[ Question ]

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

by orenmn 5mo6th May 201919 comments

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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).

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6 Answers

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.

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.

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.

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).

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

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.