Getting Enough Sleep

The original story was in the New York Times Magazine but many other outlets picked it up and commented as well.  Sleep is the new status symbol.  If you get 7 or more hours of sleep per night you are the envy of the neighborhood (or the office).

There was a time, not too long ago, when bragging rights went to those with more endurance, the marathon runners of staying awake.  If someone needed only 4 or 5 hours (or less) a night, we were sure to hear about it.  It put him or her in a league with many people famous, in part, for their admirable work ethic.  The list includes Thomas Edison, Nicola Tesla, Buckminster Fuller and Leonardo Da Vinci. If someone achieves stardom but needs a normal amount of sleep, we never hear about it.  The rich and famous who got by on much less had it listed with other credentials of superiority.

Now driven by promotion of a supposedly new, cool image, we are being sold a wide variety of sleep solutions that are expected to fly off the shelves.  The researchers are investigating a broad spectrum of ideas and devices including: a machine for bedroom air quality measurement, recordings of Icelandic fairy tales, specialty hammocks, weighted blankets, lavender oil and a headband that uses sound waves to induce sleep.  Another inventor came up with “a gadget you wear on your finger that uses sound to startle you awake every three minutes for an hour.”  The theory is that it gets all disruptions out of the way allowing you to fall asleep.   He also markets “a pair of goggles fitted with tiny green-blue lights that shine back into your eyes, [which] aims to reset your body’s clock.”  This is becoming big business.  “Sleep entrepreneurs from Silicon Valley and beyond have poured into the sleep space, as branders like to say -- a $32 billion market in 2012 -- formerly inhabited by old-style mattress and pharmaceutical companies.”  (I guess if they can sell us water that falls from the sky, they can sell us sleep, too.)

While the purpose of sleep may not be totally clear, the benefits of getting enough sleep and the dangers of getting too little are well known and broadly publicized.  The website health.com lists many benefits.  Getting enough sleep is among the big, common sense lifestyle recommendations on such websites as Mayo Clinic, WebMD and many others – along with healthy eating, not smoking, not drinking to excess and exercise.  In his book about addiction Irresistible, Adam Alter lists the following as symptoms of sleep deprivation:  heart disease, lung disease, kidney disease, appetite suppression, poor weight control, weakened immune functioning, lower resistance to disease, higher pain sensitivity, slow reaction times, mood fluctuation, depressed brain functioning, depression, obesity, diabetes and certain forms of cancer. (p. 68).  The annual loss to businesses in the US attributed to sleep-deprived employees is estimated at $411 billion.

We know all the truth of this and usually feel it the next day but pay no attention to the advice.  One source estimates the problem at thirty percent of the population.  In 2017 does it take hype, gadgets and gimmicks to get Americans doing what they have known all along they really should be doing?  That doesn’t paint a very encouraging picture of our society and its future.  It used to be simple.  Our cave-dwelling ancestors could fall asleep without an app or a sleep coach even as they faced more threatening daily perils; why can’t we?

Critical Thinking About the United Airlines Fiasco

By now everyone has heard the news and seen pictures of the doctor being dragged from the United Airlines flight from Chicago to Louisville.  The Internet and network news went crazy with cell-phone videos of the incident.  The company stock is dropping based partially on talk of a boycott in protest.  The CEO apologized, but it’s too late; the damage is done.  Now Americans are pouring out prayers and sympathy for the doctor, but is this really justified?  

It is clear that the company screwed up to such an extent that they deserve the public relations disaster they are experiencing.  There were clearly other solutions.  Four seats were needed on the plane for crewmembers who had to be in Louisville (and rested) in the morning for uninterrupted service the next day.  Since there were no more flights available that night, the company could have used the thousands of dollars offered in vouchers to pay for ground transportation for the five-hour drive either for the bumped passengers or the crew.  Otherwise, they could have announced that the plane was not moving until that passenger got off and let peer pressure take over.  Instead they called in the airport security goons.

But something is missing.  According to earlier stories, the airline offered vouchers and motel to volunteers but got none.  Then they resorted to a random drawing to choose passengers to give up their seats.  What of the other three passengers?  They were not dragged from the plane, only the doctor.  How was he treated before being forcibly removed and how did he react?  The airline characterized him as "disruptive and belligerent.”  That is an opinion, but in the videos he certainly didn’t appear to be cooperative.

The big question in the midst of this outpouring of sympathy and prayers is, what was the underlying message?  It was there.  If people were alert and thinking instead of emotionally reacting to only the video, they could see it very clearly.  The underlying message from the doctor, and he might as well have stood up and shouted it at the rest of the passengers, was “I am more important than you!”

That’s right.  Three other passengers, who are receiving no media attention, cooperated with the airline in the legal exercise of their authority based on the agreement on every ticket.  “Federal rules dictate a carrier must first check whether anyone is willing to voluntarily give up their seat before then bumping flyers involuntarily if nobody comes forward.”  It’s the law.

So did the doctor react as the others did?  If someone else had been chosen, he would have sat back and enjoyed the flight with the message unspoken.  But when he was chosen, he reacted like a two-year-old who didn’t get his way.  He went limp, forcing security agents to drag him off.  He looked like a protester being removed from a picket line.  But remember what he was protesting – he was protesting his right, his firm belief, that he was better than everyone else on that flight.  If you had been on the flight, the implicit message figuratively being shouted in your face as he was dragged from the plane would have been, “I am more important than you, too!”

With that in mind, give him as much sympathy as you think he deserves, but don’t forget the message.  Also note that one interviewed passenger mentioned that she and her son “were sitting in the row directly behind…the doctor and his wife.”  Wait, yet another solution, if he had patients so desperately in need of attention the following morning, couldn’t he have turned to his wife and said, “Excuse me for imposing, Dear, but you know the situation.  Would you be so kind, and I promise to make it up to you.”  Given that information perhaps the patients were not the issue but merely a pretext for the real message, “I am more important than you.”

Let's Not Become Victims

Last Tuesday was the celebration (?) of women not being paid as much as men.  It seems odd that people would go out of their way to make themselves feel bad, but that’s the way it is.  Maybe taking on the status of victimhood draws sympathy or gives one a chance to express pent up anger and resentment, but it doesn’t really do anything to solve the problem.  What’s worse was the blatant exaggeration to make the point – 20% indeed!

But that’s what politicians were telling us last summer and for many years, and there is no reason to change the story now.  CBS proudly reported:  “The gender pay gap is a well documented phenomenon” according to a new study by an organization called Glassdoor.  The lead was that a survey of half a million people in America revealed that a woman earn 76 cents for every dollar a man earns.  But they then added, the “statistic may be slightly misleading, in that it doesn't compare men and women on an apples-to-apples basis, such as comparing women with similar levels of education and experience with men in the same situation.”  Later in the article this apples-to-apples comparison yields a real difference of 5.4%.  Another source using similar calculations had come up with about 1% less.

In a different article they elaborate on this:  “Yet even when controlled for those factors and other issues (such as employers and job titles), women earn more than 5 percent less than men.”  So where does the 20% number come from, except from an attempt to purposely make the gap look a lot worse by using an invalid comparison?  Apparently trying to soften this discrepancy, they argue:  “Male preschool and kindergarten teachers earn $16.33 per hour, compared with $14.42 per hour for their female counterparts.”  Instead of providing further evidence for a deliberate gap, this should strike us as odd.  Don’t almost all kindergarten teachers belong to a union that negotiates wages for schoolteachers?  I’m sure their contracts don’t say, “Just pay the guys a little more.”  As an attempted example of a valid comparison, this statistic is incredible.

Yet people continue to make these false claims about the size of the gap, despite the ease of finding information like this from Forbes to clearly explain the misconceptions, both from faulty calculations and from poor understanding of the situation.  “President John F. Kennedy signed the Equal Pay Act in 1963, making sex-based discrimination in pay illegal.”  We don’t need more laws; we need better enforcement.  The government is quick to point out to a business owner when there are fewer than the required number of handicap parking spaces, but for nine presidential administrations this wage-gap problem persists.

Of course advertisers have been jumping on the bandwagon to promote the falsehood.  Several businesses showed support by offering a 20% discount for women on the wage-gap “holiday” last week.  Some say those businesses are doing this to “try to raise awareness” about the unfairness.  Get real! – They are not trying to raise awareness; they are trying to sell stuff and to develop a base of loyal customers.

Now it’s not right that any woman with the same background and experience should be paid less than any man for doing exactly the same job.  Until the 4% or 5% becomes zero the problem is not solved.  (Nor would it be right if positions were reversed.)  However, it’s also not right to intentionally mislead women by exaggerating the size of the problem as a ploy to gain support for political or commercial gain.

Grandma Fell Off the Wagon

The news was coming from all major sources earlier this week.  The incidence of drinking among Americans over 60, especially among women, is rising.  A story from the CNN wire cites a recently published study of analysis of “over 145,000 responses to the National Health Interview Survey from 1997 to 2014. They observed a steady increase in the number of older adults who consumed alcohol. Men reported higher numbers of regular and binge-drinking tendencies than women, but the largest percentage increases were seen in the female population.”

In light of my entry one week ago about the need for careful definitions and last time about studies that give us very little new information, this was worth looking into.  Experts believe this trend will increase the need for more “public health programming,” whatever that is.

They clearly define current drinkers as those who consumed “12 or more drinks in any one year in their lifetime and one or more drinks in the past year.”  That is a very broad range, but here is the concern.  “In the US 20 years ago, 54% of men 60 and older were reported to be ‘current drinkers,’ and 37.8% of women fit the same description.” By 2014, both groups had seen increases:  Men rose to 59.9% and women to 47.5%.  The difference decreased from 16.2 to 12.4 percentage points.  Actually, based on the definition, those numbers are lower than I expected.

The other increase comes in binge drinking: “consuming five or more drinks in a single day in the past year.”  For men the increase was from 19.9% to 22.5%, and it was from 4.9% to 7.5% for women.  These are people over 60 whose bodies are less able to adapt to large alcohol consumption.  They are also more likely to be on medications that may interact poorly with alcohol – hence the concern.

A couple of questions come to mind.  First they base their numbers on self-reporting, which is typically less reliable; but with such a large sample this is less of a concern.  Second, they are not talking about a stable population.  Those who are 60 today were 40 twenty years ago and likely carried their drinking habits forward over those years.  Many of those over 60 twenty years ago may not be around to answer the latest survey.

In summary the article recommends doctors have a talk with older patients.  My doctor has a talk with me about alcohol.  He asks how much, and I say (honestly) rarely more than one drink a week.  And he is OK with that because according to the Mayo Clinic: “Moderate alcohol consumption may provide some health benefits,” with emphasis on the may.  And they define moderate for healthy adults as “one drink a day for women of all ages and men older than age 65.”  (That's a lot more than the 12 drinks per year cited above.)

Another question is whether this is really news.  An analysis published last December found pretty much the same trends, but looked at people over 50 who answered a different survey.  This one didn’t clearly define binge drinking.  (Perhaps they used the different definition from the NIH of 4 drinks or just let the survey respondents decide for themselves.)  Also, the Huffington Post featured information from yet another survey about two years ago telling how the increase in binge drinking for women of all ages was greater than that of men.

Although men may have a greater drinking problem, some outlets seem more distressed at the prospect of women catching up.  The headlines on at least two sites, CBS and newsmax, about that most recent study read:  “More older women are drinking hard,” downplaying the same trend among men.

In any case, just wait a month or two and there will be more headlines and more shocking stories.  This may be an important issue to the subscribers to the journal Alcoholism: Clinical and Experimental Research, but to the media it is just a periodic opportunity to try to incite a little panic in the general public – until the next crisis or shocking research finding comes along.

The Best Exercise for Losing Weight

News of the latest study from Duke University claims to settle what some refer to as a decades-old debate - which type of exercise: classic cardio, strength training, or a combination of the two is the best for losing weight?  “An 8 month study that followed 119 overweight volunteers found that cardio was the winner!”  That’s the simple answer, but not the whole story.  Let’s use some critical thinking and research to take a deeper look into this revelation.

First, they were not using a very large sample size, and we find out the 119 subjects were split into three smaller subgroups of about 40 each.  Cardio did provide the best results but the group that did both “actually had the most improved ration of fat-to-lean muscle mass.”  In an attempt to decide if it’s one or the other, they conclude that the best answer is both – pretty anticlimactic.

But pay close attention to the subtitle of the article:  “Don't forget to make healthy food choices too.”  Exercise alone isn’t the answer.

The big mystery, though, is why they presented this as a decades-old debate.  Another very thorough article on the subject from the WebMD archives dated 2007 tells us, “In all cases, however, you'll burn more calories with cardio (aerobic) exercise than with strength or resistance training.”

Then they come to pretty much the same conclusion about the benefits of doing both and top it off with:  “Eating and exercise are not separate issues…Too many people think these large doses of exercise are an excuse to eat whatever you want."

Which takes us to an NPR segment from six months ago on the results of long-term research looking at the effectiveness of wearable technology, specifically those fitness monitors.  “The 470 people in the study were put on a low-calorie diet and asked to exercise more. They all started losing weight. Six months in, half the group members started self-reporting their diet and exercise. The other half were given fitness trackers to monitor their activity.”  Researchers were surprised to find that after two years, reporting equal amounts of physical activity, the group with the fitness trackers lost less weight.”

A possible explanation for this difference is related to a theory of behavior called risk compensation (later renamed risk homeostasis).  The theory was developed to “explain the fact that people adjust their behaviour in the face of interventions.”  Often used to explain why making cars safer causes some drivers to take more risks and adding padding to playgrounds results in wilder play among some children, risk compensation can also refer to how a technological monitor could cause some dieters to eat more than they otherwise might have.  They are more easily tempted to offset the more visible effect of the exercise by snacking a little more.

This brings us full circle.  There was never any need for a debate or for a new study.  We’ve known for at least 10 years that cardio burns more calories but cardio and strength training work well together.  But any exercise alone is not enough.  It’s well known that healthy eating is top priority and that it’s much easier not to eat calories than to burn them off through exercise.

Finally, the same wisdom applies to both exercise and dieting.  The best exercise for you is the one you will do.  The best diet is the one you will stick to.  Nothing new here!