Sleep deprivation, usually chronic (ie, regularly experienced)
-Sleep deprivation happens when not sleeping enough, and it becomes "chronic" when it happens regularly. Sleep deprivation not only has major impacts on health that majorly increases all-cause mortality, including by cardiovascular diseases and cancer (see also here), and can even lead to sudden death by cardiac arrhythmic arrest through oxidants accumulation in the body, particularly, but not only (see also here and here), for those with obstructive sleep apnea (see also here), and sleep deprivation is now a primary target of treatment for the modern comprehensive approach for cardiac diseases prevention. The influence of subqualitative sleep on cardiovascular risks is so important that the American Heart Association acknowledged the issue since its 2016 guidelines and aims to run public health campaigns on the importance of sleep for cardiac health. The increase in cardiovascular risks also affects children, and it may be dependent on predisposition to metabolic syndromes. It can also curb the benefits of diet or lifestyle changes and it impairs the evaluation of risks by causing an overly optimistic bias. Sleep loss majorly impairs the immune system. Sleep and the immune system are interacting bidirectionally: severe infections can cause sleep deprivation, and a shorter sleep impairs the immune response to infections and inflammations so that the risk of infections is increased and vaccines efficacy is decreased by directly decreasing the number of antibodies produces, since sleep promotes their production. During the COVID-19 pandemic, short sleep was assessed as a risk factor for more severe symptoms, and scientists suggested that requiring longer sleep prior and after vaccination may be an effective and inexpensive way to increase a COVID-19 vaccine's efficacy. Furthermore, again with COVID-19, each 1-hour decrease in sleep was associated with 12% higher odds of infection (see also here). Indeed, sleep deprivation can alter the DNA, RNA and proteins. An informal survey reported that half of COVID-19 long-haulers complained about new sleep disturbances. All these risks also affects children and teenagers ("general pediatric population") and lead to poor academic performance. Since sleep deprivation reduces light therapy effectiveness, a vicious cycle can appear where chronic sleep deprivation impairs the very therapies that could reduce sleep deprivation. Chronic sleep deprivation has a dose-dependent cumulative effect on cognitive impairment: sleeping 4h per night is worse than 6h per night, and the impairment will only increase day by day, even though subjectively the individual doesn't feel more sleepy than on the first day sleep deprivation started. Compared to partial sleep deprivation (eg, 4h), total sleep deprivation (0h for 3 days) results in a "disproportionately large" neurobehavioral impairment. Hence, fixing sleep deprivation by allowing the individual to sleep according to their natural sleep schedule or by napping (or to another schedule with entrainment) should be a primary target for general health improvement. Ironically, chronic sleep deprivation can cause treatment-resistance chronic insomnia as suggested by the Randy Gardner case, or even lifelong psychoses and personality changes even after recovery sleep as shown by the Peter Tripp's case (although he lost his job due to the payola scandal and not due to the lasting effects of sleep deprivation), which shows that all-nighters can only worsen the condition. Personality makes little difference, but if anything and if you believe in the psychological concept of personality, extroverts performed worse after sleep deprivation than introverts. Interestingly, it seems that partial chronic sleep deprivation requires more time for cognitive recovery than total sleep deprivation. A neuroimaging fMRI study found that sleep deprivation affects differentially various brain regions, with decreased activation in the posterior cerebellum, right fusiform gyrus and precuneus, and left lingual and inferior temporal gyri, and increased activation in the bilateral insula, claustrum and right putamen. A neuroimaging review details that the DMN in particular demonstrates significant alterations under sleep deprivation, including decreased connectivity between the anterior and posterior cingulate gyrii of the DMN and a degraded connectivity segregation with the external awareness network, which is the type and areas of connectivity that is impaired in disorders of consciousness. Chronic sleep loss impairs neurodevelopment and incurs neuronal loss, especially if from a young age, hence the necessity for accomodations of children with sleep disorders as chronic sleep deprivation can not only stunts cognitive performance, but pave the way for the development of neurological disorders. Sleep deprivation impairs auditory attention cognitive performance (see also here and here). Sleep deprivation causes more impairments and damages than just the loss of the benefits of sleeping. Three nights of consecutive, chronic sleep loss of just a few hours per day was sufficient to significantly impair mood and cognitive functions. Multitasking is impaired by sleep deprivation, as well as innovative thinking and adaptation to new situations (flexible decision making). Medical students' judgment and reaction time are also impaired by sleep deprivation. A lot of evidence is emerging that sleep deprivation, whether acute or chronic, drastically increases the risk of cardiac events, including arrythmias, atrial fibrillations and bradyarrhythmia and regardless of other traditional factors (see also here for an overview). Sleep disturbances have also been shown to increase the rate of cardiac arrests and ventricular ectopy.
+Sleep deprivation happens when not sleeping enough, and it becomes "chronic" when it happens regularly. Sleep deprivation not only has major impacts on health that majorly increases all-cause mortality, including by cardiovascular diseases and cancer (see also here), and can even lead to sudden death by cardiac arrhythmic arrest through oxidants accumulation in the body, particularly, but not only (see also here and here), for those with obstructive sleep apnea (see also here), and sleep deprivation is now a primary target of treatment for the modern comprehensive approach for cardiac diseases prevention. The influence of subqualitative sleep on cardiovascular risks is so important that the American Heart Association acknowledged the issue since its 2016 guidelines and aims to run public health campaigns on the importance of sleep for cardiac health. The increase in cardiovascular risks also affects children, and it may be dependent on predisposition to metabolic syndromes. It can also curb the benefits of diet or lifestyle changes and it impairs the evaluation of risks by causing an overly optimistic bias. Sleep loss majorly impairs the immune system. Sleep and the immune system are interacting bidirectionally: severe infections can cause sleep deprivation, and a shorter sleep impairs the immune response to infections and inflammations so that the risk of infections is increased and vaccines efficacy is decreased by directly decreasing the number of antibodies produces, since sleep promotes their production. During the COVID-19 pandemic, short sleep was assessed as a risk factor for more severe symptoms, and scientists suggested that requiring longer sleep prior and after vaccination may be an effective and inexpensive way to increase a COVID-19 vaccine's efficacy. Furthermore, again with COVID-19, each 1-hour decrease in sleep was associated with 12% higher odds of infection (see also here). Indeed, sleep deprivation can alter the DNA, RNA and proteins. An informal survey reported that half of COVID-19 long-haulers complained about new sleep disturbances. All these risks also affects children and teenagers ("general pediatric population") and lead to poor academic performance. Since sleep deprivation reduces light therapy effectiveness, a vicious cycle can appear where chronic sleep deprivation impairs the very therapies that could reduce sleep deprivation. Chronic sleep deprivation has a dose-dependent cumulative effect on cognitive impairment: sleeping 4h per night is worse than 6h per night, and the impairment will only increase day by day, even though subjectively the individual doesn't feel more sleepy than on the first day sleep deprivation started. Compared to partial sleep deprivation (eg, 4h), total sleep deprivation (0h for 3 days) results in a "disproportionately large" neurobehavioral impairment. Hence, fixing sleep deprivation by allowing the individual to sleep according to their natural sleep schedule or by napping (or to another schedule with entrainment) should be a primary target for general health improvement. Ironically, chronic sleep deprivation can cause treatment-resistance chronic insomnia as suggested by the Randy Gardner case, or even lifelong psychoses and personality changes even after recovery sleep as shown by the Peter Tripp's case (although he lost his job due to the payola scandal and not due to the lasting effects of sleep deprivation), which shows that all-nighters can only worsen the condition. Personality makes little difference, but if anything and if you believe in the psychological concept of personality, extroverts performed worse after sleep deprivation than introverts. Interestingly, it seems that partial chronic sleep deprivation requires more time for cognitive recovery than total sleep deprivation. A neuroimaging fMRI study found that sleep deprivation affects differentially various brain regions, with decreased activation in the posterior cerebellum, right fusiform gyrus and precuneus, and left lingual and inferior temporal gyri, and increased activation in the bilateral insula, claustrum and right putamen. A neuroimaging review details that the DMN in particular demonstrates significant alterations under sleep deprivation, including decreased connectivity between the anterior and posterior cingulate gyrii of the DMN and a degraded connectivity segregation with the external awareness network, which is the type and areas of connectivity that is impaired in disorders of consciousness. Chronic sleep loss impairs neurodevelopment and incurs neuronal loss, especially if from a young age, hence the necessity for accomodations of children with sleep disorders as chronic sleep deprivation can not only stunts cognitive performance, but pave the way for the development of neurological disorders. Sleep deprivation impairs auditory attention cognitive performance (see also here and here). Sleep deprivation causes more impairments and damages than just the loss of the benefits of sleeping. Three nights of consecutive, chronic sleep loss of just a few hours per day was sufficient to significantly impair mood and cognitive functions. Multitasking is impaired by sleep deprivation, as well as innovative thinking and adaptation to new situations (flexible decision making). Medical students' judgment and reaction time are also impaired by sleep deprivation. A lot of evidence is emerging that sleep deprivation, whether acute or chronic, drastically increases the risk of cardiac events, including arrythmias, atrial fibrillations and bradyarrhythmia and regardless of other traditional factors (see also here for an overview). Sleep disturbances have also been shown to increase the rate of cardiac arrests and ventricular ectopy.
@@ -2875,7 +2875,7 @@
-Hyposensitivity to zeitgebers such as light may be a factor, as indeed the sensitivity to zeitgebers is highly variable for everyone, with a 50-fold variability among typical sleepers. The opposite, hypersensitivity to zeitgebers, may also cause circadian rhythm disorders. However, it remains unclear whether hyposensitivity and hypersensitivity are causes or just consequences of circadian rhythm disorders, since it was demonstrated that non-24h light-dark schedules (T-cycles) cause SCN desynchrony, similarly to long days, and hence reduced responsiveness to phase shifts and that weak entrainment to a zeitgeber, such as by being entrained to a short day of bright light, causes a higher synchrony of SCN neurons and phase shifts of a wider magnitude (see also here and here). Potentially, hypo and hypersensitivity may be reinforcing feedback loops, that once set in motion worsen the symptoms. However, although there certainly are negative feedback loops, it is in the author's experience that the circadian rhythm always reverts back to its original state after just a few weeks of discontinuing any therapy and resuming exposure to environmental light, whatever environment (ie, living in more brightly lit indoor housing and going outdoors more often did not have any long lasting effect). A 2021 study that assessed alterations in ipRGC cells response to bright light using post-illumination pupil response (PIPR) found that individuals with DSPD and sighted non24 both impaire phototransduction, in other words they have reduced response and pupillary diameters compared to controls, with a much more extreme reduction for sighted non24, which strongly supports the hypothesis that hypophotosensitivity is likely a possible etiology for at least some individuals with DSPD and sighted non-24. +Hyposensitivity to zeitgebers such as light may be a factor, as indeed the sensitivity to zeitgebers is highly variable for everyone, with a 50-fold variability among typical sleepers. The opposite, hypersensitivity to zeitgebers, may also cause circadian rhythm disorders. However, it remains unclear whether hyposensitivity and hypersensitivity are causes or just consequences of circadian rhythm disorders, since it was demonstrated that non-24h light-dark schedules (T-cycles) cause SCN desynchrony, similarly to long days, and hence reduced responsiveness to phase shifts and that weak entrainment to a zeitgeber, such as by being entrained to a short day of bright light, causes a higher synchrony of SCN neurons and phase shifts of a wider magnitude (see also here and here). Potentially, hypo and hypersensitivity may be reinforcing feedback loops, that once set in motion worsen the symptoms. However, although there certainly are negative feedback loops, it is in the author's experience that the circadian rhythm always reverts back to its original state after just a few weeks of discontinuing any therapy and resuming exposure to environmental light, whatever environment (ie, living in more brightly lit indoor housing and going outdoors more often did not have any long lasting effect). A 2021 study that assessed alterations in ipRGC cells response to bright light using post-illumination pupil response (PIPR) found that individuals with DSPD and sighted non24 both impaire phototransduction, in other words they have reduced response and pupillary diameters compared to controls, with a much more extreme reduction for sighted non24, which strongly supports the hypothesis that hypophotosensitivity is likely a possible etiology for at least some individuals with DSPD and sighted non-24.
@@ -3547,7 +3547,7 @@
-It is hence crucial to accept circadian rhythm disorders, and especially non-24, as a debilitating, severe invisible disability. Indeed, they bar from accessing virtually every work positions that exist, whether as employee or as a business owner, due to the severe disruptions they cause in social, cognitive and physical functions. The social disruptions are especially critical, as they cause a physical, logical incompatibility between the person with non24's sleep-wake schedule and the social expectations. Statistics estimate show that contrary to the naive assumptions, 80% of individuals with handicaps have an invisible handicap, whereas only 2% are in a wheelchair. Stigmatisation, as per the works of Erving Goffman, is the major problem individuals with handicaps, invisible or visible, face from society. The stigmatisation of being perceived as lazy is not specific to sleep disorders, but is a common societal mischaracterization of individuals with invisible handicaps, as they are peirceved as lacking the effort to simply willfully fix their handicap that causes them to be incomprehensibly unable to perform simple actions, in this case the ability to sleep at socially acceptable hours at night. +It is hence crucial to accept circadian rhythm disorders, and especially non-24, as a debilitating, severe invisible disability. Indeed, they bar from accessing virtually every work positions that exist, whether as employee or as a business owner, due to the severe disruptions they cause in social, cognitive and physical functions. The social disruptions are especially critical, as they cause a physical, logical incompatibility between the person with non24's sleep-wake schedule and the social expectations. Statistics estimate show that contrary to the naive assumptions, 80% of individuals with handicaps have an invisible handicap, whereas only 2% are in a wheelchair. Stigmatisation, as per the works of Erving Goffman, is the major problem individuals with handicaps, invisible or visible, face from society. The stigmatisation of being perceived as lazy is not specific to sleep disorders, but is a common societal mischaracterization of individuals with invisible handicaps, as they are peirceved as lacking the effort to simply willfully fix their handicap that causes them to be incomprehensibly unable to perform simple actions, in this case the ability to sleep at socially acceptable hours at night.
@@ -3555,7 +3555,7 @@
-Rather than paraphrasing, we will extensively cite extracts from this impressively accurate and fairly exhaustive academic work: The Handbook of Social Studies in Health and Medicine, 2003, chapter Experiencing Chronic Illness, pp 277-292, ISBN: 0761942726, 9780761942726 : +Rather than paraphrasing, we will extensively cite extracts from this impressively accurate and fairly exhaustive academic work: The Handbook of Social Studies in Health and Medicine, 2003, chapter Experiencing Chronic Illness, pp 277-292, ISBN: 0761942726, 9780761942726 :
@@ -4972,7 +4972,7 @@
-The DSM-5 recognizes the possibility of light hypo/hypersensitivity as a predisposing factor of DSPD and non-24: "predisposing factors may include a longer than average circadian period, changes in light sensitivity, and impaired homeostatic sleep drive. Some individuals with delayed sleep phase type may be hypersensitive to evening light, which can serve as a delay signal to the circadian clock, or they may be hyposensitive to morning light such that its phase-advancing effects are reduced". +The DSM-5 recognizes the possibility of light hypo/hypersensitivity as a predisposing factor of DSPD and non-24: "predisposing factors may include a longer than average circadian period, changes in light sensitivity, and impaired homeostatic sleep drive. Some individuals with delayed sleep phase type may be hypersensitive to evening light, which can serve as a delay signal to the circadian clock, or they may be hyposensitive to morning light such that its phase-advancing effects are reduced".
@@ -5180,7 +5180,7 @@
Transition/progressive/photochromic lenses not adequate because they require UV, hence they work only against direct sunlight (ie, not through a window, and not with artificial light either). Hence they are not adequate.
-Alternative for prescription glasses: laser safety clip on amber glasses, if they filter from 400nm to 550nm then it should be good enough for dark therapy, and they should be certified since it's for laser safety hence you are guaranteed they will filter those wavelength.
+Alternative for prescription glasses: laser safety clip on amber glasses, if they filter from 400nm to 550nm then it should be good enough for dark therapy, and they should be certified since it's for laser safety hence you are guaranteed they will filter those wavelength.
If UVEX glasses become unavailable in the future, look for laser safety amber or red glasses filtering from 400nm to 550nm with certification, this should be as efficient if not more than the UVEX glasses, and laser safety glasses will always be available in the future as laser is a generic technology that will always be useful.
Shading films quality can be assessed with their VLT percentage, but for clip-ons it's less standardized, you won't know how much dimming you'll get so it's impossible to say what clip-ons to use exactly. If you want more reliability, use shading films with a defined VLT percentage. If you want a more ergonomic and easy solution, use clip-ons with flip-up so they can easily be put on and flipped up if you want to stop using the shading without removing the clip-on, this will work well on prescription glasses and you can combine with the UVEX S0360X on top. However, clip-ons are incompatible with the UVEX glasses themselves, whether S0360X or Skyper, they are simply too small and misplaced for these big glasses, so the clip-ons not only look weird but they don't dim light from all the peripheral vision. Use clip-ons only on prescription glasses, not on the UVEX glasses. If you want the UVEX glasses to be shaded themselves, use shading films for car windows with 5% VLT and tape them on the UVEX glasses as shown above.
-To test lower dosages of melatonin, below 1mg, which are usually very hard to find in both pharmaceutical products or over-the-counter dietary supplement products, it's possible to either ask for a magistrale preparation at the pharmacy (extemporaneous preparation) who can dose very precisely for you but will be more expensive, or get melatonin in liquid form, although note that in the latter case the degradation of melatonin is much faster, so once the liquid bottle is opened, expect the contained melatonin to be inactivated after a few days. It's also possible to try to cut solid tablets, although this leads to a great variability in the dosage between 50% and 150% even with specialized cutters, and it will break the coating and hence make the melatonin instant release (which can be an issue if you seek prolonged release melatonin, this is in fact contraindicated for any "slow or modified release" drug). For more details including a thorough evaluation of the efficacy of the various types of extemporaneous preparations (ie, methods of pharmacologists to prepare individually tailored drugs, and also various at-home transformations of drugs such as cutting tablets or grinding and dispersing in water the powder to drink), read here, here and here. Magistral preparations can only be done under some specific circumstances as regulated in the European Union (see also here). Extemporaneous preparations have fallen out of favor in some countries such as United Kingdom in favor of specials instead, which are manufactured by industrials specifically for a set of patients. If OTC products are chosen, always ensure to choose products that only contain pure synthetic melatonin, not any other compounds such as valerian as combined products usually have much lesser quality controls and hence more variable dosage, up to 10x less or more than what is claimed on the label. +To test lower dosages of melatonin, below 1mg, which are usually very hard to find in both pharmaceutical products or over-the-counter dietary supplement products, it's possible to either ask for a magistrale preparation at the pharmacy (extemporaneous preparation) who can dose very precisely for you but will be more expensive, or get melatonin in liquid form, although note that in the latter case the degradation of melatonin is much faster, so once the liquid bottle is opened, expect the contained melatonin to be inactivated after a few days. It's also possible to try to cut solid tablets, although this leads to a great variability in the dosage between 50% and 150% even with specialized cutters, and it will break the coating and hence make the melatonin instant release (which can be an issue if you seek prolonged release melatonin, this is in fact contraindicated for any "slow or modified release" drug). For more details including a thorough evaluation of the efficacy of the various types of extemporaneous preparations (ie, methods of pharmacologists to prepare individually tailored drugs, and also various at-home transformations of drugs such as cutting tablets or grinding and dispersing in water the powder to drink), read here, here and here. Magistral preparations can only be done under some specific circumstances as regulated in the European Union (see also here). Extemporaneous preparations have fallen out of favor in some countries such as United Kingdom in favor of specials instead, which are manufactured by industrials specifically for a set of patients. If OTC products are chosen, always ensure to choose products that only contain pure synthetic melatonin, not any other compounds such as valerian as combined products usually have much lesser quality controls and hence more variable dosage, up to 10x less or more than what is claimed on the label.
@@ -5977,7 +5977,7 @@
-To monitor if the ketogenic diet is done properly, use ketostix, an urinary measument bands that will color depending on the amount of ketone bodies in urine. A strict ketogenic diet should consistently produce a color between the 2 highest grades (0.8 g/L to 1.6 g/L). A reusable alternative may be the electronic breath ketone meters, but the author did not test this kind of product yet. +To monitor if the ketogenic diet is done properly, use ketostix, an urinary measument bands that will color depending on the amount of ketone bodies in urine. A strict ketogenic diet should consistently produce a color between the 2 highest grades (0.8 g/L to 1.6 g/L). A reusable alternative may be the electronic breath ketone meters, but the author did not test this kind of product yet.
@@ -6354,7 +6354,7 @@
-An alternative solution for traveling to both the sleepmask and the sleep earmuffs is the Wrap-A-Nap travel pillow, but the sound filtering is much less effective and it requires a precise positioning to achieve the sound filtering effect that not everyone seem to achieve. Ostrich pillows are another similar alternative but they are known to leak easily and hence have a very short durability. +An alternative solution for traveling to both the sleepmask and the sleep earmuffs is the Wrap-A-Nap travel pillow, but the sound filtering is much less effective and it requires a precise positioning to achieve the sound filtering effect that not everyone seem to achieve. Ostrich pillows are another similar alternative but they are known to leak easily and hence have a very short durability.
@@ -6409,7 +6409,7 @@
-In general, when it comes to digestive issues, the first and most important step is to identify the issue and the triggering conditions, then the usual solution is to avoid these triggers, especially in the hours before bedtime. After we eat, it takes about six to eight hours for food to pass through your stomach and small intestine, so it is safe to set as a rule of thumb that we want to avoid eating triggering foods at least 8 hours before sleep. +In general, when it comes to digestive issues, the first and most important step is to identify the issue and the triggering conditions, then the usual solution is to avoid these triggers, especially in the hours before bedtime. After we eat, it takes about six to eight hours for food to pass through your stomach and small intestine, so it is safe to set as a rule of thumb that we want to avoid eating triggering foods at least 8 hours before sleep.
-Ultradian cycles are any cycle smaller than 24h, hence any cycle shorter than circadian. In sleep science, an ultradian cycle refers to the 1h30-2h blocks of vigilance/sleep cycles. There are smaller ultradian cycles in other biological processes. Ultradian cycles were initially discovered by Nathaniel Kleitman - who is considered the father of sleep science - and were initially named Basic Rest-Activity Cycle or BRAC. These ultradian cycles are exactly the duration of one full sleep cycle (including going through the various deep sleep stages and REM sleep, until it starts again with the next cycle). Even more interestingly, medical doctors observed during the Tripp experiment, where a radio presenter did not sleep for 200h to raise funds for a children charity, that hallucinations due to sleep deprivation also are following a 90 minutes pattern, in other words an ultradian cycle, which strongly suggests that ultradian cycles happen all the time, including when awake, but are simply suppressed when the homeostatic sleep pressure is minimal. Indeed, recent research support the initial hypothesis of Kleitman that ultradian cycles (or BRAC) are in fact happening all the time: +Ultradian cycles are any cycle smaller than 24h, hence any cycle shorter than circadian. In sleep science, an ultradian cycle refers to the 1h30-2h blocks of vigilance/sleep cycles. There are smaller ultradian cycles in other biological processes. Ultradian cycles were initially discovered by Nathaniel Kleitman - who is considered the father of sleep science - and were initially named Basic Rest-Activity Cycle or BRAC. These ultradian cycles are exactly the duration of one full sleep cycle (including going through the various deep sleep stages and REM sleep, until it starts again with the next cycle). Even more interestingly, medical doctors observed during the Tripp experiment, where a radio presenter did not sleep for 200h to raise funds for a children charity, that hallucinations due to sleep deprivation also are following a 90 minutes pattern, in other words an ultradian cycle, which strongly suggests that ultradian cycles happen all the time, including when awake, but are simply suppressed when the homeostatic sleep pressure is minimal. Indeed, recent research support the initial hypothesis of Kleitman that ultradian cycles (or BRAC) are in fact happening all the time:
@@ -7250,7 +7250,7 @@
-Nevertheless, nightmares can be more troublesome for some people. Nightmares are more likely to happen during vivid dreams, and vivid dreams happen during REM sleep, towards the end of the night, and the end of the night is when micro-awakenings are more likely too. Hence, vivid dreams including nightmares are more likely to happen towards the end of the night. Anecdotally, in the present document's author's experience, this is the case, and it also is more frequent during sleep sessions in circadian misalignment, as despite the reduced short duration due to the lack of circadian rhythm support, deep sleep stages are shorter and less frequent, and REM sleep stages are more frequent then. +Nevertheless, nightmares can be more troublesome for some people. Nightmares are more likely to happen during vivid dreams, and vivid dreams happen during REM sleep, towards the end of the night, and the end of the night is when micro-awakenings are more likely too. Hence, vivid dreams including nightmares are more likely to happen towards the end of the night. Anecdotally, in the present document's author's experience, this is the case, and it also is more frequent during sleep sessions in circadian misalignment, as despite the reduced short duration due to the lack of circadian rhythm support, deep sleep stages are shorter and less frequent, and REM sleep stages are more frequent then.
@@ -7266,7 +7266,7 @@
-Furthermore, the vast majority (98%) of dreams just randomly recombine elements of the waking life (ie, they are NOT symbolic representations of the unconscious contrary to Freud's beliefs). Dreams content is influenced by the most recent events experienced in the day (see previous ref, mirror here). Also, personally significant and novel experiences are more frequently integrated in dreams than common, repetitive daily activities. Interestingly, non-REM sleep also serves the role of a 10x accelerated and random access offline replay of memories (see also here for humans and here and here). Hence, it is important to have some time to wind down and do pleasurable hobbies before sleeping, and thus avoid stressing or mood depressing activities at the same time. This technique is called positive presleep suggestion. Interestingly, expanding on Stephen Laberge's landmark works on lucid dreams, a study where scientists could bidirectionally communicate with lucid dreamers by asking them questions during their sleep shown that their recollection of the questions after they wake up differed substantially from the actual questions they had answer during their dream, which shows that our dream recall is often fragmented and distorted, what we recall from a dream or a nightmare is not exactly what happened. Interestingly, this bidirectional communication is possible because although the body is paralyzed during sleep, the eyes are not, and can be controlled by the sleeper during their dream. +Furthermore, the vast majority (98%) of dreams just randomly recombine elements of the waking life (ie, they are NOT symbolic representations of the unconscious contrary to Freud's beliefs). Dreams content is influenced by the most recent events experienced in the day (see previous ref, mirror here). Also, personally significant and novel experiences are more frequently integrated in dreams than common, repetitive daily activities. Interestingly, non-REM sleep also serves the role of a 10x accelerated and random access offline replay of memories (see also here for humans and here and here). Hence, it is important to have some time to wind down and do pleasurable hobbies before sleeping, and thus avoid stressing or mood depressing activities at the same time. This technique is called positive presleep suggestion. Interestingly, expanding on Stephen Laberge's landmark works on lucid dreams, a study where scientists could bidirectionally communicate with lucid dreamers by asking them questions during their sleep shown that their recollection of the questions after they wake up differed substantially from the actual questions they had answer during their dream, which shows that our dream recall is often fragmented and distorted, what we recall from a dream or a nightmare is not exactly what happened. Interestingly, this bidirectional communication is possible because although the body is paralyzed during sleep, the eyes are not, and can be controlled by the sleeper during their dream.
@@ -7286,7 +7286,7 @@
-Side-note 3: although sleep necessity was previously thought to be due to brain cleanup processes including dreams, which was shown to be incorrect, it now appears that dreams major purpose beside memory consolidation may be to allow for creative thoughts by recombining memories in innovative ways allowing for innovative insights compared to individuals who do not sleep. Although this hypothesis of a key role of sleep for memory consolidation remains unconfirmed and controversial, there is now an experimental framework that will allow the testing of this hypothesis in the upcoming years. A related but slightly different hypothesis is that dreams primary functional purpose is to generalize from personal experiences, which technically involves reducing overfitting in neural networks as for artificial intelligence systems, and this may explain the strangeness of some dreams and nightmares. +Side-note 3: although sleep necessity was previously thought to be due to brain cleanup processes including dreams, which was shown to be incorrect, it now appears that dreams major purpose beside memory consolidation may be to allow for creative thoughts by recombining memories in innovative ways allowing for innovative insights compared to individuals who do not sleep. Although this hypothesis of a key role of sleep for memory consolidation remains unconfirmed and controversial, there is now an experimental framework that will allow the testing of this hypothesis in the upcoming years. A related but slightly different hypothesis is that dreams primary functional purpose is to generalize from personal experiences, which technically involves reducing overfitting in neural networks as for artificial intelligence systems, and this may explain the strangeness of some dreams and nightmares.
@@ -8536,7 +8536,7 @@
-It's worth noting that the International Classification of Sleep Disorders (ICSD) added in its 1990 edition the "Inadequate Sleep Hygiene" as a diagnostic subcategory to insomnia but later retracted it in the ICSD-3, which was a systematic issue of the ICSD before its revision, with critics arguing against the "uncertain validity of several concepts" including inadequate sleep hygiene and the premature subcategorization as "a form of pseudo-precision" (mirror , pages 11-12). Furthermore, the poor reliability and validity of insomnia subclassifications in both the DSM-IV and ICSD-2 were confirmed by a study, finding unreliable site-varying support for "Inadequate sleep hygiene" and "Psychophysiological insomnia", and poor support for "Paradoxical insomnia" also called "sleep state misperception". Paradoxical insomnia is purposefully vaguely defined as sleep complaints without objective signs observed which can explain them, which of course bear the circular reasoning bias that if the cause of the complaint is not tested in the first place, such as the circadian rhythm, it obviously won't be observed. The same diagnosis of "Inadequate Sleep Hygiene" was also present in WHO ICD-9-CM and ICD-10-CM but seems to have been removed in ICD-11. The DSM-IV followed a similar evolution, with the various subcategories of insomnia being replaced by a single, primary insomnia diagnostic category, and the distinction between secondary and primary insomnia being removed later in the DSM-V in favor of a single and simple "Insomnia" category: +It's worth noting that the International Classification of Sleep Disorders (ICSD) added in its 1990 edition the "Inadequate Sleep Hygiene" as a diagnostic subcategory to insomnia but later retracted it in the ICSD-3, which was a systematic issue of the ICSD before its revision, with critics arguing against the "uncertain validity of several concepts" including inadequate sleep hygiene and the premature subcategorization as "a form of pseudo-precision" (mirror , pages 11-12). Furthermore, the poor reliability and validity of insomnia subclassifications in both the DSM-IV and ICSD-2 were confirmed by a study, finding unreliable site-varying support for "Inadequate sleep hygiene" and "Psychophysiological insomnia", and poor support for "Paradoxical insomnia" also called "sleep state misperception". Paradoxical insomnia is purposefully vaguely defined as sleep complaints without objective signs observed which can explain them, which of course bear the circular reasoning bias that if the cause of the complaint is not tested in the first place, such as the circadian rhythm, it obviously won't be observed. The same diagnosis of "Inadequate Sleep Hygiene" was also present in WHO ICD-9-CM and ICD-10-CM but seems to have been removed in ICD-11. The DSM-IV followed a similar evolution, with the various subcategories of insomnia being replaced by a single, primary insomnia diagnostic category, and the distinction between secondary and primary insomnia being removed later in the DSM-V in favor of a single and simple "Insomnia" category:
@@ -8544,7 +8544,7 @@
-The magnitude of this paradigm shift cannot be understated, as most cases of insomnia used to be misdiagnosed and mistreated as secondary insomnia to a mental disorder less than a decade earlier, which depended on the clinical institutions, with institutions either overdiagnosing secondary insomnia, and others diagnosing mostly with primary insomnia, and interestingly with no significant difference between the diagnoses pattern of specialists and non-specialists, demonstrating how much this paradigm affected sleep diagnoses throughout medical fields: +The magnitude of this paradigm shift cannot be understated, as most cases of insomnia used to be misdiagnosed and mistreated as secondary insomnia to a mental disorder less than a decade earlier, which depended on the clinical institutions, with institutions either overdiagnosing secondary insomnia, and others diagnosing mostly with primary insomnia, and interestingly with no significant difference between the diagnoses pattern of specialists and non-specialists, demonstrating how much this paradigm affected sleep diagnoses throughout medical fields:
@@ -9129,7 +9129,7 @@
> Uchiyama et al. had earlier determined that sighted non-24 patients' minimum core body temperature occurs much earlier in the sleep episode than the normal two hours before awakening. They suggest that the long interval between the temperature trough and awakening makes illumination upon awakening virtually ineffective,[22] as per the phase response curve (PRC) for light.
-Ref: https://en.wikipedia.org/wiki/Non-24-hour_sleep–wake_disorder from https://pubmed.ncbi.nlm.nih.gov/11058797
+Ref: https://en.wikipedia.org/wiki/Non-24-hour_sleep%E2%80%93wake_disorder from https://pubmed.ncbi.nlm.nih.gov/11058797
@@ -9418,7 +9418,7 @@
-Book summarizing latest findings (2020) in the genetics of chronotypes such as DSPD: Neurological modulation of sleep, 2020. Does not mention MTNR1B however. See section Genetics of Sleep, also explain that genetic analyses and public biobanks have helped make tremendous progress! + GWAS of Chronotype (summarizes all big studies but says should be interpreted with caution) + page 62 interactions of both genetic and environment cause sleep disorders (first sentence of page 62) + link between sleep duration and depression on same page + no link between shift work and type 2 diabetes +Book summarizing latest findings (2020) in the genetics of chronotypes such as DSPD: Neurological modulation of sleep, 2020. Does not mention MTNR1B however. See section Genetics of Sleep, also explain that genetic analyses and public biobanks have helped make tremendous progress! + GWAS of Chronotype (summarizes all big studies but says should be interpreted with caution) + page 62 interactions of both genetic and environment cause sleep disorders (first sentence of page 62) + link between sleep duration and depression on same page + no link between shift work and type 2 diabetes
@@ -9563,7 +9563,7 @@