A few years ago, two studies found that people with sleep apnea have a much higher rate of cancer than people without it, even controlling for several cancer-related variables. In one study, the increase in risk was five-fold. These studies raised several questions: 1. Were the associations due to chance? 2. If real, did the associations reflect cause and effect? Surely people with sleep apnea are different in several ways from people without it. 3. If the associations did reflect cause and effect, which of the many effects of sleep apnea was/were responsible?

A new study found that rats woken up frequently got more cancer. This is a correct prediction from the idea that bad sleep increases cancer, increasing the plausibility of that idea.

[The study] used mice, housed in small groups. During the day—when mice normally sleep—a quiet, motorized brush moved through half of the cages every two minutes, forcing those mice to wake up and then go back to sleep. The rest of the mice were not disturbed. After seven days in this setting, both groups of mice were injected with cells from one of two tumor types (TC-1 or 3LLC). All mice developed palpable tumors within 9 to 12 days. Four weeks after inoculation the researchers evaluated the tumors. Tumors from mice with fragmented sleep were twice as large, for both tumor types, as those from mice that had slept normally. A follow-up experiment found that when tumor cells were implanted in the thigh muscle, which should help contain growth, the tumors were much more aggressive and invaded surrounding tissues in mice with disrupted sleep.

Great Sleep! Reduced Cancer! is a whole book (98 pp) about the connection between sleep and cancer.

Epidemiologists haven’t yet figured out that they should always measure sleep quality, just as they always measure cigarette smoking and body weight, but at least interest is growing. Both short and long sleep are associated with a higher risk of heart disease.

 

 

Philip Seymour Hoffman, the great actor, was found dead a few days ago with a needle in his arm. Last year, Cory Montieth, the actor, died in similar circumstances. Why did they die? It was hardly the first time they’d taken heroin.

Starting in the 1970s, Shepard Siegel, a psychology professor at McMaster University, did a series of rat experiments that showed that drug tolerance and craving involved a large amount of Pavlovian conditioning. Repeated exposure (e.g., injection) of Drug X in Situation Y (e.g., your bedroom at 11 p.m.) will cause learning of an association between X and Y. This association has two effects. First, when exposed to Y, you will crave X. Second, when you take Drug X in Situation Y, the effect of the drug is diminished. You become “tolerant” to it.

You have probably experienced both effects — they occur with caffeine, chocolate and alcohol, for example — but are unaware of Siegel’s explanation: Situation-drug associations. After you learn the association, Siegel said, the situation generates a response in your body that opposes (reduces) the drug effect. If the drug makes you less sensitive to pain, the conditioned response is more pain sensitivity. If the drug makes you awake, the conditioned response makes you sleepy. It’s easy to realize that drug craving involves associative learning: You notice that you crave coffee or whatever in familiar situations but not unfamiliar ones. You crave Drug X at college but not at home. It’s much harder to grasp that the tolerance involves associative learning.

Drug users, such as Hoffman and Montieth, as they become “tolerant”, take larger and larger doses, not realizing that their “tolerance” depends on a learned association. The situation becomes more and more dangerous because if you take the drug without eliciting the conditioned compensatory response, you may die. Without the conditioned response, a drug amount you survived yesterday may kill you today.

Siegel explored the possibility that this actually happened — that drug addicts died of “drug overdose” because they took the drug under unusual circumstances that didn’t evoke the compensatory response. He found plenty of support for this idea. One sort of support was interviews with “overdose” survivors. They often described unfamiliar circumstances at the time of the injection — e.g., there’s usually music, but this time there wasn’t. Another sort of support was a rat experiment with heroin. After developing tolerance to heroin, rats injected with a really large dose in a strange situation were much more likely to die than rats injected with the same dose in the same situation where they became tolerant.

I am pretty sure Hoffman and Montieth didn’t know about this research. There is a connection with the Shangri-La Diet. In both cases, Pavlovian learning has a big effect on something we care a lot about (life/death in the drug case, body weight in the diet case) and this connection is highly non-obvious.

A 2009 study followed about 9000 men for 10-20 years. It found that strength (how much you can bench and leg press) measured at the start of the study was associated with likelihood of dying of cancer during the study. Men in the upper two-thirds of the study population in strength had 40% less cancer mortality. This might be the most surprising result:

Further adjustment for BMI, percent body fat, waist circumference, or cardiorespiratory fitness had little effect on the association. The associations of BMI, percent body fat, or waist circumference with cancer mortality did not persist after further adjusting for muscular strength.

In other words, muscle strength was a better predictor than several similar measures (BMI, etc.) and these other measures stopped predicting when corrected for muscle strength. Muscle strength is closely connected to something important.

Men who are stronger by and large exercise more, no doubt. Yet muscle strength is determined by resistance training, not aerobic exercise — and it is aerobic exercise (and to some extent walking) that have been promoted by countless experts since the 1960s and the invention of the concept aerobic. Jogging reduces how much time you have for resistance training.

These findings interest me because I do a lot of resistance training — stand on one leg to exhaustion several times per day — purely to sleep better. By improving something easy to measure (sleep), these data suggest I have also been improving something hard to measure (chance of dying from cancer). Not surprising, but reassuring.

My data also suggest two different possible reasons for the strength-cancer association. One is that men who exercise more sleep better as a result; better sleep, better immune function, less cancer. Another possibility is that strength is a marker for good sleep. Among men who do equal amounts of exercise, those who sleep better will be stronger.

From The Breviary.

I am one of the presenters — that is, interviewees — at PaleoCon, which began a few days ago. The presenters were interviewed by John Durant. Among the presenters are Paul Jaminet and Chris Kresser.

In a review of biographies of Charles Dickens I found this:

In 1849 he showed a short account of his early years to his close friend John Forster, revealing a story he never told his own family: the shame-inducing months he spent, while his father was in a debtor’s prison, as a 12-year-old “laboring hind” in a factory that bottled shoe-blacking.

Suddenly I understood why he wrote Oliver Twist and why it is so good. Budding writers are told write what you know. They should be told write what you feel bad about.

The work of James Pennebaker has shown the benefits of even small amounts of self-disclosure. No doubt this is why all sorts of psychotherapy, supposedly based on enormously different theories, help roughly the same amount: All involve self-disclosure. I see this effect as something built into us by evolution to increase self-disclosure. Talking about bad experiences helps your listeners avoid what happened to you. To motivate such disclosures, evolution has built into us something that causes us to feel better after we talk this way.

Scientists are not told study what you know and they are especially not told study what you feel bad about. Scientists are mostly men, of course, and that sort of thing makes men uncomfortable. My personal science, however, suggests the correctness of this idea.

Because of cold weather in America, Longform (the website) linked to a 1995 article about the death by freezing of Teresa McGovern, daughter of George McGovern. She was drunk and fell down. Her alcoholism was intractable. She went for treatment dozens of times. I have a theory about what causes alcoholism and other addictions and why they resist treatment.

Let me start with the fairly obvious part. People go to their addiction (alcohol, gambling, smoking, whatever) to escape pain. The addictive activity provides a hit of pleasure that eliminates the pain for a while. It is difficult to endure pain and after a while, if you can escape, it is impossible — your “willpower” runs out. An addict keeps feeling pain, keeps doing the addictive activity to get rid of the pain. Pain triggers the addiction. Addictive activities, such as drinking, often produce cravings, which are an additional source of pain. This makes the problem worse — makes the total pain even harder to endure — but it is not the whole problem. The addiction started when there were no cravings. This is why abstinence alone — which does get rid of the cravings — is not a good solution. It does not get rid of the sources of pain that were/are the ultimate cause of the problem.

The McGovern article illustrates the pain-reduction aspect of addiction:

I can numb the pain, says a voice. “It doesn’t sound like an evil voice. It sounds like a friend, telling you the truth.” Teresa’s younger brother, Steven McGovern, is describing the voice of alcohol, as it whispers to you when you are feeling tense or dissatisfied or empty: Here’s your old pal, I can get you through this. ”I have experience with this,” he explains. Like Teresa, Steven has struggled for years with addiction.

At the end of Double Down, a great memoir by Frederick and Steven Barthelme, about loss of a large inheritance due to gambling addiction, the authors say something similar, that their addiction derived from depression. I haven’t talked with addiction specialists but I doubt any of these ideas would surprise them.

The less obvious part of this comes from my discovery that seeing faces in the morning caused a large oscillation in mood: happy during the day, unhappy at night (while asleep). The effect of being happy during the day was that small amounts of badness (e.g., bad news) made me less happy but did not push me all the way to feeling bad (= painful). I had a buffer. If I feel very happy and then something bad makes me feel less happy — only slightly happy — this has no effect on my behavior. I don’t go out of my way to increase my happiness. Only when the border between happy and unhappy is crossed, and I start to feel bad (pain), not merely less happy, do I feel any desire to reduce the pain.

Life is full of pain-causing stuff. Everyone should have a buffer of happiness provided by morning faces but almost no one does. For almost everyone, as far as I can tell, most of the time they are in a neutral state, neither happy nor unhappy. When something bad happens, lowering their mood, they don’t go from very happy to slightly happy, they go from neutral to unhappy (= painful). And when in pain they seek ways to escape it. This makes all sorts of pleasure-causing activities, including drinking alcohol and eating “comfort food” (= food with a strong flavor-calorie association – the stronger the flavor-calorie association, the more pleasant a food tastes), more attractive.

Long ago, people had this buffer of happiness during the day which made it possible for them to forage together in spite of problems, such as hunger and thirst and yesterday’s disappointments. In the evening, the buffer disappeared as your mood went down. The problems indicated by pain became more urgent and were dealt with. If you were thirsty, for example, you would drink something. Modern life has reduced or eliminated many sources of pain but it has also (a) eliminated the buffer, our natural protection, and (b) provided many short-term sources of pleasure (such as drinking) harmful in large doses. Because we live in a world that is inevitably painful now and then — no treatment can change that — the combination of (a) and (b) causes addiction. Treatments for addiction, at best, push people away from one short-term source of pleasure. They never restore the buffer, the natural protection.

When The Shangri-La Diet was published, many SLD dieters said it had become easier for them to stop smoking. My explanation is that because their hunger (one source of pain/discomfort) went down, they had more willpower left over to deal with another source of pain/discomfort, craving a cigarette. As my sleep has improved in recent months, due to bedtime honey and related changes, I have found it easier to do everything. My explanation is essentially the same. No longer having to use willpower to overcome tiredness — I am less tired — leaves more of it to do everything else.

• Benefits of yacon syrup
• MIT & Aaron Swartz
• A job search in the English Department at UC Riverside
• Watch out for iron overload. You may be eating too much iron.
• Scoliosis successfully treated without surgery. “Surgery was recommended as the only option to help her recover.”

Several people have said that bedtime honey made them wake up too early. For example:

No effect for me, worse for my wife (hours of wakefulness in the middle of the night after a few hours of sleep)

The commenter said this meant it wasn’t working.

My view is different. To me, this experience suggests that there is something safe, cheap and practical (honey) that has a powerful and non-intuitive effect on sleep. Finding something like that is extremely hard. (Drug companies have spent billions of dollars trying to do this, with far worse results.) It isn’t easy or obvious or trivial to learn how to use that powerful force to produce improvement rather than harm (“hours of wakefulness in the middle of the night”), but I am sure it is possible.

My first important use of self-experimentation was in graduate school. I discovered that one of the medicines my dermatologist had prescribed for my acne wasn’t working. The notion that a prescribed medicine didn’t work is useful, but not shocking. This success was enough to launch me into self-experimentation to improve my sleep — specifically, to reduce early awakening. This turned out to be very hard.

After ten years of trial and error (all error), I discovered something that made my early awakening reliably worse. I was thrilled. After ten years, something finally made a difference, albeit in the wrong direction. It was a turning point. I did many experiments and finally figured out that any breakfast made my sleep worse. This was far more progress than finding out that a prescribed medicine didn’t work. It was progress because (a) nutrition experts usually said that breakfast was “the most important meal of the day”. My discovery flatly contradicted that. I became a lot more skeptical of experts, a view that has served me well. (b) Eliminating breakfast greatly reduced early awakening, and (c) the discovery showed that self-experimentation could do better than expert advice in surprising ways. My interesting self-experimentation began with the discovery of something that made my sleep worse.

I too have found that although I am sleeping much better, bedtime honey and other evening sugars have also made me wake up too early more often. I too need to learn how to better use this new knowledge.

“Your writing has dramatically improved my health in a number of ways,” a reader said. I asked for details. He replied:

I’ve tried most of your health interventions. The first was SLD. Overall, I lost about 90 lbs. Roughly half of this was from a more traditional diet of eating whole foods esp. vegetables and exercise. I had plateaued until I discovered SLD and lost the rest. I added flax oil, butter and homemade kefir to my taste free meal over time. The butter helped me lose more weight. At the same calories, the saturated fat was somehow more filling. Initially the butter made me happier but that wore off after a few months. My HDLs and triglyceride levels are better than when I was training for a marathon and not eating this stuff. The flax oil has improved my gum health. I can’t really see a direct result from the kefir. I’m more eating it on faith. I skinned my knees quite badly a while ago. My wife commented on how quickly I healed. So maybe the kefir and other items are helping me heal faster.

I tried morning faces twice over about a week without success. My job exposes me to a lot of evening fluorescent lights. I picked periods when I wouldn’t be exposed, but even if it worked, I couldn’t have maintained it over a long period.

Insomnia has been a long-time problem for me. One legged standing didn’t have a noticeable impact. Shifting my vitamin D3 to the morning seemed to help a bit. Bedtime honey has led to a big improvement. It’s uneven, but more often than not I’m sleeping much better. Even when I don’t sleep as well, I don’t feel as tired as I did without using honey. My mood has also improved. I’m calmer and happier. The honey seems to reinforce my circadian rhythm. I have more energy in the morning and am tired in the evening. I’m currently tracking what else I’m consuming and when to see if I can figure out how to get the benefits on the honey more consistently. My wife and friend have tried honey at bedtime and both report improvements.

My view is that of the cause-effect relations I have emphasized, the most useful will be (a) the effect of morning faces on mood (hard to use at first), (b) the effects of sweets on sleep (easy), and (c) the effects of foods on brain function b. Bedtime honey is just the first of the sweets effects and flaxseed oil and butter are just the first of the brain effects. Full understanding and use of the morning faces discovery lies many years in the future. Of the various methods I’ve developed, I think the most useful will be the use of reaction time measurements to improve brain function (and, probably, overall health). At the level of what might be called “meta-methods” (the usual name is big ideas), I think the most useful will be that people who aren’t health experts can discover important things about health.

by Nathanael Nerode

I have an inhalation allergy to polyester and acrylic dust that caused no end of trouble, especially nasal congestion. It took 20 years to figure out.

I live in Ithaca, NY. My nasal congestion started after a multi-month trip to China in 6th grade, in 1988. The air in Beijing was truly awful, and literally everyone had nasal congestion while there. But my congestion didn’t go away when I came back.

To figure out why it hadn’t gone away, a doctor (allergist) back in roughly 8th grade did prick tests. The “dust” test was said to use actual dust collected from houses. In retrospect, it presumably included polyester dust. It was the only prick test, other than the control histamine injection, to show an allergic response. The idiot doctor proceeded to claim that I had a dust mite allergy even though the “dust mite” prick test was negative. I told him no, I didn’t, and he should learn to read his test results. I asked what was in household dust other than skin, hair and mites. He somehow did not manage to come up with “fabric”. If I’d been bright enough to think of that then, I might have been able to figure this out much sooner.

In some ways my nasal congestion was quite bad. I got secondary sinus infections repeatedly, due to the airways never, ever clearing out. I carried Kleenex with me everywhere, and bought it by the case. I had to mop my nose a few times every hour. When I caught a cold, the frequency would increase to every couple of minutes.

The congestion lasted continuously through multiple living quarters at college and back in Ithaca — of course, at all those locations I had brought a full set of clothes, and had a typical polyester bed, and most had carpeting. It mysteriously cleared up once — during a trip to North Carolina. Only in retrospect did I realize that on the trip I was sleeping on a futon in a house with no carpeting, with nothing but cotton clothes.

The allergies were definitely triggered more indoors than outdoors and were worse in fall than spring. I quickly eliminated the possibility of detergents by repeated changes of detergent with no result. I was then stuck with no further ideas for 20 years.

After 20 years, I moved into a new house while bringing very little with me (only a couple of sets of clothes). Suddenly my allergies went away. I realized the cause was something in the old house but not the new house.

I could keep stuff at the old house, and I moved in really slowly, so I was able to do challenge-response experiments, with a multi-week test time for each.

I had had work done on the new house. I first eliminated wood dust, tile dust, drywall dust, and grout dust as possibilities, because they were all over the place while I was there. Then I moved in huge piles of books. Still no allergies.

Then I moved in my clothes. (Still no bed, latex futon.) My allergies came back instantly. I moved the clothes back out, sorted them by fabric, and waited four weeks for my symptoms to clear.

Then I moved the clothes back in one fabric at a time, with a two-week testing period to see whether symptoms developed for each. Luckily I was not allergic to the first thing I tried, which was cotton.

After finding the polyester allergy and moving the polyester out, I waited four weeks for symptoms to clear up before moving the next set in. Eventually I found the acrylic allergy too.

I also had to stop testing for a month or so at least three times when I caught colds, as determined by additional symptoms or by family and friends developing the same symptoms.

This took a long time — about a year — and is not a straightforward option for most people. I haven’t tested every fabric yet. I stopped after I got through all the common ones.

After I was “detoxed”, I started having a noticeable mild contact allergy to polyester and acrylic, which confirmed the conclusions. I think this wasn’t noticeable before due to constant exposure creating suppression of the response.

So I solved the problem from a combination of luck (moving into the new house showed that it wasn’t generic “dust”) and pure grinding testing, much like most science.

I’m not sure many people would have the opportunity to test the way I did. I modeled what I did on the hardcore “challenge” protocol used for food allergies where you start with a very limited diet and “challenge” it with one thing at a time. How many people can do that with fabrics? You need a place to store the rest of your clothes. You may need to buy all-cotton socks or underwear or shirts or pants if you didn’t own any (luckily I did) — and you need to have no carpet and remove your BED from the house (which I had done anyway coincidentally).