(I’ll reply in more substance by the end of the week—have a big deadline coming up this Thursday)
From skimming the post, three parts stand out to me
1. the fact that acute sleep deprivation relieves depression in ~50% of people with depression seems completely unaddressed and Natália’s section about bipolar people seems to imply that this would not be happening. I specifically noted in this the section Natália addresses by writing:
Lack of sleep is such a potent trigger for mania that acute sleep deprivation is literally used to treat depression. Aside from ketamine, not sleeping for a night is the only medicine we have to quickly – literally overnight – and reliably (in ~50% of patients) improve mood in depressed patients
2.
One of Guzey’s theses is that “[o]ccasional acute sleep deprivation is good for health and promotes more efficient sleep.” His argument supporting that thesis is pretty much that, because some types of acute stress (such as exercising and fasting) are good, and acute sleep deprivation causes acute stress, then acute sleep deprivation is also good. (Yes, that does seem to actually be the entirety of his argument in that section. You can read it yourself.)
The obvious problem with that argument is that the set of things that cause acute bodily stress is much larger than the set of things that cause long-term benefits. Stubbing your toe, for example, causes acute bodily stress. Guzey’s argument works equally well for showing that occasional toe-stubbing is good for health as for showing that occasional acute sleep deprivation is.
As far as I know, there’s no evidence that stubbing depressed people’s toes relieves their depression in 50% of the cases, which combined with the relationship with mania in bipolar people, and the analogical reasoning to exercise and fasting leads me to believe that acute sleep deprivation is good.
3. Natália misquotes me at the end of the piece. I never wrote that 6 hours of sleep is optimal. I have no idea how many hours of sleep is optimal and I believe (please let me know if this is not the case) I never stated that a particular amount of sleep is optimal.
What I wrote in the appendix of the Why We Sleep piece Natália linked to was: “people who have the lowest mortality actually sleep 6 hours a night”. Earlier in that article (which, it is clear that Natália read carefully), I specifically wrote “we should almost never use [epidemiological evidence] to claim causality”.
The fact that I spotted these three points after spending ~3 minutes skimming the post do not make me optimistic about the rest of the critique, but, as noted above, I will reply in more detail in a few days.
Natália doesn’t set out to disprove all of your theses, but rather to put forth some counter-theses. She says:
I decided to write a post pointing out several of the mistakes I think he’s made, and reporting some of what the academic literature on sleep seems to show.
Read carefully, she neither claims that every point you’ve made is mistaken, nor to give a comprehensive review of the academic literature. So I don’t think you can fault her for not addressing the point about the use of sleep deprivation as a depression cure. She’s critiquing those theses of yours which she found weak, not issuing a comprehensive point-by-point criticism of your entire original post.
I think that you owe this level of care in interpreting her language, because you’re insisting that she offer you that same level of care. You said:
people who sleep just 6 hours a night might have the lowest mortality
And then you complain when she rephrases this as:
six hours of sleep being optimal for mortality, as Guzey has hypothesized before (as well as evidence against eight hours being optimal for mortality, of course).
To my eye, these reflect approximately equal levels of imprecision, thought that’s a purely subjective claim. I think you would both be in the right to object to each others’ misreporting of your exact claims. To put it in more collegial terms, I think this discussion can and will benefit from precise reading and deep consideration.
The obvious problem with that argument is that the set of things that cause acute bodily stress is much larger than the set of things that cause long-term benefits. Stubbing your toe, for example, causes acute bodily stress. Guzey’s argument works equally well for showing that occasional toe-stubbing is good for health as for showing that occasional acute sleep deprivation is. - Natália
As far as I know, there’s no evidence that stubbing depressed people’s toes relieves their depression in 50% of the cases, which combined with the relationship with mania in bipolar people, and the analogical reasoning to exercise and fasting leads me to believe that acute sleep deprivation is good. - Guzey
Here, I think that while it’s reasonable to desire Natália to have inferred that you think the utility of SD as a depression treatment is supporting evidence for it being a “good stressor,” you also did not specifically tie this in as a piece of evidence in the relevant section here. So I think Natália is more or less literally correct when she points out that this is “the entirety of [your] argument in that section” (emphasis mine), even if it’s not a maximally charitable synthesis of your post as a whole.
That aside, I think it’s clear that this is a crux, as others have brought up the question of why we intuit that some forms of acute stress (i.e. stubbing a toe) are just bad, while others (i.e. exercise and maybe sleep deprivation) can be good. I think it’s an interesting question, and worth carrying on the argument, as you’re doing here.
I’m looking forward to reading a more extensive response to Natália’s post!
That aside, I think it’s clear that this is a crux, as others have brought up the question of why we intuit that some forms of acute stress (i.e. stubbing a toe) are just bad, while others (i.e. exercise and maybe sleep deprivation) can be good.
FWIW, I don’t think the stubbed toe example is integral to the argument. The stubbed toe example was almost certainly just an analogy, not a knockdown argument, in regards to the more general point that the link between acute stress and health benefit seems to be weak.
I think a better way of phrasing this crux is that it’s unclear why this form of acute stress is beneficial, where this refers to sleep deprivation. It would be nice to get specific evidence regarding why sleep deprivation is the right type of acute stress to promote health, when the relationship does not hold in general.
I don’t think I’m objecting to your current summary of the debate necessarily, but I do think focusing on the stubbed toe example is mostly a distraction, and all parties are better off relying on different arguments.
I agree that stubbed toes needn’t be a central example of “acute stress,” and I would hope that most people are just using it as you suggest—a convenient analogy for a minor but pretty-clearly-bad form of injury, one that stands in contrast to plausibly beneficial stressors like exercise.
Natália’s section about bipolar people seems to imply that [sleep deprivation’s short-term antidepressant effects] would not be happening.
I disagree. I said,
A night of total sleep deprivation seems to be able to trigger full-blown mania in a substantial percentage of people with bipolar disorder (even those currently depressed) and even cause mania-like behavior in healthy subjects. Moreover, a shift towards mania or hypomania after a short night of sleep seems common in bipolar patients.
Here, I think it was clear that what I said is consistent with sleep deprivation having antidepressant effects, and it could even be interpreted as implying that it does. So I think it’s misleading to suggest that this section implied that the antidepressant effect does not exist.
2. Your section arguing that occasional sleep deprivation is good for health makes no mention of its antidepressant effects, which were addressed separately earlier on in your post. I thought you were making a separate argument in that section, which is why I countered with an appropriate analogy. I merely think that the argument “sleep deprivation causes acute stress, therefore it’s good” is weak, and that was my point in that section. My particular analogy might not have been great, however, I agree.
Separately, I don’t think that association between sleep deprivation and mania is evidence that sleep deprivation is good rather than bad; as my section in this matter showed, manic episodes very often have severe long-term consequences.
3. I apologize, I used poor phrasing here that made it seem like I was claiming something I wasn’t. I didn’t mean to say that you were hypothesizing that 6 hours was causally optimal, in the sense that people should sleep for 6 hours if they want to have the lowest mortality, in that paragraph. I was using the word “optimal” to mean “associated with the lowest mortality.” I’ll rephrase the paragraph to make it clearer that I was not interpreting you as making a causal claim.
Overall, I don’t think the errors you pointed out so far were particularly glaring. The last part of your point (1) seems to be based on a misunderstanding of what I wrote, though perhaps upon further elaboration we’ll find that we do actually disagree on something specific here. Point (2) reflects more of a clash of intuitions between us, rather than a mistake on my part; it’s reasonable to disagree about the strength of my analogy, but it really wasn’t a large part of my argument. Point (3) was merely an error in the sense that I used poor phrasing when describing your position.
I think it’s a little unfair to say “The fact that I spotted these three points after spending ~3 minutes skimming the post do not make me optimistic about the rest of the critique” when your points were individually and together, quite weak. However, I am hopeful that we can have a productive dialogue about this subject soon, and get closer to our cruxes on these issues.
Here, I think it was clear that I pointed out the antidepressant effects of sleep deprivation in at least some subjects (before the “and”). So I think it’s misleading to suggest that this section implied that the antidepressant effect does not exist.
I don’t quite follow. The closest you come in the quote is that it can “trigger full-blown mania,” not that it is a depression treatment.
Guzey says:
Lack of sleep is such a potent trigger for mania that acute sleep deprivation is literally used to treat depression. Aside from ketamine, not sleeping for a night is the only medicine we have to quickly – literally overnight – and reliably (in ~50% of patients) improve mood in depressed patients (until they go to bed, unless you keep advancing their sleep phase ). NOTE: DO NOT TRY THIS IF YOU ARE BIPOLAR, YOU MIGHT GET A MANIC EPISODE.
I did not interpret this as saying sleep deprivation treats depression by causing mania. Instead, I think Guzey is suggesting that sleep deprivation treats depression through a neurological pathway that can also lead to mania in bipolar patients. I think it’s fine to ignore this point if you’re not interested in addressing it, but I don’t think it’s fair to characterize your reference to “trigger full-blown mania” as a clear acknowledgement of sleep deprivation’s therapeutic benefits for some depressed patients. If that was indeed your conscious intent, then my feedback is that your writing was illegible in this area.
As a caveat, it seems like you might have inferred from Guzey’s overall post that he has a positive impression of mania. I think this is belied by phrases like “DO NOT TRY THIS IF YOU ARE BIPOLAR, YOU MIGHT GET A MANIC EPISODE,” but not an impossible takeaway.
Overall, I don’t think the errors you pointed out so far were particularly glaring… I think it’s a little unfair to say “The fact that I spotted these three points after spending ~3 minutes skimming the post do not make me optimistic about the rest of the critique” when your points were individually and together, quite weak. However, I am hopeful that we can have a productive dialogue about this subject soon, and get closer to our cruxes on these issues.
I agree with your assessment, and Guzey really ought to read your article in depth before throwing shade on it. I think your commitment to constructive dialog is admirable here.
Switching to mania from depression usually (though not always) means that the depressive symptoms went away. But I agree that my phrasing was poor and I’ll edit it.
(I’ll reply in more substance by the end of the week—have a big deadline coming up this Thursday)
From skimming the post, three parts stand out to me
1. the fact that acute sleep deprivation relieves depression in ~50% of people with depression seems completely unaddressed and Natália’s section about bipolar people seems to imply that this would not be happening. I specifically noted in this the section Natália addresses by writing:
2.
As far as I know, there’s no evidence that stubbing depressed people’s toes relieves their depression in 50% of the cases, which combined with the relationship with mania in bipolar people, and the analogical reasoning to exercise and fasting leads me to believe that acute sleep deprivation is good.
3. Natália misquotes me at the end of the piece. I never wrote that 6 hours of sleep is optimal. I have no idea how many hours of sleep is optimal and I believe (please let me know if this is not the case) I never stated that a particular amount of sleep is optimal.
What I wrote in the appendix of the Why We Sleep piece Natália linked to was: “people who have the lowest mortality actually sleep 6 hours a night”. Earlier in that article (which, it is clear that Natália read carefully), I specifically wrote “we should almost never use [epidemiological evidence] to claim causality”.
The fact that I spotted these three points after spending ~3 minutes skimming the post do not make me optimistic about the rest of the critique, but, as noted above, I will reply in more detail in a few days.
Natália doesn’t set out to disprove all of your theses, but rather to put forth some counter-theses. She says:
Read carefully, she neither claims that every point you’ve made is mistaken, nor to give a comprehensive review of the academic literature. So I don’t think you can fault her for not addressing the point about the use of sleep deprivation as a depression cure. She’s critiquing those theses of yours which she found weak, not issuing a comprehensive point-by-point criticism of your entire original post.
I think that you owe this level of care in interpreting her language, because you’re insisting that she offer you that same level of care. You said:
And then you complain when she rephrases this as:
To my eye, these reflect approximately equal levels of imprecision, thought that’s a purely subjective claim. I think you would both be in the right to object to each others’ misreporting of your exact claims. To put it in more collegial terms, I think this discussion can and will benefit from precise reading and deep consideration.
Here, I think that while it’s reasonable to desire Natália to have inferred that you think the utility of SD as a depression treatment is supporting evidence for it being a “good stressor,” you also did not specifically tie this in as a piece of evidence in the relevant section here. So I think Natália is more or less literally correct when she points out that this is “the entirety of [your] argument in that section” (emphasis mine), even if it’s not a maximally charitable synthesis of your post as a whole.
That aside, I think it’s clear that this is a crux, as others have brought up the question of why we intuit that some forms of acute stress (i.e. stubbing a toe) are just bad, while others (i.e. exercise and maybe sleep deprivation) can be good. I think it’s an interesting question, and worth carrying on the argument, as you’re doing here.
I’m looking forward to reading a more extensive response to Natália’s post!
FWIW, I don’t think the stubbed toe example is integral to the argument. The stubbed toe example was almost certainly just an analogy, not a knockdown argument, in regards to the more general point that the link between acute stress and health benefit seems to be weak.
I think a better way of phrasing this crux is that it’s unclear why this form of acute stress is beneficial, where this refers to sleep deprivation. It would be nice to get specific evidence regarding why sleep deprivation is the right type of acute stress to promote health, when the relationship does not hold in general.
I don’t think I’m objecting to your current summary of the debate necessarily, but I do think focusing on the stubbed toe example is mostly a distraction, and all parties are better off relying on different arguments.
I agree that stubbed toes needn’t be a central example of “acute stress,” and I would hope that most people are just using it as you suggest—a convenient analogy for a minor but pretty-clearly-bad form of injury, one that stands in contrast to plausibly beneficial stressors like exercise.
1.
I disagree. I said,
Here, I think it was clear that what I said is consistent with sleep deprivation having antidepressant effects, and it could even be interpreted as implying that it does. So I think it’s misleading to suggest that this section implied that the antidepressant effect does not exist.
2. Your section arguing that occasional sleep deprivation is good for health makes no mention of its antidepressant effects, which were addressed separately earlier on in your post. I thought you were making a separate argument in that section, which is why I countered with an appropriate analogy. I merely think that the argument “sleep deprivation causes acute stress, therefore it’s good” is weak, and that was my point in that section. My particular analogy might not have been great, however, I agree.
Separately, I don’t think that association between sleep deprivation and mania is evidence that sleep deprivation is good rather than bad; as my section in this matter showed, manic episodes very often have severe long-term consequences.
3. I apologize, I used poor phrasing here that made it seem like I was claiming something I wasn’t. I didn’t mean to say that you were hypothesizing that 6 hours was causally optimal, in the sense that people should sleep for 6 hours if they want to have the lowest mortality, in that paragraph. I was using the word “optimal” to mean “associated with the lowest mortality.” I’ll rephrase the paragraph to make it clearer that I was not interpreting you as making a causal claim.
Overall, I don’t think the errors you pointed out so far were particularly glaring. The last part of your point (1) seems to be based on a misunderstanding of what I wrote, though perhaps upon further elaboration we’ll find that we do actually disagree on something specific here. Point (2) reflects more of a clash of intuitions between us, rather than a mistake on my part; it’s reasonable to disagree about the strength of my analogy, but it really wasn’t a large part of my argument. Point (3) was merely an error in the sense that I used poor phrasing when describing your position.
I think it’s a little unfair to say “The fact that I spotted these three points after spending ~3 minutes skimming the post do not make me optimistic about the rest of the critique” when your points were individually and together, quite weak. However, I am hopeful that we can have a productive dialogue about this subject soon, and get closer to our cruxes on these issues.
I don’t quite follow. The closest you come in the quote is that it can “trigger full-blown mania,” not that it is a depression treatment.
Guzey says:
I did not interpret this as saying sleep deprivation treats depression by causing mania. Instead, I think Guzey is suggesting that sleep deprivation treats depression through a neurological pathway that can also lead to mania in bipolar patients. I think it’s fine to ignore this point if you’re not interested in addressing it, but I don’t think it’s fair to characterize your reference to “trigger full-blown mania” as a clear acknowledgement of sleep deprivation’s therapeutic benefits for some depressed patients. If that was indeed your conscious intent, then my feedback is that your writing was illegible in this area.
As a caveat, it seems like you might have inferred from Guzey’s overall post that he has a positive impression of mania. I think this is belied by phrases like “DO NOT TRY THIS IF YOU ARE BIPOLAR, YOU MIGHT GET A MANIC EPISODE,” but not an impossible takeaway.
I agree with your assessment, and Guzey really ought to read your article in depth before throwing shade on it. I think your commitment to constructive dialog is admirable here.
Switching to mania from depression usually (though not always) means that the depressive symptoms went away. But I agree that my phrasing was poor and I’ll edit it.