There was a question that one of our WINK Sleep Members - Ahu Tükel - posted in our Member Discussion Forum.

Ahu works in Turkey and specialises in helping families with infants sleeping better, and she is passionate about learning the latest evidence-based info in this area. Like many of us working with infants, Ahu has had her fair share of opposition to methods like sleep training - dare I say - with arguments that lack compelling direct evidence.

So when the latest publications were released from the Association Professional Sleep Societies … more simply known as the APSS … more understandably known as the Hashtag Sleep 2023 conference - this particular publication caught Ahu’s eye.

Before I got a chance to respond, one of our European members commented along the lines of “this study has many limitations”.

Here’s what I followed up with …

A Few Takeaways
Takeaway 1 - The Authentic Chinese Banquet

First, this looks to be an innovative study, but there isn’t enough information to fully evaluate it. That’s because it is only published as an abstract, and has not gone through the vigorous expert review process.

Therefore, with the limited information provided, I am interested to see if the full study shows that the higher levels of hair cortisol in these babies at birth were tapping into the baby’s future chronotype.

The other population of humans that show long sleep latencies, yet the same sleep duration as their quick-to-sleep peers are … drum roll … teenagers.

So it will be interesting to see if these researchers have discovered a novel measure to detect the chronotype of babies. If so, it could help parents to prepare and prevent countless nights of confusion and crying.

But that’s IF they publish the full paper. That brings us to …

Takeaway 2 - Subway

Second, the difference between publishing an abstract at a sleep conference and publishing the full paper in a scientific journal is like comparing masturbation to a Roman orgy.

The former takes a small burst of energy to reach a deadline.

The latter requires stamina.

And when someone is about to die - and their entire life flashes before their eyes - and their lights go out with a smile on their face - do you really think one of those flashes was a flash-in-the-pan? Or was it one of those all-nighters?

People remember fully published studies. Not abstracts.

In 2017 I presented our team’s study at the Pediatric Sleep Medicine conference at Amelia Island in Florida.

It was a longitudinal study examining the development of the waking sleep homeostat during early adolescence.

For those watching from home, the above sentence means:

• we got teens to come into our sleep lab every 6 months and do the same thing (longitudinal study)

• they came in on a Friday after school. Went to bed at 9:30 PM, and woke at 8:00 AM. They stayed in the lab under dim light and did quiet activities all day, and then after dinner they went to bed. And every hour we asked them to try and fall asleep. And when they fell asleep, we woke them up. We did this until about 3 AM. This tested how sleepy they were at different times of the evening and night (waking sleep homeostat).

We could have left that study there. As a conference abstract. A flash-in-the-pan.

But nope. That ain’t what science is about.

Science is about advancing our knowledge about how our world works. We learned about whether a teenager’s ability to build up sleep pressure changes. We needed this discovery to be out there in full. So the full recipe of what we did could be copied and tested again and again to see if what we found is true.

So we wrote the study up in full, as a manuscript. And submitted it to a scientific journal.

And got told it was rejected - saying something like “This is better off in a sleep journal.”

So we reformatted it and submitted it to a sleep journal.

And got rejected by that one - saying something like “You only have 20 participants”.

Hmm. It cost about $400,000 to get the data from these 20 participants mate … oh well, let’s try again at another journ ..

Rejected.

After this many rejections you’re thinking that you’re the leper at the orgy. But after the wave of self-doubt passes, you come to realise that you have all your bits - so you press onto the next one …

Revise and Resubmit.

Yaaaaasssss!

This is a chance to possibly get published.
But wow! The hoops we gotta jump through are pretty hefty.

Nonetheless, we press on …

2nd Revise and Resubmit.

Ouch!

One of the expert reviewers is happy with our work. The other seems happy, but still wants one more thing.

To use a statistical software program we haven’t used before to perform a non-linear mixed-model regression on each sleep trial across the night, and also each time the teens came back to be retested, and finally, to to this analysis on every 30-seconds of EEG data.

So that’s about 40 epochs per sleep trial x about 9 trials per night x 4 times they visited x 20 teenagers, which is about 28,800 analyses …

Remember how I said we could have left that abstract back in 2017 and just be?

Publishing full studies in scientific journals is hard.

Publishing conference abstracts is as easy as finding lube.

So when I see a self-proclaimed ‘benchmark’ overstating their 46 out of 50 published conference abstracts - I think they must have an endless supply of lube.

Takeaway 3 - The Most Distasteful Hot Sauce

It was a bit of a passing comment, but the American Academy of Sleep Medicine (AASM):

• have an impressive sounding title

• have for donkey’s years been charging researchers 50 US bucks to submit an abstract to the APSS conference

• have for donkey’s years been charging researchers 50 bucks to submit their full scientific manuscripts to their prestigious journal SLEEP.

• have for donkey’s years been requesting the very same researchers to do a half-day’s job of reviewing manuscripts submitted to SLEEP for the prestigious sum of f#ckall (aka, zero US dollars).

For reference, there is not another journal that has charged us to submit a manuscript to them.

This begs the question one has to ask in the mirror - are sleep researchers the dumbest of all?

Conclusions?

Don’t you love how that Hot Sauce says ‘Gluten Free’ - like as if that’ll rescue it?

Kinda like how I seem to think that sexual innuendos will wrap extra velvet around my hammer I’m throwing around.

Sure - this could have been a blog inspired by that quote “water off a duck’s back”. But then it would lie there with the masses of bog-standard blogs.

I could’ve wrapped myself in the warm comforting embrace of apathy. But then if we all did that, the stronger would walk over the weak. And there’s too much of that in the world right now.

Instead, I think of Kevin Spacey’s John Doe character in the movie Se7en - “Wanting people to listen, you can't just tap them on the shoulder anymore. You have to hit them with a sledgehammer, and then you'll notice you've got their strict attention”.

Well, we won’t go too far away from the mean.

But I will ask you to stick up for what you believe in. On the proviso that you’re backed by facts. Especially compelling facts that outweigh the opposite argument.

And along the way - have some fun.

Whether it’s by yourself or with others (nudge nudge, wink wink).

• Prof MG