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Having just been officially diagnosed with obstructive sleep apnea today, let me tell you why that part of insufficient sleep is an epidemic: the system is a ra

Having just been officially diagnosed with obstructive sleep apnea today, let me tell you why that part of insufficient sleep is an epidemic: the system is a racket. Here are the steps to get your sleep apnea solved: 1. Go to your GP and have them refer you to a sleep specialist. 2. Make an appointment with the sleep specialist (one major clinic here in the Bay Area is booked out weeks in advance). Do that office visit where you get the prescription for an overnight sleep study. 3. Wait 2-3 more weeks for your sleep study date, where you get wired up like you're joining the Matrix, and then told to go to sleep at 9:30pm. Riiight. 4. Have a follow up visit at the office in step 2. Go over results. Possibly get prescribed a CPAP machine. 5. Find an in-network provider to buy the CPAP from, and make an appointment with them. This is not an off the shelf thing, expect to spend 2-3 hours in the office/store. Wait time: a couple days to a couple weeks. 6. (optional, if the study from step 3 wasn't split-phase) Return for another sleep study with your new machine so they can calibrate it. 7. Make another follow up appointment to have the doc look at the report from step 6 and actually perform the calibration. Dude, WHO HAS TIME FOR THIS? Ironically, this whole process is a bit of a nightmare.

WalterSear 11y ago
I don't have apnea. I was prescribed an apnea machine anyway. They seemed very generous in handing out prescriptions for them.
pcarmichael 11y ago
I was diagnosed with obstructive sleep apnea. Using a CPAP was life changing for me. I won't sleep without it now if I can help it, though it did take me a bit of iterating through different mask arrangements. The first few weeks were hard - I slept strangely because I dreamt intensely (and I was told that's normal). Before I couldn't remember the last time I really had a dream. After years of slowly acclimating to not getting real sleep, actually getting good sleep and rest was amazing. It was like emerging from a fog of years that I never realized I was in. Once you get too far in, you don't really realize how tired you were. True, the process to get there wasn't fun. But hopefully you find the end result as beneficial as I did.
- viraptor 11y ago
  While I wasn't diagnosed with any actual issue, I definitely didn't sleep enough during/after university. I didn't realise this until a few years later I started going to sleep at the same time as my girlfriend. And that was a huge change - like discovering that yes, you can actually wake up before the alarm and not need 5 of them. I got a similar effect too - some crazy intense dreams. It's a great indicator actually - any time I get too tired / go to sleep too late I don't have them. But go to bed around 10pm - I dream a whole story with multiple characters and long enough to make it a crazy movie. On the other hand, recently I started looking at ways to get rid of dreams... they're just too much if they happen every night.
  - hemdrup 11y ago
    I have found keeping a routine of going to bed around 11 pm and waking up at 06:00. Results in highest creative performance. The time period from 06:00 to 10:00 is the magic hours :)
  - heed 11y ago
    The only thing I've found that reduces my intense dreaming is (believe it or not) cannabis use.
    - facetube 11y ago
      Not at all surprising; there's evidence that cannabis use suppresses REM sleep. Anecdotally, people who suddenly stop taking it after long periods of use tend to report unusually vivid dreams.
      - mhink 11y ago
        That's exactly what's happening with my girlfriend right now. She gave up cannabis after years of heavy smoking, and it seems like every morning she wakes up telling me about the intense, vivid dreams she had. That said, while the quitting process has been quite difficult for her (irritability's through the roof- almost as bad as when I've tried to quit smoking cigarettes), she says she started feeling "better" almost immediately. Probably the best part (for both of us, haha) is that her natural appetite is coming back- and in fact, she's reporting that she's developing a taste for a lot of foods she previously didn't like because the flavor was too intense or the texture was too unusual. The only real explanation we can figure out is that the cannabis intensified culinary experiences to the point where she couldn't handle it, and so she just ended up avoiding a lot of types of food. The brain is an interesting organ.
ajhit406 11y ago
Would it be possible to purchase a CPAP overseas when traveling and bring it back into the US? Are there laws against that if it is for personal use?
- johnchristopher 11y ago
  That's strange, I was under the assumption it'd be easier for me to buy a (n)CPAP machinein the US than in Europe (CPAP user).
  - peejaybee 11y ago
    That's only true for firearms.
- sokoloff 11y ago
  It's a class II medical device, so federally in the US, you need a prescription. That issue aside, they're readily available used on craigslist, and you can buy "kits" online to replace the parts that wear or touch "gross parts" of the prior user, so if you don't care about the prescription issue, CL is probably better than traveling overseas to get one.
technofiend 11y ago
It must be a profitable racket because my optometrist was trying to sell me one. Lol. Fortunately my ENT wrote a prescription for a sleep study but told me to try Breathe Right strips first. He told me honestly the surgery is painful and the strips had cut his surgical load in half. He was right. I've never slept better and my wife is no longer contemplating my early demise by pillow smothering. And before anyone acuses me of being a shill I switched to knock offs long ago. The cheap Chinese ones on ebay have weaker glue but if they work for you they are far cheaper.
- GFischer 11y ago
  I really have to try those, but I haven't seen them in my country. I've tried several doctors (I snore and stuff), they think I have nasal polyps - one wanted to try surgery and the other wanted to try some ultrasound stuff.
eruditely 11y ago
I found out I have sleep apnea and it ruined my life and am now going through this process, I woke up to a new me that is several orders of magnitude more productive. I could never remember my life and would always do stuff like forget to eat, now everything is normal!
DanBC 11y ago
You missed one of the most important steps for most people with sleep apnoea: lose some weight. Most people with sleep apnoea are not helpless victims to an incurable disease. Losing weight doesn't appear to be easy, but it's certainly achievable for most overweight people. EDIT: Here's the CDC page listing obesity as a cause for apnea http://www.cdc.gov/healthyweight/effects/index.html http://www.cdc.gov/healthyweight/effects/index.html
- arrrg 11y ago
  Why did you deem it necessary to even mention that? I’m quite certain that people with sleep apnoea for whom weight is a relevant component are quite aware of that. Yours is just a pointless diversion in this context – because what exactly is the your angle here? Should it be hard for people with sleep apnoea to get treatment? I mean, what are you arguing here for exactly?
  - DanBC 11y ago
    People are complaining about the length of time it takes to get treatment, and the cost of treatment, and that treatment is a racket. All that stuff is true. All that stuff is avoided by losing weight. Your comment appears to be overly sensitive to a calm, non-judgemental bit of information. EDIT: Here's the link to the CDC page which lists overweight as a cause of sleep apnea: http://www.cdc.gov/healthyweight/effects/index.html http://www.cdc.gov/healthyweight/effects/index.html It's really easy for people, especially men, to hit a BMI of 30 and not realise that they are obese. Especially in obesogenic societies where very many people are obese, morbidly obese or even super obese. This carries a range of health risks, most of which are helped by losing weight. It's weird the source article doesn't mention weight, since it is caused by lack of sleep (especially in children and young people) and causes lack of sleep (in adults). http://www.cdc.gov/sleep/about_sleep/chronic_disease.htm http://www.cdc.gov/sleep/about_sleep/chronic_disease.htm > Laboratory research has found that short sleep duration results in metabolic changes that may be linked to obesity. Epidemiologic studies conducted in the community have also revealed an association between short sleep duration and excess body weight. This association has been reported in all age groups—but has been particularly pronounced in children. It is believed that sleep in childhood and adolescence is particularly important for brain development and that insufficient sleep in youngsters may adversely affect the function of a region of the brain known as the hypothalamus, which regulates appetite and the expenditure of energy
smartial_arts 11y ago
Not sure what's the equivalent for the steps 3-7 here in Australia, but getting a referral from a GP and then getting a portable testing machine, that you're supposed to wear at home, is very straightforward. It also doesn't cost much - think it's something like $80 after getting the Medicare rebate.
johnward 11y ago
I have central sleep apnea. The way I understand it is that there is no obstruction causing me to stop breathing my brain just doesn't feel like doing it sometimes. It took me probably 8 years to figure out what the problem was. No one had any idea until I demanded a sleep study. I couldn't even sleep on the first one so they said I was fine. I demanded another and they finally found out I had apnea. You have to really take an active role in your healthcare if you want problems solved.
philip142au 11y ago
You can buy the machine that doesn't need to be calibrated, but it costs more.
- sokoloff 11y ago
  In the US, you need a prescription (at least officially), so you still are exposed to the sleep study racket.
- cmiles74 11y ago
  My insurance company refused to cover an "automatic" (APAP) machine for my obstructive sleep apnea, only a "constant" (CPAP) machine was acceptable to them. The medical supply company then provided me with an APAP machine that was configured such that it behaved like a CPAP machine. 3 minutes of Googling and quick change to the settings enabled the automatic function. I found the APAP much easier to sleep with than the pretty harsh blasting of the CPAP setup.
flanbiscuit 11y ago
I know that I snore and that I need to do this but this doesn't seem encouraging. Plus I don't want to sleep with a machine the rest of my life. Isn't there surgery that can be done? I'd be happy to do that (even though I've heard it's not foolproof). I wake up every day feeling tired no matter what time I try and go to sleep. On weekends I can sleep in until 1pm if I let myself and I still have a hard time waking up. I should add, I'm a slim/skinny guy, been so all my life, so it's not about weight.
- DanBC 11y ago
  Once you've got medical stuff ruled out you can try exercises. This involves singing something like "UNGGG - GGAAAHHH" for twenty minutes per day. There's a little bit of research suggesting this. There is surgery to treat snoring. It's not great. https://www.nice.org.uk/guidance/ipg240 https://www.nice.org.uk/guidance/ipg240 https://www.nice.org.uk/guidance/ipg476 https://www.nice.org.uk/guidance/ipg476
  - flanbiscuit 11y ago
    Thanks for the info. I haven't had any official tests for apnoea so I do want to get sleep studies done. But I have been told by my girlfriend that I do stop breathing while sleeping, long enough that she worries that I'm not going to continue breathing, but I eventually do. To me that seems like the exact definition of apnoea.
- cmiles74 11y ago
  For some people, there's a bunch of dental things you can wear at night, some are kind of like a retainer. http://www.sleepapnea.org/treat/treatment-options/oral-appliance.html http://www.sleepapnea.org/treat/treatment-options/oral-appli...
  - Steve44 11y ago
    I think they work for very few people and unless you adhere to the jaw exercise regime you can end up with jaw problems.
jshelly 11y ago
If your not sleeping you should have plenty of time for this ;-)
outworlder 11y ago
1. IF they do the referral. Which they might not, if you are not looking like a double for The Walking Dead. 2. They are all booked everywhere, it seems 3. Or, even worse, they might hit delays and not put you to bed until way after midnight, as was with me. I could barely sleep. They still can't explain the 5h it took for me to reach deeps leep. 4. This is where I left off. Not enough obstructive sleep events to warrant a treatment, according to the clinic(perhaps because I was half awake?). My doctor did not fully agree with them. Do I have sleep apnea? Only Cthulhu knows. I wonder if I'll ever try the sleep study again. The Heisenberg Uncertainty Principle does seem to apply here. How are they supposed to diagnose your sleep issues, if you are so uncomfortable that sleeping at your work desk feels fantastic in comparison?
ambiate 11y ago
My friend recommended this long path for me. I laughed and asked what the end solution was: CPAP. I ventured to craigslist and bought a used one for $100. I bought new gear off amazon. Google search led to the keystrokes to change the pressure myself. Few tweaks and I wake well rested rather than sleepy. Previously, I could sleep for 12 hours and still feel tired. Friend is still waiting for their appointment to receive their machine two months later.
- smoothgrips 11y ago
  I guess that is one way to do it. I don't know if I would do that myself. I went through the normal channels and here in SLC it went very smoothly. The thing with the "do it yourself" approach is, without the sleep study, you don't know what pressure to use. They use the analysis from the sleep study to determine what pressure to use. Also, you will consistently need to purchase new supplies on a regular basis. You'll be paying full price for those forever, whereas mine are covered by my insurance (since I went through the proper channels), so over time you will spend more money than I will.
  - trevyn 11y ago
    APAP is shown to calibrate as well as a sleep study, and at least in my case, it was pretty straightforward to find the right pressure by feel. Personally, I did steps 2-4 above, got an APAP prescription valid until the end of time, and bought a new machine online. (Maybe insurance would reimburse? I didn't even bother; time is money too.)
  - afarrell 11y ago
    Why not both? Get a used one while you wait for your sleep study.
- ThrustVectoring 11y ago
  What you did is basically my recommendation for people who suspect they have sleep apnea. IIRC, I cribbed this off of either Gwern or Eliezer Yudkowsky, who commented that buying a CPAP machine and seeing if it helped was cheaper and faster than getting a diagnosis.
hiou 11y ago
I feel like you are not part of this group, but my understanding is that the most common cause of sleep apnea is obesity. So for most a doctor is not even needed as it will go away when the patient returns to a healthy weight. So while your case may have been difficult, for the majority its a fairly simple solution.
cdjk 11y ago
It's possible to make it a little shorter. There are at home sleep studies, and the modern machines are usually have an auto mode that automatically adjusts the pressure, which typically eliminates the need for the titration study. Trying to get a CPAP covered by insurance is a pain, but if you have a prescription you can get one online and pay for it yourself - the same is true for supplies. Also, there's tons of interesting data you can get off the machine, if you get one that's data capable (you really, really want one that. Take a look at the program sleepyhead: http://www.sleepfiles.com/SH2/ http://www.sleepfiles.com/SH2/ Monitoring things yourself with your own data is really the way to go. It makes the sleep data you get from a jawbone/fitbit/etc look extremely minimal.
- vonmoltke 11y ago
  > Trying to get a CPAP covered by insurance is a pain, but if you have a prescription you can get one online and pay for it yourself - the same is true for supplies. I was pissed when I found out the cash price for my machine at cpap.com was less than the insurance co-pay I made for it. Insurance is not always worth the crap you have to go through.
- Steve44 11y ago
  A partial solution is to get one of the finger blood O2 meters that will record, keep it on overnight and you get a log of heartrate and O2 levels in the blood. Look at your O2 levels and see how low the percentage goes, if you get some serious dips then you quite possibly have a serious apnoea problem and need to get it properly checked ASAP. I think you should be in the 90-100% range, go below 80% and you're really heading towards trouble. When you stop breathing your O2 falls. (Usual disclaimer, I'm not a doctor etc)
e40 11y ago
I'm curious: does sleeping on your side make it better/go away? I ask because my wife cannot sleep on her back or left side, but she has no problem on her right side. My father used a CPAP until he realized that he didn't need it if he slept on his side. He wore a shirt with a tennis ball in the back to prevent him from rolling onto his back.
- rrss1122 11y ago
  Results may vary, but side sleeping in general is much better if you suffer from apnea. The tennis ball trick is often suggested. The reason why side sleeping works better is because when you are sleeping on your back, gravity naturally makes your neck and jaw push down on your throat and this can cause episodes where your breathing stops momentarily. Side sleeping mitigates this by having less weight falling on your throat.
rrss1122 11y ago
I am at step 4 now. I can only do the at-home sleep study though, but I do have time for that at least. Hopefully the process here in Florida is easier than it is in the Bay Area.
crimsonalucard 11y ago
There's alternative cures to sleep apnea for those wondering. 1. Find some device that always makes you sleep on your side. 2. Find some bed or recliner that maintains your back at a 45 degree position relative to the floor. The zero gravity chair helps a lot.
- dragonwriter 11y ago
  Those aren't alternative cures, they are alternative treatments.
  - deleted 11y ago
    [deleted]
- berntb 11y ago
  I do '1.' and band-aids-on-nose things seem to help. Could you tell me more about '2.' You mean half sitting up? (Yeah, hellbanned.)
- crimsonalucard 11y ago
  @bertnb: like this: https://www.dealbeds.com/serta-motion-essentials-ii-adjustable-bed-foundation/?gclid=CjwKEAjwi4yuBRDX_vq07YyF7l8SJAAhm0rpcnAsm7pprkIt-i1ZO3v6QgXqe8Hhm9AIaxktUt8XYRoC2Bjw_wcB https://www.dealbeds.com/serta-motion-essentials-ii-adjustab...
  - berntb 11y ago
    So that helps? Thanks a bunch! Time to Google. :-)
  - crimsonalucard 11y ago
    it depends on how bad your apnea is. If you slept sideways or straight up, gravity wouldn't be pulling your flesh in the right direction to cover your throat. Sleeping at a reclining angle doesn't completely eliminate the gravity but it lessens the gravitational pull. Depending on each individual case, the decrease in gravitational pull could be enough to stop the flesh from blocking your airway. You should just sleep on some lazy boy couch or something to see if it works before buying.
dmead 11y ago
keep going man. after you've learned how to sleep through the night with the mask, get 8 hours a night for 3 months (no exceptions and you'll be a new person. 100% would recommend.
dsr_ 11y ago
You're an underinformed patient, and your healthcare system is not helping you become better informed. Step 1 and 2 should be the same thing: have your GP send you directly to a sleep study. Step 3 should include an order from your GP to titrate for CPAP immediately if N apneations occur/hour. That kills steps 4,5,6 and turns step 7 into "durable medical equipment vendor shows up at your house to set up the CPAP and figure out what mask will work for you". Sorry it was a rough experience for you. Also note: every CPAP I've met can be calibrated to your Rx by a simple procedure involving reading the manual... that they probably don't provide to you. It will be available as a PDF online from the manufacturer.
- simcop2387 11y ago
  The steps you suggest change are actually how things happened for me. I think largely because my case turned out to be incredibly serious: blood oxygen falling below ~80% and breathing ceasing every 45 seconds or so for about a minute each time. That's what happens when you've got Complex Sleep Apnea (combo of obstructive and central).
- Florin_Andrei 11y ago
  While sleep apnea can be a difficult problem for anyone suffering from it, the mass epidemic that the OP was mentioning is not due to that. There's too much competition within society. Keeping up with the Joneses, unreasonable standards of "work ethic" - we've become far too individualistic, and the consequences are starting to show. Perhaps it is time to recalibrate the whole paradigm, and investigate more ways to rely on each other and the group - the way human beings have operated since the beginning of time.
mmagin 11y ago
I'm not sure if this is really that different from the problems with getting treated for a lot of other serious but non-urgent conditions in the USA. There's a lot of administrative overhead, excessive specialization, avoiding malpractice lawsuits, etc.
lectrick 11y ago
My path was not nearly that long to getting one. Your healthcare is shitty, dude. But I can tell you that getting one, if you have serious sleep apnea, is life-changing. Here are the differences in my life 5 years later: Income has doubled. Layoffs are nonexistent (I used to get laid off every 2-4 years, like clockwork). Lost weight. Testosterone went up. I am no longer late to appointments (my "time estimation" seems to have improved!) I have dreams again AND remember them!! Been YEARS since that! Actually have energy in the morning, how the hell did I live 30 years of my life without knowing what everyone else enjoys?? So I can actually exercise (because I have the energy), leading to even more fitness. Leading to better... dating experiences (ahem), and pretty much better everything! My one recommendation with CPAP is DO NOT let the doc prescribe you the over-the-nose mask... You want the ResMed Swift FX Nasal Pillow mask (google it). MUCH MUCH more comfortable/less "claustrophobic".
Diederich 11y ago
My wife went through this process years ago while we were in the midwest. A couple of years ago, I wanted to look into getting a machine, and we had (and still have) Kaiser Permanente, in Northern California. The first appointment was to pickup a take-home testing machine. It was just a 'come get it' process. I took it home, followed the instructions, and slept with it. It had a variety of connections to me, so it wasn't easy to sleep. The next day, I took that machine back. The day after that, they invited me to another appointment. In that appointment, there were about 50 people. We each sat at an assigned place at a table, with our new CPAP machine in front of us. They talked us through it, and invited us to come up and talk to one of two of three doctors, one at a time, at the end. Overall, it took maybe a week and cost maybe a hundred bucks. Health care is getting better in some areas, at least!
suneilp 11y ago
Ok, from someone who has had sleep apnea for 5 years. Screw steps 5-7. Get your prescription and go to cpap.com (or another place) and buy an Auto CPAP (APAP) using your prescription. Use cpaptalk.com to get more answers and help with picking out a machine and other stuff. Then you can "calibrate" it yourself. APAPs let you specify a range of pressures. Use the pressure you should have been told from the sleep study to pick a range around that pressure and just use that for a week. Look at the information yourself which any good machine lets you do so on your own. The machine will show you how much time was spent at various pressure levels so if its hanging low or high in the range adjust the range to fit that value in the middle. Rinse and repeat, its easy if a bit time consuming. Just don't look at the data after 1 night and make decisions. And Auto CPAPs are generally FAR better than regular CPAPs. You can try to get one covered by insurance but that depends on the equipment providers and insurance company.
- EarthLaunch 11y ago
  What about VPAPs?
malandrew 11y ago
It's not so much that it's a racket, it's that it's never been considered a public health problem and there are enough doctors that specialize in this area. I'm a diagnosed narcoleptic and have obstructive sleep apnea, which is a lot better now after having a tonsillectomy about 2-3 years go. I too am a patient at the same clinic you go to (Stanford) and have been a patient at two other clinics, one in Raleigh, NC and one in São Paulo, Brazil. I don't even remember how many sleep studies I've done. I think 8. Five in Raleigh (One for diagnosis and for as part of the clinical study that approved sodium oxybate for general narcolepsy and not just cataplexy). I did another two in SP IIRC and I did one at Stanford, but should do another one since my surgery. First thing I recommend is drop your HMO in favor of a PPO. Having to see a GP first is the biggest waste of time and you know your symptoms well enough to at least figure out what specialist to see. When booking an appointment with the clinic, you can be seen sooner by not picking who will see you. The main doctor at Stanford is Dr. Mignot. He's amazing and bar none the best of the sleep doctors I've seen. The reason that clinic is booked out forever is because he and his clinic are that much better. Booking in the summer months is particularly bad because there are lots of younger patients from elsewhere in the country that will visit Stanford due to its reputation. You're not just competing with local patients but people everywhere in the US. Also let the receptionist know that you're a local patient and that you would be happy to be on the waitlist to be called in case of a cancellation. You'll be seen much sooner this way. If you actually have sleep problems, all those wires, as inconvenient as they are, are unlikely to impact the results much. In every sleep study I've done, I've been in REM sleep in about ~2 minutes of laying my head on the pillow after the lights have been turned out. All the numbers they use for diagnosis are based on the same methodology with that equipment. If the inconvenience impacts the results than that is already accounted for. I highly recommend looking into the surgery option (tonsillectomy and lingual reduction) if your ENT doctor (mine is Dr. Capassso) thinks you're a candidate for it. My nighttime breathing was night and day better and I don't snore as much. That said, it's one of the most painful surgeries you can get as an adult. I didn't eat food for more than two weeks and didn't even miss it because it hurt to even think about it. The results were worth it. Yeah, the whole process sucks at times, but it's not trivial stuff to figure out and if you need this, it will make such a huge improvement in your life that you'll be asking yourself who has time to not go through all that song and dance.
monksy 11y ago
Many of the sleep specialists that do Sleep apnea studies in Chicago are booked until December.
yo-code-sucks 11y ago
I have it too, I went onto eBay, bought the machine, bought all new parts, face mask, etc. $400 bucks later have the whole setup. The. Wear it during the daytime, while laying on your back so your diaphragm isn't blocked, and slowly adjust the pressure until your ears feel it lightly. Never looked back, never had one issue. The system is a joke and if the patents on the hardware didn't exist it would cost few tens of dollars for everything.
WCityMike 11y ago
Respectfully, this doesn't reflect my experience at all. I live in Chicago. I was referred to a sleep specialist, saw them, had a sleep study (the Matrix wiring and unpleasantly early sleep time is accurate, though), got my machine, set with the sleep study's calibration, and began sleeping with it. No additional sleep studies for calibration. Or, to put it another way, for me, it was 1, 2, 3, and a not-as-long-as-you-describe 5.

WalterSear 11y ago

I don't have apnea. I was prescribed an apnea machine anyway. They seemed very generous in handing out prescriptions for them.

pcarmichael 11y ago

I was diagnosed with obstructive sleep apnea. Using a CPAP was life changing for me. I won't sleep without it now if I can help it, though it did take me a bit of iterating through different mask arrangements. The first few weeks were hard - I slept strangely because I dreamt intensely (and I was told that's normal). Before I couldn't remember the last time I really had a dream. After years of slowly acclimating to not getting real sleep, actually getting good sleep and rest was amazing. It was like emerging from a fog of years that I never realized I was in. Once you get too far in, you don't really realize how tired you were. True, the process to get there wasn't fun. But hopefully you find the end result as beneficial as I did.

viraptor 11y ago
While I wasn't diagnosed with any actual issue, I definitely didn't sleep enough during/after university. I didn't realise this until a few years later I started going to sleep at the same time as my girlfriend. And that was a huge change - like discovering that yes, you can actually wake up before the alarm and not need 5 of them. I got a similar effect too - some crazy intense dreams. It's a great indicator actually - any time I get too tired / go to sleep too late I don't have them. But go to bed around 10pm - I dream a whole story with multiple characters and long enough to make it a crazy movie. On the other hand, recently I started looking at ways to get rid of dreams... they're just too much if they happen every night.
- hemdrup 11y ago
  I have found keeping a routine of going to bed around 11 pm and waking up at 06:00. Results in highest creative performance. The time period from 06:00 to 10:00 is the magic hours :)
- heed 11y ago
  The only thing I've found that reduces my intense dreaming is (believe it or not) cannabis use.
  - facetube 11y ago
    Not at all surprising; there's evidence that cannabis use suppresses REM sleep. Anecdotally, people who suddenly stop taking it after long periods of use tend to report unusually vivid dreams.
    - mhink 11y ago
      That's exactly what's happening with my girlfriend right now. She gave up cannabis after years of heavy smoking, and it seems like every morning she wakes up telling me about the intense, vivid dreams she had. That said, while the quitting process has been quite difficult for her (irritability's through the roof- almost as bad as when I've tried to quit smoking cigarettes), she says she started feeling "better" almost immediately. Probably the best part (for both of us, haha) is that her natural appetite is coming back- and in fact, she's reporting that she's developing a taste for a lot of foods she previously didn't like because the flavor was too intense or the texture was too unusual. The only real explanation we can figure out is that the cannabis intensified culinary experiences to the point where she couldn't handle it, and so she just ended up avoiding a lot of types of food. The brain is an interesting organ.

ajhit406 11y ago

Would it be possible to purchase a CPAP overseas when traveling and bring it back into the US? Are there laws against that if it is for personal use?

johnchristopher 11y ago
That's strange, I was under the assumption it'd be easier for me to buy a (n)CPAP machinein the US than in Europe (CPAP user).
- peejaybee 11y ago
  That's only true for firearms.
sokoloff 11y ago
It's a class II medical device, so federally in the US, you need a prescription. That issue aside, they're readily available used on craigslist, and you can buy "kits" online to replace the parts that wear or touch "gross parts" of the prior user, so if you don't care about the prescription issue, CL is probably better than traveling overseas to get one.

technofiend 11y ago

It must be a profitable racket because my optometrist was trying to sell me one. Lol. Fortunately my ENT wrote a prescription for a sleep study but told me to try Breathe Right strips first. He told me honestly the surgery is painful and the strips had cut his surgical load in half. He was right. I've never slept better and my wife is no longer contemplating my early demise by pillow smothering. And before anyone acuses me of being a shill I switched to knock offs long ago. The cheap Chinese ones on ebay have weaker glue but if they work for you they are far cheaper.

GFischer 11y ago
I really have to try those, but I haven't seen them in my country. I've tried several doctors (I snore and stuff), they think I have nasal polyps - one wanted to try surgery and the other wanted to try some ultrasound stuff.

eruditely 11y ago

I found out I have sleep apnea and it ruined my life and am now going through this process, I woke up to a new me that is several orders of magnitude more productive. I could never remember my life and would always do stuff like forget to eat, now everything is normal!

DanBC 11y ago

You missed one of the most important steps for most people with sleep apnoea: lose some weight. Most people with sleep apnoea are not helpless victims to an incurable disease. Losing weight doesn't appear to be easy, but it's certainly achievable for most overweight people. EDIT: Here's the CDC page listing obesity as a cause for apnea http://www.cdc.gov/healthyweight/effects/index.html http://www.cdc.gov/healthyweight/effects/index.html

arrrg 11y ago
Why did you deem it necessary to even mention that? I’m quite certain that people with sleep apnoea for whom weight is a relevant component are quite aware of that. Yours is just a pointless diversion in this context – because what exactly is the your angle here? Should it be hard for people with sleep apnoea to get treatment? I mean, what are you arguing here for exactly?
- DanBC 11y ago
  People are complaining about the length of time it takes to get treatment, and the cost of treatment, and that treatment is a racket. All that stuff is true. All that stuff is avoided by losing weight. Your comment appears to be overly sensitive to a calm, non-judgemental bit of information. EDIT: Here's the link to the CDC page which lists overweight as a cause of sleep apnea: http://www.cdc.gov/healthyweight/effects/index.html http://www.cdc.gov/healthyweight/effects/index.html It's really easy for people, especially men, to hit a BMI of 30 and not realise that they are obese. Especially in obesogenic societies where very many people are obese, morbidly obese or even super obese. This carries a range of health risks, most of which are helped by losing weight. It's weird the source article doesn't mention weight, since it is caused by lack of sleep (especially in children and young people) and causes lack of sleep (in adults). http://www.cdc.gov/sleep/about_sleep/chronic_disease.htm http://www.cdc.gov/sleep/about_sleep/chronic_disease.htm > Laboratory research has found that short sleep duration results in metabolic changes that may be linked to obesity. Epidemiologic studies conducted in the community have also revealed an association between short sleep duration and excess body weight. This association has been reported in all age groups—but has been particularly pronounced in children. It is believed that sleep in childhood and adolescence is particularly important for brain development and that insufficient sleep in youngsters may adversely affect the function of a region of the brain known as the hypothalamus, which regulates appetite and the expenditure of energy

smartial_arts 11y ago

Not sure what's the equivalent for the steps 3-7 here in Australia, but getting a referral from a GP and then getting a portable testing machine, that you're supposed to wear at home, is very straightforward. It also doesn't cost much - think it's something like $80 after getting the Medicare rebate.

johnward 11y ago

I have central sleep apnea. The way I understand it is that there is no obstruction causing me to stop breathing my brain just doesn't feel like doing it sometimes. It took me probably 8 years to figure out what the problem was. No one had any idea until I demanded a sleep study. I couldn't even sleep on the first one so they said I was fine. I demanded another and they finally found out I had apnea. You have to really take an active role in your healthcare if you want problems solved.

philip142au 11y ago

You can buy the machine that doesn't need to be calibrated, but it costs more.

sokoloff 11y ago
In the US, you need a prescription (at least officially), so you still are exposed to the sleep study racket.
cmiles74 11y ago
My insurance company refused to cover an "automatic" (APAP) machine for my obstructive sleep apnea, only a "constant" (CPAP) machine was acceptable to them. The medical supply company then provided me with an APAP machine that was configured such that it behaved like a CPAP machine. 3 minutes of Googling and quick change to the settings enabled the automatic function. I found the APAP much easier to sleep with than the pretty harsh blasting of the CPAP setup.

flanbiscuit 11y ago

I know that I snore and that I need to do this but this doesn't seem encouraging. Plus I don't want to sleep with a machine the rest of my life. Isn't there surgery that can be done? I'd be happy to do that (even though I've heard it's not foolproof). I wake up every day feeling tired no matter what time I try and go to sleep. On weekends I can sleep in until 1pm if I let myself and I still have a hard time waking up. I should add, I'm a slim/skinny guy, been so all my life, so it's not about weight.

DanBC 11y ago
Once you've got medical stuff ruled out you can try exercises. This involves singing something like "UNGGG - GGAAAHHH" for twenty minutes per day. There's a little bit of research suggesting this. There is surgery to treat snoring. It's not great. https://www.nice.org.uk/guidance/ipg240 https://www.nice.org.uk/guidance/ipg240 https://www.nice.org.uk/guidance/ipg476 https://www.nice.org.uk/guidance/ipg476
- flanbiscuit 11y ago
  Thanks for the info. I haven't had any official tests for apnoea so I do want to get sleep studies done. But I have been told by my girlfriend that I do stop breathing while sleeping, long enough that she worries that I'm not going to continue breathing, but I eventually do. To me that seems like the exact definition of apnoea.
cmiles74 11y ago
For some people, there's a bunch of dental things you can wear at night, some are kind of like a retainer. http://www.sleepapnea.org/treat/treatment-options/oral-appliance.html http://www.sleepapnea.org/treat/treatment-options/oral-appli...
- Steve44 11y ago
  I think they work for very few people and unless you adhere to the jaw exercise regime you can end up with jaw problems.

jshelly 11y ago

If your not sleeping you should have plenty of time for this ;-)

outworlder 11y ago

1. IF they do the referral. Which they might not, if you are not looking like a double for The Walking Dead. 2. They are all booked everywhere, it seems 3. Or, even worse, they might hit delays and not put you to bed until way after midnight, as was with me. I could barely sleep. They still can't explain the 5h it took for me to reach deeps leep. 4. This is where I left off. Not enough obstructive sleep events to warrant a treatment, according to the clinic(perhaps because I was half awake?). My doctor did not fully agree with them. Do I have sleep apnea? Only Cthulhu knows. I wonder if I'll ever try the sleep study again. The Heisenberg Uncertainty Principle does seem to apply here. How are they supposed to diagnose your sleep issues, if you are so uncomfortable that sleeping at your work desk feels fantastic in comparison?

ambiate 11y ago

My friend recommended this long path for me. I laughed and asked what the end solution was: CPAP. I ventured to craigslist and bought a used one for $100. I bought new gear off amazon. Google search led to the keystrokes to change the pressure myself. Few tweaks and I wake well rested rather than sleepy. Previously, I could sleep for 12 hours and still feel tired. Friend is still waiting for their appointment to receive their machine two months later.

smoothgrips 11y ago
I guess that is one way to do it. I don't know if I would do that myself. I went through the normal channels and here in SLC it went very smoothly. The thing with the "do it yourself" approach is, without the sleep study, you don't know what pressure to use. They use the analysis from the sleep study to determine what pressure to use. Also, you will consistently need to purchase new supplies on a regular basis. You'll be paying full price for those forever, whereas mine are covered by my insurance (since I went through the proper channels), so over time you will spend more money than I will.
- trevyn 11y ago
  APAP is shown to calibrate as well as a sleep study, and at least in my case, it was pretty straightforward to find the right pressure by feel. Personally, I did steps 2-4 above, got an APAP prescription valid until the end of time, and bought a new machine online. (Maybe insurance would reimburse? I didn't even bother; time is money too.)
- afarrell 11y ago
  Why not both? Get a used one while you wait for your sleep study.
ThrustVectoring 11y ago
What you did is basically my recommendation for people who suspect they have sleep apnea. IIRC, I cribbed this off of either Gwern or Eliezer Yudkowsky, who commented that buying a CPAP machine and seeing if it helped was cheaper and faster than getting a diagnosis.

hiou 11y ago

I feel like you are not part of this group, but my understanding is that the most common cause of sleep apnea is obesity. So for most a doctor is not even needed as it will go away when the patient returns to a healthy weight. So while your case may have been difficult, for the majority its a fairly simple solution.

cdjk 11y ago

It's possible to make it a little shorter. There are at home sleep studies, and the modern machines are usually have an auto mode that automatically adjusts the pressure, which typically eliminates the need for the titration study. Trying to get a CPAP covered by insurance is a pain, but if you have a prescription you can get one online and pay for it yourself - the same is true for supplies. Also, there's tons of interesting data you can get off the machine, if you get one that's data capable (you really, really want one that. Take a look at the program sleepyhead: http://www.sleepfiles.com/SH2/ http://www.sleepfiles.com/SH2/ Monitoring things yourself with your own data is really the way to go. It makes the sleep data you get from a jawbone/fitbit/etc look extremely minimal.

vonmoltke 11y ago
> Trying to get a CPAP covered by insurance is a pain, but if you have a prescription you can get one online and pay for it yourself - the same is true for supplies. I was pissed when I found out the cash price for my machine at cpap.com was less than the insurance co-pay I made for it. Insurance is not always worth the crap you have to go through.
Steve44 11y ago
A partial solution is to get one of the finger blood O2 meters that will record, keep it on overnight and you get a log of heartrate and O2 levels in the blood. Look at your O2 levels and see how low the percentage goes, if you get some serious dips then you quite possibly have a serious apnoea problem and need to get it properly checked ASAP. I think you should be in the 90-100% range, go below 80% and you're really heading towards trouble. When you stop breathing your O2 falls. (Usual disclaimer, I'm not a doctor etc)

e40 11y ago

I'm curious: does sleeping on your side make it better/go away? I ask because my wife cannot sleep on her back or left side, but she has no problem on her right side. My father used a CPAP until he realized that he didn't need it if he slept on his side. He wore a shirt with a tennis ball in the back to prevent him from rolling onto his back.

rrss1122 11y ago
Results may vary, but side sleeping in general is much better if you suffer from apnea. The tennis ball trick is often suggested. The reason why side sleeping works better is because when you are sleeping on your back, gravity naturally makes your neck and jaw push down on your throat and this can cause episodes where your breathing stops momentarily. Side sleeping mitigates this by having less weight falling on your throat.

rrss1122 11y ago

I am at step 4 now. I can only do the at-home sleep study though, but I do have time for that at least. Hopefully the process here in Florida is easier than it is in the Bay Area.

crimsonalucard 11y ago

There's alternative cures to sleep apnea for those wondering. 1. Find some device that always makes you sleep on your side. 2. Find some bed or recliner that maintains your back at a 45 degree position relative to the floor. The zero gravity chair helps a lot.

dragonwriter 11y ago
Those aren't alternative cures, they are alternative treatments.
- deleted 11y ago
  [deleted]
berntb 11y ago
I do '1.' and band-aids-on-nose things seem to help. Could you tell me more about '2.' You mean half sitting up? (Yeah, hellbanned.)
crimsonalucard 11y ago
@bertnb: like this: https://www.dealbeds.com/serta-motion-essentials-ii-adjustable-bed-foundation/?gclid=CjwKEAjwi4yuBRDX_vq07YyF7l8SJAAhm0rpcnAsm7pprkIt-i1ZO3v6QgXqe8Hhm9AIaxktUt8XYRoC2Bjw_wcB https://www.dealbeds.com/serta-motion-essentials-ii-adjustab...
- berntb 11y ago
  So that helps? Thanks a bunch! Time to Google. :-)
- crimsonalucard 11y ago
  it depends on how bad your apnea is. If you slept sideways or straight up, gravity wouldn't be pulling your flesh in the right direction to cover your throat. Sleeping at a reclining angle doesn't completely eliminate the gravity but it lessens the gravitational pull. Depending on each individual case, the decrease in gravitational pull could be enough to stop the flesh from blocking your airway. You should just sleep on some lazy boy couch or something to see if it works before buying.

dmead 11y ago

keep going man. after you've learned how to sleep through the night with the mask, get 8 hours a night for 3 months (no exceptions and you'll be a new person. 100% would recommend.

dsr_ 11y ago

You're an underinformed patient, and your healthcare system is not helping you become better informed. Step 1 and 2 should be the same thing: have your GP send you directly to a sleep study. Step 3 should include an order from your GP to titrate for CPAP immediately if N apneations occur/hour. That kills steps 4,5,6 and turns step 7 into "durable medical equipment vendor shows up at your house to set up the CPAP and figure out what mask will work for you". Sorry it was a rough experience for you. Also note: every CPAP I've met can be calibrated to your Rx by a simple procedure involving reading the manual... that they probably don't provide to you. It will be available as a PDF online from the manufacturer.

simcop2387 11y ago
The steps you suggest change are actually how things happened for me. I think largely because my case turned out to be incredibly serious: blood oxygen falling below ~80% and breathing ceasing every 45 seconds or so for about a minute each time. That's what happens when you've got Complex Sleep Apnea (combo of obstructive and central).
Florin_Andrei 11y ago
While sleep apnea can be a difficult problem for anyone suffering from it, the mass epidemic that the OP was mentioning is not due to that. There's too much competition within society. Keeping up with the Joneses, unreasonable standards of "work ethic" - we've become far too individualistic, and the consequences are starting to show. Perhaps it is time to recalibrate the whole paradigm, and investigate more ways to rely on each other and the group - the way human beings have operated since the beginning of time.

mmagin 11y ago

I'm not sure if this is really that different from the problems with getting treated for a lot of other serious but non-urgent conditions in the USA. There's a lot of administrative overhead, excessive specialization, avoiding malpractice lawsuits, etc.

lectrick 11y ago

My path was not nearly that long to getting one. Your healthcare is shitty, dude. But I can tell you that getting one, if you have serious sleep apnea, is life-changing. Here are the differences in my life 5 years later: Income has doubled. Layoffs are nonexistent (I used to get laid off every 2-4 years, like clockwork). Lost weight. Testosterone went up. I am no longer late to appointments (my "time estimation" seems to have improved!) I have dreams again AND remember them!! Been YEARS since that! Actually have energy in the morning, how the hell did I live 30 years of my life without knowing what everyone else enjoys?? So I can actually exercise (because I have the energy), leading to even more fitness. Leading to better... dating experiences (ahem), and pretty much better everything! My one recommendation with CPAP is DO NOT let the doc prescribe you the over-the-nose mask... You want the ResMed Swift FX Nasal Pillow mask (google it). MUCH MUCH more comfortable/less "claustrophobic".

Diederich 11y ago

My wife went through this process years ago while we were in the midwest. A couple of years ago, I wanted to look into getting a machine, and we had (and still have) Kaiser Permanente, in Northern California. The first appointment was to pickup a take-home testing machine. It was just a 'come get it' process. I took it home, followed the instructions, and slept with it. It had a variety of connections to me, so it wasn't easy to sleep. The next day, I took that machine back. The day after that, they invited me to another appointment. In that appointment, there were about 50 people. We each sat at an assigned place at a table, with our new CPAP machine in front of us. They talked us through it, and invited us to come up and talk to one of two of three doctors, one at a time, at the end. Overall, it took maybe a week and cost maybe a hundred bucks. Health care is getting better in some areas, at least!

suneilp 11y ago

Ok, from someone who has had sleep apnea for 5 years. Screw steps 5-7. Get your prescription and go to cpap.com (or another place) and buy an Auto CPAP (APAP) using your prescription. Use cpaptalk.com to get more answers and help with picking out a machine and other stuff. Then you can "calibrate" it yourself. APAPs let you specify a range of pressures. Use the pressure you should have been told from the sleep study to pick a range around that pressure and just use that for a week. Look at the information yourself which any good machine lets you do so on your own. The machine will show you how much time was spent at various pressure levels so if its hanging low or high in the range adjust the range to fit that value in the middle. Rinse and repeat, its easy if a bit time consuming. Just don't look at the data after 1 night and make decisions. And Auto CPAPs are generally FAR better than regular CPAPs. You can try to get one covered by insurance but that depends on the equipment providers and insurance company.

EarthLaunch 11y ago
What about VPAPs?

malandrew 11y ago

It's not so much that it's a racket, it's that it's never been considered a public health problem and there are enough doctors that specialize in this area. I'm a diagnosed narcoleptic and have obstructive sleep apnea, which is a lot better now after having a tonsillectomy about 2-3 years go. I too am a patient at the same clinic you go to (Stanford) and have been a patient at two other clinics, one in Raleigh, NC and one in São Paulo, Brazil. I don't even remember how many sleep studies I've done. I think 8. Five in Raleigh (One for diagnosis and for as part of the clinical study that approved sodium oxybate for general narcolepsy and not just cataplexy). I did another two in SP IIRC and I did one at Stanford, but should do another one since my surgery. First thing I recommend is drop your HMO in favor of a PPO. Having to see a GP first is the biggest waste of time and you know your symptoms well enough to at least figure out what specialist to see. When booking an appointment with the clinic, you can be seen sooner by not picking who will see you. The main doctor at Stanford is Dr. Mignot. He's amazing and bar none the best of the sleep doctors I've seen. The reason that clinic is booked out forever is because he and his clinic are that much better. Booking in the summer months is particularly bad because there are lots of younger patients from elsewhere in the country that will visit Stanford due to its reputation. You're not just competing with local patients but people everywhere in the US. Also let the receptionist know that you're a local patient and that you would be happy to be on the waitlist to be called in case of a cancellation. You'll be seen much sooner this way. If you actually have sleep problems, all those wires, as inconvenient as they are, are unlikely to impact the results much. In every sleep study I've done, I've been in REM sleep in about ~2 minutes of laying my head on the pillow after the lights have been turned out. All the numbers they use for diagnosis are based on the same methodology with that equipment. If the inconvenience impacts the results than that is already accounted for. I highly recommend looking into the surgery option (tonsillectomy and lingual reduction) if your ENT doctor (mine is Dr. Capassso) thinks you're a candidate for it. My nighttime breathing was night and day better and I don't snore as much. That said, it's one of the most painful surgeries you can get as an adult. I didn't eat food for more than two weeks and didn't even miss it because it hurt to even think about it. The results were worth it. Yeah, the whole process sucks at times, but it's not trivial stuff to figure out and if you need this, it will make such a huge improvement in your life that you'll be asking yourself who has time to not go through all that song and dance.

monksy 11y ago

Many of the sleep specialists that do Sleep apnea studies in Chicago are booked until December.

yo-code-sucks 11y ago

I have it too, I went onto eBay, bought the machine, bought all new parts, face mask, etc. $400 bucks later have the whole setup. The. Wear it during the daytime, while laying on your back so your diaphragm isn't blocked, and slowly adjust the pressure until your ears feel it lightly. Never looked back, never had one issue. The system is a joke and if the patents on the hardware didn't exist it would cost few tens of dollars for everything.

WCityMike 11y ago

Respectfully, this doesn't reflect my experience at all. I live in Chicago. I was referred to a sleep specialist, saw them, had a sleep study (the Matrix wiring and unpleasantly early sleep time is accurate, though), got my machine, set with the sleep study's calibration, and began sleeping with it. No additional sleep studies for calibration. Or, to put it another way, for me, it was 1, 2, 3, and a not-as-long-as-you-describe 5.