Sleep regularity is a stronger predictor of mortality risk than sleep duration (2023)

Original Article ↗ Hacker News Discussion ↗

Irregular sleep schedules may be more strongly linked to early death than short sleep itself, according to a large observational study that has people rethinking whether “when” you sleep matters more than “how long.” Commenters debate causation versus correlation, noting that chaotic sleep often tracks with stress, mental health issues, poverty, shift work, and other risk factors that themselves drive poor outcomes. Many share practical strategies to stabilize circadian rhythms—light exposure, exercise, magnesium or melatonin, CBT‑I, and strict wake times—while others highlight how hard consistent sleep can be in modern life, even when you know it’s important.

How commenters interpret the study

  • Many emphasize the study is observational and shows association/prediction, not proven causation.
  • Several note the authors’ own wording: “predictor” and “may be a target,” but worry popular coverage will overstate causal claims.
  • Some point to very low R² values and caution against overinterpreting a statistically significant but weak predictor.

Confounders and alternative explanations

  • Repeated concern that sleep regularity may just mark other factors:
    • Lower stress, more orderly lives, safer jobs, higher income, healthier habits.
    • Underlying illness: pain, diabetes, apnea, UARS, mental health issues, neurodivergence.
    • Occupation (shift work, frequent flying, exposure to carcinogens) not fully captured.
  • Others counter that the paper explicitly adjusts for many sociodemographic, lifestyle, and health variables, though commenters still doubt that all relevant factors can be controlled.

Chronotypes, irregular patterns, and disorders

  • Multiple anecdotes of delayed sleep phase, drifting (“non‑24”), and extreme early waking; some have gene variants or long-standing patterns.
  • Some find their natural rhythm only when free of work constraints, often incompatible with “modern life.”
  • Several note links between atypical sleep, ADHD/anxiety/depression, and neurodivergence.

Practical strategies and tools discussed

  • Classic “sleep hygiene”: fixed wake time, morning bright light/sun, reduced evening light (blue-blocking glasses, red filters), no screens or stimulating activities before bed, cooler room, regular exercise, lighter evening meals, avoiding late caffeine.
  • Behavioral and cognitive approaches: CBT‑I apps, meditation/body scans, journaling/voice notes to offload racing thoughts, prioritizing sleep over late-night entertainment.
  • Environmental tweaks: blackout masks, AC, mattress cooling pads; some suggest mechanical vibration-damping for noisy environments.

Supplements and medications

  • Magnesium (especially glycinate; L‑threonate more debated) and glycine are widely reported as helpful by some, useless or unpleasant by others.
  • Melatonin: disagreement about dose and efficacy; many argue lower doses and timing for circadian shift vs “knockout” use; concerns about early awakenings and long‑term effects.
  • Other agents mentioned: trazodone, orexin antagonists, guanfacine, antihistamines, muscimol, even LSD microdosing; experiences range from “life-changing” to “made things worse.”

Broader reflections

  • Several argue regular sleep underpins mental stability, productivity, and aging well, but also note that for many people “just sleep regularly” is neither simple nor fully under voluntary control.
  • Insurance and wellness programs are beginning to reward “good sleep,” raising concerns about fairness if the metrics or causal links are misunderstood.