I've suggested 4 people over the last couple of years to get tested based on them casually mentioning some of these symptoms, and all 4 got diagnosed with moderate to severe sleep apnea (which is classified by the number of times you stopped breathing every hour - AHI, and the blood oxygen level). Getting tested is easy and cheap - you can find kits for under $100 which essentially are just a monitor you attach your finger + a few ECG stickers on your body which you use for a couple of nights. You can order them online without talking to a doctor, and you will get a prescription for CPAP if you are diagnosed as positive.
Treatment with CPAP is highly effective in eliminating these symptoms, and also reversing the brain damage (although MRI scans shows that it takes around a year for the gray matter in your brain to restore itself).
The other suggestion I'd make is that if you are overweight or obese, GLP-1 has proven to be also a miracle drug for sleep apnea. Unlike the study mentioned above, that essentially reduced the average AHI of participants by 4, which for almost everyone wouldn't cure them. Drugs like Zepbound have shown that over half are cured from sleep apnea after roughly a year of use. This is in addition to the other health benefits they provide with the weight reduction. Essentially. This unfortunately won't work for everyone, as weight is not the only cause of sleep apnea, but it is by far the most common one.
So it’s not a surprise that a casual mention of sleep quality ended with a CPAP machine rented by the month. It’s kind of what happened to me.
Currently I've just given up and embracing feeling relatively tired all the time. I've tried side sleeping devices (woody knows backpack) mandibular advancement splints etc.
So hard to tell (I find anyway) to get to a definitive answer
For some people, they don't feel any better but it improves their health.
Did you examine your numbers at all in something like OSCAR? You could get a good idea of how many events you were having at night, and if the CPAP was improving it.
Even if you aren't feeling any better (yet) it could still be helping. You could also have multiple things that are causing you fatigue issues, and maybe fixing only one of them wasn't enough... that doesn't mean that one wasn't also important, though.
I'm always a bit puzzled that this needs to be pointed out? I don't have sleep apnea per se, at least not chronically, but I've definitely had bouts of it due to allergy, sickness, stuff like that. The symptoms are the same because the mechanism is the same: I didn't get enough oxygen in the night.
It's always glaringly obvious to me the next day. I feel way more tired and exhausted than I normally would given the amount of sleep. I sometimes had instances of waking up gasping for air.
I really don't need to be told in those instances that there was an issue during the night. My sleep didn't sleep, of course there's something wrong and needs to be looked at?
Like, one time's a fluke, but if it happens a lot...
One, not all sleep apnea patients snore. 20% do not snore
Second, I am not sure what your experience has to do with people that DO have sleep apnea? If you are correct and you do NOT have chronic sleep apnea, then it makes sense you would notice clearly on the nights you did. For someone who has suffered from it for years (or even their whole life), they aren't going to have anything to compare it to. They don't 'feel way more tired and exhausted' then normal because THIS IS THEIR NORMAL. If everything feels the same as it always feels, why would they assume it was sleep apnea?
Just because you experience something a particular way doesn't mean everyone does
I remember one person who thought waking up tired is just part of being an adult?
The original comment said "multiple folds higher chances to be depressed, unemployed", for me that's a bit like saying that being on fire has a very high chance to make you depressed and unemployed.
Yeah, of course that's true, but the effect on performance and well-being after a sleep apnea night is so obvious to me, I don't have to look for the proximate cause...
EDIT: Through the other answer came to me that maybe in other cases, it's not so directly obvious just after waking up.
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> I'm always a bit puzzled that this needs to be pointed out?
You're puzzled that most people don't know the symptoms of sleep apnea? Maybe there are big campaigns where you are, but I've never seen any public information about its symptoms.
You noticed it because it’s happened to you occasionally. What about people who’ve been experiencing it most of their lives? To them, they are just tired all the time and don’t know why. It could be any number of things.
To someone who’s never experienced it, how could they understand?
My wife has bad sleep apnea and has to use a CPAP - neither of us noticed or understood the issue until she did a sleep study to deal with her bad snoring. We knew she was tired all the time, but attributed it to factors like work stress or maybe diet.
The average person’s understanding of sleep apnea is probably around the level of “it exists and they have to wear a device at night” and not much more.
Maybe it was always that much obvious to me that what should have been a good night of sleep had no, or maybe even a negative, effect on my wellbeing, and therefore something must be wrong during the sleep.
But if the effects are a bit more muted and accumulate more gradually, and you've never heard much about sleep apnea, you might not directly attribute it to the sleep itself.
If you’re curious to try this, read James Nestor’s book Breath, do yoga with breathing exercises, or see a physical therapist. It takes time to fix these structural issues, but you can literally change the shape of your nose, palate, and jaw from just practice.
Here’s a quick exercise you could try. Sit up, relax your body, breathe in through your nose, and feel the breath move up your nose, down to the base of your skull, down your neck, and then as far down your spine as you can. The air isn’t literally moving through these areas, but you should feel a current of sensations moving roughly along that path. As you breathe out, follow the current in the opposite direction. As you tune into this current, your neck and back will naturally straighten a bit, it should feel very natural and even pleasant. Keep your body relaxed and allow your neck and back to align with this current. If you keep doing this regularly it should help improve your posture and breathing. This is basically a pranayama / yoga breathing exercise. If it feels painful, definitely stop and try physical therapy or working with a hatha yoga instructor who can give you more guided instruction.
I used to snore so badly it sounded like, without much exaggeration, a dying elephant. I only did this exercise for a couple years and it slowly improved over that time, and now I sleep quietly.
Many cases it is not. I'm not trying to be a contrarian but I don't want to plant hope in some people who suffer from sleep apnea thinking it's something they can just do breathing exercises for.
https://www.mayoclinic.org/diseases-conditions/central-sleep...
Personally I would not be surprised at all if in 50-100 years we look back on this era as one where we massively overprescribed CPAP machines to treat an entirely-fixable condition in most people (alongside all the other medical interventions that will turn out to be bandaid fixes for actually fixable problems). I'm aware this is a bit of an outlandish take. But you can tell how many people's breathing and posture is bad just by existing in the world for ten minutes and looking at them. I think it's really an epidemic.
So breathing better during the day can be trained, even at an old age, and it improves sleep
Not everyone breathes suboptimally of course, but I think more do than realize it. There’s a reason that breath work is in the traditions of many different cultures, and why it survived
But things like this aren’t necessarily profitable or worth a doctor’s time, so you have to do them yourself, or see therapists, etc
I had a good experience with a myofunctional therapist and posture therapist
Yeah we'll go with fabrications based solely on this sentence "But things like this aren’t necessarily profitable or worth a doctor’s time, so you have to do them yourself, or see therapists, etc"
I’ve found this is all really worth learning, even if you don’t have sleep apnea. I feel more clear headed and energized when I can breath through my nose now.
I'm sure that many of the lessons in the book are applicable and there is much to learn. But a lot of it felt like woo, even though I know full well that the author is a well-respected journalist.
I'd really like to hear a sound review from someone who knows the domain better than me.
There are researchers actively working and studying people with sleep apnea. They're not suffering from "forward head posture" or "breathing wrong".
I have severe sleep apnea and no amount of "breathing exercises" are going to cause my soft palate to uncollapse itself while I'm trying to get REM sleep.
1) Make sure you have a CPAP machine with a water tank so the forced air is moist. For me, if the water runs out, that's when I wake up bc my nose dries.
2) Get a spray saline solution for your nose -- not Afrin or drugs (habit inducing) -- just simple and cheap Arm & Hammer Simply Saline.
3) Wear a shirt when you're in bed and put the hose under your shirt so it's hard to roll off.
4) Bonus -- sleep elevated.
Those are my best tips. If you can do the CPAP and suffer the awkwardness, you'll really feel so much better. First time it stuck, I woke up at 4:45 am fully rested and felt as if a heavy weight was lifted off me.
Best luck :)
Oh and it's so loud that I'm at risk of damaging my own hearing.
And I bounced off CPAP hard, no matter what I tried, I would eventually remove the mask in my sleep, it was heartbreaking, I was so excited to finally be able to fall asleep beside my wife.
I also tried the mouth guards and would wake up panicking and gagging.
So my only other option currently is self-funding expensive surgery (our public system doesn't fund treatment for severe snoring unless it causes apnoea, and my private health insurance excludes the most expensive portions shrug), which like all surgery, carries no guarantees of success, and also carries the risk that any general anaesthesia application does.
So this is awesome! I just hope it continues proving efficacious and safe.
Adult AHI Severity Levels
Normal: Less than (5) events per hour.
Mild Sleep Apnea: (5) to (14.9) events per hour (frequent minor interruptions).
Moderate Sleep Apnea: (15) to (29.9) events per hour.Severe Sleep Apnea: (30) or more events per hour.
"By mapping the neural circuits that lead to this common condition, work from the Horner lab laid the foundation for AD109, a new treatment developed by researchers in Boston to specifically target the two pathways that contribute to sleep apnea. The daily oral medication contains two drugs: one that increases noradrenaline levels and another that blocks muscarinic receptors.
In a recently published phase 3 randomized clinical trial, people with mild to severe sleep apnea who received AD109 had less airway obstruction and higher oxygen levels than those who received a placebo. On average, per hour of sleep, participants on AD109 had four fewer events where they stopped breathing or had very shallow breathing."
A CPAP is really effective, so it would be first line treatment. If I couldn't use one but needed it, I'd be happy to have fewer events per hour than all of it. Improvement is better than nothing in this case. Besides, a lot of drugs are improved after the initial breakthrough drug - so this gives hope that we might actually be able to be free of the CPAP for many more folks.
the cpap is a wonder, I can't sleep without it. I only wish I'd gotten one 10 years sooner. I have whole years of my life missing from my memory - REM sleep is very important to long-term memory formation.
Using my CPAP now nets me about 1.5 AHI.
if your doctor tells you to get one, get one.
As of the last 12 months it seems to be heald, after I used mouth tape and a nasal dilator consistently for 30 nights in a row. I highly recommend trying this, it was quite cheap (~$20) and the change seems to have been permanent. I used 3m micro-pore tape that doesn't tear the facial hair, and the nasal dilator I used was called "woody knows", though there are many brands that may work just as well. I barely snore anymore where I used to be a raging snorer according to those in the know and my own audio recordings of myself. Most importantly, I only need about 7 to 7.5 hours of sleep now and I will wake up feeling well rested most days. I can also breathe exclusively through my nose now where before I could not. I can take very big breaths through just the nose and do this now when exercising.
I don't think it's all perfect though as I still often breathe through my mouth. I'm starting to wear the mouth tape at night again as an experiment - it really isn't that annoying.
Relatedly, I recently started looking into "mewing" after a breath-work teacher I took classes with recommended it to me as she has been doing it with good results (improved breathing). It seems related to this as Mew recommends keeping the mouth shut all the time. I intend to try the mewing exercises and see if that helps my breathing further.
Best bet is to get this custom made. Here in Australia there are specialist dentists that do this for you. It’s far easier than CPAP and works just as well for many like myself.
Often folks will use CPAP at home and these mouth guards when travelling.
Four events per hour AHI improvement would not be a meaningful change for my therapy, but this is the beginning of better treatment options in the future.
The best benefit of CPAP is that it thwarts heart arrhythmias which arise from depriving the brain of oxygen.
The pictures on the website are a little misleading: it comes with a strap to keep the device in your nostrils, so they don't just fall out in the middle of the night.
FDA-approved, and does require a prescription...
The preconception that it is mostly obesity related is a dangerous stigma since it prevents a lot of people understanding what is happening and getting treatment.
I started with sleep apnea in my 20s when I was in amazing physical condition. I would jolt awake, heart racing, almost panic attack levels. No idea what was happening.. took me another 15 years to do a sleep study and get diagnosed, and CPAP treatment literally overnight cured the condition. I went from 20-30 events per night to less than 1 on average.
If anyone has any sleep issues at all, or suspects any.. go get a sleep study. It’s not as scary as it sounds and there’s no downside to having one done.
I mean, the person you replied to literally said "60% of cases are linked to obesity"
Which obviously implies that 40% of cases are NOT linked to obesity. You are saying the exact same thing the person you replied to is saying, just without the numbers.
I feel like the person you replied to's comment was not stigmatizing obesity at all, in fact learning that 40% of sleep apnea cases are unrelated to obesity entirely probably educated some people that it was less tied to weight than they believed before.
Doctors think I’m doing fine due to total amount of hours used, and my resmed cpap claims I’m at below 1 event/hour. I’m not doing fine and I think the numbers are lying to me.
I snore a million, my mouth gets dry, and my nose tightens up, so my nasal mask isn’t always that nice to use. Other masks also annoy me.
What do? I haven’t sleep a solid 8 hours for 3-4 years :(
If you aren’t overweight, this might not help, but hopefully it’ll help someone!
Can you take fluticasone permanently? Sometimes it’s like I just lie down and my nasal congestion gets worse instantly
This is a surprisingly controversial question.
I've known more than one person who claims something to the effect of becoming addicted to Flonase. Like now they have to take it only to feel like how they felt before they started taking it.
Rebound inflammation when stopping use is a real effect with long-term use of corticosteroids and can, at least briefly, be worse than the initial symptoms were.
As someone with multiple mild inflammatory disorders I've always been afraid to use steroids consistently lest I have nothing effective when things are worst.
After dealing with unexplained ectopic heartbeats (sometimes PVCs, sometimes PACs) I saw a chain of doctors and that included both getting a sleep study done and seeing a cardiologist.
I was diagnosed with mild apnea (AHI just above 10), but despite the apnea being mild on the AHI scale, my Sp02 blood oxygen percentage was dropping into the low 80%s for extended periods per night down from a normal 95-99% most of the time.
I weigh 180 lbs at 6 foot 2, being overweight was a non-factor in my apnea.
Got a CPAP machine, it helped but even after dialing in my personally optimal pressure settings using the CPAP data with OSCAR my AHI was still kind of all over the place, from under 1 to as much as 6 seemingly randomly per night with no mechanical issues like mask leaks showing up.
Had heard (on reddit /r/CPAP) about some people using soft cervical collars to help with their apnea and I gave it a try and when wearing one my AHI drops down to 0.0 - 0.4 per night. The collar alone helps more consistently in my case than the CPAP machine does.
Basically my sleep apnea is almost entirely due to the fact that when I'm sleeping (even on my side, but worse on my back) I seem to naturally tuck my chin in toward my neck in a way that constricts my upper airway and the collar stops this from happening. This is very much YMMV, there are lots of different causes of apnea.