So biological garbage collection pauses then? skip sleep, and the brain tries to run gc cycles during runtime. Causing attention and performance latency spikes. Evolution wrote the original JVM.
this might explain how "power napping" (<30min) can help so much when you are sleep deprived even through it's too short to really count as sleep. I wonder if you can find that when sleep deprived people power nap a "flush" happens then
There’s a phenomenon we have known about since at least the late 1980s when Race Across America riders were using it.
Essentially these guys try to stay up for the first few days and then sleep less than 8 hours after that. Way less. Many of them end up hallucinating by the end, and only their extreme fitness levels probably save them from just dying from lack of sleep.
The trick is that waking up to daylight makes you feel more rested. So the teams would have their riders sleep 2-3 hours from just before dawn until dawn so they would wake up to sunlight. Physiologically the difference is small, but psychologically it’s much bigger.
Some of the effect of power napping is likely the same sort of trickery, just as caffeine is partly trickery and partly adrenal.
I used to do adventure races of 24 or 48 hour duration. can confirm that after 20+ hours of endurance you 100% start having microsleeps and hallucinations. 20 mins sleep is all you need to get going again for a few more hours.
Fun fact: Suppressed/hidden/lost memories due to trauma that appear to re-surface through therapy are not a real thing, as previously thought (and still by some psychotherapists). Nowadays it's understood by psychology that any memories "re-surfacing" in therapy are in fact newly created, although the patient themselves cannot tell the difference. Allegedly, whole accusations of childhood abuse may have been created out of thin air, without the victim realizing.
Sure it's a real thing for memories to surface that were previously buried. It's happened to me.
If it happens in therapy, that doesn't mean the memories are "implanted". And not all memories lack the ability to validate them... for example, if you've forgotten someone's name, then remember it later, you can call out to them by their name to confirm that you've correctly remembered it.
Memories tumble around in the brain all the time, not all memories are easy to access, but that doesn't mean they're inaccessible.
The point that memories can also be implanted or fabricated during therapy is absolutely an important one, but dismissing the possibility for memories to resurface (and conflating any situation where this might happen with a specific type of discredited therapy) is needlessly reductive.
The problem is not that memories can't be repressed. There's plenty of research demonstrating repression does exist as a defence mechanism. The problem is that even highly evocative memories can also relatively easily be falsified, or modified through elicitation and reframing. Since there's no neurological stenographer, there is no mechanism even in principle to identify the difference between the two. With potential consequences like the satanic panic of recovered and elicited memories of sexual abuse. That's what Elizabeth Loftus and others have shown, and shown so thoroughly that eye witness testimony should never be trusted.
As a counterpoint to this, I am replying here because I can't make myself write a polite response to the GPP.
Yes, witness testimony is always potentially flawed.
But knowing "some repressed memory recovery is false" does not justify saying that repressed memories are not a real thing. Repressed memories do happen. They do come back sometimes. When they do, they are just as valid as any normal memory that a person thinks they always had.
I know because I had them myself. Mine were of trauma in the age range from 5-9. I had a high "ACE score" when I eventually looked into this. I did not have any therapy session prompting the recall, I just remembered them spontaneously around age 15 when I was empathizing with a schoolmate who told me about domestic violence. It was a sickening feeling to have this whole phase of my past come unlocked.
Amazingly, it submerged into repression again. I next remembered it at about age 20. In between, I had years of basically not remembering/knowing that I had any of this trauma or that I had experience the earlier recall. They all came back together, again triggered by an empathetic moment in college. Again it was disorienting to have this whole aspect of my past reopen.
At that later point, I confronted people who were around my childhood and got enough of a painful discussion, confession, and apology to know that these memories were not invented.
I had other forms of childhood trauma that never submerged. I don't know why this one section did.
I find it very offensive for someone to make broad statements that these phenomena do not exist.
You might "think" you had a repressed memory but it could all be completely made up. You might even get other people to believe it, because human memory is incredibly faulty. Shared delusions are literally a "known bug" of human biology. Wikipedia has a whole page on them (https://en.wikipedia.org/wiki/Folie_%C3%A0_deux). The Seattle Windshield Pitting Epidemic (https://en.wikipedia.org/wiki/Seattle_windshield_pitting_epi...) is yet another example
The thing that changed though is since the 2010s everyone has a high definition camera in their pocket. Everything you do is recorded online. Kids that grew up in the last few years will have their entire childhood recorded in some way or another. Every movement tracked by GPS. Therefore, while I don't agree completely, I wouldn't be surprised if some assumptions about psychology are upended and a great deal of so called repressed memories turn out to be bogus when we can easily disprove them.
The person you’re responding to said they did the work of verifying themselves with third parties. Do you not believe that too? People dont suddenly just admit to committing severe abuse because they were convinced to do so. In fact, usually the opposite happens with abusers - they delude themselves into thinking the abuse never happened and believe/defend this very aggressively.
This whole thread is gross. I’d say you should be ashamed of yourself but you likely lack the prerequisite self inspection.
Thank you so much, the parent thread was truly an uncomfortably disturbing read and your post is a necessary contrast to "rational" "objective" "minds" armchairing something so delicate with gross finality.
This mirrors my experience as well of multiple instances over my life of repressing childhood trauma and some event or conversation suddenly bringing it back to the surface.
Not to minimize your experience or anything like that, I'm just thinking out loud: What's typically the delineation between repressed and "not on the mind at the moment"? We naturally "forget" things all the time because there's no need for them to be in our current context window, e.g. I can't recite every coffee shop I've been to, but maybe if you start talking about a coffee shop with uncomfortable seats, I'll remember the one I went to with uncomfortable seats. Not a comparable experience in general of course, but one wouldn't say I repressed the coffee shop. Is it more like if I started at "uncomfortable coffee shop", nothing came to mind, but then I later remembered only after smelling some special flavor of coffee beans they had had?
A repressed memory and its associated knowledge and entailment is "not there" until triggered properly. To the extent that our autobiographical memories construct our sense of identity, repressed memories have been censored from ourselves. And, I think it is censored for a purpose, not because it was one too many bits of trivia to keep in ready memory. I think it is a coping mechanism like very deep and targeted denial or dissociation.
When such memories come back, it can be like a mini identity crisis. You suddenly know things that are counter to your self-identity from the moment before. Once I was able to absorb the whole picture and not recoil back into repression, it became a permanent and unpleasant part of my self. .
There can be flashbacks of related events, some of which I also might feel are remembered for the first time in a long time. Those little flashbacks might be like remembering your specific uncomfortable cafe. The overall memory recovery is like suddenly realizing I spent years in a theater of war, that happened to have such cafes in it.
IME for me repressed is “not on the mind at the moment” but like so constant that any attempt to access it, your subconscious fights to divert your attention from it. it’s kind of like dim stars you can only see out of the corner of your vision.
the craziest one I had, my reaction wasn’t “oh my god i never knew i had this memory” it was “wow, i cant believe i havent thought about that in 25 years.” I knew and had known it was there all along, I just literally never thought of it to the point my other thoughts just didnt collide with it, ever. It’s almost like your brain just puts it in storage in a dark corner of your garage.
I understand it isn’t the same for everyone, but that was how it felt for me.
TLDR for me it was dissociation, and the only treatment that ever worked was scraping the corners of my mind for stuff like this and it got so much better the issues basically went away. I used a great deal of meditation, particularly tibetan buddhism.
I can objectively say your reply minimizes the previous two posts who shared childhood traumas by the objective fact that you are implying (if they are not able to satisfy your Scientific Endeavor) that, if there is no delineation, then their repression of childhood trauma is equivalent and minimized or perhaps exalted if coffee is your religion to the repression of your religious experience of this coffee shop. If you were perhaps a child victim in this coffee shop maybe? You literally erased the trauma part. That is the delineation if you still need to think about this out loud
Thanks so much. I was wanting to write a scathing response as well but you calmly explained what I wanted to. I had severe childhood abuse that was documented by third parties I’d completely forgotten about - when I remembered them in therapy, my therapist thought they were fake or delusional too and sorta gaslit me about it. I had to go hunt down the receipts, which for me was traumatic in and of itself and permanently severed a few relationships with my family members, which didn’t have to happen. I fired her over it.
The comments in this thread are indeed disturbing. Clearly many on this forum have led blessed lives and can’t imagine people having it differently,
There are two types of repression, however. The notion that primarily repressed memories--say, those of being breastfed, of being potty trained--could ever resurface is bogus of course. But it is that original violence, first of being cared for, and then having that care taken away and even, in many cases, transforming into authoritarian violence in order to be socialized properly, that precipitates all other "secondary" repressions like Freudian slips, even screen memories or rationalizations. No, most people traumatized past the age of say, 5, won't readily forget it. But perhaps they will have a way of reconciling with that trauma in an unhealthy or not fully conscious manner (consider self-harming, or drug abuse, making up a narrative in order to stay with a partner who violently abuses them). And they will not readily connect their traumatic experiences with their unhealthy coping mechanisms. And we could say that the connection between unconscious behaviors and trauma, when revealed, could be considered a "re-surfacing." Even if I can't remember being breastfed, I know that I find the warm embrace of another's arm's comforting and soothing, and this perhaps relates to my original state of relaxation as a child in my mother's arms, for instance.
Why would it relate to your past experience of being held in your mothers arms, rather than to whatever inbuilt tendencies that lead one to respond well to being held in one’s mother’s arms while a baby?
Like, if kissing is derived from impulses relating to breastfeeding (which is a hypothesis that, AIUI, is in good standing, though not the only one in good standing nor necessarily more favored than a couple others), I wouldn’t think that therefore someone who was only ever bottle-fed as a baby would therefore not get anything out of kissing. The appeal of “my lips on another person” should be there regardless, just as it was for the first time a baby is breastfed (though, of course, it is also a cultural thing: not all cultures have had kissing as a standardized way of expressing affection, so whether one grows up in a context where kissing plays a role, that probably also plays a part in whether one finds it appealing to have one’s lips on another person).
People can remember things that hadn’t re-entered their mind for decades. It certainly happened to me a number of times (completely trauma-unrelated and not actively elicited).
A valid memory spontaneously re-entering your mind is different.
The idea of "repressed memories" was that people had hidden memories that they couldn't access, even if they tried. According to the theory, even if someone brought up the past event and tried to remind the person about it, they would be unable to recall it happening because their brain had blocked it out.
The idea was that only intervention by a therapist or some other special event could help the person "unlock" the repressed memories, making them available for remembering again.
What was really happening was that some therapists were leading people into "remembering" things that didn't happen through aggressive prompting and pushing, much like what happens when an aggressive investigator convinces a vulnerable person to falsely confess to something they didn't do.
I wouldn't be surprised if there are inaccessible, partly corrupted memories encoded in the hippocampus. I suspect most of them cannot be prompted by a therapist though, and likely there is no practical way to recover them.
I think it's all a matter of finding a trigger (or reference) to grab the memory. A therapist talking to you almost certainly wouldn't achieve that, but walking down the street and smelling an odd smell might.
That makes sense considering that human memory is strongly based on associations. Activating nearby memories can bring things back.
If you hear the first tones or words of a song you're much more likely to be able to tell the lyrics that follow compared to being asked to say those lyrics based on the title.
This is a more precise statement than just "you can recall things you thought you forgot".
It is specifically about trauma, and generally you don't forget traumatic events and that's often a big part of the problem. We are not talking about trivial things like the name of your maths teacher in high school, which have a tendency to come and go.
It is also specifically about therapy, that is an environment where you are actively encouraged to recall memories. We know how easy it is to make up memories, especially with the help of a third party (here, the therapist).
Combine the two: memories that are hard to forget and an environment conductive to making false memories and it becomes very likely that the "lost" memories are completely made up.
My guess is that long term memory recovery is inherently a reconstruction from the pieces that you have retained. So it is not unlikely to include dreamed up parts.
The debunked recovered memory therapy was something different: They would use different techniques and leading questions to try to get a patient to think they remembered something that may not have happened at all.
Some of the techniques included hypnosis or even giving the patients (including children) sedative-hypnotic drugs before pressuring them with the leading questions.
If they could eventually get the person or child to claim to have some memory of the event (after asking a lot of leading questions and maybe even drugging them) they considered it to be a recovery of the memory.
The accuracy of recollection can certainly vary, but the point is that some information is retained long-term even when it isn’t made use of in the meantime. Of course one could argue that actually it is being made use of unconsciously, but I’m skeptical of that, given the relative irrelevance of the details that can be recollected. It’s also not that difficult to imagine that some memory-representing micro-structures in the brain just happen to be stable over decades even when they remain untapped.
This has been my experience as someone who has experienced childhood trauma, and what I've inferred from my therapist. He taught me that the memories I have are typically exaggerations of what happened and it's hard to pin down what truly happened. The only evidence I have that has any merit is my siblings can corroborate with similar experiences since it happened to all of us, and I'm sensitive to things related to these traumas. Almost every day I can feel the things that happened, and on my worst days these areas are much more sensitive.
On top of that, I have legitimate memories that were not traumatic, but still related to the same traumas because said person attempted to encourage these activities throughout my young life on rare occasions. I didn't remember what happened as a kid, but I knew something wasn't right and I wasn't comfortable. It wasn't until I was almost 30 that I had my first "flashback" which was a fractured memory, I still remember it looked like a faded photograph in my mind, and it was accompanied by an extremely uncomfortable feeling.
The re-surfacing memories aren't real in a sense, but in my case they aren't entirely fake either.
I wonder if it's possible that things can be completely imagined with absolutely no basis what-so-ever in certain circumstances, and I also wonder how difficult it is to discern that. It seems to be a difficult concept to manage.
Indeed. I was browsing a Nintendo fan site I made in 1998 on archive.org when I was just 11 years old. I don't remember every detail about making it, but my brain had no problem stitching all the pieces it did retain back together.
On the other hand, I do have some Gandalf "I have no memory of this place" moments for other things.
if you specialize in looking for black swans, and you've looked for more black swans than anybody ever, and all the black swans you thought you'd found have turned out to be sooty white swans, people might be interested in reading about your experience and have their faith shaken that black swans actually exist.
I'm reminded of the story of dragon sightings in Great Britain: after the printing press and newspapers and newspaper reporters chasing stories emerged, as news distribution out from city centers into rural areas increased, it seems dragons picked up and moved farther away, only being spotted in the hinterlands without news.
You apparently would keep your mind open to the idea that dragons don't like the smell of newsprint as no other conclusion could be more plausible sheerly on the basis of logic?
I beg to differ, or at least I'd need clarification, some people experience traumatic visions from what is assumed repressed memories (with or without therapy)
It might be something that one might not understand if he/she doesn't live through it I guess
What about Dr. Jim Tucker’s two child psych cases, James Leininger and Ryan Hammons?
One remembered memories of a WWII pilot named James Huston Jr. and the other a deceased Hollywood agent named Marty Martyn.
Putting aside the reincarnation hypothesis for the moment, do you think the kids invented the details and coincidentally happened to match to a real person or were they fully coached? Maybe they didn’t get enough sleep or got too much sleep?
> any memories "re-surfacing" in therapy are in fact newly created,
You're saying that those memories are exactly the same as all the other memories.
Every time you "recall" something, you are not pulling up some file that is always the same. You are actively recreating the memory.
There's nothing "fun" or insightful about this, this mechanism has been known for a long time.
Obviously it's not unique to psychotherapy.
> may have been created
Most things that "may" have happened do not warrant absolute statements such as "that's not a thing" (which, incidentally, is a particularly empty statement in any context, since every thing is a thing)
That is extremely weak to nonexistent counter-evidence that seems to focus on supporting Loftus, who has put a lot of effort into the defense of her public persona. I don’t disagree that it is possible to manufacture memories but the evidence isn’t there to support your conclusion or the converse.
Recovered-memory therapy (the topic of the Wikipedia article) is very clearly quack science and has been discredited.
Some of the techniques used in the therapy include giving patients sedative-hypnotic drugs to put the patient in a waking dream-like state while the therapist asks leading questions to get them to "remember" an event. The same drugs they used are known to be associated with false memories, like when someone falsely recalls something from a vivid dream as having actually happened.
It has fallen out of favor based on a lack of evidential support, for sure. It has not really been dismantled publicly scientifically, but mostly quietly, perhaps in order to protect its practitioners, perhaps because the research cannot currently be ethically conducted.
I am not advocating for it, just stating the near total lack of substantive scientific evidence presented either in support or opposed.
In science. On a casual forum you have no obligation and I’d rather someone leave a short comment so I at least know, if I’m interested I’ll go look and verify myself.
Most people think that when their memory fails it's just the act of not remembering something, but misremembering something happens equally often, and completely making up shit also does happen. It's just like LLM hallucinations.
No, a lapsed memory can be provoked. It doesn't have to be relearned. It is "lapsed" because the organizational path to it within your brain has been lost, like a book in a library that has been left out of the card catalog, but just like the book, if you happen to find it anyway, it will be there.
> at the first news of English ships in the area, Buckley rushed to the spot. He attempted to make contact, but couldn’t swim out to the ship and couldn’t convince the ship to send a boat to him (Buckley had, at this point, forgotten how to speak English.) Buckley was again heartbroken until another ship showed up, and he found the English colonists and tried to approach them:
> “Presently some of the natives saw me, and turning round, pointed me out to one of the white people; and seeing they had done so, I walked away from the well, up to their place, and seated myself there, having my spears and other war and hunting implements between my legs. The white men could not make me out–my half-cast colour, and extraordinary height and figure [Buckley was around 6’5” or taller,]–dressed, or rather undressed, as I was–completely confounding them as to my real character. At length one of them came up and asked me some questions, which I could not understand; but when he offered me bread–calling it by its name–a cloud appeared to pass from over my brain, and I soon repeated that, and other English words after him. …
> “Word by word I began to comprehend what they said, and soon understood, as if by instinct, that they intended to remain in the country; that they had seen several of the native chiefs, with whom–as they said–they had exchanged all sorts of things for land; but that I knew could not have been
I submit that it takes more than a day to learn English if you don't already know it.
Once I was in a Toys-R-Us and noticed a cover image among the bottom-of-the-barrel DVD display which caused me to put what I was doing on hold for several minutes while I stared at the DVD. I bought it, and it turned out to be a movie I had watched many times when I was very young, but that information hadn't been accessible to me.
I realize you're making a joke, but there is no such thing as "unreferenced memories", as in, something that is no longer in use and has been removed from the brain.
Every memory your brain has ever produced is still there, even if most are beyond conscious access. Memories quite literally become a permanent part of you.
A lot of people mistakenly think of human memory as a sort of hard drive with limited capacity, with files being deleted to make room for new ones. It's very much not like that.
If you are implying that human memory has infinite capacity, that's not possible. The human brain is a finite, physical thing. It can't store an infinite amount of data.
If you just mean that human memory has a finite capacity that's much larger than anyone has come close to reaching by storing the memories of a normal human lifetime, that might make sense.
Do you have any references for your statements about memory? I'm not familiar with whatever science there is in this area.
The claim that everything is there does not imply infinite, or even large capacity.
Consider an exponentially weighted moving average - you can just keep putting more data in forever and the memory requirement is constant.
The brain stores information as a weighted graph which basically acts as lossy compression. When you gain more information, graph weights are updated, essentially compressing what was already in there further. Eventually you get to a point where what you can recall is useless, which is what we would consider forgotten, and eventually the contribution of a single datapoint becomes insignificant, but it never reaches zero.
> i can't give you evidence of those things you made up yourself.
I didn't ask for that. I asked if you have references for what you said. Even if I misunderstood you, that shouldn't be a reason for you not to give references for your statements, if you have them.
If you don't have any references to back up your statements, then I'm not sure what you're basing them on.
It wouldn't imply infinite storage because human life is not infinite in time and memories do not accumulate at an infinite rate in storage consumed per unit time, so the total storage over a human lifespan is finite, so the claim can be true with finite storage.
It is almost certainly false, but it doesn't require infinite storage to be true.
> The human brain is a finite, physical thing. It can't store an infinite amount of data.
True, but it doesn't really detract from his statement because do we really know what that upper bound even is? I don't think we come close to the theoretical storage limit... So saying "every memory you have is permanently stored" is effectively true, at least true enough for a thought experiment like this. Perhaps when people live to be 200 years old and we know more about the brain we can test this, though.
I used to be weary of learning new, complex things, thinking I'd "lose" old knowledge XD
Bullocks. Memories fade. Or do you really believe that 'subconsciously' I still know what I had for dinner today exactly 30 years ago?
The way I understand it, it's just that, unlike on disk, the deletion process is not binary. Weak connections that are not revisited regularly gradually become weaker, until they're undistinguishable from noise (false memories).
Knowing almost nothing about memory and the brain, I don't know if I agree with "Every memory your brain has ever produced is still there".
Memories seem to be constructed by a group of neurons together, and it seems clear that neurodegeneration is a thing, whether by trauma or due to aging. When pathways degenerate, maybe you have a partial memory that you brain can help fill the gaps with(and often incorrectly), but that does not make it the original memory.
I had this experience at Big Bend State park that makes me think they are. I didn't bring enough water and camped in the primitive area. At night, I was dehydrated pretty bad. When I finally got a little sleep (it was tough to say the least), I had this vivid dream where I put a pebble in my mouth and started sucking on it to make saliva. Then I woke up for real, and I knew it because there was a lot of wind IRL, that wasn't in the dream. So I took out a coin from my back, put it in my mouth to make saliva, and got a little bit of relief. Enough for a couple hours until it was dawn, and had enough light to hike down to the restroom area.
I don't know where I got this trick. Likely some survival show or some novel. But I don't have any background in survival, otherwise, I would have brought a lot more water.
So my brain knew there was a memory that could help and made up a dream about it is my theory.
I hope that the actual medical field starts taking note of this.
My wife still has to work 24 hour shifts with no sleep, performing emergency surgeries no matter how long it has been since she slept. During residency only a few years ago she and her co-residents were almost weekly required to do 36 hour shifts (on top of their regular 16 hours per day, 5 day per week schedule) and once even a 48 hour shift when the hospital was short staffed.
Of course I’m sure they won’t. No one cares if doctors are over worked.
I've never understood those long shifts. Unless a shift just means you are there but sleeping, what is the reason for allowing it? We don't let truck drivers do 24h shifts, why do doctors the world over seem to do this?
My understanding is that the research shows that the harm to patient care from information loss during doctor shift turnover is worse than the harm from fatigued doctors.
Yes, a tired doctor sucks. But a tired doctor who already has the patient's state loaded into their head may still be better than doctor who is completely fresh in both senses.
I have never, in my entire life, ever personally encountered a situation in which a doctor paid enough attention to anyone over a period of time exceeding two hours that I could possibly believe that keeping the doctor on shift for a long time had the slightest benefit.
I’m sure cases exist. But I’d be rather surprised if they’re common.
The answer is there’s already a doctor shortage, and the US simply does not have the capacity to effectively 2x the doctor-patient ratio.
Doctors are also unlikely to want a 50% pay cut in exchange for shorter hours. They aren’t directly exposed to the risk caused by fatigue since they will have malpractice insurance. Therefore the safer method of care would be simply too expensive, and doctors wouldn’t see an upside.
Part of the shortage is a result of artificially constrained supply as there aren’t enough med school seats to keep up with demand.
Doctors do not get along and that’s too many Drs. Each patient often has multiple speciality Drs visiting them and reviewing their case up to 3 or 4 sometimes already. Imagine being on consult and trying to figure out which guy on a team of 4 you should talk to about such and such.
Here's an anecdote that might help answer. When my wife was pregnant with our first doctor, she started hemorrhaging spontaneously ten weeks before her due date. We rushed to the ER.
1. Shortly after, a doctor A came in, asked some questions, looked at the chart, and told us she was having the baby tonight. Holy shit our life is about to get crazy and we're going to be parents 2+ months early! He leaves.
2. Several hours later doctor B comes in. We ask about delivery. "Oh, no. You're not going to have the baby now. But you will have to be on bed rest until the due date." Jesus, my wife is going to have to quit her job.
4. Even more hours later, now the next morning, doctor C arrives. "OK, you're free to go home. No bed rest needed. Just let us know if anything else happens."
My general experience with doctors is that you get as many unique opinions as there are doctors in the room. This is not an indictment of the profession. Human bodies are insanely complex, there is way more variation between them than most people realize, and doctors are operating under very very limited time and information.
Having overlapping doctors would likely cause even more patient confusion and increase the risk conflicting treatments. Also, it would obviously double the cost of care.
(My wife and baby were fine. Partial abruption. Very scary and my daughter was born five weeks early, but no other significant problems.)
Many industries have solved this issue already. Use a pilot/copilot model. First doctor drives, second one mostly observes and makes sure the first one doesn’t make mistakes.
> Yes, a tired doctor sucks. But a tired doctor who already has the patient's state loaded into their head may still be better than doctor who is completely fresh in both senses.
AI fixes this. Imagine the boot time of loading a patient's state from dozens of labs and files vs. a summary that gets you to exactly what they're going to end up remembering anyways. And if a doctor finds something interesting that the AI doesn't flag, they should be flagging it in the chart for the next doctor anyways.
In my experience, AI summarization is a pretty lame application. I don’t really need a block of potentially wrong, rephrased text. I’ve got a feeling that the same applies to healthcare.
> My understanding is that the research shows that the harm to patient care from information loss during doctor shift turnover is worse than the harm from fatigued doctors.
This would not appear to apply to emergency surgeries. They aren't done by doctors who are familiar with the patient anyway. (Neither are non-emergency surgeries. Surgeries are done by doctors who do that kind of surgery. Familiarity with the patient is useful in deciding what surgery should be done, but not in doing the surgery.)
The European Working Time Directive has requirements for rest, etc. Either Europeans have much better hand-off procedures, they don't know how to comply with the rules they make, or they're fucking idiots who are going to kill people due to information loss during shift turnover. It was proposed decades ago. I wonder what compliance is like in Germany, etc.
Here in Norway the doctor's association have worked hard against it, and talking to a relative which became a doctor some years ago, it's primarly because they want to keep the extra premium pay they get from the "uncomfortable hours" as it's called here.
The AMA works to prevent importing doctors from other countries, largely to maintain wages, but we don't have enough doctors.
Doctors boards and AGME (partly governed by AMA, but there is some amount of public representation) control residency admissions and board certification. We don't necessarily want low admissions standards, but there is a lot potential conflict of interest in constraining supply.
Some states, I think I read Florida recently, have started pushing back to allow in foreign doctors.
I think both doctors and patients would want a different system for both doctors and patients. Having seen a poor performing medical system, and comparing it with the US medical system, all I can say it's that the US one doesn't seem designed to optimize health and well being of patients and, based on reading several articles representing doctors opinions, neither doctors'.
I do think it's maximially optimized to extract revenue. That can sometimes be good (e.g. good access to healthcare) but often times it's not great.
Given healthcare, along with education should be a national priority, both should be heavily "configured" to serve peoples' goals first and any financial goal should be secondary (although arguably useful).
I suspect the current shareholder structures from hedge funds are (intentionally or not) driving things in the wrong direction wrt to public health goals. This is article from a few days ago is also interesting https://news.ycombinator.com/item?id=45680695
her at her worst is better than 90% of people at their best.
if you get through and into a good med school -match into surgery- you are Peak in a way very few are.
I don’t see this changing unless they reduce the requirements for med school; if they let anyone in who wants in and force that group to work 30hr shifts - you’ll get enough bad outcomes the system will change.
There was a study, I believe on nurses and shift durations. The study found the nurses were happier with shorter shifts - but the patients did worse. Patients come first.
I could see a group of Doctors loudly proclaiming love for Donald Trump (and mentioning very much how great he is) and pleading the case for a change and something happening. He is an interesting president.
I would be interested in hearing a european drs perspective, I heard they work shorter shifts (but no EU dr I met has confirmed, it’s like meeting a unicorn)
This is the nature of the medical system in North America, and some other advanced nations. Also, you're not just being blunt, you're being both ignorant and arrogant.
GP's wife isn't being forced into this profession and they are making a lot of money from it. Do we need to offer sympathy for all people with difficult working conditions regardless of the remuneration?
I doubt her spouse makes her be a doctor. Most people who go through premed and medical school are pretty dedicated and driven on their own. This is a corporate vs labor issue, and likely not a domestic issue. I’m sure he dislikes it greatly, too.
Imagine doing your best to help someone and they die as a direct result.
Then you get to go to work and deal with the next case.
Or the patient has life changing, negative outcomes. Damn, that bad. Next case.
Living in that mental state takes a pretty unusual character type. We can expect some extreme behaviour.
It’s also interesting watching the change over time. The trainee versus consultant, or the surgeon as they near retirement.
I’m not a surgeon or a doctor and so I see a small part of their world but see some of the perks (they get everything) and some of the downsides, and there are a lot.
> The scientists found that during these lapses, a wave of cerebrospinal fluid (CSF) flows out of the brain
> Lewis and colleagues showed that CSF flow during sleep follows a rhythmic pattern in and out of the brain
> Most significantly, they found a flux of CSF out of the brain just as those lapses occurred. After each lapse, CSF flowed back into the brain.
I can't believe the authors of the article didn't address one of the most obvious questions: Where does the CSF flow to and where does it flow back from? It's not like there are pipes leading out of the brain, or the CSF will just leave my brain through my ears or anything, will it?¹ What happens with the waste products? (¹ Though it would be kinda funny if this was where snot comes from.)
EDIT: Wikipedia's got the answer:
> Clearing waste: CSF allows for the removal of waste products from the brain,[3] and is critical in the brain's lymphatic system, called the glymphatic system. Metabolic waste products diffuse rapidly into CSF and are removed into the bloodstream as CSF is absorbed. When this goes awry, CSF can become toxic […]
> It's not like there are pipes leading out of the brain
There are, in fact, “pipes” leading out of the brain. Cerebrospinal fluid is (and this is probably somewhat oversimplified) produced from material in the bloodstream in the ventricles in the brain, flows through the system of ventricles and then out of the brain into the subarachnoid space around the brain and spinal cord, and is then reabsorbed into the bloodstream.
They didn’t put it in there because knowing the flow of CSF is so elemental to performing research in the field that it would be a waste of everyone’s time.
What I want to know is: can we trigger these flushes? My grandfather died of/with Alzheimer’s, and I’d prefer not to follow in his footsteps. If we determine that these flushes are key to good brain health, and there were a way either through a pill or even a treatment to up the frequency of these flushes, that would be awesome.
We can't "trigger" the flushes, however, it looks like we can increase the power of the pump.
This is specifically the area we work in traditionally called slow-wave enhancement which is stimulating the restorative function of sleep.
This paper [1] specifically looks at amyloid response as a result of stimulation and shows a corresponding relationship between stimulation response, amyloid response, and memory. I wouldn't say it's putting a bow on the results, but it is a very promising result.
If you're curious about what we're building, I'll be posting a ShowHN next week which dives into some of the data in a way regulatory requirements don't permit us to do on our website, but until then, check out https://affectablesleep.com
I work in neurotech/sleeptech and this is the primary function our work focuses on.
However, I also mis-stated that. It is possible to create a slow-wave, however only through magnetic stimulation (rTMS), but that is not realistic outside of a hospital environment.
Ok awesome. Are you saying that because it is an autonomic process or some other reason?
You will probably say no but I wonder if those yogis who can exert some control over heart rate, blood pressure, and breathing pattern might try to target this process as well.
I'm just saying that based on known science. I don't know if anyone has looked at if yogis, etc can control the glymphatic system.
What blew my mind when I got into neuro just over 5 years ago, is that the glymphatic system was only discovered in 2012!!!! We have SO much to learn about the brain.
I know a reliable way to trigger this. 400 gram of lamb, one bell pepper, one or two leek, one zucchini, some random spices (red chili pasta from the shop works a-okay), put in at slow heat for an hour and a half, so by 4 in the evening it's ready and you can close your laptop. Serve with rice or mercimek chorbasi.
The fluids have no chance to not be flushed once you are done with it.
What I’m picking up here is that if I can just get an automated CSF circulator installed I won’t need to sleep or get distracted when I’m tired. That was the point of this article, right?
Kind of related, but there is a concept of polyphasic sleep - where you sleep for small increments throughout the day (like 30 minutes every 3 hours). I did it for a bit at a startup thinking we were "hacking sleep" and "getting more productive hours out of every day!" - It takes awhile to transition to it, but once there, your scheduled "sleeps" are insane, 15 minutes, feel like straight to REM. The main problem was if you missed on schedule sleep you were a zombie.
Yeah, when I was looking into the plausibility and function of polyphasic sleep, I stumbled across studies from the US Airforce. Their conclusion was similar: In a controlled enviroment, it can be spectacular and work really, really well.
However, it is very, very fragile to any kind of interruption, so they stopped looking into it.
When I worked an overnight shift and lived alone, I got into a pattern of 2 to 3 hours a go three times a day. These were after work, halfway or so through my personal time, and before work. I used these separate times in between sleeps for work, almost exclusively for chores, and a dedicated slot for hobbies. I started each one refreshed, which was great. It doesn’t necessarily work so well when aligning your life with a partner.
Searching back, as I recall a video that was supposed to cause [increased] CSF flow, I did find this - https://news.ycombinator.com/item?id=34764730 about suggestions some learning difficulties might be due to interrupted CSF fluid flow.
The video (?) was related to clearing of plaques from the brain with a view to mitigating Alzheimer's effects.
It was not the NSDR (Non-Sleep Deep Rest) videos a sibling commenter posted.
Anecdotally, it seems to. I have laid down and closed my eyes even for a short while. And believe that I have even had a "flushing" sensation, that feels like a mental fog being lifted (or "drained", I guess).
I pop up 5 minutes later and feel completely refreshed.
When I owned some property out in the country, it was a 2 1/2 hour car trip to get there. Sometimes I just couldn't finish the drive home but pulling over to the side of the road for a 10-minute nap made me feel fully refreshed.
Fwiw, i have the opposite experience of napping. Napping adds to mental fog for me especially for the hour immediately after napping. Its not until several hours later that i actually experience any loss of mental fog or increase in clarity.
There's controversy over exact mechanisms involved in glymphatic function, so suffice it to say that allegedly even just NSDR / yoga nidra will engage a rest deep enough for glymphatic function to engage/improve
I was disappointed the article didn’t mention that. Can you give me some pointers. I will use Google but HN curated content is often a better starting point. :)
2. > Because the doctor will rigorously apply artificial and unreliable diagnostic categories backed up by invalid and arbitrary screens and queries to make a diagnosis. So after this completely subjective and near useless evaluation is completed, your doctor should be able to exercise prudent clinical judgment to decide if Ritalin could be of benefit.
What else can you do for psychiatric conditions? We don't have a magic ADHD-o-meter but know that it statistically impacts lifespan, health, etc. Even for more objective measures like blood glucose, BP, BMI, clinical interventions are based on discrete thresholds that don't exist in nature.
TLP was doxxed in a way that threatened their real life psychiatry practice, briefly blogged on Tumblr under a different psuedonym, and has since had little online presence other than rare tweets and randomly dropping a self-published book on Amazon (_Sadly, Porn_ by 'Edward Teach').
Not a college dude, but i used to work on shits (including night shifts) and adjusting to and from a five-nights (23:30-07:30) shift isn’t that pleasant either.
Disordered sleep can cause executive dysfunction similar to ADHD, but it does not cause ADHD. It certainly can exacerbate it or be diagnosed incorrectly.
I suppose it's possible, but it seems less likely to me because ADHD is a life long neurodevelopmental disorder that shows [visible physical changes in the brain on scans](https://pmc.ncbi.nlm.nih.gov/articles/PMC7879851/). That said, there are statistically more people with narcolepsy who have ADHD, and the same goes for sleep apnea. There's a number of hypotheses I've read as to why, to name a couple: related epigenetic causes, or [possible misdiagnosis](https://pmc.ncbi.nlm.nih.gov/articles/PMC7336577/) (narcolepsy is much harder to diagnose than ADHD if you don't have textbook symptoms). So there is definitely something there.
I'm not an expert, but that wouldn't really fit with my understanding of ADHD. It's not that we have a lack of attention ("defecit" of attention, as the name suggests), it's an impaired ability to direct it.
To abuse a metaphor, the sleep-deprivation-induced spontaneous CSF flush is slamming on the brakes of a car, and ADHD related attention shifts would be more like a drunk toddler is turning the steering wheel wherever they please, but the gas/brakes still work fine.
I would imagine it has more to do with its principal function in recycling ADP back to ATP (fuel for cells). People who are sleep deprived also have impaired glucose metabolism, meaning that the cellular "fuel pipeline" is impeded. Perhaps creatine is especially helpful under these conditions.
Hypothetically, more water retention would mean that the fluid being flushed is less concentrated, and if the flushing mechanism is triggered by a certain concentration level then it'll happen less frequently.
Hard to imagine that it would be worth more than a few percent though.
That is very interesting. I have a somewhat related issue with sleep cycles.
This issue, waking around 3:00am every morning then not going back to sleep until 6 or 7am, is not really a productive sleep cycle. I read somewhere that taking a spoon of sugary substance, like Raw Honey, MCT or Collagen, before going to bed can replenish the brain of this energy, so it becomes easier to fall asleep. I've been trying it with two to three spoons of honey, right before hitting the sack to see if it can help me fall asleep again. It seems to be having a somewhat positive effect as it does not take me too long to go back to sleep.
Exogenous ketones (such as BHB salts) are known to help with glymphatic drainage in the brain during sleep. I've used them extensively and have noticed improved sleep with nearly a doubling of the time spent in REM stage.
Sure. When I have a night of poor sleep or anticipate one, I usually take 6 grams of BHB salts in the morning on an empty stomach. You can work your way up to a maximum of 12 grams, but I would advise caution since it can cause diarrhea. I would start by buying the cheapest product (nutricost) you can find online; if it costs more than $80 for ~300g, then you're probably getting ripped off. I noticed that I have very lucid dreams and experience strong hypnagogic jerks when I take this supplement.
Here is some literature that I've perused to support my experimentation with BHB salts:
Back when I used to meditate regularly, I would find that an extra meditation in the middle of a sleepless night would go a long way toward pushing off the need for sleep. Generally, meditating always left me in a slightly heightened awake state. Perhaps the help with brain fluid regulation is a core reason for both effects. (I should go back to meditating again.)
Maybe unrelated but, years ago, I had a job that had me criss-crossing the country by plane Monday through Friday and sometimes Saturday. So my sleep and the time zones and hotels could sometimes mess with me.
One day, I went to a grocery store and mid-turn onto another street, I forgot what city I was in. Worse, I was half a mile from my apartment in my home town.
In high school a friend of mine told me about "microsleep" and how your brain will oscillate into it if you're under-rested. This would align with that theory.
hmm.. this is interesting... the article says "spinal fluid exits the cerebrospinal fluid (csf) flows out of the brain... I wonder where it discharges these waste products. I ask because it is believed we have a sort of chimney on our backs. I think I read this on the article of the Irish lady who could detect alzheimers years before any modern medical detection systems. But maybe it is discharged in the gut? via the mesentery, the new organ they finally named fo rthe stuff that holds our intestines together. If anyone knows where it is discharged, please comment, I'm interested in this, because I do prolong waterfasts every 3 months, and I strongly believe the brain drains waste into my mouth during that time, because the taste in my mouth is godawful, but if there are other exit points the brain discharges waste, we probably need to know about them.
Why do you think that the taste in your mouth is waste draining from your brain and not the result of some metabolic changes in your body from the fast? Ketosis is known to cause a metallic taste in the mouth, for example.
What I understood from youtube gurus, take it with a grain of salt, is that your brain is taking ketones as source of energy to preserve the little glucose that goes into the system, and as result it consumes less oxygen.
But I'm not sure the mouth taste comes from the brain's waste.
To some degree, if you had your brain inflamed by bad eating habits, fasting would revert that and make the flushing more efficient as well.
Again please take with with double grain of salt, since I don't even know inflame brain is a thing for sure, or the correct term.
I believe it's discharged basically half directly into the venous system in the neck, the other half goes through the lymphatic/glymphatic system and ultimately also the venous system in the neck. That being said, that's just based on our very crude understandings and I'm sure there are other pathways.
anecdotally, i never feel better than when i haven't slept. spent 8pm tuesday -- 8pm thursday this week awake nursing cheap energy drinks, and not only could i manage a higher-than-usual level of focus, i was genuinely content.
bombed a midterm halfway though, but at least i felt good about it.
It's not unusual to feel good after pulling an all-nighter. Sleep is when re-uptake of serotonin takes place, so if you interrupt it you end up with a surplus. Although there are also other possible explanations [1]
I'm assuming it is similar to the "runners high" people get at the end of a long run? You will feel very energized in ways that don't make sense. And if you don't force yourself to just lay down and pass out, you can keep going for longer than you would have thought. Will crash harder, though, if my experience is common.
I've got pretty bad ADHD and I find that my mind is more quiet, focused and productive on mornings after a night of 2-4 hrs of sleep than it has ever been on meds or anything else. It all falls apart by the afternoon, but for a while it's a nice feeling.
I've attributed it to a my brain moving to power-saving mode and muting some of my anxiety / perfectionism tendencies. Does this explanation resonate with you at all?
That's possible. It feels a lot like the placebo component in drinking: if you're free to ignore one of the few things you need to /live/, it should be much easier psychologically to be carefree (similar to "oh, haha, i'm drunk, might as well get wacky").
I've done a few all-nighters in my 30s and 40s, and they generally feel the same as my 20s. Still get that clear headed, high focus second wind around 4am that carries through until noon or so.
But, I definitely crash harder than I did in my 20s and need longer to recover after. In my 20s, would be fine if the next night was a normal one, now it takes multiple days.
It's definitely something I try to avoid at this age, as opposed to just being standard procedure back in college.
Indeed, as a 20 year old I would stay up all night pretty regularly for work and occasionally fun. At 40 I'm not sure I would live through it, at least not in a cognitive state where I could converse.
anecdotally i feel pretty good when im buzzed but reality is my performance is impaired. there is a teeter-totter of overconfidence and impairment where the liquid confidence actually helps more than the impairment impairs but its a sweet spot
sleep deprivation definitely reduces raw reasoning ability. in some cases, though (and this is true for getting buzzed as well) the trade-off is absolutely productive.
This is fascinating, and somewhat directly related to the work we do increasing slow-wave response during sleep.
For those who are not aware, slow-wave are the hallmark of deep sleep and closely linked to the flushing the glymphatic system, which is what they are referring to in this article.
We can't create slow-waves, but we can increase their effectiveness through precisely timed auditory stimulation. I'll be posting a Show HN next week which dives into the data of how this works, but if you want to know more, there is info on our website and links to over 50 published peer-reviewed papers. https://affectablesleep.com
While many people will point to "getting more sleep" that isn't really the answer. More time asleep does not automatically mean increased glymphatic flush. Additionally, as we age, the power of the pump gets weaker, and more sleep does not help with that.
We believe the focus on counting minutes of sleep misses the point of what makes sleep truly restorative and beneficial, which are the neurological processes, and downstream physiological changes as a result. This is why we talk about restorative function, and that should be the focus of sleep health, not time.
After all, you wouldn't measure your diet based on how much time you spend chewing, would you?
I slept around 5 hours last night split up into two periods because my baby daughter woke up crying from fever and wanted to play / was hallucinating / etc. She's totally fine now but I am wondering if there is a correlation between dementia and having kids.
Memory loss from sleep deprivation is an evolutionary advantage. If you remembered how rough the first few months of new children are, you wouldn't do it again.
I’m on my 3rd (she’s 1 week old today) at 42. With the first 2 it was only terrible for the first couple months. Once I just got used to going to sleep at 9:30 I was mostly fine.
I have a similar natural rhythm, or I should say "had". For the first year, especially the first few months, it was a godsend (for my wife, especially), but now that we're in a fairly consistent sleep routine with our two year old (~8pm-7am), I've shifted to something more like 8pm-1am out of necessity.
Although... I was up until 4am and got up at 6:30am and feel surprisingly great, so it still happens from time to time. :)
As a father of two I would say "nope", primarily because you won't be deciding the rhythm. Best you can do is coordinate sleep with your partner so that there's at least one somewhat functioning parent at all times.
As I'm typing this my 1.5yo is napping. I had maybe 6h of sleep but I'm after (part time) work and at home already, so I should probably nap as well.
Can't. My adult body won't go to sleep right now even though I'm feeling drowsy because it's too bright, too loud and chiefly I already had too much caffeine in the morning and I have like 15 minutes until I'll have to head out to collect my older child from preschool.
My SO is knocked out cold at the moment though, so I'll be relying on her this evening.
Ah, those days were the absolute grinder for me. How a precious and sweet little baby girl can become an absolute monster all night long, and then wake up the next day back to her normal self while leaving me a hollowed out mess of a human is a mystery for science to solve someday.
aren't they the best though? but yeah, back to the grind, and now i also have her respiratory disease and am trying to launch my startup off the ground ...
What have you done when your toddler wakes up at random hours during the night to interrupt your sleep and come and play? That's what has truly obliterated our sleep. Everything else was a passing fad that was minimally painful at best..
I mean the baby stage doesn't last very long. I dont even remember the sleepless nights from my own kids anymore lol
Chronic sleep deprivation is the larger issue. And how we really don't have treatments on how to fix that, and how ultimately sleep phase issues are a social issues (being forced to follow a fixed modern schedule). Not to mention how closely that's tied to ND people. So a lot of us deal with sleep issues since we were little, but work and school dont give us the flexibility we need. For example, flex hours could be helpful here. I would rather work 10am to 6pm or 11am to 7pm most days. Or 5-6 hours during the day and 2-3 hours late at night.
I suffered chronic insomnia most of my life and seen my fair share of experts and read a few books about it. There are definitely treatments for the majority of insomniacs.
Sleep deprivation is often caused by alcohol, inconsistent sleep/wake times, high color temperature lighting (>3000K) in the hours before bed, failure to spend time outdoors in natural light in the morning, temperature too warm (68F is ideal), caffeine (or other stimulants) in the afternoon, associating the bedroom with tasks other than sleep and sex, or simply spending too much time in bed.
Following doctor's advice for the last one: Start by going to bed at, say, 1am and waking up at 6am. Follow this without fail for a few weeks. You'll be exhausted but keep at it. Eventually you should find yourself falling asleep quickly. If you wake up exhausted, pull back bedtime by 10 minutes. Do this for a week. Rinse and repeat until you are waking up at 6am refreshed. That is how you determine how many hours your body needs to sleep, and how long you should be in bed. Helped me.
I'm autistic with delayed sleep-wake cycle. For autistics DSWPD is pretty common. There's just no fixing that for the vast majority of us, we're just expected to follow strict schedules and if we are underslept, too bad for us.
ND people get this pretty badly. 2023 study: The incidence of sleep problems in ASD patients ranges from 32 to 71.5%, especially insomnia, while an estimated 25–50% of people with ADHD
Insomnia is different, but tbf, insomnia for many people can't be treated well or if not at all. CBT is helpful if you look at the studies and ignore the follow up studies showing relapses between 40-70%. We can stuff people with melatonin and hypnotics but after a while that no longer works. So looking at this, it looks like things like drugs and CBT can help 70% of insomnia sufferers but the relapse rate is as high as 70%, so we're looking at people who can actually be cured as low as 15-20% of total insomnia sufferers.
Its not caffeine or screens for us, its just how the machinery of the human body works. This is like telling a depressed person to just 'cheer up.' I'm glad that worked for you, but your story is just an anecdote, and the science for this is still pretty dismal unfortunately.
The science can't work because at this point we're going against our nature. A lot of people cannot subscribe to a modern industrialized sleep schedule because its not natural for us to have extremely strict sleep and wake times.
Thanks for elaborating. I have an autistic child, and you might've just explained why my kid has more energy at night than during the day. She tends to fall asleep around midnight (but at least gets a solid 8 hours of sleep from there). We're lucky to have a school with a late start time.
Physically exhausting yourself isnt a solution. Its tangential to the real issue. Its a bit like suggesting you can solve anxiety caused by trauma by drinking large amounts of alcohol everyday. No, instead we should be treating trauma. Its like putting autistic kids through rough ABA therapy, no instead we should finding accommodations and support for autistic people.
People have natural sleep rhythms. Society should conform to that, instead capitalism demands we conform to what it deems profit maximizing.
Not physically exhausting yourself is the real issue. It's our natural state as humans. We're not meant to be staring at screens having discussions about chronic sleep deprivation on an internet forum, we're meant to be outside moving our bodies.
I agree with you. I regularly have strong insomnia and I have tried physical exhaustion.
It usually works for the first few days of doing it but then it's like my body (probably moreso my mind) gets used to it and it doesn't help with sleep anymore.
Arguably it feels even more unhealthy because it's like my body is fully exhausted and tired but my mind won't let me sleep so no restoration can happen.
Or some parentheses. Is "due to" naturally left-associative or right-associative? I would have said 'right', which gives the unintended reading of the sentence.
Attention lapses due to (sleep deprivation due to flushing fluid from brain).
(Attention lapses due to sleep deprivation) due to flushing fluid from brain.
My pet theory is that dreams are the brain booting up/shutting down and the equivalent of old analog TVs that have the flash of static and bloom/collapse on the screen when turning off/on.
This reminds me of delirium tremens a bit. Same compensatory mechanism, different sleep process - or at least that's the pattern I'm seeing.
The MIT study shows CSF waves—normally a sleep-only process that flushes metabolic waste—intruding into wakefulness when you're sleep-deprived. Your brain is apparently so desperate for the cleanup that it forces the process to happen anyway. Cost: attention lapses.
From what I've read, delirium tremens during alcohol withdrawal seems to follow a similar pattern, except it's REM sleep intruding into waking consciousness instead of CSF flushing.
What strikes me is the system-level similarity here. Sleep normally maintains clean states: you're either awake (alert, reality-testing intact, no CSF flushing) or asleep (offline, dreams permitted, maintenance running). But when the system gets stressed enough—whether through sleep deprivation or the neurochemical chaos of alcohol withdrawal—it seems to start making desperate tradeoffs.
The brain apparently needs certain processes to run. Period. Total no-brainer! CSF flushing can't wait indefinitely. Neither can REM sleep, which serves its own critical functions. So when normal sleep architecture fails, the system appears to force these processes anyway, even though the conditions are completely wrong for them.
Maybe that's why the costs are so specific. CSF intrusion during wakefulness costs you attention. REM intrusion costs you reality testing, because REM is the state where your brain accepts impossible narratives without question. Same compensatory mechanism, different critical process forced into the wrong state.
What I find interesting is how the brain knows what lever it needs to pull and how it pulls it. Sleep deprivation forces waste removal. REM deprivation forces wakeful dream states; which might be a side effect not the actual goal. The brain seems to know what maintenance is overdue and attempts the repair, consequences be damned.
Good to know that the brain finds a way to flush itself while awake. I think I've become pretty good at putting unused parts of my brain to sleep while awake. My brain is like that of a dolphin now.
But on rare occasions (like a couple of times a year), I get migraine auras and stuff disappears from my field of view. Can last about an hour. I feel like that's my visual cortex falling asleep.
So biological garbage collection pauses then? skip sleep, and the brain tries to run gc cycles during runtime. Causing attention and performance latency spikes. Evolution wrote the original JVM.
This is a hilarious comment, I actually laughed out loud
this might explain how "power napping" (<30min) can help so much when you are sleep deprived even through it's too short to really count as sleep. I wonder if you can find that when sleep deprived people power nap a "flush" happens then
There’s a phenomenon we have known about since at least the late 1980s when Race Across America riders were using it.
Essentially these guys try to stay up for the first few days and then sleep less than 8 hours after that. Way less. Many of them end up hallucinating by the end, and only their extreme fitness levels probably save them from just dying from lack of sleep.
The trick is that waking up to daylight makes you feel more rested. So the teams would have their riders sleep 2-3 hours from just before dawn until dawn so they would wake up to sunlight. Physiologically the difference is small, but psychologically it’s much bigger.
Some of the effect of power napping is likely the same sort of trickery, just as caffeine is partly trickery and partly adrenal.
I used to do adventure races of 24 or 48 hour duration. can confirm that after 20+ hours of endurance you 100% start having microsleeps and hallucinations. 20 mins sleep is all you need to get going again for a few more hours.
Luckily it doesn’t clear all unreferenced memory, though.
Fun fact: Suppressed/hidden/lost memories due to trauma that appear to re-surface through therapy are not a real thing, as previously thought (and still by some psychotherapists). Nowadays it's understood by psychology that any memories "re-surfacing" in therapy are in fact newly created, although the patient themselves cannot tell the difference. Allegedly, whole accusations of childhood abuse may have been created out of thin air, without the victim realizing.
https://en.wikipedia.org/wiki/Recovered-memory_therapy (see research section)
Sure it's a real thing for memories to surface that were previously buried. It's happened to me.
If it happens in therapy, that doesn't mean the memories are "implanted". And not all memories lack the ability to validate them... for example, if you've forgotten someone's name, then remember it later, you can call out to them by their name to confirm that you've correctly remembered it.
Memories tumble around in the brain all the time, not all memories are easy to access, but that doesn't mean they're inaccessible.
The point that memories can also be implanted or fabricated during therapy is absolutely an important one, but dismissing the possibility for memories to resurface (and conflating any situation where this might happen with a specific type of discredited therapy) is needlessly reductive.
The problem is not that memories can't be repressed. There's plenty of research demonstrating repression does exist as a defence mechanism. The problem is that even highly evocative memories can also relatively easily be falsified, or modified through elicitation and reframing. Since there's no neurological stenographer, there is no mechanism even in principle to identify the difference between the two. With potential consequences like the satanic panic of recovered and elicited memories of sexual abuse. That's what Elizabeth Loftus and others have shown, and shown so thoroughly that eye witness testimony should never be trusted.
As a counterpoint to this, I am replying here because I can't make myself write a polite response to the GPP.
Yes, witness testimony is always potentially flawed.
But knowing "some repressed memory recovery is false" does not justify saying that repressed memories are not a real thing. Repressed memories do happen. They do come back sometimes. When they do, they are just as valid as any normal memory that a person thinks they always had.
I know because I had them myself. Mine were of trauma in the age range from 5-9. I had a high "ACE score" when I eventually looked into this. I did not have any therapy session prompting the recall, I just remembered them spontaneously around age 15 when I was empathizing with a schoolmate who told me about domestic violence. It was a sickening feeling to have this whole phase of my past come unlocked.
Amazingly, it submerged into repression again. I next remembered it at about age 20. In between, I had years of basically not remembering/knowing that I had any of this trauma or that I had experience the earlier recall. They all came back together, again triggered by an empathetic moment in college. Again it was disorienting to have this whole aspect of my past reopen.
At that later point, I confronted people who were around my childhood and got enough of a painful discussion, confession, and apology to know that these memories were not invented.
I had other forms of childhood trauma that never submerged. I don't know why this one section did.
I find it very offensive for someone to make broad statements that these phenomena do not exist.
You might "think" you had a repressed memory but it could all be completely made up. You might even get other people to believe it, because human memory is incredibly faulty. Shared delusions are literally a "known bug" of human biology. Wikipedia has a whole page on them (https://en.wikipedia.org/wiki/Folie_%C3%A0_deux). The Seattle Windshield Pitting Epidemic (https://en.wikipedia.org/wiki/Seattle_windshield_pitting_epi...) is yet another example
The thing that changed though is since the 2010s everyone has a high definition camera in their pocket. Everything you do is recorded online. Kids that grew up in the last few years will have their entire childhood recorded in some way or another. Every movement tracked by GPS. Therefore, while I don't agree completely, I wouldn't be surprised if some assumptions about psychology are upended and a great deal of so called repressed memories turn out to be bogus when we can easily disprove them.
The person you’re responding to said they did the work of verifying themselves with third parties. Do you not believe that too? People dont suddenly just admit to committing severe abuse because they were convinced to do so. In fact, usually the opposite happens with abusers - they delude themselves into thinking the abuse never happened and believe/defend this very aggressively.
This whole thread is gross. I’d say you should be ashamed of yourself but you likely lack the prerequisite self inspection.
Malicious suppression and gas-lighting are also known functions of human biology.
Yes, real life is messy and ideals like justice are quite difficult or impossible to achieve.
Don't assume you can cleverly deduce a nice, absolute and comfortable answer. That's just another coping mechanism called rationalization.
Thank you so much, the parent thread was truly an uncomfortably disturbing read and your post is a necessary contrast to "rational" "objective" "minds" armchairing something so delicate with gross finality.
This mirrors my experience as well of multiple instances over my life of repressing childhood trauma and some event or conversation suddenly bringing it back to the surface.
Not to minimize your experience or anything like that, I'm just thinking out loud: What's typically the delineation between repressed and "not on the mind at the moment"? We naturally "forget" things all the time because there's no need for them to be in our current context window, e.g. I can't recite every coffee shop I've been to, but maybe if you start talking about a coffee shop with uncomfortable seats, I'll remember the one I went to with uncomfortable seats. Not a comparable experience in general of course, but one wouldn't say I repressed the coffee shop. Is it more like if I started at "uncomfortable coffee shop", nothing came to mind, but then I later remembered only after smelling some special flavor of coffee beans they had had?
A repressed memory and its associated knowledge and entailment is "not there" until triggered properly. To the extent that our autobiographical memories construct our sense of identity, repressed memories have been censored from ourselves. And, I think it is censored for a purpose, not because it was one too many bits of trivia to keep in ready memory. I think it is a coping mechanism like very deep and targeted denial or dissociation.
When such memories come back, it can be like a mini identity crisis. You suddenly know things that are counter to your self-identity from the moment before. Once I was able to absorb the whole picture and not recoil back into repression, it became a permanent and unpleasant part of my self. .
There can be flashbacks of related events, some of which I also might feel are remembered for the first time in a long time. Those little flashbacks might be like remembering your specific uncomfortable cafe. The overall memory recovery is like suddenly realizing I spent years in a theater of war, that happened to have such cafes in it.
IME for me repressed is “not on the mind at the moment” but like so constant that any attempt to access it, your subconscious fights to divert your attention from it. it’s kind of like dim stars you can only see out of the corner of your vision.
the craziest one I had, my reaction wasn’t “oh my god i never knew i had this memory” it was “wow, i cant believe i havent thought about that in 25 years.” I knew and had known it was there all along, I just literally never thought of it to the point my other thoughts just didnt collide with it, ever. It’s almost like your brain just puts it in storage in a dark corner of your garage.
I understand it isn’t the same for everyone, but that was how it felt for me.
TLDR for me it was dissociation, and the only treatment that ever worked was scraping the corners of my mind for stuff like this and it got so much better the issues basically went away. I used a great deal of meditation, particularly tibetan buddhism.
I can objectively say your reply minimizes the previous two posts who shared childhood traumas by the objective fact that you are implying (if they are not able to satisfy your Scientific Endeavor) that, if there is no delineation, then their repression of childhood trauma is equivalent and minimized or perhaps exalted if coffee is your religion to the repression of your religious experience of this coffee shop. If you were perhaps a child victim in this coffee shop maybe? You literally erased the trauma part. That is the delineation if you still need to think about this out loud
Thanks so much. I was wanting to write a scathing response as well but you calmly explained what I wanted to. I had severe childhood abuse that was documented by third parties I’d completely forgotten about - when I remembered them in therapy, my therapist thought they were fake or delusional too and sorta gaslit me about it. I had to go hunt down the receipts, which for me was traumatic in and of itself and permanently severed a few relationships with my family members, which didn’t have to happen. I fired her over it.
The comments in this thread are indeed disturbing. Clearly many on this forum have led blessed lives and can’t imagine people having it differently,
There are two types of repression, however. The notion that primarily repressed memories--say, those of being breastfed, of being potty trained--could ever resurface is bogus of course. But it is that original violence, first of being cared for, and then having that care taken away and even, in many cases, transforming into authoritarian violence in order to be socialized properly, that precipitates all other "secondary" repressions like Freudian slips, even screen memories or rationalizations. No, most people traumatized past the age of say, 5, won't readily forget it. But perhaps they will have a way of reconciling with that trauma in an unhealthy or not fully conscious manner (consider self-harming, or drug abuse, making up a narrative in order to stay with a partner who violently abuses them). And they will not readily connect their traumatic experiences with their unhealthy coping mechanisms. And we could say that the connection between unconscious behaviors and trauma, when revealed, could be considered a "re-surfacing." Even if I can't remember being breastfed, I know that I find the warm embrace of another's arm's comforting and soothing, and this perhaps relates to my original state of relaxation as a child in my mother's arms, for instance.
Why would it relate to your past experience of being held in your mothers arms, rather than to whatever inbuilt tendencies that lead one to respond well to being held in one’s mother’s arms while a baby?
Like, if kissing is derived from impulses relating to breastfeeding (which is a hypothesis that, AIUI, is in good standing, though not the only one in good standing nor necessarily more favored than a couple others), I wouldn’t think that therefore someone who was only ever bottle-fed as a baby would therefore not get anything out of kissing. The appeal of “my lips on another person” should be there regardless, just as it was for the first time a baby is breastfed (though, of course, it is also a cultural thing: not all cultures have had kissing as a standardized way of expressing affection, so whether one grows up in a context where kissing plays a role, that probably also plays a part in whether one finds it appealing to have one’s lips on another person).
People can remember things that hadn’t re-entered their mind for decades. It certainly happened to me a number of times (completely trauma-unrelated and not actively elicited).
A valid memory spontaneously re-entering your mind is different.
The idea of "repressed memories" was that people had hidden memories that they couldn't access, even if they tried. According to the theory, even if someone brought up the past event and tried to remind the person about it, they would be unable to recall it happening because their brain had blocked it out.
The idea was that only intervention by a therapist or some other special event could help the person "unlock" the repressed memories, making them available for remembering again.
What was really happening was that some therapists were leading people into "remembering" things that didn't happen through aggressive prompting and pushing, much like what happens when an aggressive investigator convinces a vulnerable person to falsely confess to something they didn't do.
I wouldn't be surprised if there are inaccessible, partly corrupted memories encoded in the hippocampus. I suspect most of them cannot be prompted by a therapist though, and likely there is no practical way to recover them.
I think it's all a matter of finding a trigger (or reference) to grab the memory. A therapist talking to you almost certainly wouldn't achieve that, but walking down the street and smelling an odd smell might.
I once found a recording of a lab session in high school physics. A day I completely forgot about. A moment that had no bookmarks in my brain.
Other things about that day were surfaced. How my braces felt and the fear I felt about forgetting a textbook.
All real, but unsurfaced until then.
That makes sense considering that human memory is strongly based on associations. Activating nearby memories can bring things back.
If you hear the first tones or words of a song you're much more likely to be able to tell the lyrics that follow compared to being asked to say those lyrics based on the title.
I think it depends on the stage of degradation and whether the network is still connected to something that can interpret it.
This is a more precise statement than just "you can recall things you thought you forgot".
It is specifically about trauma, and generally you don't forget traumatic events and that's often a big part of the problem. We are not talking about trivial things like the name of your maths teacher in high school, which have a tendency to come and go.
It is also specifically about therapy, that is an environment where you are actively encouraged to recall memories. We know how easy it is to make up memories, especially with the help of a third party (here, the therapist).
Combine the two: memories that are hard to forget and an environment conductive to making false memories and it becomes very likely that the "lost" memories are completely made up.
>It is specifically about trauma, and generally you don't forget traumatic events and that's often a big part of the problem.
Oh, of course you can.
> and generally you don't forget traumatic events
That depends on how many you endured really. Only so much room in the old noggin with everything else important going on.
My guess is that long term memory recovery is inherently a reconstruction from the pieces that you have retained. So it is not unlikely to include dreamed up parts.
The debunked recovered memory therapy was something different: They would use different techniques and leading questions to try to get a patient to think they remembered something that may not have happened at all.
Some of the techniques included hypnosis or even giving the patients (including children) sedative-hypnotic drugs before pressuring them with the leading questions.
If they could eventually get the person or child to claim to have some memory of the event (after asking a lot of leading questions and maybe even drugging them) they considered it to be a recovery of the memory.
The accuracy of recollection can certainly vary, but the point is that some information is retained long-term even when it isn’t made use of in the meantime. Of course one could argue that actually it is being made use of unconsciously, but I’m skeptical of that, given the relative irrelevance of the details that can be recollected. It’s also not that difficult to imagine that some memory-representing micro-structures in the brain just happen to be stable over decades even when they remain untapped.
This has been my experience as someone who has experienced childhood trauma, and what I've inferred from my therapist. He taught me that the memories I have are typically exaggerations of what happened and it's hard to pin down what truly happened. The only evidence I have that has any merit is my siblings can corroborate with similar experiences since it happened to all of us, and I'm sensitive to things related to these traumas. Almost every day I can feel the things that happened, and on my worst days these areas are much more sensitive.
On top of that, I have legitimate memories that were not traumatic, but still related to the same traumas because said person attempted to encourage these activities throughout my young life on rare occasions. I didn't remember what happened as a kid, but I knew something wasn't right and I wasn't comfortable. It wasn't until I was almost 30 that I had my first "flashback" which was a fractured memory, I still remember it looked like a faded photograph in my mind, and it was accompanied by an extremely uncomfortable feeling.
The re-surfacing memories aren't real in a sense, but in my case they aren't entirely fake either.
I wonder if it's possible that things can be completely imagined with absolutely no basis what-so-ever in certain circumstances, and I also wonder how difficult it is to discern that. It seems to be a difficult concept to manage.
Indeed. I was browsing a Nintendo fan site I made in 1998 on archive.org when I was just 11 years old. I don't remember every detail about making it, but my brain had no problem stitching all the pieces it did retain back together.
On the other hand, I do have some Gandalf "I have no memory of this place" moments for other things.
They won't remember it accurately anyways, so it's kind of a moot point.
Though you're right - a specific scent can easily call up an ancient, forgotten memory.
The statement "there is evidence of black swans" does not justify the conclusion "every swan is black".
if you specialize in looking for black swans, and you've looked for more black swans than anybody ever, and all the black swans you thought you'd found have turned out to be sooty white swans, people might be interested in reading about your experience and have their faith shaken that black swans actually exist.
I'm reminded of the story of dragon sightings in Great Britain: after the printing press and newspapers and newspaper reporters chasing stories emerged, as news distribution out from city centers into rural areas increased, it seems dragons picked up and moved farther away, only being spotted in the hinterlands without news.
You apparently would keep your mind open to the idea that dragons don't like the smell of newsprint as no other conclusion could be more plausible sheerly on the basis of logic?
This idea of unconscious memories perhaps being a type of fantasy is also discussed in this article too:
https://en.wikipedia.org/wiki/Freud%27s_seduction_theory
I beg to differ, or at least I'd need clarification, some people experience traumatic visions from what is assumed repressed memories (with or without therapy)
It might be something that one might not understand if he/she doesn't live through it I guess
What about Dr. Jim Tucker’s two child psych cases, James Leininger and Ryan Hammons?
One remembered memories of a WWII pilot named James Huston Jr. and the other a deceased Hollywood agent named Marty Martyn.
Putting aside the reincarnation hypothesis for the moment, do you think the kids invented the details and coincidentally happened to match to a real person or were they fully coached? Maybe they didn’t get enough sleep or got too much sleep?
> any memories "re-surfacing" in therapy are in fact newly created,
You're saying that those memories are exactly the same as all the other memories.
Every time you "recall" something, you are not pulling up some file that is always the same. You are actively recreating the memory.
There's nothing "fun" or insightful about this, this mechanism has been known for a long time.
Obviously it's not unique to psychotherapy.
> may have been created
Most things that "may" have happened do not warrant absolute statements such as "that's not a thing" (which, incidentally, is a particularly empty statement in any context, since every thing is a thing)
Careful with this absolute assumption. The brain rationalizes. Though irrationally.
Sometimes yes, created to validate, sometimes no, unlearns to disassociate
Gonna need some citations on that “fun fact”
https://en.wikipedia.org/wiki/Recovered-memory_therapy (especially the research section)
Claim: "modern cancer research is a scam"
Proof: "colloidal silver has been used to attempt to cure cancer".
Solid logic.
That is extremely weak to nonexistent counter-evidence that seems to focus on supporting Loftus, who has put a lot of effort into the defense of her public persona. I don’t disagree that it is possible to manufacture memories but the evidence isn’t there to support your conclusion or the converse.
Recovered-memory therapy (the topic of the Wikipedia article) is very clearly quack science and has been discredited.
Some of the techniques used in the therapy include giving patients sedative-hypnotic drugs to put the patient in a waking dream-like state while the therapist asks leading questions to get them to "remember" an event. The same drugs they used are known to be associated with false memories, like when someone falsely recalls something from a vivid dream as having actually happened.
It has fallen out of favor based on a lack of evidential support, for sure. It has not really been dismantled publicly scientifically, but mostly quietly, perhaps in order to protect its practitioners, perhaps because the research cannot currently be ethically conducted.
I am not advocating for it, just stating the near total lack of substantive scientific evidence presented either in support or opposed.
People downvoting a request for supporting evidence is peak Hacker News.
people demanding supporting evidence without expending any effort themselves is peak internet.
The onus of proof lies on those making a claim. If you're unwilling to back up what you say, don't say it.
In science. On a casual forum you have no obligation and I’d rather someone leave a short comment so I at least know, if I’m interested I’ll go look and verify myself.
It’s not my job to track down proof only every bullshit claim thrown at me.
Most people think that when their memory fails it's just the act of not remembering something, but misremembering something happens equally often, and completely making up shit also does happen. It's just like LLM hallucinations.
Cleanup is an LRU process.
Once a memory lapses you have to relearn from life experience (or not at all).
No, a lapsed memory can be provoked. It doesn't have to be relearned. It is "lapsed" because the organizational path to it within your brain has been lost, like a book in a library that has been left out of the card catalog, but just like the book, if you happen to find it anyway, it will be there.
Compare, from https://evolutionistx.wordpress.com/2016/12/16/anthropology-... :
> at the first news of English ships in the area, Buckley rushed to the spot. He attempted to make contact, but couldn’t swim out to the ship and couldn’t convince the ship to send a boat to him (Buckley had, at this point, forgotten how to speak English.) Buckley was again heartbroken until another ship showed up, and he found the English colonists and tried to approach them:
> “Presently some of the natives saw me, and turning round, pointed me out to one of the white people; and seeing they had done so, I walked away from the well, up to their place, and seated myself there, having my spears and other war and hunting implements between my legs. The white men could not make me out–my half-cast colour, and extraordinary height and figure [Buckley was around 6’5” or taller,]–dressed, or rather undressed, as I was–completely confounding them as to my real character. At length one of them came up and asked me some questions, which I could not understand; but when he offered me bread–calling it by its name–a cloud appeared to pass from over my brain, and I soon repeated that, and other English words after him. …
> “Word by word I began to comprehend what they said, and soon understood, as if by instinct, that they intended to remain in the country; that they had seen several of the native chiefs, with whom–as they said–they had exchanged all sorts of things for land; but that I knew could not have been
I submit that it takes more than a day to learn English if you don't already know it.
Once I was in a Toys-R-Us and noticed a cover image among the bottom-of-the-barrel DVD display which caused me to put what I was doing on hold for several minutes while I stared at the DVD. I bought it, and it turned out to be a movie I had watched many times when I was very young, but that information hadn't been accessible to me.
I forgot what I was going to type, but I didn't get enough sleep last night.
Are you sure about that?
I realize you're making a joke, but there is no such thing as "unreferenced memories", as in, something that is no longer in use and has been removed from the brain.
Every memory your brain has ever produced is still there, even if most are beyond conscious access. Memories quite literally become a permanent part of you.
A lot of people mistakenly think of human memory as a sort of hard drive with limited capacity, with files being deleted to make room for new ones. It's very much not like that.
If you are implying that human memory has infinite capacity, that's not possible. The human brain is a finite, physical thing. It can't store an infinite amount of data.
If you just mean that human memory has a finite capacity that's much larger than anyone has come close to reaching by storing the memories of a normal human lifetime, that might make sense.
Do you have any references for your statements about memory? I'm not familiar with whatever science there is in this area.
The claim that everything is there does not imply infinite, or even large capacity.
Consider an exponentially weighted moving average - you can just keep putting more data in forever and the memory requirement is constant.
The brain stores information as a weighted graph which basically acts as lossy compression. When you gain more information, graph weights are updated, essentially compressing what was already in there further. Eventually you get to a point where what you can recall is useless, which is what we would consider forgotten, and eventually the contribution of a single datapoint becomes insignificant, but it never reaches zero.
> The claim that everything is there does not imply infinite, or even large capacity.
It implies enough capacity to store everything. But what you describe is not storing everything.
> lossy compression
Which means you're not storing all the information. You're not storing everything.
> When you gain more information, graph weights are updated, essentially compressing what was already in there further.
In other words, each time you store a new memory, you throw some old information away.
Which the person I was responding to said does not happen.
I didn't mean either of the things that you are wondering whether I meant, so i can't give you evidence of those things you made up yourself.
If you have questions about my comment, I'm happy to try to explain myself better
"I didn't understand you at all, so you must have meant either A or B" is not the way to reach an understanding
> i can't give you evidence of those things you made up yourself.
I didn't ask for that. I asked if you have references for what you said. Even if I misunderstood you, that shouldn't be a reason for you not to give references for your statements, if you have them.
If you don't have any references to back up your statements, then I'm not sure what you're basing them on.
Your words: "Every memory your brain has ever produced is still there [..]"
How would that not imply infinite storage?
It wouldn't imply infinite storage because human life is not infinite in time and memories do not accumulate at an infinite rate in storage consumed per unit time, so the total storage over a human lifespan is finite, so the claim can be true with finite storage.
It is almost certainly false, but it doesn't require infinite storage to be true.
> human life is not infinite in time and memories do not accumulate at an infinite rate in storage consumed per unit time
Which would put it into the category of the second part of my comment--which the person I was responding to said was not relevant to what they meant.
> The human brain is a finite, physical thing. It can't store an infinite amount of data.
True, but it doesn't really detract from his statement because do we really know what that upper bound even is? I don't think we come close to the theoretical storage limit... So saying "every memory you have is permanently stored" is effectively true, at least true enough for a thought experiment like this. Perhaps when people live to be 200 years old and we know more about the brain we can test this, though.
I used to be weary of learning new, complex things, thinking I'd "lose" old knowledge XD
> I don't think we come close to the theoretical storage limit
That was the point of the second part of my comment--which the person I was responding to said was not relevant to what he meant.
Bullocks. Memories fade. Or do you really believe that 'subconsciously' I still know what I had for dinner today exactly 30 years ago?
The way I understand it, it's just that, unlike on disk, the deletion process is not binary. Weak connections that are not revisited regularly gradually become weaker, until they're undistinguishable from noise (false memories).
Knowing almost nothing about memory and the brain, I don't know if I agree with "Every memory your brain has ever produced is still there".
Memories seem to be constructed by a group of neurons together, and it seems clear that neurodegeneration is a thing, whether by trauma or due to aging. When pathways degenerate, maybe you have a partial memory that you brain can help fill the gaps with(and often incorrectly), but that does not make it the original memory.
I had this experience at Big Bend State park that makes me think they are. I didn't bring enough water and camped in the primitive area. At night, I was dehydrated pretty bad. When I finally got a little sleep (it was tough to say the least), I had this vivid dream where I put a pebble in my mouth and started sucking on it to make saliva. Then I woke up for real, and I knew it because there was a lot of wind IRL, that wasn't in the dream. So I took out a coin from my back, put it in my mouth to make saliva, and got a little bit of relief. Enough for a couple hours until it was dawn, and had enough light to hike down to the restroom area.
I don't know where I got this trick. Likely some survival show or some novel. But I don't have any background in survival, otherwise, I would have brought a lot more water.
So my brain knew there was a memory that could help and made up a dream about it is my theory.
Is Sun Microsystems in the room with us?
Skip enough sleep and parts of your brain will try to nap while you’re doing things like meetings.
Depending on the meeting it might be worth a nap even if I'm well rested.
But in that cause you are well aware that you have invested no brain at all instead of investing half a brain while thinking you’re engaged.
I hope that the actual medical field starts taking note of this.
My wife still has to work 24 hour shifts with no sleep, performing emergency surgeries no matter how long it has been since she slept. During residency only a few years ago she and her co-residents were almost weekly required to do 36 hour shifts (on top of their regular 16 hours per day, 5 day per week schedule) and once even a 48 hour shift when the hospital was short staffed.
Of course I’m sure they won’t. No one cares if doctors are over worked.
I've never understood those long shifts. Unless a shift just means you are there but sleeping, what is the reason for allowing it? We don't let truck drivers do 24h shifts, why do doctors the world over seem to do this?
My understanding is that the research shows that the harm to patient care from information loss during doctor shift turnover is worse than the harm from fatigued doctors.
Yes, a tired doctor sucks. But a tired doctor who already has the patient's state loaded into their head may still be better than doctor who is completely fresh in both senses.
It's a hard problem.
I have never, in my entire life, ever personally encountered a situation in which a doctor paid enough attention to anyone over a period of time exceeding two hours that I could possibly believe that keeping the doctor on shift for a long time had the slightest benefit.
I’m sure cases exist. But I’d be rather surprised if they’re common.
Instead of 1 doctor covering a 24 hour shift, why not pair them and overlap?
12:00am - 6:00am: Doctor 1 and Doctor 4 are doing everything together.
6:00am - 12:00pm: Doctor 1 and Doctor 2 are doing everything together.
12:00pm - 6:00pm: Doctor 2 and Doctor 3 are doing everything together.
6:00pm - 12:00am: Doctor 3 and Doctor 4 are doing everything together.
This way, all 4 doctors only do 12 hour shifts, and the patient's state is maintained continuously through all 24 hours.
The answer is there’s already a doctor shortage, and the US simply does not have the capacity to effectively 2x the doctor-patient ratio.
Doctors are also unlikely to want a 50% pay cut in exchange for shorter hours. They aren’t directly exposed to the risk caused by fatigue since they will have malpractice insurance. Therefore the safer method of care would be simply too expensive, and doctors wouldn’t see an upside.
Part of the shortage is a result of artificially constrained supply as there aren’t enough med school seats to keep up with demand.
The doctor shortage is entirely caused by intentionally limiting how many doctors are admitted to med school every year
Doctors do not get along and that’s too many Drs. Each patient often has multiple speciality Drs visiting them and reviewing their case up to 3 or 4 sometimes already. Imagine being on consult and trying to figure out which guy on a team of 4 you should talk to about such and such.
Here's an anecdote that might help answer. When my wife was pregnant with our first doctor, she started hemorrhaging spontaneously ten weeks before her due date. We rushed to the ER.
1. Shortly after, a doctor A came in, asked some questions, looked at the chart, and told us she was having the baby tonight. Holy shit our life is about to get crazy and we're going to be parents 2+ months early! He leaves.
2. Several hours later doctor B comes in. We ask about delivery. "Oh, no. You're not going to have the baby now. But you will have to be on bed rest until the due date." Jesus, my wife is going to have to quit her job.
4. Even more hours later, now the next morning, doctor C arrives. "OK, you're free to go home. No bed rest needed. Just let us know if anything else happens."
My general experience with doctors is that you get as many unique opinions as there are doctors in the room. This is not an indictment of the profession. Human bodies are insanely complex, there is way more variation between them than most people realize, and doctors are operating under very very limited time and information.
Having overlapping doctors would likely cause even more patient confusion and increase the risk conflicting treatments. Also, it would obviously double the cost of care.
(My wife and baby were fine. Partial abruption. Very scary and my daughter was born five weeks early, but no other significant problems.)
Many industries have solved this issue already. Use a pilot/copilot model. First doctor drives, second one mostly observes and makes sure the first one doesn’t make mistakes.
Maybe doctors are divas and they tend to not communicate very well with others
If engineers ran the world
That’s a lot of handovers.
What about the harm to the doctor themselves+the harm to the patient? Would the sum of both be worse?
One signed up knowing the risk
(not defending, I also think its insane, just devils advocate)
That only works if the mean stay in the hospital (or at least the critical care period) is several hours but also way below 24h…
Longer shifts mean fewer shift turnovers for any patients that stay a sufficient amount of time, especially if longer than 24h.
The world doesn't run on boolean logic. A solution can improve an issue without solving it completely.
> Yes, a tired doctor sucks. But a tired doctor who already has the patient's state loaded into their head may still be better than doctor who is completely fresh in both senses.
AI fixes this. Imagine the boot time of loading a patient's state from dozens of labs and files vs. a summary that gets you to exactly what they're going to end up remembering anyways. And if a doctor finds something interesting that the AI doesn't flag, they should be flagging it in the chart for the next doctor anyways.
Jesus Christ you have to be fucking kidding me.
Your solution to information loss during doctor handover is to insert a brainless hallucinating program with zero responsibility into the middle?
In my experience, AI summarization is a pretty lame application. I don’t really need a block of potentially wrong, rephrased text. I’ve got a feeling that the same applies to healthcare.
> My understanding is that the research shows that the harm to patient care from information loss during doctor shift turnover is worse than the harm from fatigued doctors.
This would not appear to apply to emergency surgeries. They aren't done by doctors who are familiar with the patient anyway. (Neither are non-emergency surgeries. Surgeries are done by doctors who do that kind of surgery. Familiarity with the patient is useful in deciding what surgery should be done, but not in doing the surgery.)
The European Working Time Directive has requirements for rest, etc. Either Europeans have much better hand-off procedures, they don't know how to comply with the rules they make, or they're fucking idiots who are going to kill people due to information loss during shift turnover. It was proposed decades ago. I wonder what compliance is like in Germany, etc.
Here in Norway the doctor's association have worked hard against it, and talking to a relative which became a doctor some years ago, it's primarly because they want to keep the extra premium pay they get from the "uncomfortable hours" as it's called here.
The AMA works to prevent importing doctors from other countries, largely to maintain wages, but we don't have enough doctors.
Doctors boards and AGME (partly governed by AMA, but there is some amount of public representation) control residency admissions and board certification. We don't necessarily want low admissions standards, but there is a lot potential conflict of interest in constraining supply.
Some states, I think I read Florida recently, have started pushing back to allow in foreign doctors.
I think both doctors and patients would want a different system for both doctors and patients. Having seen a poor performing medical system, and comparing it with the US medical system, all I can say it's that the US one doesn't seem designed to optimize health and well being of patients and, based on reading several articles representing doctors opinions, neither doctors'.
I do think it's maximially optimized to extract revenue. That can sometimes be good (e.g. good access to healthcare) but often times it's not great.
Given healthcare, along with education should be a national priority, both should be heavily "configured" to serve peoples' goals first and any financial goal should be secondary (although arguably useful).
I suspect the current shareholder structures from hedge funds are (intentionally or not) driving things in the wrong direction wrt to public health goals. This is article from a few days ago is also interesting https://news.ycombinator.com/item?id=45680695
her at her worst is better than 90% of people at their best.
if you get through and into a good med school -match into surgery- you are Peak in a way very few are.
I don’t see this changing unless they reduce the requirements for med school; if they let anyone in who wants in and force that group to work 30hr shifts - you’ll get enough bad outcomes the system will change.
There was a study, I believe on nurses and shift durations. The study found the nurses were happier with shorter shifts - but the patients did worse. Patients come first.
I could see a group of Doctors loudly proclaiming love for Donald Trump (and mentioning very much how great he is) and pleading the case for a change and something happening. He is an interesting president.
I would be interested in hearing a european drs perspective, I heard they work shorter shifts (but no EU dr I met has confirmed, it’s like meeting a unicorn)
> her at her worst is better than 90% of people at their best.
A fraction of a fraction of a percentage of people are good at surgery.
If I need someone cutting me, I’d prefer someone good, and that they were rested.
Were these continual shifts? I thought that doctor's on shift like this were given sleep rooms to sleep when they aren't needed.
This stupid hazing ritual is only happening because of the AMA, which is doing it for really stupid "because we had to" logic.
Allow me to be a bit blunt here:
Don't you, as presumably a SWE in the US, make a sh!tton of money?
Howcome your wife still is forced into such detrimental working conditions?
This is the nature of the medical system in North America, and some other advanced nations. Also, you're not just being blunt, you're being both ignorant and arrogant.
If OP feels the same way, I offer my heartfelt apologies.
I don't think what I said would come across this negatively in person though, but okay..
GP's wife isn't being forced into this profession and they are making a lot of money from it. Do we need to offer sympathy for all people with difficult working conditions regardless of the remuneration?
Who said she was forced, and why the personal attack?
> still has to work 24 hour shifts with no sleep
Reads like being more or less forced to me, it doesn't to you?
> and why the personal attack?
Not at all my intention! It's a genuine question, which I would ask myself too were I in OP's shoes
I doubt her spouse makes her be a doctor. Most people who go through premed and medical school are pretty dedicated and driven on their own. This is a corporate vs labor issue, and likely not a domestic issue. I’m sure he dislikes it greatly, too.
It's not so much "forced", as "given an offer they can't refuse".
A surgeon is going to make more than an SWE. Also, surgeons are famously unhappy with anyone questioning any of their decisions.
It’s an interesting paradox.
Imagine doing your best to help someone and they die as a direct result.
Then you get to go to work and deal with the next case.
Or the patient has life changing, negative outcomes. Damn, that bad. Next case.
Living in that mental state takes a pretty unusual character type. We can expect some extreme behaviour.
It’s also interesting watching the change over time. The trainee versus consultant, or the surgeon as they near retirement.
I’m not a surgeon or a doctor and so I see a small part of their world but see some of the perks (they get everything) and some of the downsides, and there are a lot.
> The scientists found that during these lapses, a wave of cerebrospinal fluid (CSF) flows out of the brain
> Lewis and colleagues showed that CSF flow during sleep follows a rhythmic pattern in and out of the brain
> Most significantly, they found a flux of CSF out of the brain just as those lapses occurred. After each lapse, CSF flowed back into the brain.
I can't believe the authors of the article didn't address one of the most obvious questions: Where does the CSF flow to and where does it flow back from? It's not like there are pipes leading out of the brain, or the CSF will just leave my brain through my ears or anything, will it?¹ What happens with the waste products? (¹ Though it would be kinda funny if this was where snot comes from.)
EDIT: Wikipedia's got the answer:
> Clearing waste: CSF allows for the removal of waste products from the brain,[3] and is critical in the brain's lymphatic system, called the glymphatic system. Metabolic waste products diffuse rapidly into CSF and are removed into the bloodstream as CSF is absorbed. When this goes awry, CSF can become toxic […]
https://en.wikipedia.org/wiki/Cerebrospinal_fluid
> It's not like there are pipes leading out of the brain
There are, in fact, “pipes” leading out of the brain. Cerebrospinal fluid is (and this is probably somewhat oversimplified) produced from material in the bloodstream in the ventricles in the brain, flows through the system of ventricles and then out of the brain into the subarachnoid space around the brain and spinal cord, and is then reabsorbed into the bloodstream.
And some people literally need an actual pipe implanted to assist with CSF drainage.
https://www.mayoclinic.org/tests-procedures/brain-shunt/abou...
They didn’t put it in there because knowing the flow of CSF is so elemental to performing research in the field that it would be a waste of everyone’s time.
This is a pop sci article, though?
What I want to know is: can we trigger these flushes? My grandfather died of/with Alzheimer’s, and I’d prefer not to follow in his footsteps. If we determine that these flushes are key to good brain health, and there were a way either through a pill or even a treatment to up the frequency of these flushes, that would be awesome.
We can't "trigger" the flushes, however, it looks like we can increase the power of the pump.
This is specifically the area we work in traditionally called slow-wave enhancement which is stimulating the restorative function of sleep.
This paper [1] specifically looks at amyloid response as a result of stimulation and shows a corresponding relationship between stimulation response, amyloid response, and memory. I wouldn't say it's putting a bow on the results, but it is a very promising result.
If you're curious about what we're building, I'll be posting a ShowHN next week which dives into some of the data in a way regulatory requirements don't permit us to do on our website, but until then, check out https://affectablesleep.com
[1] https://doi.org/10.1093/ageing/afad228
Why is a headband a subscription service?
> We can't "trigger" the flushes
How do you know that?
I work in neurotech/sleeptech and this is the primary function our work focuses on.
However, I also mis-stated that. It is possible to create a slow-wave, however only through magnetic stimulation (rTMS), but that is not realistic outside of a hospital environment.
Ok awesome. Are you saying that because it is an autonomic process or some other reason?
You will probably say no but I wonder if those yogis who can exert some control over heart rate, blood pressure, and breathing pattern might try to target this process as well.
I'm just saying that based on known science. I don't know if anyone has looked at if yogis, etc can control the glymphatic system.
What blew my mind when I got into neuro just over 5 years ago, is that the glymphatic system was only discovered in 2012!!!! We have SO much to learn about the brain.
I know a reliable way to trigger this. 400 gram of lamb, one bell pepper, one or two leek, one zucchini, some random spices (red chili pasta from the shop works a-okay), put in at slow heat for an hour and a half, so by 4 in the evening it's ready and you can close your laptop. Serve with rice or mercimek chorbasi.
The fluids have no chance to not be flushed once you are done with it.
Choosing to sleep more, I guess.
Long live healthy sleep for brain health, and thank goodness light exercise helps this same glymphatic system.
ISTR that light exercise also helps with quality of sleep.
It stands to reason.
It lays to drain.
What I’m picking up here is that if I can just get an automated CSF circulator installed I won’t need to sleep or get distracted when I’m tired. That was the point of this article, right?
So... can we trigger it manually? I'd love to be able to lay down and press the 'flush brain' button.
Research on NDSR, I have been using this for days I had to wake up without proper rest.
If you have 15m, search this on YT for a guided practice and test it yourself.
NSDR, rather—Non-Sleep Deep Rest.
I believe you were referring to NSDR (Non-Sleep Deep Rest)?
Mixing up acronyms is on brand with sleep deprivation.
Kind of related, but there is a concept of polyphasic sleep - where you sleep for small increments throughout the day (like 30 minutes every 3 hours). I did it for a bit at a startup thinking we were "hacking sleep" and "getting more productive hours out of every day!" - It takes awhile to transition to it, but once there, your scheduled "sleeps" are insane, 15 minutes, feel like straight to REM. The main problem was if you missed on schedule sleep you were a zombie.
Yeah, when I was looking into the plausibility and function of polyphasic sleep, I stumbled across studies from the US Airforce. Their conclusion was similar: In a controlled enviroment, it can be spectacular and work really, really well.
However, it is very, very fragile to any kind of interruption, so they stopped looking into it.
When I worked an overnight shift and lived alone, I got into a pattern of 2 to 3 hours a go three times a day. These were after work, halfway or so through my personal time, and before work. I used these separate times in between sleeps for work, almost exclusively for chores, and a dedicated slot for hobbies. I started each one refreshed, which was great. It doesn’t necessarily work so well when aligning your life with a partner.
Searching back, as I recall a video that was supposed to cause [increased] CSF flow, I did find this - https://news.ycombinator.com/item?id=34764730 about suggestions some learning difficulties might be due to interrupted CSF fluid flow.
The video (?) was related to clearing of plaques from the brain with a view to mitigating Alzheimer's effects.
It was not the NSDR (Non-Sleep Deep Rest) videos a sibling commenter posted.
https://news.ycombinator.com/item?id=41942775
If you're very tired you should be able to fall asleep, or at least doze off, whenever you let yourself go.
It seems likely that you'll get those flushes right after falling asleep, so a nap of a few minutes could help a lot.
In my experience, after a night without sleep even a 30 seconds nap reinvigorates you significantly.
I wonder if a 30-min nap improves the situation. But I need to tell the brain to hold the flushing until the nap.
Anecdotally, it seems to. I have laid down and closed my eyes even for a short while. And believe that I have even had a "flushing" sensation, that feels like a mental fog being lifted (or "drained", I guess).
I pop up 5 minutes later and feel completely refreshed.
I do something similar, although there's an added peculiarity when I do it. I lie down for 5 minutes and wake up 9 hours later.
Agree though it's 10 minutes for me.
When I owned some property out in the country, it was a 2 1/2 hour car trip to get there. Sometimes I just couldn't finish the drive home but pulling over to the side of the road for a 10-minute nap made me feel fully refreshed.
I had the same experience. The only trick is to keep it short, like 5-10 minutes. Any longer and the nap may bring negative impacts.
Fwiw, i have the opposite experience of napping. Napping adds to mental fog for me especially for the hour immediately after napping. Its not until several hours later that i actually experience any loss of mental fog or increase in clarity.
It probably depends on how much sleep you're lacking, and how long the nap is.
My experience after sleeplessness nights is that even few seconds help significantly, especially when you're almost unable to function anymore.
If the nap lasts longer than 30 minutes, though, you have a good chance of feeling groggy afterwards.
There's controversy over exact mechanisms involved in glymphatic function, so suffice it to say that allegedly even just NSDR / yoga nidra will engage a rest deep enough for glymphatic function to engage/improve
I was disappointed the article didn’t mention that. Can you give me some pointers. I will use Google but HN curated content is often a better starting point. :)
> I wonder if a 30-min nap improves the situation.
I pretty much wait until I feel drowsy, and then take a 15-30 minute nap
Rest in peace to all the college dudes covering the whole syllabus within 24 hours of the exam
It is always great to follow the instructions from a psychiatrist [1].
[1] https://thelastpsychiatrist.com/2007/08/how_to_take_ritalin_...
This is just outdated, bad and dangerous advice that a ton of recent research invalidates.
1. Ritalin, and other stimulants are not cognition enhancing for non-ADHD adults and may in fact do the opposite.
https://www.cam.ac.uk/research/news/smart-drugs-can-decrease...
2. > Because the doctor will rigorously apply artificial and unreliable diagnostic categories backed up by invalid and arbitrary screens and queries to make a diagnosis. So after this completely subjective and near useless evaluation is completed, your doctor should be able to exercise prudent clinical judgment to decide if Ritalin could be of benefit.
What else can you do for psychiatric conditions? We don't have a magic ADHD-o-meter but know that it statistically impacts lifespan, health, etc. Even for more objective measures like blood glucose, BP, BMI, clinical interventions are based on discrete thresholds that don't exist in nature.
I miss her.
What happened? Did they pass or something or just stop posting or what?
TLP was doxxed in a way that threatened their real life psychiatry practice, briefly blogged on Tumblr under a different psuedonym, and has since had little online presence other than rare tweets and randomly dropping a self-published book on Amazon (_Sadly, Porn_ by 'Edward Teach').
Not a college dude, but i used to work on shits (including night shifts) and adjusting to and from a five-nights (23:30-07:30) shift isn’t that pleasant either.
I think you meant to say "...I used to work on shifts..."
That, or maybe try a laxative.
(Man, if ever there was a time I wanted emoji support on HN, this is it!)
Could ADHD be caused by a broken flushing response? Lots of flushing followed by intense focus caused by the tabula rasa?
Disordered sleep can cause executive dysfunction similar to ADHD, but it does not cause ADHD. It certainly can exacerbate it or be diagnosed incorrectly.
I suppose it's possible, but it seems less likely to me because ADHD is a life long neurodevelopmental disorder that shows [visible physical changes in the brain on scans](https://pmc.ncbi.nlm.nih.gov/articles/PMC7879851/). That said, there are statistically more people with narcolepsy who have ADHD, and the same goes for sleep apnea. There's a number of hypotheses I've read as to why, to name a couple: related epigenetic causes, or [possible misdiagnosis](https://pmc.ncbi.nlm.nih.gov/articles/PMC7336577/) (narcolepsy is much harder to diagnose than ADHD if you don't have textbook symptoms). So there is definitely something there.
I'm not an expert, but that wouldn't really fit with my understanding of ADHD. It's not that we have a lack of attention ("defecit" of attention, as the name suggests), it's an impaired ability to direct it.
To abuse a metaphor, the sleep-deprivation-induced spontaneous CSF flush is slamming on the brakes of a car, and ADHD related attention shifts would be more like a drunk toddler is turning the steering wheel wherever they please, but the gas/brakes still work fine.
Not sure if it's related, but I have way more ADHD-like symptoms if I'm on late sleep schedule, but sleeping the same amount of hours.
I wonder if this could help explain why creatine helps mitigate the effects of sleep deprivation. Since creatine aids in water retention.
https://pubmed.ncbi.nlm.nih.gov/16416332/
I would imagine it has more to do with its principal function in recycling ADP back to ATP (fuel for cells). People who are sleep deprived also have impaired glucose metabolism, meaning that the cellular "fuel pipeline" is impeded. Perhaps creatine is especially helpful under these conditions.
https://pmc.ncbi.nlm.nih.gov/articles/PMC1991337/
Mix your cheap instant coffee with creatine powder and ORS for that ultimate early morning flavor bomb!
Welp, now I’m bout to make the nastiest coffee known to man for the next 3 months
Don't forget to intensely shake your head after consumption for a proper brain flush
The mechanism of creatine isn't that straight forward.
You need to take it for a while for it to build up, and for water to accumulate in cells.
It would also be disgusting in a cup of coffee!
It’s not clear how water retention would help with the needed flushing.
Hypothetically, more water retention would mean that the fluid being flushed is less concentrated, and if the flushing mechanism is triggered by a certain concentration level then it'll happen less frequently.
Hard to imagine that it would be worth more than a few percent though.
Less flushing sounds like it would also worsen the sleep deprivation, even if it reduces the momentary lapses.
That is very interesting. I have a somewhat related issue with sleep cycles. This issue, waking around 3:00am every morning then not going back to sleep until 6 or 7am, is not really a productive sleep cycle. I read somewhere that taking a spoon of sugary substance, like Raw Honey, MCT or Collagen, before going to bed can replenish the brain of this energy, so it becomes easier to fall asleep. I've been trying it with two to three spoons of honey, right before hitting the sack to see if it can help me fall asleep again. It seems to be having a somewhat positive effect as it does not take me too long to go back to sleep.
Extremely fine optimizations - like you are describing - only make sense after the major, gross actions have already been exhausted.
Do you have a regular, intensive, exercise routine with a good mix of aerobic and resistance training?
Don’t buy the fancy high flow air filter if you’re not even doing oil changes…
Exogenous ketones (such as BHB salts) are known to help with glymphatic drainage in the brain during sleep. I've used them extensively and have noticed improved sleep with nearly a doubling of the time spent in REM stage.
Could you go into detail what you take, how much, and when? I could always use a little boost for my sleep!
Sure. When I have a night of poor sleep or anticipate one, I usually take 6 grams of BHB salts in the morning on an empty stomach. You can work your way up to a maximum of 12 grams, but I would advise caution since it can cause diarrhea. I would start by buying the cheapest product (nutricost) you can find online; if it costs more than $80 for ~300g, then you're probably getting ripped off. I noticed that I have very lucid dreams and experience strong hypnagogic jerks when I take this supplement.
Here is some literature that I've perused to support my experimentation with BHB salts:
1. β-hydroxybutyrate is a metabolic regulator of proteostasis in the aged and Alzheimer disease brain (https://www.sciencedirect.com/science/article/pii/S245194562...)
2. Refueling the post COVID-19 brain: potential role of ketogenic medium chain triglyceride supplementation: an hypothesis (https://www.frontiersin.org/journals/nutrition/articles/10.3...)
My motivation for pursuing this was protracted sleep disturbance from long-covid.
Back when I used to meditate regularly, I would find that an extra meditation in the middle of a sleepless night would go a long way toward pushing off the need for sleep. Generally, meditating always left me in a slightly heightened awake state. Perhaps the help with brain fluid regulation is a core reason for both effects. (I should go back to meditating again.)
Maybe unrelated but, years ago, I had a job that had me criss-crossing the country by plane Monday through Friday and sometimes Saturday. So my sleep and the time zones and hotels could sometimes mess with me.
One day, I went to a grocery store and mid-turn onto another street, I forgot what city I was in. Worse, I was half a mile from my apartment in my home town.
How long did it take you to orient or to get home (whichever one happened first)?
It was very brief. Only a few seconds
In high school a friend of mine told me about "microsleep" and how your brain will oscillate into it if you're under-rested. This would align with that theory.
I can feel when this fluid hasn't properly flushed.
hmm.. this is interesting... the article says "spinal fluid exits the cerebrospinal fluid (csf) flows out of the brain... I wonder where it discharges these waste products. I ask because it is believed we have a sort of chimney on our backs. I think I read this on the article of the Irish lady who could detect alzheimers years before any modern medical detection systems. But maybe it is discharged in the gut? via the mesentery, the new organ they finally named fo rthe stuff that holds our intestines together. If anyone knows where it is discharged, please comment, I'm interested in this, because I do prolong waterfasts every 3 months, and I strongly believe the brain drains waste into my mouth during that time, because the taste in my mouth is godawful, but if there are other exit points the brain discharges waste, we probably need to know about them.
Why do you think that the taste in your mouth is waste draining from your brain and not the result of some metabolic changes in your body from the fast? Ketosis is known to cause a metallic taste in the mouth, for example.
What I understood from youtube gurus, take it with a grain of salt, is that your brain is taking ketones as source of energy to preserve the little glucose that goes into the system, and as result it consumes less oxygen.
But I'm not sure the mouth taste comes from the brain's waste.
To some degree, if you had your brain inflamed by bad eating habits, fasting would revert that and make the flushing more efficient as well.
Again please take with with double grain of salt, since I don't even know inflame brain is a thing for sure, or the correct term.
I believe it's discharged basically half directly into the venous system in the neck, the other half goes through the lymphatic/glymphatic system and ultimately also the venous system in the neck. That being said, that's just based on our very crude understandings and I'm sure there are other pathways.
The description of the mesentery as a single organ dates to the time of Da Vinci, at the latest.
anecdotally, i never feel better than when i haven't slept. spent 8pm tuesday -- 8pm thursday this week awake nursing cheap energy drinks, and not only could i manage a higher-than-usual level of focus, i was genuinely content.
bombed a midterm halfway though, but at least i felt good about it.
It's not unusual to feel good after pulling an all-nighter. Sleep is when re-uptake of serotonin takes place, so if you interrupt it you end up with a surplus. Although there are also other possible explanations [1]
1. https://www.pnas.org/doi/10.1073/pnas.2214505120
I'm assuming it is similar to the "runners high" people get at the end of a long run? You will feel very energized in ways that don't make sense. And if you don't force yourself to just lay down and pass out, you can keep going for longer than you would have thought. Will crash harder, though, if my experience is common.
I've got pretty bad ADHD and I find that my mind is more quiet, focused and productive on mornings after a night of 2-4 hrs of sleep than it has ever been on meds or anything else. It all falls apart by the afternoon, but for a while it's a nice feeling.
Well, not sleeping through the night, you'll feel genuinely euphoric around dawn, it's one of the most immediate "cures" for clinical depression.
I see the same thing in myself.
I've attributed it to a my brain moving to power-saving mode and muting some of my anxiety / perfectionism tendencies. Does this explanation resonate with you at all?
That's possible. It feels a lot like the placebo component in drinking: if you're free to ignore one of the few things you need to /live/, it should be much easier psychologically to be carefree (similar to "oh, haha, i'm drunk, might as well get wacky").
Age sounds like a factor here. I know zero long-term healthy ppl in 30s and beyond who act/think this way.
I've done a few all-nighters in my 30s and 40s, and they generally feel the same as my 20s. Still get that clear headed, high focus second wind around 4am that carries through until noon or so.
But, I definitely crash harder than I did in my 20s and need longer to recover after. In my 20s, would be fine if the next night was a normal one, now it takes multiple days.
It's definitely something I try to avoid at this age, as opposed to just being standard procedure back in college.
Indeed, as a 20 year old I would stay up all night pretty regularly for work and occasionally fun. At 40 I'm not sure I would live through it, at least not in a cognitive state where I could converse.
anecdotally i feel pretty good when im buzzed but reality is my performance is impaired. there is a teeter-totter of overconfidence and impairment where the liquid confidence actually helps more than the impairment impairs but its a sweet spot
sleep deprivation definitely reduces raw reasoning ability. in some cases, though (and this is true for getting buzzed as well) the trade-off is absolutely productive.
> For example, what you don't want to do is NOT take amphetamines at testing if you had used them to study;
Hard disagree there. If you get any anxiety during the test it's better to take it only while studying.
Did you mean to reply to <https://news.ycombinator.com/item?id=45772306>?
Huh? Care to explain?
This is fascinating, and somewhat directly related to the work we do increasing slow-wave response during sleep.
For those who are not aware, slow-wave are the hallmark of deep sleep and closely linked to the flushing the glymphatic system, which is what they are referring to in this article.
We can't create slow-waves, but we can increase their effectiveness through precisely timed auditory stimulation. I'll be posting a Show HN next week which dives into the data of how this works, but if you want to know more, there is info on our website and links to over 50 published peer-reviewed papers. https://affectablesleep.com
This paper specifically looks at amyloid clearance as a result of this glymphatic flush https://doi.org/10.1093/ageing/afad228
While many people will point to "getting more sleep" that isn't really the answer. More time asleep does not automatically mean increased glymphatic flush. Additionally, as we age, the power of the pump gets weaker, and more sleep does not help with that.
We believe the focus on counting minutes of sleep misses the point of what makes sleep truly restorative and beneficial, which are the neurological processes, and downstream physiological changes as a result. This is why we talk about restorative function, and that should be the focus of sleep health, not time.
After all, you wouldn't measure your diet based on how much time you spend chewing, would you?
Sometimes when I get a really bad migraine and poor sleep together, I can literally feel a flushing feeling in my head once I can fall asleep.
I slept around 5 hours last night split up into two periods because my baby daughter woke up crying from fever and wanted to play / was hallucinating / etc. She's totally fine now but I am wondering if there is a correlation between dementia and having kids.
Probably negatively correlated cause you have someone to interact with in your old age/better chance of community :)
Also I think of (hopefully at least one of) my three kids as a diversed retirement portfolio :)
I remember this quote from when we had young kids:
"Insanity is hereditary. You can get it from your children."
And then as soon as they are in their 20s and reasonably self sufficient we had to get a puppy to keep me sane!
Long days and short years.
Did you have empty nest syndrome?
More like empty head syndrome - but getting a dog was the best thing I've done in years.
Memory loss from sleep deprivation is an evolutionary advantage. If you remembered how rough the first few months of new children are, you wouldn't do it again.
I’m on my 3rd (she’s 1 week old today) at 42. With the first 2 it was only terrible for the first couple months. Once I just got used to going to sleep at 9:30 I was mostly fine.
We're expecting our first in a few months.
NGL I'm low key wondering if my messed up natural rhythm of 9pm-4am is going to be potentially handy.
I have a similar natural rhythm, or I should say "had". For the first year, especially the first few months, it was a godsend (for my wife, especially), but now that we're in a fairly consistent sleep routine with our two year old (~8pm-7am), I've shifted to something more like 8pm-1am out of necessity.
Although... I was up until 4am and got up at 6:30am and feel surprisingly great, so it still happens from time to time. :)
As a father of two I would say "nope", primarily because you won't be deciding the rhythm. Best you can do is coordinate sleep with your partner so that there's at least one somewhat functioning parent at all times.
As I'm typing this my 1.5yo is napping. I had maybe 6h of sleep but I'm after (part time) work and at home already, so I should probably nap as well.
Can't. My adult body won't go to sleep right now even though I'm feeling drowsy because it's too bright, too loud and chiefly I already had too much caffeine in the morning and I have like 15 minutes until I'll have to head out to collect my older child from preschool.
My SO is knocked out cold at the moment though, so I'll be relying on her this evening.
Yeah that's the trick, sleep asap
This kind of fear is a quick route to insomnia. One of the most effective ways to reduce sleep is to worry about it.
And when that happens, of course HN has the answer https://news.ycombinator.com/item?id=15997016
I think CBTI is pretty horrible but I'm happy it works for some people.
There's so much helpful stuff out there now it's rather a blessing.
Ah, those days were the absolute grinder for me. How a precious and sweet little baby girl can become an absolute monster all night long, and then wake up the next day back to her normal self while leaving me a hollowed out mess of a human is a mystery for science to solve someday.
aren't they the best though? but yeah, back to the grind, and now i also have her respiratory disease and am trying to launch my startup off the ground ...
What have you done when your toddler wakes up at random hours during the night to interrupt your sleep and come and play? That's what has truly obliterated our sleep. Everything else was a passing fad that was minimally painful at best..
I mean the baby stage doesn't last very long. I dont even remember the sleepless nights from my own kids anymore lol
Chronic sleep deprivation is the larger issue. And how we really don't have treatments on how to fix that, and how ultimately sleep phase issues are a social issues (being forced to follow a fixed modern schedule). Not to mention how closely that's tied to ND people. So a lot of us deal with sleep issues since we were little, but work and school dont give us the flexibility we need. For example, flex hours could be helpful here. I would rather work 10am to 6pm or 11am to 7pm most days. Or 5-6 hours during the day and 2-3 hours late at night.
I suffered chronic insomnia most of my life and seen my fair share of experts and read a few books about it. There are definitely treatments for the majority of insomniacs.
Sleep deprivation is often caused by alcohol, inconsistent sleep/wake times, high color temperature lighting (>3000K) in the hours before bed, failure to spend time outdoors in natural light in the morning, temperature too warm (68F is ideal), caffeine (or other stimulants) in the afternoon, associating the bedroom with tasks other than sleep and sex, or simply spending too much time in bed.
Following doctor's advice for the last one: Start by going to bed at, say, 1am and waking up at 6am. Follow this without fail for a few weeks. You'll be exhausted but keep at it. Eventually you should find yourself falling asleep quickly. If you wake up exhausted, pull back bedtime by 10 minutes. Do this for a week. Rinse and repeat until you are waking up at 6am refreshed. That is how you determine how many hours your body needs to sleep, and how long you should be in bed. Helped me.
I'm autistic with delayed sleep-wake cycle. For autistics DSWPD is pretty common. There's just no fixing that for the vast majority of us, we're just expected to follow strict schedules and if we are underslept, too bad for us.
ND people get this pretty badly. 2023 study: The incidence of sleep problems in ASD patients ranges from 32 to 71.5%, especially insomnia, while an estimated 25–50% of people with ADHD
Insomnia is different, but tbf, insomnia for many people can't be treated well or if not at all. CBT is helpful if you look at the studies and ignore the follow up studies showing relapses between 40-70%. We can stuff people with melatonin and hypnotics but after a while that no longer works. So looking at this, it looks like things like drugs and CBT can help 70% of insomnia sufferers but the relapse rate is as high as 70%, so we're looking at people who can actually be cured as low as 15-20% of total insomnia sufferers.
Its not caffeine or screens for us, its just how the machinery of the human body works. This is like telling a depressed person to just 'cheer up.' I'm glad that worked for you, but your story is just an anecdote, and the science for this is still pretty dismal unfortunately.
The science can't work because at this point we're going against our nature. A lot of people cannot subscribe to a modern industrialized sleep schedule because its not natural for us to have extremely strict sleep and wake times.
Thanks for elaborating. I have an autistic child, and you might've just explained why my kid has more energy at night than during the day. She tends to fall asleep around midnight (but at least gets a solid 8 hours of sleep from there). We're lucky to have a school with a late start time.
"Chronic sleep deprivation is the larger issue. And how we really don't have treatments on how to fix that"
Sure we do, however, not everyone is willing to hike 20-30 miles a day and sleep in a tent. It's not practical but it is very effective.
Physically exhausting yourself isnt a solution. Its tangential to the real issue. Its a bit like suggesting you can solve anxiety caused by trauma by drinking large amounts of alcohol everyday. No, instead we should be treating trauma. Its like putting autistic kids through rough ABA therapy, no instead we should finding accommodations and support for autistic people.
People have natural sleep rhythms. Society should conform to that, instead capitalism demands we conform to what it deems profit maximizing.
Not physically exhausting yourself is the real issue. It's our natural state as humans. We're not meant to be staring at screens having discussions about chronic sleep deprivation on an internet forum, we're meant to be outside moving our bodies.
I agree with you. I regularly have strong insomnia and I have tried physical exhaustion.
It usually works for the first few days of doing it but then it's like my body (probably moreso my mind) gets used to it and it doesn't help with sleep anymore.
Arguably it feels even more unhealthy because it's like my body is fully exhausted and tired but my mind won't let me sleep so no restoration can happen.
[This is one of those article titles that would really benefit from adding one more word.]
Or some parentheses. Is "due to" naturally left-associative or right-associative? I would have said 'right', which gives the unintended reading of the sentence.
Attention lapses due to (sleep deprivation due to flushing fluid from brain).
(Attention lapses due to sleep deprivation) due to flushing fluid from brain.
Could this be why SNRIs help some patients mitigate ADHD symptoms?
As a chronic undersleeper, good thing I don't drive!
should have given them a cup of joe while in the fmri to see what difference that made
Need a cron job to flush that cache
My pet theory is that dreams are the brain booting up/shutting down and the equivalent of old analog TVs that have the flash of static and bloom/collapse on the screen when turning off/on.
This reminds me of delirium tremens a bit. Same compensatory mechanism, different sleep process - or at least that's the pattern I'm seeing.
The MIT study shows CSF waves—normally a sleep-only process that flushes metabolic waste—intruding into wakefulness when you're sleep-deprived. Your brain is apparently so desperate for the cleanup that it forces the process to happen anyway. Cost: attention lapses.
From what I've read, delirium tremens during alcohol withdrawal seems to follow a similar pattern, except it's REM sleep intruding into waking consciousness instead of CSF flushing.
[Polysomnographic studies from the 1960s-80s](https://pubmed.ncbi.nlm.nih.gov/7318677/) documented this. Patients in alcohol withdrawal exhibit what researchers call ["Stage 1-REM"](https://www.sciencedirect.com/topics/neuroscience/delirium-t...)—a hybrid state where wakefulness and REM sleep characteristics get mixed together. Right before full-blown DTs, [some patients hit 100% Stage 1-REM](https://link.springer.com/chapter/10.1007/978-1-4757-0632-1_...). The hallucinations appear to be [literally enacted dreams](https://www.sciencedirect.com/science/article/abs/pii/S01651...) occurring while technically awake. The sleep-wake boundary just completely breaks down.
What strikes me is the system-level similarity here. Sleep normally maintains clean states: you're either awake (alert, reality-testing intact, no CSF flushing) or asleep (offline, dreams permitted, maintenance running). But when the system gets stressed enough—whether through sleep deprivation or the neurochemical chaos of alcohol withdrawal—it seems to start making desperate tradeoffs.
The brain apparently needs certain processes to run. Period. Total no-brainer! CSF flushing can't wait indefinitely. Neither can REM sleep, which serves its own critical functions. So when normal sleep architecture fails, the system appears to force these processes anyway, even though the conditions are completely wrong for them.
Maybe that's why the costs are so specific. CSF intrusion during wakefulness costs you attention. REM intrusion costs you reality testing, because REM is the state where your brain accepts impossible narratives without question. Same compensatory mechanism, different critical process forced into the wrong state.
What I find interesting is how the brain knows what lever it needs to pull and how it pulls it. Sleep deprivation forces waste removal. REM deprivation forces wakeful dream states; which might be a side effect not the actual goal. The brain seems to know what maintenance is overdue and attempts the repair, consequences be damned.
Good to know that the brain finds a way to flush itself while awake. I think I've become pretty good at putting unused parts of my brain to sleep while awake. My brain is like that of a dolphin now.
But on rare occasions (like a couple of times a year), I get migraine auras and stuff disappears from my field of view. Can last about an hour. I feel like that's my visual cortex falling asleep.
Title sucks