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Evidence Based Longevity (EBL)
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Goal: sleep

Evidence by Goal: Sleep

Every graded record measured on sleep, sleepiness, sleep apnea or the body clock, including the ones that failed. A letter here describes the human trial evidence for that use; it is not advice.

43 graded uses, grouped by what the trials measured, highest letter first within each group. Every letter is copied at build time from the record that owns it, and records graded D, tested without benefit or not yet tested, are listed with the rest.

Measured on deaths and disease events

Trials that counted deaths, heart attacks, strokes, fractures, falls, cancers or other clinical events.

  • DHard clinical endpoint · Tested, no benefit
    CPAP for obstructive sleep apnea
    Device or therapy · Randomized trials and meta-analyses A study that pools the numbers from several trials into one combined estimate. of CPAP against usual care, sham A fake version of a procedure or device used as the comparison, so participants cannot tell which one they received. CPAP or inactive control
    Grade for: Heart attack, stroke and cardiovascular death in adults with moderate to severe obstructive sleep apnea, mostly without daytime sleepiness
    27571048 31839558 26914592

Measured on function, or by a blinded clinician

Trials that measured performance with an instrument, or used a scale scored by a clinician who did not know the treatment.

  • AMeasured function
    Daytime napping (length and timing)
    Protocol · Randomized laboratory and workplace trials and meta-analyses of them (short-term alertness and performance); cohort studies An observational study that follows a group of people over time and compares what happens to them. and genetic analyses on heart disease, mortality and dementia are listed as excluded evidence and carry no letter
    Grade for: Alertness and cognitive performance in the hours after an afternoon nap, healthy adults
    16796222 11007448 12220317
  • AMeasured function
    Daytime napping (length and timing)
    Protocol · Randomized laboratory and workplace trials and meta-analyses of them (short-term alertness and performance); cohort studies and genetic analyses on heart disease, mortality and dementia are listed as excluded evidence and carry no letter
    Grade for: Cognitive performance during a night shift after an on-shift nap
    32492169 17052562 26715234
  • AMeasured function
    Daytime napping (length and timing)
    Protocol · Randomized laboratory and workplace trials and meta-analyses of them (short-term alertness and performance); cohort studies and genetic analyses on heart disease, mortality and dementia are listed as excluded evidence and carry no letter
    Grade for: Memory retention after an afternoon nap
    36041284 18554731 28329381
  • AMeasured function
    CPAP for obstructive sleep apnea
    Device or therapy · Randomized trials and meta-analyses of CPAP against usual care, sham CPAP or inactive control
    Grade for: Daytime sleepiness measured by the maintenance of wakefulness test, in moderate to severe sleep apnea with daytime sleepiness
    10382693 23204602 16467072
  • BMeasured function
    Melatonin
    Supplement · Meta-analyses of randomized trials, with per-use rows
    Grade for: Sleep onset timing in delayed sleep phase disorder
    16423108 11211063 1674014
  • CMeasured function
    Melatonin
    Supplement · Meta-analyses of randomized trials, with per-use rows
    Grade for: Sleep onset latency and sleep quality (primary sleep disorders)
    16423108 15649737 23691095
  • CMeasured function
    Melatonin
    Supplement · Meta-analyses of randomized trials, with per-use rows
    Grade for: Sleep in adults with high blood pressure taking beta-blockers
    23024438
  • CMeasured function
    Montmorency Tart Cherry
    Supplement · Small randomized trials; two meta-analyses for exercise recovery
    Grade for: Sleep quality and duration
    22038497 36011907 28901958
  • CMeasured function
    Melatonin 0.3 to 0.5 mg (low dose), 30 to 60 minutes before bed
    Protocol · Meta-analysis of randomized trials
    Endpoint The outcome a trial measures to decide whether the treatment worked, such as heart attacks, blood pressure or a symptom score.: Sleep onset and sleep efficiency at low doses (0.3 to 0.5 mg)
    23691095 11600532 29912983
  • CMeasured function
    Daytime napping (length and timing)
    Protocol · Randomized laboratory and workplace trials and meta-analyses of them (short-term alertness and performance); cohort studies and genetic analyses on heart disease, mortality and dementia are listed as excluded evidence and carry no letter
    Grade for: A short nap combined with caffeine for afternoon sleepiness
    9401427 14652086
  • CMeasured function
    Daytime napping (length and timing)
    Protocol · Randomized laboratory and workplace trials and meta-analyses of them (short-term alertness and performance); cohort studies and genetic analyses on heart disease, mortality and dementia are listed as excluded evidence and carry no letter
    Grade for: Reducing habitual napping in older adults: verbal memory over one year
    41973339 21314644
  • CMeasured function
    Evening warm bath or shower (40 to 42.5°C water)
    Protocol · A meta-analysis of small experimental studies, and a null crossover A trial design in which each participant receives both the treatment and the comparison, one after the other, and serves as their own control. trial
    Endpoint: Sleep onset latency and sleep quality after a warm bath or shower one to two hours before bed
    31102877 2578367 3381061
  • CMeasured function
    Morning bright light (light box or daylight) for sleep and the body clock
    Protocol · Randomized laboratory and clinical trials and meta-analyses of them; population studies of personal light exposure, mood, sleep and mortality are listed as excluded evidence and carry no letter
    Grade for: Insomnia: sleep measured by actigraphy, polysomnography and questionnaires
    37002704 39733392 42263407
  • CMeasured function
    Morning bright light (light box or daylight) for sleep and the body clock
    Protocol · Randomized laboratory and clinical trials and meta-analyses of them; population studies of personal light exposure, mood, sleep and mortality are listed as excluded evidence and carry no letter
    Grade for: Delayed sleep phase and late sleepers: sleep timing and daytime function
    31108433 26606319 2267478
  • CMeasured function
    Morning bright light (light box or daylight) for sleep and the body clock
    Protocol · Randomized laboratory and clinical trials and meta-analyses of them; population studies of personal light exposure, mood, sleep and mortality are listed as excluded evidence and carry no letter
    Grade for: Dementia in care facilities: nighttime sleep with morning bright light
    24574061 35180479 16035127
  • CMeasured function
    Morning bright light (light box or daylight) for sleep and the body clock
    Protocol · Randomized laboratory and clinical trials and meta-analyses of them; population studies of personal light exposure, mood, sleep and mortality are listed as excluded evidence and carry no letter
    Grade for: Older adults without dementia: sleep with brighter morning or daytime indoor light
    26181467 39821044 39627630
  • CMeasured function
    Morning bright light (light box or daylight) for sleep and the body clock
    Protocol · Randomized laboratory and clinical trials and meta-analyses of them; population studies of personal light exposure, mood, sleep and mortality are listed as excluded evidence and carry no letter
    Grade for: Rotating-shift nurses: daytime sleepiness and reaction time with brief morning light
    21597232 34099750 39747347
  • CMeasured function
    Molecular Hydrogen (Inhaled)
    Device or therapy · Randomized controlled trials People are assigned to the treatment or a comparison by chance, so the groups differ only in what they received. It is the design that can show cause and effect., one small trial per indication; the one hard-endpoint trial null
    Grade for: Sleep time and efficiency in people with sleep disorders
    40826930
  • DMeasured function · Not yet tested
    Morning bright light (light box or daylight) for sleep and the body clock
    Protocol · Randomized laboratory and clinical trials and meta-analyses of them; population studies of personal light exposure, mood, sleep and mortality are listed as excluded evidence and carry no letter
    Grade for: Healthy adults: outdoor light within a fixed window after waking, for sleep, mood or energy
    12932084 24179293 21704557

Measured on a blood marker or other stand-in

Trials that measured a number standing in for the outcome, such as blood pressure, LDL Low-density lipoprotein cholesterol, the cholesterol fraction most closely tied to plaque in the arteries. cholesterol or HbA1c A blood test that reflects average blood sugar over the previous two to three months.. These letters stop at B.

  • BSurrogate biomarker
    Morning bright light (light box or daylight) for sleep and the body clock
    Protocol · Randomized laboratory and clinical trials and meta-analyses of them; population studies of personal light exposure, mood, sleep and mortality are listed as excluded evidence and carry no letter
    Grade for: Body clock timing (melatonin onset) moved earlier, healthy adults
    12932084 24179293 19187411
  • BSurrogate biomarker
    CPAP for obstructive sleep apnea
    Device or therapy · Randomized trials and meta-analyses of CPAP against usual care, sham CPAP or inactive control
    Grade for: Blood pressure in adults with obstructive sleep apnea
    40254559 26624827 39401854
  • BSurrogate biomarker
    Oral appliance (mandibular advancement) for obstructive sleep apnea
    Device or therapy · A randomized crossover against CPAP and network meta-analyses of randomized trials
    Grade for: Apnea severity, daytime sleepiness and blood pressure against inactive control and against CPAP
    23413266 26624827 26497082
  • BSurrogate biomarker
    Hypoglossal nerve stimulation for obstructive sleep apnea
    Device or therapy · Randomized sham-controlled, delayed-activation and withdrawal trials of implanted stimulators
    Grade for: Apnea-hypopnea index and Epworth sleepiness in implanted adults with moderate to severe sleep apnea who cannot use CPAP
    34209581 42008810 25205641
  • BSurrogate biomarker
    Tirzepatide
    Prescription · Randomized controlled trials
    Grade for: Apnea-hypopnea index in adults with obesity and moderate to severe obstructive sleep apnea
    38912654
  • BSurrogate biomarker
    Retatrutide
    Prescription · Randomized controlled trials (phase 2 and phase 3)
    Grade for: Apnea-hypopnea index in adults with obesity and moderate to severe obstructive sleep apnea
    42904878
  • CSurrogate biomarker
    GABA (Gamma-Aminobutyric Acid)
    Supplement · RCTs Randomized controlled trial: people are assigned to the treatment or a comparison by chance, so the groups differ only in what they received. It is the design that can show cause and effect. (small) + systematic review A review that searches for every study on a question using a method set in advance, then assesses them together.
    Endpoint: Sleep quality, mood and heart-rate variability (self-report and surrogate)
    38321713 33041752 29856155
  • CSurrogate biomarker
    Sleep duration & quality (as longevity target)
    Device or therapy · Randomized trials of sleep extension and a meta-analysis of them; mortality data are observational Research that watches what people already do rather than assigning a treatment. It can show that two things travel together, not that one causes the other. and carry no grade
    Grade for: Blood pressure, insulin sensitivity and glucose after behavioral sleep extension in habitual short sleepers
    34279625 41564347 34459060
  • CSurrogate biomarker
    Sleep duration & quality (as longevity target)
    Device or therapy · Randomized trials of sleep extension and a meta-analysis of them; mortality data are observational and carry no grade
    Grade for: Energy intake and body weight after sleep extension in adults with overweight who sleep under 6.5 hours
    35129580 42044907
  • CSurrogate biomarker
    Hypoglossal nerve stimulation for obstructive sleep apnea
    Device or therapy · Randomized sham-controlled, delayed-activation and withdrawal trials of implanted stimulators
    Grade for: Blood pressure in implanted adults with obstructive sleep apnea
    38032624
  • CSurrogate biomarker
    Positional therapy for position-dependent sleep apnea
    Device or therapy · One sham-controlled randomized trial of a vibration device; pooled analyses mix cohort studies
    Grade for: Apnea-hypopnea index and daytime sleepiness in position-dependent obstructive sleep apnea
    40992934
  • CSurrogate biomarker
    Nasal valve (nasal EPAP) for obstructive sleep apnea
    Device or therapy · Two sham-controlled randomized trials with opposite results, and a null crossover after stroke
    Grade for: Apnea-hypopnea index and Epworth sleepiness in obstructive sleep apnea
    21461326 23723343 27306393
  • DSurrogate biomarker · Tested, no benefit
    Inspiratory Muscle Training
    Device or therapy · RCT + meta-analysis of randomized trials
    Grade for: Sleep apnea severity (apnea-hypopnea index)
    41721779 36576599 37258418

Measured on what people reported

Trials that asked people how they felt or slept. These letters stop at B.

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