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A Good Night’s Sleep Is Tied to Interruptions, Not Just Hours (wsj.com)
117 points by lxm on Dec 2, 2015 | hide | past | favorite | 80 comments



I suffered insomnia for years (5+ years for sure). I had very poor sleep hygiene. I went sleep at 2 am, and woke up at 11 am. I felt tired at work and I drank coffee everyday. I was coffee-maniac, and coffee effectively destroyed quality of my sleep.

So you see that I spent about 9 hours in bed and I had very bad sleep quality.

A few months ago, I started learn a lot of stuff about sleep. Most of what I read on the internet was useless.

But I found in academic sources (i.e. inside ".edu" and ".gov" domains) two very important concepts (they tightly connected to each other):

1. Sleep effectiveness;

2. Sleep restriction;

You can get idea about them here:

https://en.wikipedia.org/wiki/Sleep_restriction

I started to follow very strict sleep schedule.

1. I go to bed in the interval between 21:15 - 21:50

2. I wake up in the interval between 06:00 - 06:03

Note that my wake up time is strictly fixed.

Now I spend even less time in bed (21:50 - 06:00), but I feel much, much, much better. As my fitbit shows me, I have much less interruptions during the night.


What if some social event wants you to be awake after nine? I would end up sacrificing all my social life if I go your route.


That's a good question. My social life is mostly daily (e.g. rock climbing etc). I don't drink alcohol, I don't go to bars/nightclubs.

But sometimes I have to brake my sleep schedule.

For example, two weeks ago I had to fly to another country for a job interview. Unfortunately, I had no better flights, so I had to go to the airport at late evening.

I finally got home (from airport) at 3 am.

I felt very tired during next 4 days.

My sleep schedule was:

Day 1: 3:30 am - 8:30 am

Day 2,3,4: 21:30 - 06:00 (applied sleep restriction!)

If I didn't apply sleep restriction in the following days I would mess up my sleep at lest next two weeks.

In my case, one night with broken sleep schedule costs me 4 days.

I think it's possible to brake your sleep schedule once in 3 weeks but if you do it frequently it would be bad for your sleep hygiene.

So frequent alcohol and night-life is not compatible with healthy life style (at least for me, it's 100% truth).

So it's probably question of priorities.


This sounds to me like a huge disadvantage.

I have what I thought of a terrible sleep hygiene too but after several years of watching collegues adapting "new ways to sleep", I realized it's not that bad at all.

So me (and my girlfriend) usually stay up long. Midnight to 1am is normal for a weekday. 1-2am is the time when we say: we should have been in bed already but it happens more often then I thought. We get up at 7:30 on 3 of 5 days and 6:30 on the others.

Obviously this shouldn't be enough sleep and it isn't. We both get tired sometimes somewhere around 6-7pm where we sometimes take a nap (usually on the 6:30-days) of max 1h. Sometimes we break it up early.

On Friday we stay up as long as we can and sleep as long as we can and want on Saturday. Same goes for Sunday where we stay up to ~2am until the late NFL game is finished.

It works pretty good I must say. I don't drink coffee or take any pills, energy drinks, whatever. I can sleep pretty good on the train or plane for some bonus hours and fall asleep instantly when I get into bed. I can even go to sleep early or sleep through a whole day if I'm sick and I think there is nothing better to do (but being sick is very rare for me. I was sick one day some weeks ago. Slept through it almost completely. Got up just to eat and pee).

I would never want to miss the flexibility even if it's unhealthy or whatever.


Some people obviously need better sleep hygiene than others. It's not a question of social life vs health. Both those things are factors that affect quality of life in general. If your body simply couldn't cope with poor sleep you would change your opinion on the relative importance of your sleep vs your waking life.


If you fall asleep almost immediately after going to bed, it's a sign that you need to sleep more. According to a lecture by a professor in sleep I watched many years ago when Google Video was still alive.


I normally never do this. But since your grammar, punctuation, and spelling was quite good and you used the word "brake" in more than 1 post. I think you should be using the word break instead for these use cases.

My apologies for being that person today.

Otherwise great responses! Thanks!


It's your wake up time that is the mots important : you should wake up at the same time every day, including week ends, no matter what.

Napping can help compensate a shorter night.


why is that? Do you have some reading on the subject?


Sorry you'll have to Google it. I read almost everything I find on sleep and I encountered this quite a lot, it was even said to me by my doctor and a psychiatrist.

A few days ago there was something on HN about how people that slept late on week ends had a shorter lifespan than other, it shouldn't be hard to find.

Now for my sample of one : I'm subject to SAD (seasonal affective disorder) and common depression too but when I manage to stick to a strict wake up time (6AM at the moment) my quality of life is greatly enhanced. And this despite that I'm more an evening (even night) person.


> 06:00 - 06:03

That's tight. Do you face any resistance and have to train your mind or does it come easy when you sleep timely ?


I usually easily wake up with first/second alarm at 6:00/6:01 and feel fresh.

Sometimes, I feel sleepy at 06:00 but since I clearly got idea of "sleep restriction" into my mind, I actually inverted my emotions about wake up time.

I mean I actually worry if I spend in bed later than 6:03 because I know very well that it's costly to break my sleep schedule.

One day I actually missed my alarm clock because my phone was out of charge.

Since my room is completely dark, I woke up at 7:20 confused about time and with headache (i.e. headache after unusually long deep sleep).

Next 4 days I felt tired and my sleep wasn't very good.

So now, I double check my alarm clock and my phone always charged every evening :)

I.e. most of the time it's easy to wake up at 6:00. When it's not easy, I wake up anyway since I get a lot of negative emotions if I brake sleep restriction principle :)


So my biggest issue here is the artificialness of the wake up time given how much change there is in sunlight during the course of a year. And given clocks are a very recent invention it seems to be the odd one to chose. It can be well and truly light and sunny or pitch dark for another hour or more at 6am depending on the time of the year.

In general I think it's great you moved your sleeping cycle closer to sunlight sundown than before and am not surprised you feel much better. I just am reticent to get into the hard "clock" game as it's such an artifical, new event for humanity.


> I usually easily wake up with first/second alarm at 6:00/6:01 and feel fresh.

I thought the signal for good sleep was that you didn't need an alarm to wake up? Can you point to those academic articles you've mentioned?


I need alarm because I need to keep my sleep schedule in strict time frame.

I often wake up at 5:30 because I slept very well at night. But I stay in bed and waiting for alarm.

If I didn't sleep very well, I could wake up at 6:30, but my alarm triggers at 6:00 and I wake up at 6:01.

In the beginning of my experiments with sleep, I tried to use natural wake up. But my sleep schedule started floating a lot and sleep quality degraded when offset become big.

So I decided to keep strict sleep schedule. It's very balanced. If one night my sleep quality wasn't very good, then next night it's guaranteed that I have good sleep quality. But alarm clock guaranteed that I don't oversleep.

I found "sleep restriction" for the first time here (look at "case illustration" on page 3):

http://www.ncbi.nlm.nih.gov/pmc/articles/PMC3060715/pdf/nihm...

After I just read another articles which I found by keywords "sleep restriction".

It also contains very useful ideas about mindfulness meditation.

I wrote about it in another comment:

https://news.ycombinator.com/item?id=10564930


You might consider trying out an app for sleeping. I use one called Sleep Cycle, but there are many like it. I give the app a 30 minute timeframe that I want to wake up within, then I leave my phone on my bed. As I sleep it monitors my movement. The app will sound a gentle alarm when it determines you are out of REM (happens multiple times over the course of your sleep).

I've found this app has improved my sleep quality dramatically and I never feel tired when I wake up because I'm not torn out of REM.


What seems to affect me the most is the time I go to sleep. If I do get to sleep before 11 I generally feel very refreshed. Sleeping the same number (I assume, ignoring interruptions I don't remember) of hours but beginning 12, or later, end up with me feeling groggy for the morning.

The older I get, the earlier I am starting to feel tired, and the earlier I want to wake. I have friends who are very much the opposite, so we are definitely not all wired the same.


Funny, my grandmother used to say that one hour of sleep before midnight is worth two hours after midnight. I'm not sure if it's placebo but I found it to be true for me.


To me there's also the morning factor. Waking up after 8 makes me feel late and wasteful, even if I slept long and well.


Humans need to sleep in dark.


Even artificial light is bad; I can't sleep with the TV on and prefer complete darkness.


Best thing I ever did for my sleep was to cover my eyes. An eye mask is fine, but I just have a really soft pillow I lay over my eyes and top of my head. As a teenager I worked overnights in the summer (10pm-8am), and I learned early on that no light equals good sleep.


what about noise ?


Same here - I go to bed at 8, when my kids do. Probably asleep by 9-9:30 depending on how long I read/whatever before actually sleeping. I am up before 5 AM to have some time to myself and by the time most people get rolling for the day, I've already accomplished quite a bit.

Sure, I don't do much in the evenings, but I am awake as much as anyone else, and feel better with this timing.


This is what I like to do for the exact same reasons. I get some alone time and I've found I enjoy studying various things during this time.

My issue is always that I find it hard to keep a straight sleep schedule. Even when I was young I was like that, it's like my circadian rhythm is longer than 24 hours and I have to force it to reset.

sucks, but when I'm able to get up early I love it.


I was hoping this article would be about smaller "microinterruptions" as opposed to 20 minute "active interruptions". I recently moved to NYC and I feel that my quality of sleep has decreased compared to when I lived elsewhere. I'm certain it has to do with noise-related interruptions throughout the night.

I was woken up briefly twice tonight, once by my flatmates returning home and talking to each other and again by the heating pipes clanging as I live in a prewar and the steam boiler turns on at 5 every morning. I also imagine the train noise from the Metro North/other outside vehicle noise has an effect I'm not aware of.

If anyone has studies about optimizing sleep quality given these kinds of conditions, I would be very interested to read about it.


I used white noise to great effect in a similar situation. It takes some getting used to, but you'll quickly get used to it and it will drown out any interrupting noise. Specifically, https://simplynoise.com/ worked well.


I use a physical white noise generator by Marpac: https://www.marpac.com/

It's essentially a fan inside of a cylindrical thing, but it doesn't cause any real air movement like an actual fan would. You can adjust the volume and timbre of the sound, too.

It probably won't drown out a snoring partner, but I never wake up when a train sounds its horn a few blocks away in the middle of the night. When I traveled without it once, I really missed it as I heard all the traffic noise outside of my hotel.


This (or rainymood as suggested by the other reply) seems to be a decent option. Did you use a pair of speakers near your bed? Or did you buy a pair of headphones/earbuds designed for sleeping? Also what sort of volume level did you use?


I used speakers near my bed, since I can't stand wearing earbuds while sleeping. Usually I just set the volume to the quietest it could be while still drowning out other random noises. Surprisingly, there were times when it had to be set pretty loud to drown out conversation, and it still worked well.


I have a Westinghouse air purifier which has the perfect white noise cover to anything I might be able to hear.


Plugs in your ears and or thick isolations on your bedroom walls should help.


Isolations are out of the question, I'm leaving when the lease is up (August 1) so I have no intent to invest heavily. Also the window/doorway will let enough noise through even with isolation on the walls.

I might try earplugs again. I bought a pack when I moved in but I never found them super comfortable, I'd usually fall asleep and end up waking up and pulling them out after a few hours.


Earplugs is the way to go. Get good foam earplugs, I use these [1]. If you experience discomfort or even pain during the night maybe you are shoving them too deep into the ear canal.

[1]: http://www.britishsnoring.co.uk/shop/snore_calm_foam_ear_plu...


If you pull up on your ear with your opposite hand while putting in the earplug, that will helps it to fit better.

Having a pitch black room, covering any LEDs with electrical tape, and using an eye mask also help.


http://www.rainymood.com/ might help with that


There are people claiming all sorts of things here without much proof. The amount of actual sleep can be as low as 3-4 hours for 8-9 hours spent in bed, and there is no way of knowing how much you sleep without some sort of investigation using a reliable device.

To really know what's happening with your sleep, you need polysomnography. An actual sleep study.

The second best option are some of the consumer-grade ballistocardiography devices - the "under mattress" alternative to wearables.

I have been tracking my sleep and fixing problems with it using the Beddit device. As a gadget and product, I rate it 2 or 3 out of 5 - I'd love it to be more polished. But considering its potentially life changing value and its technical merits, a highly recommended purchase.

Even just the resting heart rate reading and HRV data are worth the price.

My 2 months of data are so far fairly inconclusive and pending deeper statistical analysis. There are many variables at play, so recognizing and documenting them takes time and effort and is error prone. The most confident recommendations are not drinking alcohol, earplugs (fairly noisy environment), and melatonin. Even with these, I have been unable to consistently get more than an average of 5 hours (±1) of actual total sleep during 7-9 hours of time spent in bed. The time spent awake isn't something I experience or remember. This hasn't been noticeable to me despite long days and an active athletic lifestyle including goal-oriented recreational endurance and strength training.


This experiment is ridiculous. Of course you're going to be tired if someone jolts you awake every hour on the hour.

What would be way more interesting is to study people who wake up naturally multiple times per night to toss and turn. I do this at least 5-10 times per night due to muscle aches and pains. I fall back asleep very quickly. I've been doing this for years, but do remember rare times when I've slept through the night and felt so fresh in the morning.


You might want to check about why you have muscle aches and pains so bad that it wakes you up multiple times a night.

That is definitely not "waking up naturally"


I know, I'm working on range of motion and flexibility exercises right now. It's gotten to the point where it effects my day-to-day, so now I'm focusing on it.


Yeah, I agree.

In the winter, I'm more inclined to go to bed early, be up for a bit in the middle of the night, and then sleep until dawn. So my sleep isn't continuous, but neither is it disrupted externally.

I suspect the original experiment was reasonable if you're looking to measure the effects of extreme disruption. But the WSJ article suggesting it applies to other sorts of non-continuous sleep strikes me as bunk. Up until the invention of the electric light, non-continuous sleep was the norm. But anxiety sells papers, and people are certainly inclined to be anxious about sleep lately.


I've had a problem with sleep for about 2 years. My mind is always racing and "doing work" even during the night and I end up being conscious (but "asleep") for a good part of the night. I've kind of trained myself to do this, because I was lazy in high school and just figured out solutions to my homework right before going to sleep (so I could quickly write them down on the bus to school during the morning).

Now I'm in university and it's killing me. Reading before bed helped ease my mind for a while, meditation helped for a while, but now I'm still in the same position. I wake up frequently because of this weird "habit" and my mind never gets to rest. What should I do?


One possibility is that this is because you're working/programming late at night, basically up until the time you're going to bed (or within an hour or two of it).

I've found over the last 10 years that if I'm programming late (and really only programming, other types of work don't do this to me), and don't give myself 2-3 hours of down time before bed, my sleep is exactly as you described. My brain is running on work, it takes me a long time to fall asleep, and my night is spent drifting in and out of light sleep and work related thinking. It's pretty bad and can screw me up for days and weeks at a time.

Usually this happens because my focus is very high with late night programming (to keep me going longer), and I don't give my brain the time it needs to finish working through problems after I'm done coding. (You may be able to relate to thinking up a solution to a problem after closing your laptop, or waking up realizing there is a bug in your code. It's this type of thinking that your brain needs to finish.)

I'd suggest that if you are programming late at night, stopping 2-3 hours before you usually go to bed and do some reading or watch a movie. A few nights of that is all that it takes for my sleep to get back to normal.


I have overcame this by forcing myself to "dream". By this I mean put myself in a situation outside of my body so that I begin to think of this dream as the reality. My mind eventually turns off my local body receptors and falls into the dream. I also have a white noise in the background to help drown out all the sounds as any little sound change brings me back to reality. I hope this helps.


That sounds at least somewhat like anxiety - not trying to judge, just trying to help. I'd suggest reaching out to your university health people and describing your symptoms, they'll be able to help you.


Yeah seconding this. When my anxiety was really bad I had exactly what you described- being asleep but still thinking.


I think I had your problem as well. my solution was physical exercise,a more intense social life, fixed sleeping times and no caffeine.

It improved it quite a lot, hih


The traditional chinese medicine doctor has a saying. Every hour you sleep before 12 midnight counts twice as much.


That sorta explains why people who sleep late also tend to feel groggy. The "early worms" tend to be a noisy bunch in the mornings (I currently have construction work start in the condo above mine every morning from 9am onwards)


Those in the disrupted group were awakened each hour for 20 minutes for seven of the eight hours.

Does that mean the disrupted group received 140 minutes less sleep than the control group?


Really, this article seems to say, "a bad night's sleep is not good for the next day." Most of us have figured that out by adulthood, no?


> Getting up in middle of the night multiple times to soothe a crying baby or go to the bathroom impacts your mood and cognitive abilities the next day, new research has found.

Thanks, new research, we totally owe you one!


This article sums up basically what I learned through my own experiences.

For myself I've found that an uninterrupted chunk of sleep > a long sleep with waking periods caused by interruptions (bathroom breaks, police sirens, etc.).

It is for this reason that a year ago I adopted the usage of ear plugs when I go to sleep, and now I cannot sleep without them. I found a good brand of ear plugs that are comfortable and dampen ambient sounds (traffic, footsteps), but don't completely block out all sounds so I can hear my phone or the alarm clock.

Another thing I've found is that usually when I can recall having a dream, I feel like I was able to achieve a deep level of sleep, and consequently I feel more refreshed that morning. I often don't remember details about the dream, and I even quickly forget what the dream was even about (or even if it was a nightmare) but the important thing is that my mind went into that dream state.

I would value a 4 hour chunk of deep sleep more than 8 hours of sleep broken up by some interruptions.


I kinda figured this out in high school. I slept irregular hours throughout the week, in bed around 10:00 PM weeknights, but staying up until 1:00 - 2:00 AM on weekends and sleeping until 9:00 - 10:00. I had headaches 2-3 days week.

Then I got a job that required a 7:00 AM start on the weekends, and the late nights stopped. So did the headaches.


I get up about two to three times a night. I'm not sure why, as there are multiple explanations. I go to the toilet, drink some water, and go back to bed. That takes about two minutes.

In this research, people were forced to wake up every hour and then stay up for 20 minutes. Then I would feel totally different - I have no doubt. After twenty minutes, probably in bright light, I would be awake and that would disrupt the sleep cycle totally. This might be the case when you have a small kid, but how often does this happen (in the real world) with these frequencies?

With me this is not the case. It feels natural. I don't put the light on - I can find my way without it. It takes two or three minutes, and that's it. Back in bed I fall asleep right away.

This research is presented here as if this would influence my mood? I don't know. I guess I can sleep better, but this is not the explanation that works for me.


This isn't surprising at all if you see how REM sleep works. In short, you get more REM sleep in every subsequent cycle (each ~90 minutes), but a significant break between sleep cycles starts over the process. So getting 9 straight hours of sleep means you get significantly more sleep than getting 6 1.5 blocks.


In conclusion, earplugs are the best investment you can get.


I'd imagine if I lived in a dangerous neighborhood, I'd want to avoid earplugs. Same if I had a newborn baby. I suppose in various cases, interruptions are preferable to a good night's sleep.


Maybe there's a market for selective electronic earplugs for parents?


Don't think all those things right now, just go to sleep ;)


It's 13:29 here :)


> In conclusion, earplugs are the best investment you can get.

Careful with that. Wearing earplugs every day for an extended duration (like while sleeping) might cause issues with the inner ear. I did that and ended up suffering from vertigo for a while. Discontinuing the use of earplugs made the symptoms gradually disappear. Starting to use earplugs again made vertigo come back. Repeat for a few cycles.

I have stopped using earplugs while sleeping. Brief usage (like when using loud machinery) seems fine.

I'm sure everyone is different and not all people will suffer from inner ear issues from earplugs, but keep this in mind.


That is odd. I have been an sleep earplug user for years now and a few weeks ago experienced permanent vertigo. Have you ever received a diagnosis as to what is specifically wrong? Any pointers are appreciated.


Didn't ask the doctor. I guess it was the old bogus excuse - I was afraid I'd get something serious confirmed.

Anyway, I've stopped using earplugs during sleep and vertigo has gradually (slowly) disappeared.


Just make sure to get your ears cleaned regularly. Regular use of earplugs can cause a buildup of wax in your ears that really dampens your hearing.


Not sure about the "polyphasic sleep disorder"? What about people doing that since ages?

I think you need to find your own best sleep cycle and follow it.


Not getting enough good quality sleep with a newborn baby in the house is a real problem. But what is the solution, though? Hiring a full-time stay-at-home nanny seems the only way both parents can get enough sleep for the first several months, but there are many reasons why one wouldn't want to do that. Does anyone have any advice?


If you're the father, sleep on the couch (or buy another bed). Then when you're more refreshed, you can try and help out the mother (I'm assuming breast feeding here).

If you're the mother, try really hard to get some kind of daily cycle induced in the baby. So minimize breastfeeding, chatting, other activity at night.

YMMV. Also you need to accept that you're going to be lacking some amount of sleep for years.


This is pretty bad news for those who can't stay asleep. Sometimes I'll try to sleep for, say, 3 hours, then my alarm will wake me up and I'll decide to sleep longer. I guess I'll have to stop doing that. Kind of seems like it's pretty difficult not to negatively impact cognition in one way or another.


I think anyone with small-ish children can easily confirm this.


I wonder why small children are so restless they disrupt their parents' normal operation. There should be a clear evolutionary disadvantage in that.

You might need attention, but attention has two sides and as a baby you don't want to get angry adults' attention, especially in more primitive societies.


If you don't pester your parents but your siblings do, they may get more attention and resources than you.

Besides, the parents having strict daily schedules is a recent phenomenon. I bet hunter-gatherers don't care if they wake up three hours late because the baby was restless last night.


Depends on the climate. In some climates you really really want to be up at sunrise so you can do stuff before it becomes too hot. But then again, the night is long when you don't have artificial light.


You can also ask your sister, mother, aunt, grandmother or older child to look after the kid while you go gather food.

Before agriculture, it wasn't hard to find someone with free time willing to look after the children.


Or you might die. If you happen to pester the wrong person you might die. If you happen to pester your parents at the wrong time you might be injured. People under stress are dangerous.


I'm pretty sure that if our cave-man ancestors raised children the way we do, humanity would have either have gone extinct or babies would be way less annoying[1] thanks to evolutionary selection. There's no way a huge percentage of stone age babies wouldn't have been shaken to death or hurled off cliffs at 2am otherwise. I'm sure some were anyway, but it'd have been most of them.

It had to have been a more collective effort than it is now, with a greater relief from work for those involved in the caretaking than we enjoy. It must have been both, because even a single dedicated stay-at-home caretaker will go nuts without support/relief, and the typical working partner does not have the capacity to properly provide that at night and not be really, really messed up during the day.

[1] I write this as a parent of two. Hospitals bombard new parents with "don't shake your baby" educational material. They do this because babies are phenomenally shakeable things, especially when they're shrieking for no damn reason at 2am and you're so tired from days on end of terrible sleep that you're beginning to hallucinate.


Not just "our caveman ancestors", but I think most historical societies features a greater degree of both intergenerational support and "lateral" support from other families for shared child-rearing tasks than has generally been the case in industrial to post-industrial capitalist (and the more capitalist-leaning of the modern mixed) economies (the more socialist-leaning mixed economies in some cases probably, while still featuring less intergenerational familial support than earlier societies, may come closer, or even exceed, the total support through increased lateral support through state mechanisms.)


That is an excellent question.


20 minutes every hour - this effect is really not very surprising. I mean good they've done the research to confirm - but it's totally obvious.


Agreed! This is clearly a terrible night's sleep, can't imagine anyone doubting that.




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