Should we consider the sleep loss epidemic an urgent global issue?

post by orenmn · 2019-05-06T06:42:41.563Z · score: 19 (11 votes) · EA · GW · 19 comments

This is a question post.

Contents

  Answers
    7 PeterMcCluskey
    5 Khorton
    3 Julia_Wise
    3 aarongertler
    2 lukeprog
    1 Holly_Elmore
3 comments

I have recently read Why We Sleep (a nice book review) by Matthew Walker PhD (AKA Sleep Diplomat).

The book explains about the benefits of sleeping enough and the negative consequences of not sleeping enough, based on scientific research.

It also explains how this problem is neglected. For example, a short snippet from the book about driving:

At the highest levels, we need better public campaigns educating the population about sleep. We spend a tiny fraction of our transportation safety budget warning people of the dangers of drowsy driving compared with the countless campaigns and awareness efforts regarding accidents linked to drugs or alcohol. This despite the fact that drowsy driving is responsible for more accidents than either of these two issues—and is more deadly. Governments could save hundreds of thousands of lives each year if they mobilized such a campaign. It would easily pay for itself, based on the cost savings to the health-care and emergency services bills that drowsy-driving accidents impose. It would of course help lower health-care and auto insurance rates and premiums for individuals.

And:

I conducted an informal survey of colleagues, friends, and family in the United States and in my home country of the United Kingdom. I also sampled friends and colleagues from Spain, Greece, Australia, Germany, Israel, Japan, South Korea, and Canada.
[...]
0 percent received any educational materials or information about sleep.

(Of course, this is anecdotal evidence, but I don't think there is a question about the extremely low amount of hours schools dedicate to educating about sleep.)

The book also claims the sleep loss epidemic is a large-scale problem:

This silent sleep loss epidemic is the greatest public health challenge we face in the twenty-first century in developed nations.

And:

Insufficient sleep robs most nations of more than 2 percent of their GDP

(With regard to the last claim, the book references RAND Corporation, Lack of Sleep Costing UK Economy Up to £40 Billion a Year.)

I am not an expert in sleep, nor in cause selection, but this problem seems to me quite neglected (relatively to its scale), and at least partially (e.g., educating about sleep, later school start times) easy to solve (relatively to other issues).

I am less certain about its scale relatively to other global issues, but I wonder about its total score (scale+neglectedness+solvability), if it were assessed like other issues in this table by 80k Hours.

Edit: To clarify, by "the sleep loss epidemic" I refer mainly to sleep-deprived people with no sleep disorders. I assumed (please correct me if I were wrong) that sleep disorders aren't the main cause for sleep-deprivation, which means that we mainly have to deal with seemingly-easier-to-change causes (e.g., education, social norms).

Answers

answer by PeterMcCluskey · 2019-05-06T15:27:31.067Z · score: 7 (4 votes) · EA · GW

Sleep loss is an important problem, but it's unclear whether any charity should focus on it directly.

The problem of driving while sleep-deprived will likely be solved by robocars more than by any altruistic efforts.

The rest of the problem seems better tackled by focusing more on the stresses that cause sleep problems, and by relatively decentralized efforts to shift our cultures to be more sleep-friendly.

Sleep is something to keep in mind when asking whether EAs should donate to mental health charities or to meditation charities such as Monastic Academy. I'm very uncertain whether these charities should be considered effective enough to be EA causes.

comment by orenmn · 2019-05-07T13:09:17.435Z · score: 1 (1 votes) · EA · GW
The problem of driving while sleep-deprived will likely be solved by robocars more than by any altruistic efforts.

I don't know how much time this would take, but of course when we evaluate the scale of the problem, we should put into our calculations robocars eliminating traffic collisions at some point.

The rest of the problem seems better tackled by focusing more on the stresses that cause sleep problems, and by relatively decentralized efforts to shift our cultures to be more sleep-friendly.

I might be overestimating the amount of people that are sleep-deprived only because they don't prioritize sleep (due to being unaware of its benefits and the costs of being sleep-deprived (both benefits and costs are very significant, according to the book and the research it references)). But if the number of these people is not trivial, getting them to sleep more seems to me like a strong combination of scale+neglectedness+solvability.

answer by Khorton · 2019-05-06T09:33:09.994Z · score: 5 (4 votes) · EA · GW

Educating people about sleep seems easy enough, but there might be less tractable reasons why people don't get sleep (eg young children, working two jobs) which might make this problem more difficult than it appears on the surface.

comment by orenmn · 2019-05-06T11:04:01.867Z · score: 1 (1 votes) · EA · GW

I think that's a good point, especially with regard to young children.

With regard to jobs, if sleep is well-known to make employees more productive, maybe employers would (someway) encourage employees to get more sleep. (On the other hand, it might make employers less willing to hire people that don't get enough sleep, but I am going deep into speculation-land here.)

I edited my phrasing from "quite solvable" to "at least partially easy to solve (relatively to other issues)".

Thanks!

answer by Julia_Wise · 2019-05-07T13:32:13.353Z · score: 3 (3 votes) · EA · GW

I don't think this is a particularly good area for EAs to tackle, but I do suspect that new parents should be more informed/reminded of the dangers of driving while sleep-deprived. I remember borrowing a car to drive to a meetup for new parents and and some point realizing, "This is ridiculous. I'm so exhausted I don't always feel confident in my ability to walk downstairs. I shouldn't be operating heavy machinery." Not like isolation is great for new parents either, but I needed to find ways to get out without driving.

comment by orenmn · 2019-05-07T13:56:06.598Z · score: 5 (2 votes) · EA · GW

I agree that everyone should be informed about the dangers of driving while sleep-deprived.

I don't think this is a particularly good area for EAs to tackle

Would you please explain a bit about your reasoning?

comment by Julia_Wise · 2019-05-07T18:02:46.592Z · score: 11 (6 votes) · EA · GW

No particularly strong reason. I guess it seems strange that given that it would be low cost for public health systems to issue advice about this, it's not already happening more. Maybe the fact that no one really opposes it and it might be cheap to improve means that it's ripe for more attention, but maybe the fact that it hasn't already been done means EAs who aren't already working in public health can't do a lot.

It's not totally neglected - there are a ton of results for "sleep deprivation epidemic," the CDC describes sleep deprivation as a serious national problem, and my local schoolyard has a banner telling children to get 9 hours of sleep. But obviously more progress could be made.

answer by aarongertler · 2019-05-07T00:27:01.945Z · score: 3 (2 votes) · EA · GW

The problem seems to be large-scale and relatively neglected, but not especially solvable. When people don't sleep, it seems unlikely that their sleep is disordered than that they are choosing to do something else with their time (maybe an obligation like childcare, maybe some form of entertainment).

Example: While getting people to stop drinking puts "having soda/water/nothing" up against "having alcohol", getting people to sleep more puts "unconsciousness" up against "the most important and/or entertaining thing you believe you can do instead".

That said, there are clearly some modest interventions that could help some groups:

  • Apps like f.lux to reduce blue light exposure before sleep
  • Having schools (especially high schools) start classes later, to sync up with teen sleep schedules
  • Improving the quality of remote-work software to reduce commute times and help people start their days later

But none of these seem broad enough to make a significant dent in the problem, and I'm not aware of any charities that are doing obviously effective work in this area (though "starting school later" probably has some active advocates I'm not aware of).

comment by orenmn · 2019-05-07T04:26:16.514Z · score: 1 (1 votes) · EA · GW
getting people to sleep more puts "unconsciousness" up against "the most important and/or entertaining thing you believe you can do instead".

Have you read the book or some review of it or watched/listened to some long form interview with Matthew Walker (just search in YouTube)?

I ask because I would have probably said the same if I hadn't read it, but after reading the book, the equation for me is more like:

"unconsciousness + better memory + better processing of stuff I learned + better health + better mental health + being less hungry + feeling better while awake (+ more stuff mentioned in the book that I don't remember at the moment)" up against "the most important and/or entertaining thing you believe you can do instead + worse memory + worse learning abilities + health problems + ..."

comment by aarongertler · 2019-05-07T05:42:04.466Z · score: 2 (1 votes) · EA · GW

Yes, I agree that sleep has many benefits, just as eating vegetables has many benefits (some of which are almost immediately apparent, just like the benefits of sleep). But while many people know about these, they still don't sleep enough. I'm trying to get at the reasons I think people take these harmful actions, not arguing that sleeping as little as possible is correct/rational :-)

comment by orenmn · 2019-05-07T07:18:58.212Z · score: 3 (2 votes) · EA · GW

I knew (generally) about the benefits of sleep before I read the book, but reading the book made this "knowing" extremely more vivid.

The thing that makes me so optimistic about getting people to sleep more is that sleep is something our body actively urges us to do.

Like our body actively urges us to eat a lot of sugar (e.g., and not vegetables), it actively urges us to sleep (unless we use caffeine, etc.).

answer by lukeprog · 2019-05-07T05:23:25.081Z · score: 2 (2 votes) · EA · GW

I looked into this a bit. Unfortunately the quality of evidence in sleep medicine was underwhelming, e.g. on behavioral treatments.

comment by orenmn · 2019-05-07T07:39:21.596Z · score: 1 (1 votes) · EA · GW

I apologize for not being clear enough.

I assumed (please correct me if I was wrong) that sleep disorders aren't the main cause for sleep-deprivation, which means that we mainly have to deal with seemingly-easier-to-change causes (e.g., education, social norms).

(I edited the question to say this explicitly.)

answer by Holly_Elmore · 2019-05-06T19:10:02.298Z · score: 1 (1 votes) · EA · GW

I'm biased in favor of this. I started sleeping enough when I got very ill (proper sleep on a routine schedule is the most important thing I can do besides medication to manage my disease) and it has made such a difference to my experience of life. I'm beginning to suspect overstimulation in general is a hugely underappreciated cause of pysical and psychological dysfunction.

My only hesitation is that the solutions that are forthcoming aren't exactly in EA's wheelhouse, but that could be because I'm not thinking creatively enough. Sleep deprivation is important and neglected, but might not be very tractable and effective solutions may or may not be scalable. There's not some cheap supplement that everyone needs that we could just hand out. You have to be dedicated to making an against-the-grain personal behavior change to sleep more, and that's complicated and hard. (As I say, only severe illness was able to move the needle for me.) My first thoughts are all policy solutions: later school start times, more mandatory sleep breaks for hospital workers, shift workers, etc., some way of regulating smartphones to cut into sleep less? One of those might rise to EA criteria.

comment by orenmn · 2019-05-07T13:51:32.184Z · score: 6 (3 votes) · EA · GW
There's not some cheap supplement that everyone needs that we could just hand out. You have to be dedicated to making an against-the-grain personal behavior change to sleep more, and that's complicated and hard. (As I say, only severe illness was able to move the needle for me.)

I am just hopeful that reading the book (or some equivalent experience that educates one about the benefits of sleep and costs of sleep-deprivation) is enough to make some people change their sleep habits.

If I let my hopefulness run wild, I imagine these few people that changed their sleep habits (like you and me) telling their friends and families about its positive consequences, who would in turn tell their friends and families, and so on.

Also, I think that advocacy is something that the EA community can be quite effective at. For example (though it is just my guess - I don't have evidence for that), I guess the EA community helped a lot in making people less dismissive about the risk of unaligned AI.

(Honestly, I don't think there is any neglected problem that the EA community would be ineffective against. It seems to me that this community includes many highly capable people, and so as long as some problem is quite neglected, I am sure EAs can at least find some of the low hanging fruit, as long as they direct their attention toward that problem.)

comment by Holly_Elmore · 2019-05-07T21:00:14.120Z · score: 14 (8 votes) · EA · GW

Although I don't think it's a likely EA cause area, I definitely think it's good for the world to raise awareness about the costs of sleep deprivation among EAs! I'd love to see norms in our community of respecting sleep, like not having events too late, not making them too overstimulating, not relying on alcohol to make something a social event, rejecting startup-y "always on" culture on by doing business mostly by daylight, etc.

19 comments

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comment by weeatquince · 2019-05-06T16:16:46.989Z · score: 4 (4 votes) · EA · GW

There is a very obvious upside to sleeping less: when you are not asleep you are awake and when you are awake you can do stuff.

On a very quick glace the economic analysis referenced above (and the quotes from Why Sleep Matters) seems to ignore this. If, as Khorton says, a person is missing sleep to raise kids or work a second job, then this benefits society.

This omission makes me very sceptical of the analysis on this topic.

comment by orenmn · 2019-05-06T16:57:48.772Z · score: 5 (4 votes) · EA · GW

I agree that Matthew Walker seems quite biased in favor of sleep.

Still, I don't think he omits your point. Instead, he argues that a person's performance (in various areas) is much worse when sleep deprived, and so a sleep deprived person that invests more time in doing stuff is still less productive than a person that gets enough sleep (and has less time to do stuff).

I highly recommend checking out the book (Why We Sleep) - it depicts many of the experiments that make Matthew so confident that he is right.

comment by orenmn · 2019-05-09T11:20:16.043Z · score: 1 (1 votes) · EA · GW

I found some pages in Why We Sleep that seem to answer your argument, and tried to quote the essence of it:

Early studies demonstrated that shorter sleep amounts predict lower work rate and slow completion speed of basic tasks. That is, sleepy employees are unproductive employees. Sleep-deprived individuals also generate fewer and less accurate solutions to work-relevant problems they are challenged with. [W. B. Webb and C. M. Levy, “Effects of spaced and repeated total sleep deprivation”]
We have since designed more work-relevant tasks to explore the effects of insufficient sleep on employee effort, productivity, and creativity. Creativity is, after all, lauded as the engine of business innovation. Give participants the ability to choose between work tasks of varying effort, from easy (e.g., listening to voice mails) to difficult (e.g., helping design a complex project that requires thoughtful problem solving and creative planning), and you find that those individuals who obtained less sleep in the preceding days are the same people who consistently select less challenging problems. They opt for the easy way out, generating fewer creative solutions in the process. [...]
take the same individuals and repeat this type of experiment twice, once when they have had a full night of sleep and once when they are sleep-deprived, and you see the same effects of laziness caused by a lack of sleep when using each person as their own baseline control. [M. Engle-Friedman and S. Riela, “Self-imposed sleep loss, sleepiness, effort and performance”] [...]
The irony that employees miss is that when you are not getting enough sleep, you work less productively and thus need to work longer to accomplish a goal. [...]
Interestingly, participants in the above studies do not perceive themselves as applying less effort to the work challenge, or being less effective, when they were sleep-deprived, despite both being true. They seemed unaware of their poorer work effort and performance—a theme of subjective misperception of ability when sleep-deprived that we have touched upon previously in this book. Even the simplest daily routines that require slight effort, such as time spent dressing neatly or fashionably for the workplace, have been found to decrease following a night of sleep loss. [M. Engle-Friedman and S. Riela, “Self-imposed sleep loss, sleepiness, effort and performance”] Individuals also like their jobs less when sleep-deprived—perhaps unsurprising considering the mood-depressing influence of sleep deficiency.