Comment by TZubiri
2 years ago
"Obviously there's an implication that people with terrible sleep regularity in that one week snapshot had terrible sleep regularity chronically, which in turn had a causative effect on mortality"
You got it.
"but we have to make a couple of deductive jumps to get to that conclusion"
This is always the case unless you assume reality is as big as what you can perceive.
"I'd really like to see the same study with longer term sleep data."
You can say this of literally 100% of the studies, it will never be enough. I understand it when authors put this at the end of a study because they want more funding and because their subject is all they think about. But for reasonable human beings you gotta make a common sense jump and allocate resources to other subjects. Yes, regular sleep has good effects on health, the burden of proof of that was already 0, this study is a nice added touch, there will be no double dessert, move on.
Every deductive leap comes with uncertainty in establishing a causal chain. I don't I'm being overly reductive about the nature of evidence when I say that.
There is a specific question that needs to be addressed: With a one week window into sleep habits, are we selecting for people who are chronically poor sleepers, with those poor sleep habits leading to disease?
OR
Are we selecting for people who are chronically ill for other reasons and those chronic illnesses prevent them from getting regular sleep?
For example, people with sleep apnea have terrible sleep, and they have lower life expectancy than the general population. However, the cause of that lower life expectancy is not the poor quality of sleep; it's the cardiac effects of abnormal breathing over a long period of time.
If a person with decades of excellent sleep habits developed sleep apnea in the last 5 to 10 years of their life, the accelerometer will capture their irregular sleep and the death registry will capture their early deaths. That doesn't mean poor sleep habits killed them.
There are many other such chronic illnesses that can be confounded this way. Heart failure. Obstructive lung disease. Dementia. All can lead to irregular sleep. Add them together and you've captured a large segment of the population with ~10 years left to live.
The authors address this relationship in the conclusion and supplementary materials, but they appear to approach it entirely from the framework of poor sleep being causative of cardiovascular disease. Well yes, there's evidence that poor sleep can cause cardiovascular disease, but it's also well established (as I explained) that it can happen the other way around. If you want to cement a full chain of causality, you need a longer time window. Capture a young population with a low burden of chronic disease, show that poor sleep habits came first (i.e. within a certain age window), then cardiovascular disease, and then shorter lifespan. That would be the ideal data, even if difficult to acquire.
Too much word. Sleep good, regular sleep good. No more think, more do.
It is easy to say that good quality sleep is good for a person. But what if I literally never get that type of sleep. What should I do? How concerned should I be? How much focus and effort should I put into this? Should I take the Ambien I'm prescribed or should I try to go for the best natural path - because I really, really don't have good experience with Ambien. And it's almost like it's the best modern medicine can offer.
How to fix is an entirely different topic.
My bet is no drugs, and have faith in your agency.