.
A lack of sleep means a lack of energy. You're body compensates by getting food energy.
Too much stigma around what should just be understood as a biological mechanism.
>> A lack of sleep means a lack of energy. You're body compensates by getting food energy.
I saw this ironically during military basic training. Lots of exercise, but very little sleep. The body compensates by keeping blood sugar levels high. I was one of the many that actually gained weight during basic training. The eating routine of three solid meals eaten very quickly also was not healthy.
My doctor wore one of those continuous glucose monitors for a while and reports something similar. He considers himself an endurance athlete and his blood sugar levels were always a bit high when he was regularly exercising, but once he took some time off, his blood sugar levels dropped to "normal" levels once his body realized it wasn't under so much stress.
that concurs with my anecdotal sample size = 1 study, where I have gone for 3.5 days without sleep before, and just keep feeling hungry and snacking every hour or so.
(for those asking what happened after 3.5 days, I basically started getting hysterical - literally just laughing at nothing - and when I was finally able to get to a bed, it took about 2 hours of staring at the ceiling before my body finally decided I was no longer under stress, and allowed me to fall asleep).
Absolutely. When I was in the Navy, working 80-100hrs/wk, we were served four meals a day, every six hours, like clockwork. You can substitute sleep with calories for days or weeks at a time. It's terrible for you, I do not recommend it, but it can keep you going.
This is stated as biological fact when it's simply not. Sleep apnea doesn't change the laws of thermodynamics - if you are gaining weight you need to eat less or move more. It's not stigma, it's simply the way it is for the vast majority of people (the rest being covered by rare hormonal conditions that require a doctor to treat).
Being tired may cause you to eat more but being tired isn't making you gain weight, it's the overeating that is.
People love to think of the body as a simple energy-in->energy-out equation, but it's definitely more complex than that, as the body can change what it's deciding to hold on to and what it's deciding to burn or expel.
I am one of those that stayed skinny as a rake throughout my childhood and mid-adulthood (in my mid-40s I'm starting to become more normal sized). I wasn't particularly active, and I ate voraciously -- third or fourth helpings of pasta bowls. But the food never stuck to my ribs. (And it wasn't a worm or anything -- the whole side of my mother's family is the same, while my dad's side is the opposite.)
No one should look at my body and say "clearly he is exercising more than he is eating" because it wouldn't have been true at all, and yet that's what the simplistic energy-in and energy-out conclusion would say.
>People love to think of the body as a simple energy-in->energy-out equation, but it's definitely more complex than that, as the body can change what it's deciding to hold on to and what it's deciding to burn or expel.
If calories-in/calories-out didn't work, then it would be impossible to starve to death.
Where people get confused is that the number of calories changes as your metabolism speeds up or slows down.
If you are ingesting fewer calories than your body requires, you will lose some combination of fat and muscle. There is no possible way for this to be false.
It's the flip side that is quite possible to be false. You can certainly eat more calories than your body requires and yet not gain weight. Your gut could absorb less, so you excrete otherwise-digestible carbs. You could have a parasite.
Further, you could be burning more calories without doing more exercise or otherwise doing anything "useful" with the energy -- i.e. having a higher basal metabolic rate. These calories can be burned doing all sorts of things that the person has no control over: you could have a higher core body temperature, you could be spending more energy on cellular repair and other cellular processes, you could be synthesizing more hormones, you could be spending more energy metabolizing foods, etc etc.
These latter causes are obviously on the "energy out" side of the equation, but they do not relate to things under our control. Further, they can change with age, stress, and (relevant to TFA) sleep.
So a body that has been coasting by eating 2200 calories per day and never gaining a pound could suddenly change and start putting on weight, even though the person's diet and activities haven't changed.
The point is that two people could eat the exact same calories, and do the exact same exercise, and one of them go up in weight and the other go down. The "calories in vs calories out" idea usually simplistically makes people think this couldn't be true, because "calories out" is simplistically taken as "exercise."
The reason I shared my story is that so many people just quote "calories in vs calories out" as if both sides of the equation were perfectly under control, and those people are also often like me: they find it easy to keep the pounds off (because of a high metabolic rate) and so they look down on people who have trouble shedding weight and figure that those people could live just like them. But those heavier people could well be eating less and doing more exercise than them.
> It's the flip side that is quite possible to be false. You can certainly eat more calories than your body requires and yet not gain weight. Your gut could absorb less, so you excrete otherwise-digestible carbs. You could have a parasite.
Is the flip-side really debated that much tho? I feel like when people talk about CICO they're primarily talking about reducing CI to lower than your CO. No?
The complexity in CICO of course is measuring your CO. Ie you could estimate your CO, reduce your CI to what you believe your CO is - and still not lose weight. But does that undermine CICO? Because as the other commenters mentioned, it's "impossible" for you to burn more than you take in without losing mass, so our issue in this example is incorrectly asserting the output (assuming of course we're not also underestimating the input).
Note my questions here are generally questions. I am not an expert here, so please correct me if i'm wrong.
> The reason I shared my story is that so many people just quote "calories in vs calories out" as if both sides of the equation were perfectly under control, and those people are also often like me: they find it easy to keep the pounds off (because of a high metabolic rate) and so they look down on people who have trouble shedding weight and figure that those people could live just like them. But those heavier people could well be eating less and doing more exercise than them.
Fwiw, i don't dispute that some people have the wrong ideas with CICO. Perhaps frequently even. But i thought it still stood as a foundational truth nonetheless; that you have to "simply" burn more than you take in. If you gain weight (ignoring water weight for simplicity), then you have ate more then you burned, always.
My takeaway with CICO is that the hardest question seems to be correctly figuring out how much you're burning. Which i feel like usually, especially for overweight people, it's much less than they think. You can't outrun a bad diet, as they say. Rarely do people actually want to exercise enough to truly compensate for the thing they want to eat. Hence why i like CICO, as to me it signals the only effective action is in restricting your CI, since increasing CO is so difficult.
I believe you confuse an inequality of Energy(Fat) ≤ Energy(Food) - Energy(Activity) with an equation and are trying to disprove it with a counter-example. People saying "calories in, calories out" don't help with this confusion too. Another variant of your argument is "but different people extract different amounts of energy from the same food so there!". This being an equality, both arguments make no sense. I give you more - the "Energy(Food)" is calculated by burning the food in question and measuring the energy produced. It's guaranteed to be more than most humans could extract from the food as most humans excrete more complex chemicals than carbon dioxide and water, which burning food produces. But it does not matter because this is an inequality and not an equation. E.g. in your example the inequality still holds, you allegedly increased the Energy(Food) but the energy stored in fat did not increase, as asserted in the inequality.
A counter example to disprove this would be somebody gaining more weight in fat than the weight of fat needed to store energy from consumed food. Of course, this would have been broken pretty fundamental laws of nature and would have caused some kind of revolution in physics.
In my Indian family, this sort of skinny phenotype with a voracious appetite had a simple folk explanation - you eat so much that the food doesn't have time to be absorbed.
I can second this. I get routinely mistaken for a runner because of my size. I do strive for 10k steps a day, but generally, my activity levels would not easily reflect my BMI.
And yet, if you want to lose weight, it’s almost always (outside of medical conditions) as simple as getting into a caloric deficit that matches the deficit necessary to induce weight loss.
If you have a 500cal deficit per day, you lose a pound of weight (fat) per week. It’s literally that simple.
There’s some auto regulation of caloric burn rate, but it’s not some impossible problem to solve.
If you knew your exact metabolic requirements as well as the exact calorie count of every food you ingested, then it would be that simple. But what if you take the elevator one day instead of the stairs and don't burn off the 30 or so calories it might take to go up them? What if someone went a little heavy on the dressing on a salad you ordered and added 100 calories or so?
I've manipulated my body weight a few times and the real world is vastly different from a simple model of CI/CO.
On average this doesn’t matter. Humans are a whole lot more predictable and pattern based than you seem to be implying.
Also, if you’re trying to aim to a specific deficit, you should be calorie counting your food. If you got fatty dressing, you should be counting that. Even estimating is relatively easy once you do it for awhile. And if you don’t get it quite right, being a little off shouldn’t impact your overall average too much. It keeps you honest, which I think is by and large the main reason people don’t think they can lose weight: dishonest assessments of food consumption.
As I've said, I can absolutley lose weight, but I cannot reliably lose one pound per week; I do not seem to have that resolution in the numbers.
I've been tracking my weight weekly and all calories (even with crude estimates in some cases) for a year and a half, and have been experimenting with exactly this: I made a scatter plot and linear regression of average calories per day on the X axis, and weight change for that week on the Y axis.
Week to week weight has extra fluctuations that make it difficult to tell what's going on, but after around 6 months of data it stabilizes, and has been consistent for any 6-month period over the last year and a half: I burn around 2200 - 2300 calories per day on average (way higher than the online estimator tools think I burn, 1600 - 1700).
Knowing this I've also been reliably able to control my weight up or down at the rate I want as long as I'm looking at it for over a month span - because as above, week to week there's too much fluctuation (fullness of stomach and bowels mostly).
That it takes that much data to see the result pretty much proves my point - maintaining a 500 calorie per day deficit is just very difficult for me and I suspect most people. I don’t mean the hunger - when I do lose weight the deficits are easily above 1000, but 500 is too marginal for me to resolve.
Reliably losing one pound a week (beyond the initial 1-2 week period where your weight is going to go all over the place due to water weight fluctuations) is as simple as cutting calories until you see the weight (on average, ignore fluctuations) drop by 1 lb a week. You have to average extensively. Bodies are very temperamental at this, unfortunately. My scale weight swings 0.5-1 lb quite frequently mainly due to sodium changes in my diet. It’s all about trend weight, though.
The body is far more complex than simple thermodynamics however, and to pretend the dozens of biological feedback loops are fully under ones control betrays a lack of understanding.
Reducing getting fat to thermodynamics is like reducing computing to adding numbers. While that may be the basic building block, only a fool thinks that merely by comprehension of the add operator, one is also able to debug hugely complicated soft- and hardware stacks.
I actually like the computing and adding numbers analogy because "Sleep apnea makes people overweight" is the nutritional equivalent of saying "1 + 1 = hammer."
The root cause of weight gain is either overeating or lack of sufficient exertion in almost every case. Sleep apnea may absolutely cause someone to overeat in part because of those dozens of biological feedback loops you mention. But that doesn't mean that sleep apnea makes people gain weight. It's still too much food at the end of the day.
>It's still too much food at the end of the day.
The problem with that is you can reach a point were trying to reduce calories further will only further sabotage your metabolism and makes you feel like shit. Which is why treating the symptom repeatedly fails to work long term.
I’m a 5’11” male who gained weight up to ~220 pounds on ~1800 calories eating a very consistent meal rotation. I now maintain ~190 pounds at ~2100 calories. My problem was likely a combination of my food acting as a chemical signal to gain weight (high in branch chain amino acids, polyunsaturated fats from fatty pork and chicken), work stress, bad sleep, and possibly even chronically elevated blood sugar or thyroid effects from essentially what was an almost carnivore one meal a day sort of diet. My body temperature was hitting lows of 96.3 degrees F. It’s now roughly two degrees higher, which seems small, but feels so much better.
> It's still too much food at the end of the day.
It's all four fundamental physical forces actually, if you want to go that route. Which isn't helpful.
> But that doesn't mean that sleep apnea makes people gain weight
I gather that you are unaware of how sleep apnea causes poor sleep, which in turn causes insulin resistance, which in turn causes an elevated production of insulin, which in turn forces glucose into your adipose tissue, which in turn makes the rest of your tissues starved for energy, which in turn causes you to be hungrier, overeat and gain weight.
This is an oversimplification, of course, as there are hormones other than insulin and cortisol involved in the complex process of insulin resistance, but it is at least a starting point that goes beyond the useless truism that "people gain weight because they overeat". Of course they do, but the mechanisms why they are hungrier than they need to be are crucial if you want to address the problem, because in the long run every human being with free access to food will eat precisely until they are no longer hungry, whether or not they are metabolically healthy or not.
But that’s not what he’s saying. Being hungry does not cause you to eat. Regardless of hunger, a caloric deficit will result in weight loss.
There definitely is the issue of how to reliably maintain a caloric deficit when your body is screaming at you to eat more, but the underlying mechanism is much simpler.
At the most basic levels, food choice doesn’t even really matter (specifically for weight loss, not general health), but choosing satiating foods with low calories is going to help with implementation. Eating 2,000 calories of oranges (45) is going to be a lot harder than 2,000 calories of fast food hamburgers (2).
The problem isn't that CICO isn't true, it's that it's not useful. It can't even explain why fat people are still hungry when they have enough calories stored in their bodies to last them for months.
> Being hungry does not cause you to eat
Yes, it does. That's why people eat: to alleviate hunger. You may will power your way to a caloric deficit for some months, maybe a couple of years, but eventually hunger will win and you will eat until satiety.
Metabolically healthy people aren't slim by being hungry all the time. They eat to satiety, and they are lucky enough that their satiety signalling is still working well enough. If you make them chronically hyperinsulinemic, they will be hungrier and they will gain weight -- it happens in humans and in animal models when allowed to eat ad libitum.
> At the most basic levels, food choice doesn’t even really matter (specifically for weight loss, not general health), but choosing satiating foods with low calories is going to help with implementation
As long as you are hyperinsulinemic, you will store a portion of the energy you consume in your adipose tissue, because that is one of the major effects of insulin in the body. The remaining energy left in you will not be sufficient to supply the energy needs of your body, and as a result you will be cold, tired and hungry.*
> Yes, it does. That's why people eat: to alleviate hunger. You may will power your way to a caloric deficit for some months, maybe a couple of years, but eventually hunger will win and you will eat until satiety.
If this is the premise of your argument, it is flawed.
You have no idea if “eventually” happens to everyone. You’re making a wildly strange assumption.
>> You may will power your way to a caloric deficit for some months, maybe a couple of years, but eventually hunger will win and you will eat until satiety. > You have no idea if “eventually” happens to everyone
Have you tried? Are you willing to try? How many people do you know that intentionally remain hungry every day for more than a couple of years, while otherwise having free access to food?
Any weight loss advice that does not adequately address hunger and satiety is naive to the point of ridicule. And any person who advises others to address their weight by telling them to be hungry in perpetuity hasn't given much thought to what they are asking for.
Yeah. Turns out when you eat less your stomach shrinks and you need less food to feel satiated. What are you on about? You’re severely incorrect.
>> Being hungry does not cause you to eat
> Yes, it does.
Nearly 1:10 people in the world are chronically hungry. Being hungry has no impact on their ability to eat. Likewise, those with access to food eat when not hungry and (believe it or not) may not eat when hungry.
I really think you’re missing the point, though. We have a host of signals in our body that can misfire due to various conditions and people cope with them. Hunger is no different and many of us have spent months ignoring it to our own benefit (and some to their own peril).
Caloric intake in excess of expense causes weight gain. What factors lead to that excess do not.
There are certainly those with a variety of issues that make caloric deficit difficult. Fortunately, that’s not most people.
I know you’re being downvoted into oblivion, but I agree. I’m not overweight, but had put on nearly 40lbs more than my historic average. There’s all kinds of advice, but the best I found was: the only way to lose weight is to have a caloric deficit.
That meant measuring calories until I could generally estimate what I was taking in each day. 1000-1500 calories a day sucks at first, but seeing the scale drop is motivating. I dropped 30lbs in about 6 months.
You can’t gain weight if you are taking in less calories than you expend. That’s pretty simple. Not eating that cheesecake, on the other hand, not so easy.
I'd like to contribute by saying that even when you are sleeping, body burns calories for various neurobiological processes. That automatically translates to bad sleep equals decreased calorie utilization (than a healthy baseline)
If overeating has causes, then it's not really a root cause.
By this logic, sleep apena doesn't make people gain weight either.
I think one of the issues with this is that most people have pretty terrible diets, most people have pretty terrible diets that can be improved pretty easily, and when dietary improvements are suggested a lot of time the response is “this is just really complicated, it’s not that simple.” Not everything is simple, but, say, giving up soda is something that’s healthy and going to have a positive impact on people’s lives. People who are saying “don’t tell me to give up soda because I have sleep apnea” are looking for excuses for their bad habits.
If someone is eating healthy foods and making a genuine effort to get good exercise, then we can talk about other factors. But too many people use “this is so complex” to avoid the very basics of healthy living.
Lack of sleep and stress are associated with overeating, and not only that, they also trigger hormons that promote the body to prioritize building up fat reserves.
I'm on mobile and don't have time to link, but a quick google search should give medical studies on this.
The "energy" thing is a simplification, but as a description of how this feels, it is apt in my view.
This is not about thermodynamics.
People do not live on a thermodynamic knife edge. There is a very wide leeway of excess intake that allows our body to burn energy “wastefully” or store it based on a hideously complex set of factors.
The idea that everyone is fat because we’re somehow more sinful (gluttonous, slothful) than in the past has repeatedly failed to resolve any problem except for the need for smug people to pat themselves on the back for using thermodynamics in a sentence.
> if you are gaining weight you need to eat less or move more
You could do a little experiment: set up an alarm to wake you up 15-30 times every hour while you try to sleep. That is what moderate sleep apnea does to you. Try this for, say, a year. See what happens to your overall health and your weight in particular. Don't forget to "eat less or move more".
Being tired changes how your body uses and stores energy. Your body might be permanently trying to save up for bad times (because the times are always bad) and so you're getting fat even if you eat very little.
By this logic, one could run an army legion without food supplies simply by keeping them sleep deprived.
Uh, no? The whole point is that the entire system breaks down. So you get sleep deprived humans who can't process food properly and have no energy as a result. Sounds like a big failure.
can you point to examples of otherwise healthy individuals under moderate to high calorie restriction that gain weight due to chronic poor quality sleep?
it's not something I have ever been made aware of, and I don't understand how it could be the case.
A lot of things about your body changes when you're extremely tired.
I don't have anything specific to link - it's just my own personal experience and what the doctor said.
In my own case, I had to eat much more than I theoretically should because my body wasn't able to process the food as well as it should (less than 50% of usual efficiency). And yet I was fat - not obese, but definitely not thin. The body redirected some of my food to storage even though I didn't have enough energy (glucose etc) as measured by blood screening. And it didn't use the reserves properly when I stopped eating.
What is mentioned in a couple of these comments about your body's response to external stressors changing how it allocates calories is absolutely true, but it's at the margins. If you're at maintenance caloric intake and ± a couple hundred calories a day, over years this can have an effect. But it's not going to meaningfully impact a 500-1000 calorie/day deficit to the point where you're still gaining weight.
I believe there is a study where people ate at a 25% deficit but had high glucose and still gained weight.
Is this the study you were referring to?
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7898726/
> Effects of moderate sleep restriction during 8-week calorie restriction on lipoprotein particles and glucose metabolism
Because the conclusion starts with,
> In this study, 8 weeks of calorie restriction with and without sleep restriction of less than 90 minutes per day on 5 days with 2 days of ad libitum sleep per week, resulted in similar degrees of weight loss
Let me be clear that sleep deprivation doesn’t seem to be good for your circulating lipoprotien levels or insulin sensitivity based on that study, but they didn’t gain weight.
Not gonna try to find a specific example, but just from having listened so much to the Stronger by Science and Iron Culture podcasts for the past few years, there have at least been numerous studies and metas over the last decade examining the effects of sleep on weight loss and weight gain as it pertains to bodybuilding goals. I don't recall any having showed an impact on the rate of gain or loss but duration of sleep opportunity definitely has an impact on the quality of gain or loss. That is, you lose more muscle and less fat losing weight while sleeping poorly, and gain more fat and less muscle when gaining weight while sleeping poorly.
> Being tired may cause you to eat more but being tired isn't making you gain weight, it's the overeating that is.
Potato pot-ah-to.
Maybe the end result is the same but it's an important distinction. It's too easy to say "oh yeah I'm gaining weight because I have sleep apnea" while you're snacking on donuts at your desk at all. The people who are tricked into believing it think that if they "cure" their apnea they'll be back to a healthy weight when a) they could be at a healthy weight despite their apnea with some effort, and b) they're building habits that even if their apnea disappears a year from now they will stay at the same weight.
Sidenote, i'm in your camp and agree with you - BUT, hypothetically there's a side to this i've not seen discussed here. That you can lose sleep and it causes a weight gain, with no other change to your CI or CO. Notably, you were previously not processing a portion of your potential CI and it was just passing through you.
In that case you didn't change how much you ate or how many calories passed your lips, but you did change your CI by way of changing your sleep.
Is this a real example or a contrived edge case from a software dev? No clue. I'll let better minds decide that hah.
The body never processes 100% of calories from food the way a bomb calorimeter does https://en.wikipedia.org/wiki/Calorimeter#Bomb_calorimeters, but depending on how much energy it needs it processes more or less.
It's entirely possible to eat less food and have your body decide that food is more scarce and choose to strip more calories from your food than it was when you were eating more.
Thermodynamics is an asinine thing to bring up in a system that can reconfigure its efficiency on the fly to optimize for different environments.
All that does is change the lower limit. The system has a compensation limit, below that you lose weight.
Sure, but it's still unhelpful to say that overeating is what makes you gain weight when other people eating the same amount and with the same amount of activity are not gaining weight, especially when eating less could cause you to gain more weight until you hit a threshold.
I don't think many people disagree with "If you starve yourself enough your body will eventually start burning fat", they disagree that it's as simple as "anyone gaining weight is necessarily doing it to themselves by eating more than other people".
And starving yourself isn't easy. It's one of the top like five things your body is designed not to let you do. So how on earth is it helpful when people are talking about factors that can influence your appetite and can literally influence the number of calories your body chooses to extract from the exact same food to say "just eat less lol"?
I might add that overwhelming research suggests that social pressure on people's weight causes people to gain weight. So even if you were right, bringing it up would be counterproductive.
> when other people eating the same amount and with the same amount of activity are not gaining weight, especially when eating less could cause you to gain more weight until you hit a threshold
That's part of the "calories out" side of the equation, that few people put in the effort to find (if they even know how). And I've found online estimators aren't very useful here, you need to find it for yourself - they say mine is around 1600 when it's actually more like 2200.
Ignoring half of CICO just because people only like talking about CI doesn't make it false.
It's even harder to change CO than CI, that's why people talk about CI. You lose a bit over 100 calories per mile run, and then you have to not compensate by eating them when you're finished. Everyone has a different metabolic set point for how many calories they burn, true.
No one said not eating is easy, especially when there's a lot of food around! I struggle with it. The laws of physics are not kind.
What I will say though, is if I exercise moderate amounts, it makes appetite control easier, at least for me. YMMV. I believe this is because insulin is more level throughout the day.
He's not entirely wrong, but perhaps not for the stated reason. Sleep deprivation can skew the ghrelin/leptin hormonal balance, which can make appetite control difficult.
You reference the laws of thermodynamics, but I'm not sure which laws you're applying to the human body? Is it the first which requires the measured system to be closed which a human body is not? Is it the second about entropy always increasing? Or is it the third defining perfect entropy at 0 Kelvin?
Bringing up thermodynamics as a generalization for biological systems is pseudo-intellectual. We aren't all equal machines that take in a fuel stock and output work. How do you account for differences in peoples' resting metabolic rates? How do you account for the difference in available energy in the foods you chose to eat, and in the differences in peoples' biological processes that extract that energy? Stress is a common hormonal modifier that impacts how the body stores fat; no where near a "rare" condition that many people experience nowadays, and yeah caused by things like sleep apnea. You betray your own argument anyway by adding an the "hormonal condition" exception (I don't see any exceptions referenced in the laws of thermodynamics, lol).
Biology has more dimensions than you are choosing to look at, and using thermodynamics as a "gotcha" when it comes to others' bodies reveals your lack of understanding and intuition.
Yes the first one. The energy contained in ingested food is far and away the dominant metabolic input.
There is no need to get into the weeds of various details of how that breaks down; the main problem is that calories are way too cheap in the modern day and age, and people's habits and instincts developed in far different eras lead to easily ingesting more than is expended. Yes the OP is not wrong, but it's not a very useful argument unless we're going to roll back the modern civilization.
This is the truth, even if people don't like it so you're receiving downvotes for it. Weight gain or loss is calories in vs calories out. Nobody's body is so special that you're defying thermodynamics and creating mass that you didn't intake as food. And that's definitely not changed by sleep apnea.
That said, there is the point that calories ingested doesn't necessarily equal calories absorbed, and sleep apnea could indeed affect that. But if you're relying on that thin margin for the difference between staying at a healthy weight or not, that's a fragile state of affairs, and you could fix your diet more to be more comfortably on the right side of it.
(My own, unscientific, hypothesis: far too many people are indeed unknowingly relying on that. I think a ton of people cram in 3k calories a day while absorbing 2k because there's just too much mass for the body to process, and then when they do cut ingestion to 2k, that doesn't change absorption and that's why they don't lose weight. (Numbers here are approximate.) It's actually pretty amazing how little food the human body actually needs and how little mass 1500 calories is.)
> and how little mass 1500 calories is
Or how much, depending on what you’re eating. It would be physically impossible for me to eat 1500 calories of lettuce in a day (10kg worth) but it definitely aids in “feeling full” when added to a meal.
I thought it was more complex than this, something like lack of sleep disrupting hormones that regulate feelings of hunger and fullness.
I'm sure it is. But the point should still stand.
CPAP has been life changing for me. For my entire life I struggled getting up in the morning, and I never felt "refreshed". Getting up before 9-10AM was super difficult. I also was often in a sort of fugue state when I would first wake up, I'd often have no memory of any interactions, and apparently was often mean.
Now I can easily get up, even at hours that were previously unthinkable, and more often than not feel fully recharged.
I have no doubt that played a part in me being unhealthy - though by no means was it the sole reason.
As an aside, also getting on a dose of Semaglutide has been similarly life changing. The damn near elimination of "food noise" has been incredible.
I know there are a number of folks of the opinion that its somehow cheating. But for me I am left wondering "Is this just how normal people feel?".
It always bothers me when someone says it’s "cheating" to use a GLP-1 agonist.
It helps but the person losing weight still has to clean up their diet and start an exercise routine. There are still major changes they need to make to become successful. GLP-1 agonists help a lot of people make better decisions due to how they fight hunger. Less hunger means less chances to make bad choices when eating, and weight loss progress is a virtuous mental cycle where you keep doing what you’re doing because you see results.
None of that is cheating. There are still major changes one must make. Taking Ozempic but continuing to eat a trash-tier diet will yield little to no progress.
Definitely agree, but man, the sheer number of folks who leave just horrible comments on videos/posts people make about how they lost weight on a GLP-1 agonist is so disheartening.
In addition to saying that its cheating, they will actively wish harm to the person by saying "just wait til you get X" where X is some side effect (real or imagined). Or just the "well once you stop taking it you'll just get fat again".
The people who say "you'll get fat again once you stop taking it" also baffle me.
The most difficult part of losing weight for me personally is changing my routine and habits. Setting myself up with a kitchen that's ready to cook. Figuring out what kind of meals I'm happy to have on a weeknight that don't require a lot of cooking. Preparing parts of meals over an hour or two on the weekend to complete some of the more time consuming parts when I'm not so constrained on time. Learning to deal with the urge I (used to) have to "eat my feelings".
All of those things don't just magically go away when you stop taking a GLP-1 agonist. Losing a lot of weight isn't just about self-control like if you're just trying to lose five pounds to make your pants more comfortable for going to your 20th high school reunion; you have to rewire your habits and mind and make a life long commitment to those changes.
Rewiring your habits and rewiring your brain are things that persist if your intention going into the weight loss was to change your habits instead of just moving the number on the scale. If you are looking to do it only temporarily and are unwilling to lock in those behavioral changes then you're likely going to fail, and that has much more to do with mindset than medication.
Just to add to this, there's data to support the intuition there that there is long term good in taking GLP1s even after you stop:
https://glp1.guide/content/do-people-regain-all-the-weight-l...
Now, we need price to go down and availability to go up, but people who think all the weight bounces back as a sort of "gotcha" are silly. It's possible, but is a testament to the difficulty of dealing with obesity -- not some sort of gotcha of the drug.
> As an aside, also getting on a dose of Semaglutide has been similarly life changing. The damn near elimination of "food noise" has been incredible.
>. I know there are a number of folks of the opinion that its somehow cheating. But for me I am left wondering "Is this just how normal people feel?".
Heavily under-weighting (heh) the opinions of people on the internet (and honestly most people in real life) is the way to go.
We generally don't (and shouldn't) ridicule people for taking scientifically proven treatments that can help save/prolong their lives.
As a fairly thin guy in my 20s (I was about 130lbs and 5'6"), I had years of undiagnosed hypopnea. I would wake up with tears streaming down my face and choking, but couldn't figure out why. I was constantly exhausted and yet, couldn't sleep. I would spend more than 12 hours in bed every night, hoping to get as close to 8 hrs as I could.
Paid for a sleep study and the doctor walked in the room and said, "You don't have sleep apnea." I was like, " I knew that, but what can I do?" The doctor shrugged and said, "You have hypopnea. You could try a mouthguard...?" trailed off and left.
So, with this newfound wisdom I was back at square one.
Some things that dramatically helped me in recovering from years of sleep loss: - A chinstrap. - I found a study (n=1, literally) about a patient who didn't fit the typical sleep apnea profile as a thin older man. The doctors treating him wondered if it was "positional sleep apnea" and had him get a chinstrap. This held his mouth shut while sleeping and prevented his tongue from falling back and blocking his airway. I found a chinstrap on Amazon and immediately started sleeping better.
- A blood test - My doctor knew that I was dealing with adrenal issues due to not sleeping, Lyme disease, and other issues, so he ordered a blood test. This was fantastic. For me, addressing my underlying magnesium and B-12 deficiency made an enormous difference in sleep quality. I found that taking my B-12 right before bed helped my sleep be so much more restorative.
- Andrew Huberman - Andrew Huberman's podcast Huberman Labs is old news, now, but when I found him a few years ago, it was some of the more actionable advice I had ever gotten about sleep, falling asleep, and circadian rhythm.
Anyway, there were more things across the way, but these are some things I shared with others that they also found helpful. I now am in control of my sleep and feel decades younger. You can get there! It's worth experimenting and finding a doctor who is going to help you find your problem. The mental clarity, focus, and energy has definitely made up for all the the months of trying to find out what was wrong with me.
I hope you sleep well!
I had sleep apnea and got jaw surgery. But I also have a dysfunctional TMJ, so my mouth opens when I sleep. Every chin strap on the market pushes the chin down into the airway, it seems. Which one did you get?
I got some random generic one. I wouldn't recommend it as the quality could've been better. For you, I also tried tape over the mouth. I got a wide washi tape from a friend and experienced similarly helpful results to the chin-strap. However, I found that comfort-wise, I preferred the chinstrap.
But, if you can breath through your nose well enough, I think some kind of mouth tape can work? I haven't tried the Hostage brand anti-snore tape, but maybe someone here has had experience with that.
If you really want the chinstrap that I got, I got this one: https://www.amazon.com/gp/product/B08DR16XGV/
Based on the pictures, it obviously pushes the jaw backwards. That obviously wouldn't work for you. I wear mine in such a way that it is helping my jaw close and stay shut. I agree that you don't want something pulling your lower jaw backwards.
Yep I've tried mouth tape and it's pretty good, especially when combined with side sleeping.
Though I have this paranoia that mouth tape will increase my philtrum length, which I know is a vain worry. Another solution is one of those incline pillows - just a 20% gradient should allow me to back sleep, which I prefer.
Post-surgery I had my jaws wired shut and they had this chin strap that was like an ace bandage that around my head and chin. I could replicate that with one of those mouth guard combined with a chin strap, but I read somewhere that this would eventually pull the upper jaw down towards the airway as well (since maxillary plates are not fixed.)
Have you tried mouth taping instead? Seems to work better for some people than chin straps, but I don't really know.
Thank you for this comment which mirrors my experience. Unfortunately CPAP seems to be considered the be all and end all of treatment, although the mask, tubes and reliance on such a bedtime setup can be enormously disruptive of sleep on its own.
CPAP is by far the best option for very nearly everyone with obstructive sleep apnea (for now).
Unless you have a very specific, isolated problem (such as huge tonsils or a fucked up jaw), surgery is rarely a good option. Results are hit or miss, recovery is unpleasant, and the scar tissue created can result in more obstructions years down the line.
None of the current implants are as good as cpap and few peole qualify for them.
Mouth guards can work, but many don't tolerate them well and they can lead to TMJ issues.
Etc.
I adapted to it really well but I am used to adapting to the needs of machines. My wife doesn't like it when it blows air on her but my cat is very curious about the mask. My doc told me that most people have a lot more trouble.
I think CPAP is just convenient and inexpensive compared to surgery. If I ever have sleep apnea, I'd want the surgery.
I talked to a bunch of dudes who had various surgeries to open up their airways. It seems the outcome of the surgeries is kind of hit and miss. Some people had multiple surgeries and still no success.
This is a really important comment. Whether for apnea or other sinus related issues, I've met far more people for whom the surgery did nothing than people I've talked to who had good outcomes.
There is also the mouth guard for apena.
https://www.sleepapnea.org/treatment/sleep-apnea-mouth-guard...
I have heard horror stories about the surgery. Who knows, but I’m skeptical because surgery presumes the precise cause is known. The number of variables for sleep apnea is large to have certainty.
"The number of variables for sleep apnea is large to have certainty."
Clearly they have to know which part of your airway is restricted. Most of the variables for sleep apnea are not related to the surgey, just factors that make it more likely to experience that restricted airway (drinking, weight, etc).
I have sleep apnea and I use a CPAP. During the diagnosis, there were tests but nothing that would/could finger a physical culprit that could be fixed via surgery.
My question is, what tools are there to narrow, to a certainty, what would need to be done via surgery? In all my research I have found none. Maybe I missed them. If I did not, then it amounts to a guess by a surgeon. And that's what worries me and has fed a lot of the horror stories I've read about.
In case this helps anybody: I've been using those BreatheRight strips (extra strength) and they've been incredibly helpful. Not nearly as effective as CPAP, I'm sure, but a milder version of the same effect.
Tape didn't work for me. What did work were nasal dilators:
https://www.amazon.com/Rhinomed-Snoring-Solution-Reduction-C...
I don't understand why, but in my 30s, it's like my nostrils aren't big enough to get the airflow I need, especially when sleeping on my side where a pillow might compress one nostril.
Disclaimer: they are not very comfortable, but far more comfortable than a CPAP mask.
I feel the same way, I wish there was some kind of way to permanently expand my sinuses or something because I feel like I can't force air through them.
Sometimes just breathing hard through my nose starts to make my ears pressurize and threaten to pop
> Sometimes just breathing hard through my nose starts to make my ears pressurize and threaten to pop
I had something similar (ears permanently felt like they needed to be popped, for months). Was diagnosed with a deviated septum + allergic response causing my eustachian tubes to not regulate ear pressure properly. Flonase helped. But cluing in that it was partially due to an allergic response (deviated septum made my nasal passage narrow, allergies closed them all the way), I have found that Benadryl is extremely helpful with both nose breathing and preventing the issue with pressure in my ears. I only take it when I have difficultly nose breathing.
I actually had surgery done to fix a deviated septum about 10 years ago, now you mention it
You're probably right it's allergy related. Nothing ever shows up on scratch tests though
I use a nasal steroid I just wish there was a permanent fix
There’s a metallic device to insert inside your sinuses. It looks like a finger trap with one side going to a point. I remember it lasts a few years then needs to be replaced for $1000 or so.
My grandfather looked into it because the surgery doesn’t last very long and he had it done multiple times.
nasal dilators definitely help a lot. I've tried the mute brand you posted and another style that smells of lavender and the mute ones are better. my only problem is I subconsciously mid sleep pull it out because they are a bit uncomfortable like you mentioned, or it falls out at some point of the night and gets lost in the bed. it is amazing how much more air I can breathe through my nose with one in though, and I definitely feel much more rested using them when they stay in. I knew they worked the first time I fell asleep and woke up the next morning in the same position
Yeah exactly. I frequently wake up to realize I yanked the sucker out at some point, sometimes even with groggy recollection of it. (Though I do the same to a CPAP mask when I use one)
But it clearly works in the best case scenario. And sometimes it's the only way I can even breathe well enough to fall asleep.
That's a little upstream of where in one's anatomy is the common choke point - usually the back of the throat/soft palate relaxes and obstructs all breathing.
But I have nose blockage issues and use nasal strips nowadays, too. It prevents mouth breathing which is nice to prevent dry mouth in the middle of the night (which even a humidifier on my nightstand can't completely solve in my climate)
I could not handle the CPAP mask but instead I got a dental appliance (custom) that juts out my lower jaw a bit. Worked great.
I got a custom dental appliance for like $1000 out of pocket, and it broke within a few months, conveniently when I had moved out of state from my original dentist.
There are a few over-the-counter options that advertise themselves as just for snoring reduction - SnoreRX and ZQuiet are ones I've tried. I've found that wearing a BreatheRight-type strip along with one of these appliances works as well or better than the one I got from my dentist, and it's MUCH cheaper. I also take an anti-allergy nasal spray, as I have pretty bad allergies also interfere with sleep.
I got mine thru the city health service, so I only made a token payment. 1000$ ouch.
Those never worked for me (mouth breather) but for some they do work wonders.
I have severe apnea and have been skinny most of my life, as I get older (in my mid-40s now) I can gain _some_ weight, but I'm still slim. My apnea is caused by having a narrow airway entrance and thick tongue that just completely blocks the entrance during sleep when my tongue relaxes and falls back. Has nothing to do with my weight, just the genetics I inherited. I use a CPAP that helps. My AHI is really low with it on. Now I just need to make myself go to bed earlier, I definitely have that "revenge nighttime procrastination" thing where I stay up way too late.
I fixed apnea using MAD night guard (pulls jaw forward using a mouth guard device). Made by dentist. Cost about $2000. But it works.
You can also try "snore prevention" night guards like ZQuiet and SnoreRX - they're less than $100 and you can buy them online. I find they work just as well as the custom night guard I got from my dentist.
When you say fixed, do you mean you no longer need the device?
Do you think sleep apnea is a condition caused by civilization? I.e. did medieval people suffer from this? And is this a consequence of the American diet and a sedentary lifestyle, or something else?
If it's not weight, what's the common cause? Such a bad impediment on so many people should have a very clear signal. And apparently it's not weight? O never really looked into it
With obstructive apnea, it's mostly hereditary. You inherit the shape of nose from your parents, why not the structures in your airway? Weight gain can make it worse as those tissues also can expand, and any weight on your breathing can help turn a partial blockage into a full one. That weight can include muscle weight, and body builders often suffer from apnea.
But the thing to keep in mind is that obstructive sleep apnea isn't so much a condition as a description of what's happening. Apnea means you stop breathing, obstructive means something is blocking it. Maybe it's because your fat belly is weighing you down, maybe it's your tiny nostrils and deviated septum, or maybe the back of your tongue is thick because your dad also had a thick tongue.
That's not even including self-imposed factors like central nervous system depressants (alcohol) and smoking, both of which can make apnea worse. Ever notice how drunk people snore?
Beyond physical obstruction, sleep apnea can also be neurological which is the more annoying one since only air pressure seems to fix it. You simply stop breathing.
Obstructive apnea doesn't need to be caused by fat either. I always thought sleep apnea was a fat person's problem until I realized at age 30 that when I slept on my back, the tissue mass at the base of my tongue was dropping into my airway. And I'm fit/slim and also a nasal breather.
(I used to think I always woke up gasping for breath in my 20s because I had frequent nightmares. Ugh, wish I could go back and fix it sooner.)
One theory is poor facial structure that develops due to faulty breathing technique.
Reference https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4686746/
One theory blames "modern life" as a supporting factor, that since modern people eat more processed and softer food, that jaw muscles are out of proportion to the bone structure and this contributes to apnea, as well as tooth problems like impacted wisdom teeth.
https://news.stanford.edu/2020/07/21/toll-shrinking-jaws-hum...
It's not exactly common, but you can have central sleep apnoea instead of obstructive sleep apnoea. Essentially, rather than your airway being blocked, you just stop attempting to breath for a period of time. I was diagnosed with this a few years ago, and IIRC there are multiple possible causes of it.
The most common cause of sleep apnea is anything that obstructs your airways. Being overweight does that and is far and away the most common cause of sleep apnea.
This is such an often repeated trope, but it's not at all as clear cut as that. Sleep apnea *causes* weight gain, the arrow of causality can go both ways.
Sometimes I wonder if humans need more variability in sleeping positions. Animals sleep in all sorts of positions on all manners of not perfectly even terrain, probably trains nassal to be strong in different orientations. When I had bad heartburn/gerd I'd pass out propped up on the couch or setup a bunch of cushions in the corner of the room, or raise head of my bed up with a few books and getting great sleeps.
I’ve had sleep apnea and CPAP for years. The last several weeks have been grueling because of mask fit, movement, and other factors. My BMI is very high, but I am in minority that will have sleep apnea regardless due to anatomy. That doesn’t mean it won’t help to lose weight.
I'll throw this out based on the comments I'm reading, it seems like doctors don't personalize medical advice sufficiently.
Glad some people were able to find the good ones that did
How would one know if they had sleep apnea in any shape/form?
Get a sleep study for accuracy.
If your partner notices you snore or stop breathing when sleeping.
You can record yourself also. You wake with a headache and dry mouth almost daily.
Sleep apnea is not the reason people are overweight.
If you are so confident, try setting up an alarm to wake yo up 15-30 times every hour of every night, for a year. See what happens to your overall health and to your weight in particular.
And that is moderate sleep apnea. Actually, apnea is worse because you wouldn't even be breathing normally while you are "asleep".
Nobody is overweight from one reason alone. But do you dispute the idea that it contributes?
Sleep deficit drives metabolic changes that may result in obesity (e.g over feeding behavior).
I’m the dad of a 7 month old baby. I think I feel around 100 years older than I actually am.
I feel you - our son had about 6 months(from ~4 months old until 10 months old) where he just wouldn't sleep for more than an hour at the time, then would wake up screaming and it took at least 30-40 minutes to put him back to sleep. I think in that period me and my wife were actual zombies, just didn't get any sleep at all, there was a point where I thought to myself I haven't had more than 2 hours of continious unbroken sleep for few months, and that there is no way this can be healthy lol.
Also, I know saying this now doesn't help, because at the moment you are in one of the most "intense" periods of their development where they need all of your attention but give relatively little back - but that will improve. They will eventually sleep better and they will start telling you how much they love you and kiss you goodnight - and then all of those early months are forgotten :-)
I can relate, sleep deprivation can have serious health effects. We did night shifts on cycles every other day, where one parent slept through the night on the couch with hearing protection, while the other stayed with the baby in the bedroom. This method worked out quite well. The advantage is that the parent who slept on the couch has more energy during the day for the child and can enjoy the time more, which is also beneficial for the child.
so... what are you supposed to do if you have a full time job?
I have an 8 month old and am full time while mum's on maternity leave. When the baby was ill recently, at times he wouldn't sleep unless he was being held by a standing person. I'm not kidding - there were nights where sitting or lying down as gently as possible would wake him up. We ended up doing half-night shifts where I'd have him from 8pm to 2am and then mum would take him from 2am-8am. I'd wake up at 8am, put him in the carrier for a nap while mum napped as well (30-60 mins) and then start work.
How parents in the US do it when maternity is only 12 weeks unpaid... I have no idea!
I caught shit from my ex-employer when out latest was born because I wanted to take 2 weeks off. 2 weeks. It was part of my review that year before I even took the time off.
I left that company the same day. We lived VERY lean for a year or so while I figured out a new direction. Thank Christ for a supportive family.
That's just awful. As a new parent I'm so much more keenly appreciative of these kinds of struggles. I found 4 weeks of pat leave and a very gentle re-introduction to work very challenging, let alone bringing up an infant without an income. I'm glad that you had family around to support you and that you did indeed find a new direction (which it sounds like you did).
As a dad I only had 1 month of paternity leave and I still found it incredibly difficult to go back to work(not because of work, but because my son needed a lot of support and I wasn't able to provide it). 2 weeks would be literally impossible, I think I'd resign.
And coming from the nordics I wonder how the parents in the rest of Europe do it when there is barely any paternity leave.
Yes, I'm very jealous of what you get, "up north". Some companies in the UK are generous - I hear Google (or at least DeepMind) provides 3 months - but some dads in my antenatal class only got a single week off. And some of the mums went back to work after 6 months, putting the baby in nursery at that age.
UK is weirdly crap at it compared to other European countries. Dads only get 2 weeks at statutory pay(like £150 a week), mums can take a full year but they get progressively less with time, where if I remember correctly after the first 3 months they only get statutory pay(about £600 a month) then in the last 3 months they get absolutely nothing. So yeah, no surprise women are getting back to work sooner - the financial penalty for staying on maternity leave is huge.
I'm not sure if her company is particularly generous, but my wife is getting 3 months at something like 80 or 90% pay, then 6 months stat pay, then 3 months nothing. Fortunately she still accrues annual leave during the year, which means we do have the option of covering the final month at full pay. We're going to try to tough it out and tack a month of leave on at the end instead.
How old is/are your kid/s now if you don't mind me asking? And did you have another one after the terrible sleeper? I only ask because we're now in that phase of trying to decide whether having another one is what we want.
Sorry for the late reply - our kid turns 3 next month.
And nope, I'm very much against having another one, exactly because the first one was such a bad sleeper, every time I start thinking whether to have another child I remember sitting on the floor and literally crying because I was so exhausted and he just wouldn't sleep, or doing something and just knowing that he will wake up in an hour and there is nothing I can do to prevent that. It was absolutely awful and I don't want to take that risk again.
Having said that......he is an absolute angel now. Very bright, very cuddly, loves to play and hug and definitely reciprocates all the love we give him. So I do sometimes think "wouldn't it be great to have another" - and then I remember again.
Thanks for the reply. I think that is a common theme - first kid being a bad sleeper makes a second kid much less likely. We're on the tail end of an illness now and he's rarely going for more than 1-2 hours without attention. And he's never regularly slept for more than 45 mins in a nap. It must be a huge difference in quality of life if you know that they're going down for a 2 hour afternoon nap. You can nap yourself, or get a workout in or something. That said, I've heard nightmare stories even at your daughter's age. One friend couple of ours has a 3 yr old who wakes up between 2 and 4 am every night, and needs playing with and reading to.
> I remember sitting on the floor and literally crying
I feel this, and it's still like that for me sometimes. Last night I shouted "Just go to sleep!" at him, I got so frustrated and upset because he kept taking his own dummy out of his mouth and waking himself up. I'm really hoping that once he starts either crawling or walking he'll burn off that energy and sleep better.
This is why I love Germany, because you don't have to ask questions like this. You have the right to take a year off (or more) as a father and mother and the state pays you.
What the parent comment is suggesting is every second night one person gets a solid night sleep.
It's a great strategy for survival. We did this a lot with our second child and still so sometimes if there is a patch of disrupted sleep.
The person with the child is not getting zero sleep. A small baby can't stay awake for an entire night. So you could get two or three hours in small batches.
You are exhausted the next day, but at least you have the following night to recover.
If you have a full time job you just do your job. You are really tired and not operating at 100℅ but you get through and it is better than having 2 or 3 hours broken sleep every night.
It will be a challenge for a few months, but as other parents pointed out, it will improve over time. My advice is, if you plan to have kids, then try to reduce any other factors of stress, such as work-related, as much as possible, because your kid requires full attention, especially in the beginning.
My experience as a working parent has been that you just have to muddle through some days one way or the other. (But taking longer shifts like GP mentioned works way better than trying to split the difference within a single night.)
Answer A (because capitalism is for sociopaths): Sleep train
Answer B: Work harder on the days you have energy.
We just slept with our son in bed and didn't have a fraction of the problems in this department.
This should be obvious, but you also had a different child.
Our oldest child wouldn't sleep until we got him not only out of the bed but the bassinet all the way out of the room.
Our second child slept like a baby pretty much whenever.
Our third did fine in the bassinet, but now that she's older and transferred to the nursery she wakes up if even the slightest bit of light comes in through her door.
Kids are wildly different from one another from a very young age. I wouldn't assume that your cosleeping is the cause of your having fewer sleep troubles. If anything it might be the reverse.
Makes you wonder where "sleep like a baby" comes from, because it definitely seems like only some babies are great sleepers.
It could also mean that you wake up every 2 hours and crap your pants crying! That’s why it’s such a great term - it can mean almost anything.
Older babies do tend to sleep very soundly though!
One thing I learnt a while ago is that every child is different and that everyone(me included!) love to extrapolate their own experiences on everyone else.
But yes, in hindsight I would probably try some form of co-sleeping, even though everyone around us was advising against it(too much of a risk).
I've dug into the studies on the co-sleeping risks.
It turns out that co-sleeping is a risky thing if you are on drugs or are drunk.
If you are 100% sober, then it's perfectly fine. If you are high, or have had a drink, or are on some sort of flu medication (NyQuil, then the risks start ratcheting up.
So, since we're most worried about the parents that do drugs and drink around their infants, the common advice is to no co-sleep. It makes sense, I totally agree with that tack, but if you are willing to be 100% sober of all drugs and alcohol, then try co-sleeping and see how it goes.
I didn't co-sleep with my first because of the warnings about co-sleeping. Instead I'd fall asleep in my office chair with my feet propped up on the coffee table.
Finally realized that I was going to fall asleep somewhere and did the same research. Co-sleeping sober ( and with a healthy BMI ) is safe and often better than sleeping somewhere else. We don't all have the money and space for cutesy recliners.
I also have always slept with our child in our bed. This hasn't done much for my sleep.
First child was terrible, she preferred having a bit of space I think, and she would flip around in the bed so you'd be constantly woken up with a foot in the face etc.
Second child did like to sleep in the bed and still does, though now we are trying to break the habit.
Each child is different and even one child can change a lot through different developmental stages.
> there was a point where I thought to myself I haven't had more than 2 hours of continious unbroken sleep for few months
Omg same, but for more than 2 years, because I'm a breastfeeding mom. Idk how this is healthy or normal!
People who haven't been through this often underestimate the severity of it... they often think that because they've pulled all-nighters for school or something that they understand but weeks or months of chronic sleep deprivation is a totally different thing.
It was living hell for me- my son wouldn't sleep during the night for more than 10-20m at a time, and my partner was having severe postpartum mental health issues (psychosis/rage/depression) so I was parenting solo, and up all night every night by myself with a crying baby. I eventually started hallucinating, and had a short temper and made very poor decisions. I couldn't get advice, help, or sympathy from anyone- usually something along the lines of "parenting is so easy for dads, why are you complaining?" Visiting family would expect me to serve meals to them, and not help either.
I almost lost my job also because I couldn't focus or code anymore. Once I started sleeping in a separate room from my son, I could finally think/code/work again. Understanding in the workplace for a struggling new dad was non-existant: everyone assumed the mother was doing all of the work, and I would perform like normal.
If anyone is reading this and can relate, don't do what I did- pay for help. Pay for a nanny- take out a loan if you have to. If you or your partner is struggling, get them professional mental health support. Prioritize your sleep, bodily, and mental health needs: you need to "put the mask on yourself first" or you can't help anyone else. Don't be afraid to set a crying baby in a safe crib and go sleep for a while if you need it.
To you and the others, just hang in there it gets better. You’ll get through and come out the other side better, stronger, and full of more love than you thought existed.
/father of a 14 and 12 year old boys
^ fully agree. I blinked an my youngest was suddenly 10yrs old. The kids all being in double digits is really awesome and far less labor intensive than the early months.
A lot of people here will say "it gets better", and it does, but be sure to take your health seriously and not let yourself normalize that feeling for the long-term. Mine are 7 and 4 now and we're well past the sleep-deprived early years, but I realized recently that I had grown accustomed to that feeling and my new baseline is significantly worse, largely due to bad sleep habits. I'm a lot busier now, juggling the needs of 2 kids and my other responsibilities, and for too long I've coasted on ~5-7 hours of sleep thinking it's OK to sacrifice 1-3 hours of sleep in favor of squeezing in extra work or some low-quality leisure time at the end of the day because, "hey, it's still better than it was when they were babies, and I made it through that".
Posting this here, because it was advice given to me by one of the founders we all look up to on HN when I had my first child (on our 4th now).
"If you are going to have kids and run a company, you all need to sleep." and then he introdued me to a sleep trainer/coach.
"No way, we are not sleep training" was my thought, but I quickly realized that there is a difference between sleep normalization and what we know as sleep training.
The sleep coach gave us a completely customized regime for 2 weeks. Once the baby is 6 months or so, you can start. (up until 6 months, I just slept with the kids in my arms every night. Oh my god I miss those nights now. It makes me cry to think about how wonderful it felt.)
We've done it 4 times now and all our children gladly sleep from 7pm to 6:30am every single night. (The older ones now go to sleep more like 9pm). Everyone in the house is rested every day and it makes a big difference. Those two weeks are a lot of work for one of the parents (it is specified that one person should be focused on it) but in our experience it works by the 3rd night or so.
The main takeaway from the aproach is to disassociate eating and interaction from the act of sleeping. It created buffers between feeding times and play times and when you finally put them down in their crib to sleep. If they do wake up during the night they don't think "oh, if I cry I will get to eat right away." and they self-soothe and go back to sleep. If they do wake up hungry, it's a failure of the parent to have ensured they've eaten properly. You adjust as they grow. (A hungry cry is totally different from a discomfort or bored cry. You learn them pretty quickly.)
When I put my 10 month old in his crib to sleep now he looks back at me briefly and then turns over and gets in his sleeping position and he's asleep before I leave the room. It's such a relief knowing that no matter how badly a day goes, you can sleep that night.
I've had a lot of friends think this isn't for them, but 100% of the ones I have convinced to do it (and in some cases have just paid for) have been successful.
I'll also add that 2 of our kids were "colicky" and were very unfcomfortable during the day for their first year. Even still we were able to have them sleeping the entire night most nights after 6 months.
Again, there is no "cry it out". In fact, the baby almost never cries at all in this process in my experience.
> "oh, if I cry I will get to eat right away."
This kinda matches what I’ve read recently in a parenting book.
I’m currently reading Bringing Up Bébé, a book written by an American journalist who lived (maybe still lives?) in Paris and had her kids there. She wrote it after she started observing that French parents don’t seem to have the myriad of exhausting issues American parents have, or at least not with the same intensity and for the same duration.
When it comes to sleep, she writes that most French babies sleep through the night by the time they’re 6 months old.
According to her, what a lot of American parents (and from my experience as an expat, parents from several other countries too) do wrong is to immediately tend to the baby the moment they make any noise at night, in the first months few of their lives (this apparently doesn’t apply to the very first month though). That trains the baby to do exactly what you wrote, to get what they want as soon as they wake up in the middle of the night.
According to the author, French parents typically wait a few minutes whenever the baby wakes up at night. Most of the time the baby goes back to sleep.
The explanation she offers is that babies’ brains don’t know how to link one sleep cycle to the next, so they wake up between cycles and typically cry or fuss for a bit. By leaving them alone for a few minutes instead of instantly reacting, parents can help their brains learn to connect sleep cycles more efficiently. If they’re immediately picked up though, they’re actually being trained to do the exact opposite and to stay awake instead.
I really like your post btw, going to look up what you wrote about as it sounds invaluable in case the French method doesn’t work :)
Can you point me in the direction of this trainer/method?
Taking Cara Babies, by Cara Dumaplin, is an excellent resource for sleep training that works super well.
who is this coach?
100% having the same experience. It's mind bending how tired you can get.
We recently all had the flu, 2 nights of the baby having a fever and both of us being sick and also having a fever was one of the most testing things in my life.
Best advice I heard on this, is for partners to take turns to get sleep if possible. Perhaps it's obvious, but we didn't do that initially. You really only need 3 hours or so (in my experience) and the insanity starts to subside.
My wife and I had a spare bedroom - we used to alternate nights down there when our child would scream all night.
Try having a kid with febrile seizures. Mine runs 105 fevers casually for 5 to 7 days. We have to check her very often to make sure she is not going into a seizure.
Sorry.
But it’s not a contest.
Oh no did not mean it that way. Not that I want a trophy for sleeping less lol. My point was as a new parent things can get a lot worse in terms of sleep deprivation. I was not prepared for it.
I'm in the same shoes, and I often wonder why evution haven't solved this yet... Like, babies' chance of survival should drop if their parents are sleep deprived. There should be a selection pressure for well-sleeping babies.
Or is it about ensuring that mom and dad don't make a sibling that takes away the baby's resources?
I think that is part of the "it takes a village" saying. Communities/grandparents (of the baby) were all either in the same abode or most likely very close.
Having run the same gamut three times, the best advice I ever got was: chunk sleep. Let the wife sleep for 4 straight hours, and then tag out, where the awake person sleeps if/when they can. I know nursing can gum this up, but either pumping, or just doing the formula thing, it's worth it.
The current situation of 2 parents alone in a box (“house”) with baby is severely unnatural. I don’t think there is an evolutionary explanation because in this regard we are out of spec.
It did: live in extended family dwellings. The modern nuclear family (with 2 working spouses to boot) is the problem.
> I'm in the same shoes, and I often wonder why evution haven't solved this yet
It did! But we, in our infinite wisdom, got selfish and we now live alone. Fight nature and she fights back!
It is our own damn fault. Back in the day people slept with their kids and being close to their parents meant they felt secure and would (1) sleep through the night, and (2) if they needed any attention it would be easy to give it to them.
Somebody invented the crib, got rich at our expense, and now people can't imagine life any other way.
It's more of the fact that we discovered the scientific method and measured that cosleeping is statistically more likely to kill your child. Even if that increase % is small, it's enough for most (western) parents to make the tradeoff and suffer through sleep deprivation.
And the tradeoff makes sense -- as a parent, you are biologically programmed to go through great lengths to keep your children safe.
Recent take of science is that co-sleeping is actually safer (reduces SIDS) if taking a couple of precautions.
Parent under drugs/medications (including smoking) is mainly what drove the death statistics in cosleeping.
Don't have links to studies but is what is teached in official parental education courses in spain atm.
Would love to see the sources if you have the time to share them.
Some have made the case that “cry it out” is preparation for sitting there and suffering while you get bullied in school, while your group gets discriminated against, when employers treat you like a thing, or when politicians scapegoat and steal.
This has nothing to do with the scientific method informing our parenting choices.
> biologically programmed
You mean Socially programmed.
Instincts are biological programming.
I'd say you have instincts to protect your child.
All I can say is that doesn't jibe with our experience.
We co-slept for the first 2-3 months, then had baby in a "next-to-me" for a few months, then moved baby to a crib in his own room at 6.5 months. Prior to being in their own room, the baby would usually wake up every 2-4 hours, with the very occasional 6-7 hour stretch. After going in his own room, his sleep began to consolidate and he would regularly last from 7-8pm to 4am without needing resettling.
We have friends with a 4 year old daughter who co-slept until now and have just moved her to her own room. She wakes up screaming and needing attention most nights around midnight.
Isn't co-sleeping a significant cause of death though? So maybe our society traded sleep to get a higher survival rate
There are two versions of this story.
"It's very safe to sleep with your baby unless you sleep with your baby drunk or on a small couch", and
"It's very dangerous to sleep with your baby especially if you sleep with your baby drunk or on a small couch"
That last bit is right and a study found "The risk associated with being found in the parental bed was not significant for older infants (>14 weeks) or for infants of parents who did not smoke and became non-significant after adjustment for recent maternal alcohol consumption..."
See
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC28288/
Anyone who has shared a bed with a cat or small dog would note that you never roll over and crush it.
Thank you for this.
As others are saying, how tired you are as a parent is a direct inverse function of: how far away your parents/inlaws live, how much they prioritize their grandchildren over boomer pastimes, and your relationship with them.
I've never seen a more zombified human being than when a friend had a fussy baby who simply would not sleep. Two hours a night was her and her husband's norm, sometimes. Godspeed, I hope you can get some rest soon. (Also, congratulations on the new baby! :))
It felt good to read the stories that we can relate to, we have a a 2.5 year old; literally sleep deprived and these stories woke me up, thank you and good morning. I can see aging process is definitely faster with sleep deprivation. We can physically see it in our photos timeline and feel it in our workouts that we work so hard to keep up. Grey hair and baldness surged in this 2 years. We use to have so much energy in the evening for personal projects after work, not anymore. It’s so hard to deal with this both mentally and physically. Sleep training definitely helped us, but again every experience is unique. Hold on and it will pass.
2 years and 5 months here. He never slept well, wakes up during the night, makes all sorts of sounds while sleeping, and wakes up early (5~6 am). Doctor said some kids are like this and it may get better over the years. The lack of sleep took a lot of my concentration, energy, and memory.
Same here. 3.5 year old and one year old twins. Poor sleep and just general fatigue most days. It’s hard to convey to those who sleep well how challenging it is to be constantly sleep deprived.
Keep in mind: this period does end at some point. All the best!
For the love of god, sleep train your baby. There are coaches online if you need help.
Ask your doctor about Modafinil, my GP prescribed it for me when my son was born and it was a life saver.
I found myself feeling "old" during north east winters, I would wake up exhausted and crabby.
Recently I tracked this down to indoor air quality, installed an ERV (basically, introduces fresh outside air into the house) and I feel much better.
There's a lot of talk about (obesity related etc) sleep apnea that's due to how the person breathes, it seems to me that there's a version of it related to WHAT you breathe.
Granted I think I am more sensitive to indoor air quality than an average person or maybe just more aware of the effect, but this seems to have been a game changer in a way.
I'm having a very similar experience with indoor air quality in winter. Googling ERV doesn't deliver anything. What would I look up to find what you're talking about?
It stands for "energy recovery ventilator" - in a nutshell it just blows fresh air into your house and exhausts stale air, but uses the heat in the exhaust air to warm up the incoming air so it's more comfortable and energy efficient compared to an open window with a fan in it.
Before you go too far that route (a multi-thousand dollar install) I recommend getting an indoor air quality meter to get a sense of what might be the problem. I recommend the Airthings View Plus, which is about $300 but is comprehensive and reliable and since (in my case) I made a multi-thousand dollar decision based on it, it was worth the investment.
In my house it was obvious there's a massive CO2 buildup, CO2 itself isn't as big a deal itself but an indicator of stale air (ie, it's not being vented out by itself) and somewhat elevated radon. The ERV isn't the "prescribed" solution for radon but since it ends up venting it out it's fine.
One last thing - for me, the connection between energy and indoor air quality was obvious in retrospect. I could wake up early and be miserable, but once I stepped outside to take my son to school I'd feel better. Or vice versa - I could be full of energy running around all day, then come home and immediately get drowsy.
It only took about 15 years to realize indoor air was the cause.
This is called MVHR (mechanical ventillation with heat recovery) in the UK. We're looking at putting it in, but have a fairly poorly insulated house, so it's not clear if the heat recovery is worthwhile. There is also PIV (positive input ventillation), which blows fresh air into a property (normally the hallways), but does not recover heat, or duct air from the rooms. So it's much simpler and cheaper to buy and install. It relies on the natural 'leakiness' of the property to vent stale air out.
// This is called MVHR (mechanical ventillation with heat recovery) in the UK.
These are actually two subtly different things. ERV (what I am talking about) recovers some of the moisture content along with heat, while an HRV (heat recovery ventilator and probably what you're talking about) does the heat but not the moisture. Depending on where you live this matters or doesn't matter (eg, if your winters are really dry and/or your summers are really humid, you want the ENERGY recovery ventilator to keep the house humidity closer to what you want vs equalizing with the outside.
// We're looking at putting it in, but have a fairly poorly insulated house, so it's not clear if the heat recovery is worthwhile
This doesn't make sense to me at all. First, if your house is "leaky" then why do you need mechanical ventilation at all, versus just relying on the natural air exchange (I can think of a valid reason but just curious how you think about it.) Second, if you DO put it in, your house is obviously better conditioned inside compared to outside so why wouldn't you want to recover that heat, at least for comfort if not economy?
// There is also PIV (positive input ventillation), which blows fresh air into a property (normally the hallways)
Yut but I think your hallway is then going to be as cold as the outside in the winter?
I find having kids in my late 30s hits really hard because of this. Biologically, I can see it being best having kids in your early 20s when you're made of rubber and can bounce back after lack of sleep.
I had my first in my mid twenties and there wasn't a lot of bouncing back happening.
In college you can bounce back after an all nighter not just because you're younger but also because it's an opt-in single event and you can opt out of the next one when you recognize that you're sleep deprived. You can also do what my brother does and regularly sleep in till 10 to make up for the late nights.
Once you have kids there's no opt out mechanism, and sleeping in isn't an option any more. There's not really an opportunity to bounce back from the sleep loss, even for a younger adult.
but your body is more resilient when you're young - you will learn this eventually, but hopefully not :D, in that you are healthy forever !
I hear this all the time regarding bouncing back after lack of sleep when younger, but I have to say that I never really experienced it - I was always completely shot after a (rare) night of not sleeping. To the point where I actually essentially lost consciousness involuntarily for a few hours on one occasion. Then, when I was in my 30's I suffered a bout of sleeplessness for a bit and found I could actually "function" to some extend during the day, though it was a bit dicey.
It really gave me a fear of situations that might involve sleep deprivation - one reason among many I never thought I could handle medical school for instance.
I'm in my late 30s, and physically healthy. Mentally, I can function better on low sleep than I could in my 20s. But two weeks ago, I had five nights in a row of 4 hours of sleep. By the end of the week, I ended up in the hospital with chest pains and doctors were concerned it was a heart attack. In the end, things checked out fine, but my body definitely can't handle the stress of lack of sleep like it used to.
I had 4 kids in my 20s, and I dealt with a lot of lost sleep.
Since I hit about 36, I've found that a poor night of sleep, such as from a red-eye flight, will wreck me for about 2 days.
Yeah have the young kids in your 20s. Thats why you dont need sleep in your 20s. Also has benefit kids are grown and moved out by the time you hit 50...
A thing I noticed had a dramatic effect on my sleeping was forcing myself to keepy my mouth closed while doing any sort of excersize, be it running or calisthenics. It forces my entire nasal cavity to empty all the mucus, and I can breath significantly better and my sleep improved dramatic.
I was having problems breathing through my nose too. It led to snoring and I felt like a had a blocked nose more often than not. Other than forcing myself to breathe through my nose I also got one of those sinus rinse bottles and did some salt rinses.
It's made such a huge difference. After years of having a blocked nose I sometimes just take a moment to enjoy the fact I can breathe through my nose at last. I've also gone from being a snorer to a "very quiet sleeper" according to my girlfriend.
A week of broken sleep is enough to change my whole personality. I end up hopeless, self-destructive, and convinced that I’m going to die imminently for some reason. Just this conviction that my heart is going to wear out any day now. It’s such a bizarre experience, especially to finally get sleep and wake up with such energy and positivity.
Classic symptoms of anxiety from the sleep deprivation, no?
I've also found that there's a lag on recovering from sleep deprivation, where the first night of good sleep often leaves me feeling foggy and lethargic the next day. After 2 or 3, that energy and positivity returns - not sure if that's idiosyncratic or not.
I feel exactly the same way. The first night of real rest feels as if my body “caught up” to how sleep deprived I was and I often don’t accomplish much that day.
The first two months after my wife had my daughter about a year ago, I was a walking zombie.
I wasn’t really here. I tripped and fell down so many times. I had not fallen down since I was in my teens and I am in my late 30’s.
I really had no idea how bad lack of sleep was going to mess me up. Of the things I had planned for in having a child, I was absolutely not prepared for this.
One of the hardships of sleeping rough is that poor sleep quality can rapidly degenerate your cognitive function. Simply put, being homeless hurts your ability to escape homelessness.
> Simply put, being homeless hurts your ability to escape homelessness.
Well known self-reinforcing mechanism, sadly :/ https://en.wikipedia.org/wiki/Cycle_of_poverty
Same with sleep surely, where bad sleep leads to worse sleep...
This is why I need to work from home. I have random periods of chronic insomnia. If I’m able to get a nap in, it breaks the cycle. If not, after 2 days, I begin to spiral down. When in the office, I could only recover on the weekends, leaving a productive Monday and Tuesday.
If only your job let you have a real office with a door, you'd have no problem working from the office.
A lot of the benefit of WFH is just undoing the damage of open office.
Not long ago Google was famous for having nap rooms (supposedly -- I never found it at the NYC office when I worked there in the mid teens).
But in the days of private offices, this was just normal.
Semi-agree. I have my own office, my boss would still say something if I dragged a couch in here. This was the case before open office took over in the private sector as well.
Couches were always reserved for managerial class, since the 80s.
I also work from home and take lunchtime naps most days! I have been chronically deprived of sleep for a while by an old dog who doesn't relax for more than 5hrs at a time and I think I'd be dead without my lunchtime naps.
I've found that my body can tolerate one day in a row of waking up via an alarm clock instead of at my natural wakeup time. The second day, I'm completely exhausted and can't think straight.
The way to sleep effectively and be most alert is to sleep when your body tells you to not when society tells you to.
I hate the fact that I must sleep everyday. I have always tried to get around 6 - 7 hours a night as a result.
Through my 20s it wasn't an issue, but I stopped gyming a few years back and it has been hard if I lose any sleep.
I started working out again and I am back to 6.5 hrs a night, no problem.
Almost 50, working out more than ever, super clean diet and it really is the key to maintaining all kinds of energy and stamina, good sleep, focus, all that stuff.
I'm hoping that someone will ""solve"" poor sleep, in the sense of working out how to determine what's actually causing it. What's the state of the art in affordable home sleep analysis? Smartwatches?
> ...what's actually causing it.
I'm not sure a smartwatch could do anything with my chronic diagnosis of "Having a toddler kicking my ribs at night."
The good news is that condition usually resolves on its own with time!
Anecdote, but I've found that the less I analyze and try to "mold" my sleeping, the better I sleep. The times I sleep worst is when I'm worried about sleeping too little, so whatever I can do to take my mind off how poor my sleep is, the better rested I feel when I wake up.
Some nights are still horrible though, and it's a hard loop to exit when you lie there at 03:43 in the morning and panicking about getting too little hours this night...
I know that feeling. You're probably onto something. If you worry about something, I think you always make it worse.
There was a point where even other people worried about me sleeping, and that made me worry about my sleep.
Eventually I decided I would go to bed when I was tired and see how it went. Been doing that half my life now. I go to bed when I'm tired (about 12-1am) and I usually wake up at 7AM feeling fine.
Forcing a whole 8 hours often makes me feel worse. YMMV
Yes, I've had terrible sleep most of my life, and a period of good sleep recently. Felt stupid, but I realized during that good period that I just needed to "chill" when going to bed. My brain has a tendency to WANT to focus, and actually slowing down is almost a foreign state at this point, and it's exactly the state you need to get in to naturally fall into sleep.
For me it’s the same. The moment I accept that I’ll be super tired the next day is the moment I finally fall asleep.
Listening to podcasts helps me. It gives my brain something else to focus on, and I drift off much more quickly.
I like listening to podcasts as well, but the ones I like when trying to fall asleep are different than those I listen to recreationally when doing chores. For falling asleep, I need to make sure whatever I listen to is something I'm OK with missing, so call-in shows often are a good fit, as there's infinite content in a call-in type show.
Sleep studies exist, and they're fairly advanced, is my understanding. For most people, though, it'll be possibly difficult lifestyle changes, like reducing light in the room, better bedding, less noise, not sleeping with a partner, winding down before bed without screens (big one), better diet, etc. The solutions are there, they're just unpalatable, like everything else you should do that's good for you.
Sleep studies collect a lot of data, but that may or may not translate into an actual intervention depending on the situation. As I understand it, they're mostly useful for detecting when sleep is disrupted, which can then potentially fit a profile for e.g. sleep apnea or be correlated to some other physiological indicator.
As for lifestyle changes, I'm not an expert in sleep science, but I've tried to read some of the literature to understand what works, since I struggle with sleep quality. As far as I can tell, a lot of the specific suggestions that often get thrown around (even by otherwise reputable sources, sadly) are somewhere between speculative and pseudoscience. There is some evidence that "sleep hygiene" interventions as a whole might have some kind of effect, but the individual components aren't typically tested, the studies usually aren't adequately controlled, and the effect is often exaggerated (e.g. by highlighting questionable measures like "sleep efficiency").
CBT-I has better evidence, although it's also not entirely clear which components are really worth the trouble (the evidence for sleep restriction seems pretty strong; the "CBT" elements less so, but it may be that they help different subpopulations), and clinicians who actually have experience delivering CBT-I are not readily available in many places.
I have followed a distilled version of CBT-i remotely via SleepReset (a HN company), because I discovered CBT-i but it wasn’t indeed readily available in my country and region.
It has helped me tremendously (together with other tooling like sport and meditation).
I suspect it will only be "solved" once the problems of existential angst and ennui are. It's remarkable how powerful our primal emotions can be at overriding even the strongest of drugs.
I've seen DIY gadgets before that cost around the same, seems very interesting. I'm wondering if there is a gap in the market in sleep quality analysis
Electronics and very bright nighttime lighting are a ton of it.
Cutting those out would turn a hell of a lot of “night owls” or people who “can’t sleep” into people who sleep on a normal schedule just fine.
It’s obvious when you consider what all that stuff really means. Obviously it’s hard to sleep when you spend your hours after sunset in hundreds-of-candle-power lighting and have hyper-stimulation of a hundred kinds available at the press of a button.
Of course there’s also apnea and kids and such, but that’s a large proportion of the problem, overall.
Color temperature is more of a factor than brightness. Blue/white light disrupts Melatonin production. Changing your lightbulbs to be below 2700K (more of a yellow light or even red light) won't disrupt Melatonin.
that's why it is imperative that you squeeze in some amount/level of workout. does not have to at the gym, even 5 mintues of jumping jack at your home helps. Granted if you have are exhuasted from lack of sleep, workout is the last thing you want to do; but through out your weekly routine -- to quote immortal bard Eddie -- go ahead jump <https://www.youtube.com/watch?v=SwYN7mTi6HM>.
I get bad sleep all the time, and I look younger than all my friends my age...
I would be curious as to how they are measuring the subject's perception of their age. Are they just asking them how old they feel? How do they get meaningful results?
The link to the paper is halfway down the article. https://royalsocietypublishing.org/doi/10.1098/rspb.2024.017...
Thanks.
> Subjective age was assessed using a single-item question: ‘On some days you may feel older or younger than your calendar age. What age do you feel right now?
How would any of these people _know_ what older actually "feels like?" It's hard to believe they felt this surrogate question would reveal anything useful, let alone, that the numeric values associated with it were worth averaging.
Good point. The study would be better if they tracked actual biomarkers like HRV, RHR, blood pressure, etc. rather than asking the question, how old do you feel.
Some martial artists of the UFC say that sleeping is the best PED (performance enhancer drug)
*when the cameras are on
I like to set an alarm for 9 hr 30 min before sunrise. This gives me 30 min to get ready for bed, and to go to bed with time for 6 full REM cycles of 1.5hr each. The rest of the timing (the timing of my rest?) is up to my body and how much sleep it wants.
When I do it this way, vs setting alarms, I'm always surprised by the sleep debt I've accrued and am now paying back.
Modern (especially urban) society demands a lot more of us than many of our bodies can sustain.
I'm sorry, but this is clickbait junk science.
> Psychologists in Sweden found that, on average, volunteers felt more than four years older when they were restricted to only four hours of sleep for two consecutive nights, with some claiming the sleepiness made them feel decades older.
The average was four years older, with some people claiming they felt "decades" older. This should be enough to tell you how useless this methodology is. People cannot reliably estimate how much "older" they feel because it's their subjective interpretation of an experience they don't have. By definition they don't know what being 4 years older feels like.
You might as well ask them whether sleep deprivation made them feel like they'd been waterboarded for 4 hours or 4 days.
Has anyone experimented with polyphasic sleep? There was a very interesting blog on "Uberman" sleep cycle (nap every 4 hours) in the 2000s, called Puredoxyk. The author tried it due to insomnia and found it very helpful. Later she developed Everyman (short "core sleep" plus several flexible naps), which works better with work and family.
I tried Uberman a few times but I seem quite nap resistant... I only ever have those catastrophic 5 hour naps, which isn't very helpful here.
I'd spend the first few days of adaptation completely sleep deprived, then finally pass out and sleep through all the alarms.
Steve Pavlina wrote about his experiences with Uberman. Says the most useful thing he got out of it was that now (back to normal sleep) he can instantly nap anytime he wants to.
Also related and fascinating: N24, zeitgebers, etc.
You don't just "feel" older, the subjective response is only a small part of it. Insulin response decreases, and there is a direct relationship between diabetes and sleep. Cortisol levels increase, which can harm sleep the following night. Memory and reaction times are measurably worse.
We're working on improving the efficiency of deep sleep (https://affectablesleep.com, https://affectablesleep.com/science).
The older I've gotten the earlier I wake up, probably due to my bladder going down the drain. I usually pop awake 4-6am and just begrudgingly stay awake, I don't work until 9-10am.
When I DO go back to bed after waking up like this and manage to actually sleep until 8-9am I feel more drained and tired by far. I did that last night/this morning and I am way more tired than I've been all week getting up as soon as I wake up.
I don't really go to bed late, 10-11 probably. My doc complains all the time that I'm not sleeping enough but that's why.
My sleep is very irregular but I always get enough. I tend to have trouble falling asleep but once I'm asleep nothing can wake me up. Some days I sleep until noon or I have to get up early but then take a nap later. I wonder if all the bad consequences that are associated with "broken" sleep apply to irregular but plenty sleep as well.
How about 20 years ? Just curious...
https://imgur.com/gallery/4e4G5
I was just sick for 2 days and spent about 1.5 days sleeping (like I literally slept 18-19 hours on one day, and probably 12-13 hours the next) - I am now recovered and I feel a couple of years younger...so I guess it goes both ways
To your point, I had a season of extremely hard work (for me) where I was on two timezones (one in Europe and one in the US) and ended up in a situation where, due to severe jet lag, I would go to bed at the right time for the timezone I was in, sleep for 12hrs, and wake up *more exhausted* than when I went to sleep. Very demoralizing, but this continued for weeks. Eventually I decided to take a sleep-cation. I went to a friend's house who generously offered a private room. I prepared a couple of meals in the fridge and proceeded to sleep as much as I could for the next three days. I probably slept more than 20 hrs per day, although I didn't necessarily have very long stretches. I only needed like 4-5 meals over that time. It really took me out of a negative spiral and got me back on track. If you actually can sleep, I've seen this approach help people "reset" on their sleep and then get more regular benefits from their sleep hygiene.
I have very very poor deep sleep, but no apneas. Anyone in the same boat?
How did you discover you have poor deep sleep? Wearables?
I’ve been discussing my issue with (for lack of a better term) chronic fatigue. He suspects it might be an issue with my sleep, but
- I fall asleep really quickly - no obvious signs of apnea - I wake up feeling pretty good
My issue is that by 10:30am I’m dragging.
apple watch first then confirmed with a proper study
Yes
Did you do anything? I Have recently done a sleep study and that was the result mainly. Haven't seen the doc yet but no idea
See also: Sleep deprivation is torture: https://www.psychologytoday.com/us/blog/dreaming-in-the-digi...
I can think of a much more fitting headline for that article. The international community not reacting to the blatant human rights violations proudly performed by the U.S. speaks volumes about opression and bullying tactics. How did the comedian I heard just yesterday express it: "You lend money to the USA, because if you dont, they come and get it."
Validated. I exercise, eat well, don't drink, don't consume caffeine after noon, and my sleep is still terrible. I get four good hours, that's it.
Same here! I'm in my 50's, so I often have to wake up to pee at anywhere from 3 - 5 AM. Sometimes I go right back to sleep but sometimes not. Then it's up at 6:15 AM to get the kids going for school (I had kids really late.)
I've just become accustomed to being in a semi-groggy state much of the time. I know it's not ideal, but I'm just not gifted with being a good sleeper. Conversely, my wife can sleep 10 hours in a row if given the opportunity.
In the rare situation where I get 6 to 7 hours of unbroken sleep, I feel fantastic.
Edited for clarity
Last night my kid slept with us because he is sick. At 2am woke up to screaming and alligator death rolls. I feel like ass after one night.
Maybe a coincidence but I got the first gray hair of my life 4 months after getting a newborn(and waking up like 4 times per night)
This is incredible. I can't remember the last time I had a night of unbroken sleep. It's literally months ago.
Recommend the book "Why we sleep" for people who want to learn a bit more about effects of sleep deprivation
I am 34,583 years old.
Ain't it the truth.
from the department of the bleedin' obvious
This is one of those "no shit" articles.