Are we winning the War on Sleeplessness?

Or, as the authors of this paper put it, are we seeing the “first signs of success in the fight against sleep deficiency?”



The high prevalence of chronic insufficient sleep in the population has been a concern due to the associated health and safety risks. We evaluated secular trends in sleep duration over the most recent 14-year period.


The American Time Use Survey, representative of US residents ≥15 years, was used to investigate trends in self-reported sleep duration and waking activities for the period 2003-2016 (N = 181335 respondents).


Sleep duration increased across survey years both on weekdays (+1.40 min/year) and weekends (+0.83 min/year, both p < .0001, adjusted models). This trend was observed in students, employed respondents, and retirees, but not in those unemployed or not in the labor force. On workdays, the prevalence of short (≤7 hr), average (>7-9 hr), and long (>9 hr) sleep changed by -0.44% per year (p < .0001), -0.03% per year (p = .5515), and +0.48% per year (p < .0001), respectively. The change in sleep duration was predominantly explained by respondents retiring earlier in the evening. The percentage of respondents who watched TV or read before bed-two prominent waking activities competing with sleep-decreased over the same time period, suggesting that portions of the population are increasingly willing to trade time in leisure activities for more sleep. The results also suggest that increasing online opportunities to work, learn, bank, shop, and perform administrative tasks from home freed up time that likely contributed to increased sleep duration.


The findings indicate first successes in the fight against sleep deficiency. Public health consequences of the observed increase in the prevalence of long sleep remain unclear and warrant further investigation

Here is the American Time Use Survey which the authors used for their study.


“What’s not going to change in the next ten years?” (via Pedro de Bruyckere’s “From experience to meaning” blog)

I normally hate Twitter “threads”, which often seem all too pompous, tendentious, and flat out wrong. But here’s a good one, via Via Pedro de Bruyckere’s From Experience to Meaning blog.  And it is also a thread that makes me think a little better of Jeff Bezos.  Here’s the beginning :


When I read the first tweet of this thread by Benjamin Riley I had the feeling we were up to something good. And Benjamin didn’t disappoint. I won’t make it into a habit of posting something like this on this blog, but I do wanted to share this here as I know that many of my readers would otherwise miss this:

Benjamin Riley@benjaminjriley

Please forgive me for the following tweet thread (not to say tirade) that will attempt to connect Jeff Bezos, , predicting the future, and cognitive science together. Get ready!

Benjamin Riley@benjaminjriley

First, here’s the quote from Jeff Bezos about building a business when the future is uncertain (it’ll take a few tweets): “”I very frequently get the question: ‘What’s going to change in the next 10 years?’ And that is a very interesting question; it’s a very common one…”

Benjamin Riley@benjaminjriley

Bezos continues: “I almost never get the question: ‘What’s not going to change in the next 10 years?’ And I submit to you that that second question is actually the more important of the two — because you can build a business strategy around the things that are stable in time.”

I am confident this is the most memorable article ever from the British Journal of Urology

Full access here. This is certainly worth reading all the way to the end…. can’t help but wholeheartedly agree with the author’s conclusion.

How (not) to communicate new scientific information: a memoir of the famous brindley lecture

In 1983, at the Urodynamics Society meeting in Las Vegas, Professor G.S. Brindley first announced to the world his experiments on self‐injection with papaverine to induce a penile erection. This was the first time that an effective medical therapy for erectile dysfunction (ED) was described, and was a historic development in the management of ED. The way in which this information was first reported was completely unique and memorable, and provides an interesting context for the development of therapies for ED. I was present at this extraordinary lecture, and the details are worth sharing. Although this lecture was given more than 20 years ago, the details have remained fresh in my mind, for reasons which will become obvious.

The lecture, which had an innocuous title along the lines of ‘Vaso‐active therapy for erectile dysfunction’ was scheduled as an evening lecture of the Urodynamics Society in the hotel in which I was staying. I was a senior resident, hungry for knowledge, and at the AUA I went to every lecture that I could. About 15 min before the lecture I took the elevator to go to the lecture hall, and on the next floor a slight, elderly looking and bespectacled man, wearing a blue track suit and carrying a small cigar box, entered the elevator. He appeared quite nervous, and shuffled back and forth. He opened the box in the elevator, which became crowded, and started examining and ruffling through the 35 mm slides of micrographs inside. I was standing next to him, and could vaguely make out the content of the slides, which appeared to be a series of pictures of penile erection. I concluded that this was, indeed, Professor Brindley on his way to the lecture, although his dress seemed inappropriately casual.

The lecture was given in a large auditorium, with a raised lectern separated by some stairs from the seats. This was an evening programme, between the daytime sessions and an evening reception. It was relatively poorly attended, perhaps 80 people in all. Most attendees came with their partners, clearly on the way to the reception. I was sitting in the third row, and in front of me were about seven middle‐aged male urologists, and their partners in ‘full evening regalia’.

Professor Brindley, still in his blue track suit, was introduced as a psychiatrist with broad research interests. He began his lecture without aplomb. He had, he indicated, hypothesized that injection with vasoactive agents into the corporal bodies of the penis might induce an erection. Lacking ready access to an appropriate animal model, and cognisant of the long medical tradition of using oneself as a research subject, he began a series of experiments on self‐injection of his penis with various vasoactive agents, including papaverine, phentolamine, and several others. (While this is now commonplace, at the time it was unheard of). His slide‐based talk consisted of a large series of photographs of his penis in various states of tumescence after injection with a variety of doses of phentolamine and papaverine. After viewing about 30 of these slides, there was no doubt in my mind that, at least in Professor Brindley’s case, the therapy was effective. Of course, one could not exclude the possibility that erotic stimulation had played a role in acquiring these erections, and Professor Brindley acknowledged this.

The Professor wanted to make his case in the most convincing style possible. He indicated that, in his view, no normal person would find the experience of giving a lecture to a large audience to be erotically stimulating or erection‐inducing. He had, he said, therefore injected himself with papaverine in his hotel room before coming to give the lecture, and deliberately wore loose clothes (hence the track‐suit) to make it possible to exhibit the results. He stepped around the podium, and pulled his loose pants tight up around his genitalia in an attempt to demonstrate his erection.

At this point, I, and I believe everyone else in the room, was agog. I could scarcely believe what was occurring on stage. But Prof. Brindley was not satisfied. He looked down sceptically at his pants and shook his head with dismay. ‘Unfortunately, this doesn’t display the results clearly enough’. He then summarily dropped his trousers and shorts, revealing a long, thin, clearly erect penis. There was not a sound in the room. Everyone had stopped breathing.

But the mere public showing of his erection from the podium was not sufficient. He paused, and seemed to ponder his next move. The sense of drama in the room was palpable. He then said, with gravity, ‘I’d like to give some of the audience the opportunity to confirm the degree of tumescence’. With his pants at his knees, he waddled down the stairs, approaching (to their horror) the urologists and their partners in the front row. As he approached them, erection waggling before him, four or five of the women in the front rows threw their arms up in the air, seemingly in unison, and screamed loudly. The scientific merits of the presentation had been overwhelmed, for them, by the novel and unusual mode of demonstrating the results.

The screams seemed to shock Professor Brindley, who rapidly pulled up his trousers, returned to the podium, and terminated the lecture. The crowd dispersed in a state of flabbergasted disarray. I imagine that the urologists who attended with their partners had a lot of explaining to do. The rest is history. Prof Brindley’s single‐author paper reporting these results was published about 6 months later [1].

Professor Brindley made a huge contribution to the management of ED, for which he deserves tremendous gratitude. He was a true lateral thinker, and applied his unique mind to a variety of problems in medicine. These include over 100 publications that focus on the areas of visual neurophysiology and several other aspects of neurophysiology, including ejaculation and female sexual dysfunction. He also published one remarkable paper studying the effect of 17 different drugs used intracorporally to induce erection [2]. Seven of these (phenoxybenzamine, phentolamine, thymoxamine, imipramine, verapamil, papaverine, naftidrofury) induced an erection. It is not clear to what degree Brindley’s own penis served as the test subject for these studies.

This lecture was unique, dramatic, paradigm‐shifting, and unexpected. It is difficult to imagine that a similar scenario could ever take place again. Professor Brindley belongs in the pantheon of famous British eccentrics who have made spectacular contributions to science. The story of his lecture deserves a place in the urological history books.

Efficacy of PRIME, a Mobile App Intervention Designed to Improve Motivation in Young People With Schizophrenia

From Schizophrenia Bulletin:

The onset of schizophrenia occurs during a period critical for development of social relationships and functional independence. As such, interventions that target the early course of illness have the potential to stave off functional decline and restore functioning to pre-illness levels. In this entirely remote study, people with recent-onset schizophrenia spectrum disorders (SSDs) participated in a 12-week randomized controlled trial to determine the efficacy of PRIME (personalized real-time intervention for motivational enhancement), a mobile-based digital health intervention designed to improve motivation and quality of life. Participants were randomized into the PRIME (n = 22) or treatment-as-usual/waitlist (TAU/WL) condition (n = 21) and completed assessments at baseline, post-trial (12 wk), and for people in the PRIME condition, 3 months after the end of the trial. After 12-weeks, WL participants received PRIME, resulting in a total sample of 38 participants completing PRIME. In PRIME, participants worked towards self-identified goals with the support of a virtual community of age-matched peers with schizophrenia-spectrum disorders as well as motivation coaches. Compared to the WL condition, people in the PRIME condition had significantly greater improvements in self-reported depression, defeatist beliefs, self-efficacy, and a trend towards motivation/pleasure negative symptoms post-trial, and these improvements were maintained 3 months after the end of trial. We also found that people in the PRIME condition had significantly greater improvements in components of social motivation post-trial (anticipated pleasure and effort expenditure). Our results suggest that PRIME has the potential to be an effective mobile-based intervention for improving aspects of mood and motivation in young people with SSDs.

The turtle menace – the peril of ICD-10 code W5922XD

Have you heard of the menace represented by ICD-10 code W5922XD?

If you don’t know what the hell I am on about, check it out here.

There’s also the menace of other species.

There’s fires in perhaps unexpected places.

Injuries can happen anywhere – such as here or here or here,

For those who may be offended by my tone, having survived multiple turtle and macaw attacks while being burnt while watersking in the prison pool en route to the library while singing arias, apologies.

At least you don’t have to face this. Repeatedly.

#LivingLibrary – College of Psychiatrists of Ireland event for #GreenRibbon month, 31st May 2018

I will be speaking as a living book in this:

The College is delighted to announce our 4th annual event in partnership with See Change for Green Ribbon Month – A Living Library
When it comes to mental health everyone has a story to share and we find comfort, empathy and compassion in shared experiences. Social contact is known to be one of the most effective ways of reducing mental health related stigma and discrimination so with this in mind, and to mark Green Ribbon month, the College is delighted to announce our ‘Living Library’ event, a library come to life in the outdoors!

At our library the ‘books’ are a little different, they are people; people with different experiences and stories to tell related to mental health including those who have experienced mental health issues and illness, their family members and carers, and the psychiatrists who help them towards the path of recovery. Mental health stigma too often creates discrimination and misunderstanding so we want to give members of the public the opportunity to connect and engage with psychiatrists and people they may not normally have the occasion to speak with.

The aim is to better understand the lived experiences of others who have experienced or facilitated recovery from mental illness and distress and to challenge their own assumptions, prejudices and stereotypes. We invite you to ‘read’ the human books through conversation and gain understanding of their experiences.

For Green Ribbon Month Let’s End the Stigma by not judging a book by its cover and develop a greater understanding of each other’s stories.

Thursday 31st May 2018
12.30pm – 2.30pm
St Stephens Green, Dublin

This is a Free Event, but space is limited. Book your place here.