Sweet Dreams
Snooze or Lose
The latest pick-up in the press with a clickable link from Axios is How to get more sleep (Americans need it), which frustratingly fails to include a proper reference to the actual source paper or data. The notation “Data: Apple Heart and Movement Study” suggests the data came from this study group out of the Brigham and Women’s Hospital with a web page here. But searching the site offers no insights into the data or access to it and searching the updates for ‘sleep’ only shows 2 articles – this from 2023 Life’s Essential 8 for Cardiovascular Health – Part 1, Sleep and World Diabetes Day: Glucose Response to Activity and the Menstrual Cycle. The latter is a non-starter and the first one has some commentary about lack of sleep but none of the detail suggested in the original piece and the graphic while similar is not the source
Source: https://appleheartandmovementstudy.bwh.harvard.edu/wp-content/uploads/2023/03/ahms_sleep_duration_usmap_over7hours-1200×636.png
A little sleuthing got me to the Sleep Foundation which shows the original chart and this page: 100+ Sleep Statistics which features the chart from the original article that pointed to data sources:
- The Journal of Clinical Sleep Medicine: Recommended Amount of Sleep for a Healthy Adult: A Joint Consensus Statement of the American Academy of Sleep Medicine and Sleep Research Society
- The CDC’s MMWR from 2014: Prevalence of Healthy Sleep Duration among Adults — United States, 2014
The first is a consensus statement of experts from 2015
The expert panel reviewed published scientific evidence addressing the relationship between sleep duration and health, using a broad set of National Library of Medicine Medical Subject Headings (MeSH) terms and no date restrictions, which resulted in a total of 5,314 scientific articles.
No sign of data here
The second was published in 2016. For context, the Apple Watch launched in 2015 but according to the forums and my memory the earlier versions did not track sleep (“The built-in apps on Apple Watch (any model, including first generation, Series 1 and Series 2) do not include sleep tracking features.” The Apple Heart and Movement Study does suggest that they accept data from watches going back as far as Apple Series 1 so it is possible there is data going back that far but again hard to find the actual source. There is an image that looks similar to the one in the original article
Source: https://www.cdc.gov/mmwr/volumes/65/wr/figures/m6506a1f.gif
So What Should you Make of it All?
Much like accounting and their Generally Accepted Accounting Principles or GAAP in clinical medicine, I think the generally accepted clinical perspective on sleep is you need enough. But what that number is remains undetermined and there is disagreement on the impact of getting too much. You might think that getting excess sleep is good for you but the data is not clear – the line seems to lie around 9 hours per night. This does not take account of any sleep debt accrued and attempts to pay it back but as usual, the story is far more complicated than that. Is the baseline of required sleep 7 hours per night? Maybe. But like your body temperature (don’t get me started on 98.4 as “normal” body temperature) there are variations and different needs. I can’t tell you what is right or for many what is possible for you but I know my number and target that every night.
But this piece as a source of truth or a useful contribution to understanding, I remain dubious about the value of this article or the insights. I am a big fan of a focus on sleep (Sleep – The Foundation of Health and Sleep and Weight amongst several pieces I have written) and there are plenty of experienced and knowledgeable people offering useful science-based insights. Unfortunately, plenty is also offering non-science-based insights, some for the purposes of selling you on the latest quackery, others with lesser harmful impact like drawing you to the website so you can be counted towards the advertising revenue generated by followers, readers, listeners, or clickers.
Generally, we are not getting enough sleep living in a constantly connected world with technology and all the distractions as well as the rising stress
Sleep Hygiene has been well documented and many links and references can be found – I feature my list of incremental steps in this article and link to a longer list of 12 things to consider. Good environment with low temperature, high-quality air, darkness, quiet, routine, and minimizing food intake and alcohol adjacent to your bedtime.
I’d suggest an incremental approach rather than trying everything and fixing the things that are easier to fix first and move to other steps as you measure their individual impact. And personally I find exercise is good but needs to be early enough before you head to bed, for me typically at least 2 hours to allow wind down.
All I got were Questions but no Real Answers
🤔 It does leave me wondering about all this data that these 3 Million people have consented to have their data studied.
❓ How accurate is that sleep data – I have a different tracker that collects this data and it is not bad but having spent time in space and with sleep studies I know that there is much more to this than plethysmography heart rate and accelerometer movement analysis to determine your sleep stages
🙁Maybe this is a statement of the obvious that we need more sleep, but re-emphasizing this with data and a study is a good thing, but the article just makes claims but offers no links or source to data to check.
Based on over 3 million sleep samples collected from 59,624 U.S. adults by Apple Watch between Feb. 1 and June 1, 2022
That is certainly a decent amount of data but where is it, who analyzed it, what are the demographics, circumstances, etc.
👎 Takes no account of personal circumstance and already pre-selects higher economic wealth individuals and wellness-focused people with resources. It fails to capture the individuals living on the edge of poverty, struggling to make rent, pay for healthcare or food, and living in poor circumstances perhaps even surrounded by loud noises disrupting any notion of relaxation or sleep throughout the day and night
Key takeaways
- Just because you read it does not make it true (see Snakeoil)
- Checking out anything online is a time-consuming process. I’d estimate at least 30-60 minutes of research on my part trying to find data and sources and look up sources.
- All this is made much worse by the Generative AI tools now available for anyone to create content with little to no insight or knowledge in an area
- While it may appear there is no harm the impact can catch you in unexpected ways changing what you see in the future since *everything* you do online is tracked and linked together to feed you more things to keep you online, this at the expense of any errors checks, health impacts directly from online excess and the impacts of dubious or patently false information
Do you have any tips to improve our overall knowledge and understanding? How do you determine the veracity of what you read?
