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If your doctor tells you to do a sleep study, do it. If, as a result, they tell you to get a CPAP, get it. Those things are life-changing. I felt like an old

If your doctor tells you to do a sleep study, do it. If, as a result, they tell you to get a CPAP, get it. Those things are life-changing. I felt like an old man at 50 years old. My back was so stiff I couldn't put on my socks. When I got out of bed in the morning I felt so fragile, like my joints were all inflamed - especially my Achilles' tendons. I was too tired to do anything beyond 6 pm. Now, 51, I feel totally normal again. And that change was pretty much overnight once I started using that wretched machine.

tstrimple 6y ago
> If your doctor tells you to do a sleep study, do it. All I got in return is a $500 inconclusive.
- zoopdewoop 6y ago
  Why did you even comment this? He's saying the upside is worth it. I also got an inconclusive, but my dad has apnea and a sleep study basically changed his life. The possibility of that is clearly worth 500$
  - throw1234651234 6y ago
    Because to some people $500 is a lot and doctor visits are often useless. "See a doctor" is default advice, but it can be very expensive advice.
    - yohannparis 6y ago
      This a USA healthcare problem, and you should flag it as such.
      - kortilla 6y ago
        Why? If going to a doctor is free for you, you know that.
        yohannparis 6y ago
        Doctor are not free to me, I pay taxes. What I was trying to say, your example is an USA problem, most people do not have to decide if seeing a doctor is a financial decision. So your case is not universal, and should be mentioned.
      - irlib 6y ago
        I am in the USA, and my cheap ass insurance covered the sleep study in full. CPAP machine, however, is upon deductible, so I have postponed it upon I'll have spent the deductible on something like CT.
- Someone1234 6y ago
  They're slowly moving to "at home" sleep studies, so hopefully the cost will come down. Essentially they just loan you a bunch of monitors on a chest belt, teach you how to put it on, and you return it the next day for your consultation. Here's a video showing how to install the monitor: https://www.youtube.com/watch?v=FHvydhYu85o https://www.youtube.com/watch?v=FHvydhYu85o It is still a "developing area" but I think it will be the norm eventually. It *should reduce the cost (but YMMV, as US healthcare costs don't conform to normal logic).
  - irlib 6y ago
    Yeah, a couple of years ago, I had an at-home sleep study. It was free for me with Kaiser insurance, so I guess the cost was neglectable.
- Broken_Hippo 6y ago
  Cervical cancer screenings save women's lives: Cervical cancer is an insane beast that often has no symptoms when it is the most treatable. Many, many women get abnormal or inconclusive results once or twice during their lives. It can be a variety of causes, even! This doesn't change the fact that they save lives or seriously increase some people's quality of life. The sleep studies are similar. Someone getting an inconclusive result doesn't negate all the folks that have been helped by it - and honestly, doesn't rule it out. The money bit is just a shameful side effect of the health care system where you live and I'm guessing it is part of the sting of an inconclusive result.
- SaintGhurka 6y ago
  That really sucks. When did you do the test - and was it in a clinic or at home? I do encourage you to keep trying if you have reason to think you have sleep apnea. Maybe get a home O2 monitor to help you decide if it's worth spending the money on another sleep study.
- virgulino 6y ago
  Thanks. I didn't know that it could be inconclusive, or how much it costs.
- AuryGlenz 6y ago
  Mine was a hell of a lot more expensive than that. $3,000. The doctor refused to treat me until I had one, even though my fatigue was the same as it was 10 years ago when I had another sleep study with no issues. So damned frustrating.
Someone1234 6y ago
Agreed. But a CPAP is only as a good as your usage, too many people "have" one but don't use it. A lot of it is comfort. So try switching from a full-face to nose pillow-style mask. Or alternative headgear. Or even talk to your doctor about lowering the pressure if it is the noise (better to have less effective treatment, than none at all). PS - A lot of, frankly, older doctors are still not prescribing Auto-CPAPs for people who may be suitable. If you're currently set on a fixed pressure, and your machine is a common Auto-CPAP (variable pressure) maybe seek a second opinion from a different (younger?) doctor. Auto-CPAPs are medically certified for many Sleep Apnea suffers, doctors just haven't adapted or haven't been re-trained, so they're chronically under-prescribed. Auto-CPAP improves your comfort, not your treatment, which improves adherence.
balfirevic 6y ago
I wonder if it would be helpful to allow people who experience sleep issues to just get a CPAP machine and try it out, instead of having to go through a sleep study.
- SaintGhurka 6y ago
  I've wondered that, too. Between my insurance company and me, we spent a combined $1000 on deciding whether I should get one. That's more than a low-end unit costs.
- kevinmgranger 6y ago
  Most people aren't good at assessing their own fatigue. A sleep study gives one quantifiable information about the quality of one's sleep. So may people find their CPAP uncomfortable when they first use it, that it's unlikely they'll use it properly. Having a first use under the watchful eyes of a physician could be a good idea. Then again, some people also get one and then don't use it, so maybe it's more of the same.
  - balfirevic 6y ago
    Yes, I'm sure it's not as good as having a proper sleep study but if the end result is that more people who need them get them it would be a positive outcome. Also, a doctor can show you how to use one, you would not necessarily be completely on your own. Sleep studies are just such a hassle (and expensive, depending on where you live), and if you have a weird sleep schedule it can be difficult to even fall asleep in time. Being able to just rent a CPAP machine for a couple of days and have a doctor show you how to use it would be a good option to have.
- jmpman 6y ago
  I bought a wearable blood oxygen meter as I was concerned I had apnea. A previous study was inconclusive (I don’t think I slept the whole night). If I sleep on my back, I’m certain I have apnea, but haven’t validated with the o2 meter. Sleeping on my stomach, my o2 levels were acceptable all night. Once I confirm apnea on my back, I’ll probably get another sleep study (I’ve gained at least 30lbs since the last), and a CPAP... just like my father.
odiroot 6y ago
If only it was so easy. I was told, in Germany, I have to wait 2+ months for the next appointment.
- SaintGhurka 6y ago
  That's the one consolation to those of us in the maddeningly expensive US system. You can usually find someone who will get you scheduled in very short order. Don't let the wait deter you. If you do need the machine, it can really improve your life.
  - jpxw 6y ago
    In my country, the UK, it’s not unusual at all to have to wait 2-3 months for a hospital appointment. People shit on America’s health system a lot (and in many cases for perfectly valid reasons), but I think they don’t quite consider the alternative.
    - vidarh 6y ago
      You can buy your way past the queues either per treatment or with private insurance in the UK and still pay far less than in the US. Most of us wait because the prioritisation is by clinical need, and is usually 'good enough' and some because they can't afford it.
      - downerending 6y ago
        Are you paying less, all in? (e.g., taxes)
        jpxw 6y ago
        We are, yes. But the average American would be shocked at the "customer experience" the average patient gets from the NHS. No such thing as a free lunch etc. And I think if you have private insurance (i.e: double paying), you'll probably be paying more than the average American. I don't know for sure though.
benwilson-512 6y ago
And even if you're young, if you find yourself waking up at night with your heart racing, excessive snoring, etc, get it checked out. I got a CPAP machine at 20, and it's hard to overstate the impact. You can even just straight up buy them these days and adjust the settings yourself, sometimes the insurance premium on the sleep study is as high as the cost of the machine.
- haram_masala 6y ago
  How feasible is that, though - to just up and buy one and set it up yourself? I'm honestly asking, not criticizing.
  - vidarh 6y ago
    Buying them is easy enough gh at least - you can buy them on amazon
- dilatedmind 6y ago
  where can you buy them without a prescription?
  - TylerE 6y ago
    There are online sites that will sell you one...basically the way I understand it is they will do a phone consult with a licensed physician. The perscription is required if you want your insurance to pay for it. The cost is not insignifigant. Cost of the machine itself is around $1000, and then perhaps $150-200 in supplies every 3 months. Totally worth it though. Life changing.
sillysaurusx 6y ago
When I say the same thing about Prozac, people react with anger. It's strange. A sleep study is definitely one of the best things I ever did. It helped uncover some undiagnosed narcolepsy, and I've been able to manage it since then. Even knowing that it existed was helpful. (For example, lots of stress was caused by getting jobs that expect you to have your butt in the seat from 9am to 5pm. Other jobs exist.) So yes. Sleep study good! Go do one!
- wincy 6y ago
  I'm glad Prozac worked for you. It made me impotent in my 20s and I felt like I was being dropped down an elevator shaft for months after discontinuing it.
  - layoutIfNeeded 6y ago
    > being dropped down an elevator shaft What do you mean by this?
    - nitrogen 6y ago
      Ddg for SSRI withdrawal symptoms.
      - layoutIfNeeded 6y ago
        I knew about SSRI withdrawal symptoms, even experienced "brain zaps" first hand, but never heard about the vestibular thing.
    - Gatsky 6y ago
      It causes vestibular symptoms. This creates the sensation of motion without movement. Incidentally, if you’ve never had true vertigo, it is very disconcerting how much a sensory organ malfunction can affect your perception of the world. It is a kind of spatial psychosis that you can observe objectively.
  - Broken_Hippo 6y ago
goldenkey 6y ago
I had a sleep study done but was so uncomfortable I couldn't fall asleep...all the wires and crap. Waste of money.
- cachestash 6y ago
  Same happened to me. I felt pressured into sleeping and as a result, I could not sleep.
  - PhantomGremlin 6y ago
    I was in the same situation, very hard for me to fall asleep. Finally the technician gave me a pill, perhaps Ambien. I fell asleep and they got the data they needed.
- SaintGhurka 6y ago
  Same for me. It took me 3 goes to get enough data for a diagnosis. Don't give up.
technofiend 6y ago
Getting an APAP (auto-adjusting machine) was automated to the point that the barrier to entry is pretty darn low. An at-home study required me to sit through dead obvious instruction on how to equip and use the machine. Once I was prescribed a machine as a result of the study, the most time-consuming part was picking up a machine and sitting with a nurse to try on various masks. Since the machine itself is set to what the CPAP community calls "lazy doctor mode" meaning it's just set to auto-adjust itself in a range and the newer machines use cell data to automatically upload usage data, once you take it home you're done. My only follow up visit was over the phone. And there is an open source project for reading the data which will appeal to the HN crowd: https://www.sleepfiles.com/OSCAR/ https://www.sleepfiles.com/OSCAR/
- elcritch 6y ago
  I’m not in a position to do a sleep study. But I’d like to self-monitor my sleep and oxygen levels. Do you know of any DIY projects in that area? In the future fitbits and Apple watches should automatically include sleep / oxygen quality. It’ll take getting past the FDA, but for the low cost of having that info bs the benefits society would gain... well DIy seems like a good way to trail blaze.
  - bradstewart 6y ago
    I can't comment on how accurate it is, but my Garmin Vivosmart measures sleep pulse ox.
  - spease 6y ago
    The best pulse ox I’ve found is the O2Ring. It’s more comfortable than any other pulse ox I’ve used, it samples at a high rate and produces absolutely gorgeous output. The downsides: I don’t believe it integrates with OSCAR, and it’s a whopping $180. https://www.amazon.com/dp/B07T5L57M4/ https://www.amazon.com/dp/B07T5L57M4/
Phenomenit 6y ago
I suspect I might have some sleep disturbance. It's really hard for me to sleep on my back, I wake up constantly and snoor so I just sleep on my stomach instead.
- spease 6y ago
  Yeah that sounds like possible sleep apnea. Have you looked into doing a sleep study?
  - Phenomenit 6y ago
    No, I have small children at the moment so my sleep is disturbed by that but as soon as they start sleeping normally through the night I'm going to have it checked out.
anonymousab 6y ago
That said, it's not always a magic bullet. I got a cpap after a sleep study found I had 80+ breathing interruptions in the short overnight test window. It easily brought them down to <10, but I feel no better in the morning, and it makes the occasional nap much more of a hassle. The value is absolutely there in the greatly reduced likelihood of death in my sleep, and the white noise is better than snoring when sleeping around others. But I wouldn't want to get people's hopes up about it providing them the bad sleep panacea they desire.
- spease 6y ago
  Did you ever figure it out?
- PhantomGremlin 6y ago
  Read forums http://www.cpaptalk.com/CPAP-Sleep-Apnea-Forum.html http://www.cpaptalk.com/CPAP-Sleep-Apnea-Forum.html and http://www.apneaboard.com/forums/Forum-Main-Apnea-Board-Forum http://www.apneaboard.com/forums/Forum-Main-Apnea-Board-Foru... often CPAP requires fine tuning with most doctors can't be arsed to do. Get OSCAR software it will help you fine tune the CPAP settings. https://www.sleepfiles.com/OSCAR/ https://www.sleepfiles.com/OSCAR/ Often people are given the cheapest CPAP machines that won't auto-adjust themselves. Guess what, at least for Medicare it's all the same price so the cheaper the machine the more profit for the DME! The forums will guide you to how to get the best from your machine. I fine tuned my CPAP based on what I learned and it really improved my AHI. You say "<10" but if you mean AHI that's not good enough. Even doctors want <5. Mine is <1.
  - bitwize 6y ago
    > Guess what, at least for Medicare it's all the same price so the cheaper the machine the more profit for the DME! The forums will guide you to how to get the best from your machine. Medicare is not "for all" yet, so a lot of people won't be helped by this.
- pwdisswordfish2 6y ago
  Did you get see different sleep docs after you realised the change with the CPAP was not as dramatic as you had hoped?
cachestash 6y ago
You're all going to think I am a crazy, but I instead elected to tape my mouth closed with 3m tape right when I go to bed. This to me is superior and should be your first port. Not only did it fix my apnoea and huge lack of energy during the day, but also my chronic sinus issues that had plagued me for years. Its also a lot cheaper, much easier to use / travel with and gets me into a good habit of nose breathing during the day. A CPAP machine is still reinforcing the poor habit that may well have contributed to your sleep abnormalities in the first place. Mouth Breathing. It costs $2 for a roll of 3m tape, so it's not like it costs a lot if its really not working for you. Mouth breathing is horrendous for your health and well being. There is a good reason why it was ostracized in the past ("mouth breather" was an insult). It was a clear sign of poor health in an individual. It's one of the best unknown health hacks out there. https://askthedentist.com/mouth-tape-better-sleep/ https://askthedentist.com/mouth-tape-better-sleep/
- balfirevic 6y ago
  > You're all going to think I am a nutball, but I instead started to tape my mouth closed with 3m tape Wait, while sleeping or during the day? If while sleeping, isn't it dangerous?
  - cachestash 6y ago
    No, not at all. I heard it first from a dentist and its quite common, well more common than would be expected. Its also perfectly safe, if your nose becomes congested you rip it off in your sleep. It fixed my apnoea and chronic sinus issues. Seems I was constantly developing nasal polyps from mouth breathing all night. Here is a dentist recommending mouth taping: https://askthedentist.com/mouth-tape-better-sleep/ https://askthedentist.com/mouth-tape-better-sleep/
    - balfirevic 6y ago
      Thanks, that's really interesting. I might try it, if I can figure out how to keep my mustache and beard intact :)
dcolkitt 6y ago
This may sound crazy, but for those who can't tolerate a CPAP, an effective alternative is playing the didgeridoo.[1] Anecdotally my wife and kids were complaining about my snoring, and I bought one for $40 off Amazon. Not only has my snoring improved, but my lung capacity has improved. Plus it's just fun to play. [1]https://www.ncbi.nlm.nih.gov/pmc/articles/PMC1360393/ https://www.ncbi.nlm.nih.gov/pmc/articles/PMC1360393/
- tartoran 6y ago
  Yes, fixing out the lung capacity, musculature of the diaphragm, throat, tongue, etc is really the cure. And loosing excess weight if that is the case. CPAP, while effective and life changing is a band aid that the medical industry can make money on. I don't hear anyone saying that the CPAP should be used in conjunction with restorative exercises. I'm glad you found this solution.
  - unishark 6y ago
    I'm pretty sure healthcare providers everywhere inform people who need to exercise and lose weight that they need to exercise and lose weight. Not really fair to ding them for making money on other treatments for people who can't bring themselves to do it the natural way.
    - tartoran 6y ago
      You may be right, I've never been diagnosed and put on CPAP personally and can't say whether that is true or not. But in general the western medicine has come to a point that it tends to offer solutions that are quite good at reducing the symptoms and generally don't address the underlying cause. It may be incompetence of the system or it may as well be financial incentives, slightly steered towards not providing a cure and but milking the patients for more money with symptom reducers. But on you're right on one thing though, a lot patients are lazy and would choose the quick fix over doing some of the work themselves.
    - westoncb 6y ago
      In my experience this is actually rare. I've heard many similar stories to mine here from friends and family, but briefly, my own recent experience with this kind of thing: I saw four doctors across two states trying to resolve a certain medical condition, which happens to be very common, has very negative effects, and has low recovery rates. They prescribed a couple different medications, and mentioned that the disorder is "associated with" a list of a bunch of things related to lifestyle and diet. (These items were never brought up again by any doctor after their initial brief mention: it was a kind of "going through the motions" with each doctor—part of the obligatory informative synopsis of the disorder.) The medications did practically nothing, and experimenting with briefly removing different items on the list from my life did practically nothing. Meanwhile my life was severely negatively impacted by this for ~4 years. Eventually I decide to "get healthier" in a general way with an improved diet, insistence on regularly getting sufficient sleep, reduced alcohol consumption, and regular strength training. A few months later the condition was at about 50%, and now it's at a point where I'm barely bothered by it. I'm also a Type 1 diabetic and ran into a similar thing there: the recommendations given to me by doctors were incompatible with the blood sugar ranges they described as desirable. So I did my own research and discovered that basically everyone who had really good numbers was doing massive carbohydrate reduction in addition to taking insulin. What it came down to in both cases: doctors will not prescribe lifestyle changes. They may mention them, but their core solution is likely to be a medication + tweaking dosage—even if this is by comparison far less useful. I do think there's a legitimate reason, though: most people are simply not willing to make these kind of lifestyle changes. However, for those who are willing to do it, there's a good chance they'll lack the info on how effective it can be, because it's not what their doctor is going to emphasize. (I'd urge anyone who thinks my cases may be uncommon to try this: if you know someone who resolved a medical condition by general lifestyle improvements like diet, sleep, exercise etc.—see if they made the changes because a doctor recommended it or if the motivation come from somewhere else.)
mancerayder 6y ago
I asked a doctor about it and he said that since I'm not obese nor overweight, and I don't regularly wake up gasping, then I'm not a candidate. I've had fitful sleep as far as I can remember. I wake up (and remember it) probably 4-5 times a night and I've been told I toss and turn all the time. I find if I take a calmant or a substance I can sleep through the night. I have chronic inflammation includes Achilles' pain just as you describe. I'm in my lower 40's. I'm also a weightlifter and I do calisthenics - both of these activities 4-5 times a week. Oh, but I sit in front of a PC 12+ hours a day!
- BurningFrog 6y ago
  Your doctor is WRONG! I spent 2 extra years barely half awake because I thought that, being thin, I could not have sleep apnea. Nor did I wake up gasping. The 4 main risk factors are overweight, being male, over 40, and current or past smoker. But some get it while being 0/4. Sleep apnea is one of the best serious medical conditions you can have, since the CPAP machine fixes it completely, with very minor discomfort!
  - pwdisswordfish2 6y ago
    The CPAP does not "fix it completely" for everyone. That is FALSE. Granted, the machine should make a noticeable difference, but it does not restore "normal" sleep in all patients. I would be interested to see statistics from a "CPAP satisfaction" survey. Instead of solely looking at AHI, ask patients to rate their sleep. There are at least a couple of commenters in this thread who are telling us the CPAP has not restored their sleep to "normal". CPAP may be the "Gold Standard" in OSA treatment but it is not the "Holy Grail" for everyone suffering from sleep disordered breathing.
    - BurningFrog 6y ago
      Sure, I should have added "for most people" and "almost".
- Afton 6y ago
  Please go see a sleep doctor, not a GP. I was diagnosed in my late 30s, and I was definitely not overweight at the time. In retrospect, many things that I thought were normal (or even positive) turned out to be very clear symptoms of chronic sleep deprivation.
oarabbus_ 6y ago
I got a CPAP for obstructive sleep apnea and it resulted in absolutely zero benefits after several months. It did cost quite a bit and take time to clean, though. I'm very skeptical about the positive effects of CPAP for all but the most severely affected individuals.
- pwdisswordfish2 6y ago
  One trick you can try which I found really helps is, if you can, to shave before bed. I get a much better seal with a full face mask this way. Over time, you may find the cleaning gets easier. It is crazy how much you have to learn on your own about this condition. You should not have to get advice from random people on the internet; the field of sleep medicine w/r/t OSA treatment is still woefully underdeveloped. Once you get the machine, if your AHI looks good, there is not much more the sleep doc will do for you. The "treatment is working" even though your sleep may continue to suffer, e.g., you continue to wake up throughout the night. A CPAP cannot not measure the time awake after your sleep is interrupted, while you wait to fall asleep again. As far as the CPAP diagnostics indicate, the treatment is working. If you stick with it, you should see some benefits, such that if you cease using it for a night, you will notice the effect. Good luck.
julianeon 6y ago
Thanks for your comment. My doctor did tell me to, and I forgot. Once I feel safer around COVID, I'll schedule my appointment.
lee 6y ago
I remember getting a sleep study where they titrated for my cpap pressure. I woke up leaving that morning feeling like superman. It was as though a long fog was lifted from my brain. I've been using CPAP for 9 years now and I can't imagine my life without it.

tstrimple 6y ago

> If your doctor tells you to do a sleep study, do it. All I got in return is a $500 inconclusive.

zoopdewoop 6y ago
Why did you even comment this? He's saying the upside is worth it. I also got an inconclusive, but my dad has apnea and a sleep study basically changed his life. The possibility of that is clearly worth 500$
- throw1234651234 6y ago
  Because to some people $500 is a lot and doctor visits are often useless. "See a doctor" is default advice, but it can be very expensive advice.
  - yohannparis 6y ago
    This a USA healthcare problem, and you should flag it as such.
    - kortilla 6y ago
      Why? If going to a doctor is free for you, you know that.
      - yohannparis 6y ago
        Doctor are not free to me, I pay taxes. What I was trying to say, your example is an USA problem, most people do not have to decide if seeing a doctor is a financial decision. So your case is not universal, and should be mentioned.
    - irlib 6y ago
      I am in the USA, and my cheap ass insurance covered the sleep study in full. CPAP machine, however, is upon deductible, so I have postponed it upon I'll have spent the deductible on something like CT.
Someone1234 6y ago
They're slowly moving to "at home" sleep studies, so hopefully the cost will come down. Essentially they just loan you a bunch of monitors on a chest belt, teach you how to put it on, and you return it the next day for your consultation. Here's a video showing how to install the monitor: https://www.youtube.com/watch?v=FHvydhYu85o https://www.youtube.com/watch?v=FHvydhYu85o It is still a "developing area" but I think it will be the norm eventually. It *should reduce the cost (but YMMV, as US healthcare costs don't conform to normal logic).
- irlib 6y ago
  Yeah, a couple of years ago, I had an at-home sleep study. It was free for me with Kaiser insurance, so I guess the cost was neglectable.
Broken_Hippo 6y ago
Cervical cancer screenings save women's lives: Cervical cancer is an insane beast that often has no symptoms when it is the most treatable. Many, many women get abnormal or inconclusive results once or twice during their lives. It can be a variety of causes, even! This doesn't change the fact that they save lives or seriously increase some people's quality of life. The sleep studies are similar. Someone getting an inconclusive result doesn't negate all the folks that have been helped by it - and honestly, doesn't rule it out. The money bit is just a shameful side effect of the health care system where you live and I'm guessing it is part of the sting of an inconclusive result.
SaintGhurka 6y ago
That really sucks. When did you do the test - and was it in a clinic or at home? I do encourage you to keep trying if you have reason to think you have sleep apnea. Maybe get a home O2 monitor to help you decide if it's worth spending the money on another sleep study.
virgulino 6y ago
Thanks. I didn't know that it could be inconclusive, or how much it costs.
AuryGlenz 6y ago
Mine was a hell of a lot more expensive than that. $3,000. The doctor refused to treat me until I had one, even though my fatigue was the same as it was 10 years ago when I had another sleep study with no issues. So damned frustrating.

Someone1234 6y ago

Agreed. But a CPAP is only as a good as your usage, too many people "have" one but don't use it. A lot of it is comfort. So try switching from a full-face to nose pillow-style mask. Or alternative headgear. Or even talk to your doctor about lowering the pressure if it is the noise (better to have less effective treatment, than none at all). PS - A lot of, frankly, older doctors are still not prescribing Auto-CPAPs for people who may be suitable. If you're currently set on a fixed pressure, and your machine is a common Auto-CPAP (variable pressure) maybe seek a second opinion from a different (younger?) doctor. Auto-CPAPs are medically certified for many Sleep Apnea suffers, doctors just haven't adapted or haven't been re-trained, so they're chronically under-prescribed. Auto-CPAP improves your comfort, not your treatment, which improves adherence.

balfirevic 6y ago

I wonder if it would be helpful to allow people who experience sleep issues to just get a CPAP machine and try it out, instead of having to go through a sleep study.

SaintGhurka 6y ago
I've wondered that, too. Between my insurance company and me, we spent a combined $1000 on deciding whether I should get one. That's more than a low-end unit costs.
kevinmgranger 6y ago
Most people aren't good at assessing their own fatigue. A sleep study gives one quantifiable information about the quality of one's sleep. So may people find their CPAP uncomfortable when they first use it, that it's unlikely they'll use it properly. Having a first use under the watchful eyes of a physician could be a good idea. Then again, some people also get one and then don't use it, so maybe it's more of the same.
- balfirevic 6y ago
  Yes, I'm sure it's not as good as having a proper sleep study but if the end result is that more people who need them get them it would be a positive outcome. Also, a doctor can show you how to use one, you would not necessarily be completely on your own. Sleep studies are just such a hassle (and expensive, depending on where you live), and if you have a weird sleep schedule it can be difficult to even fall asleep in time. Being able to just rent a CPAP machine for a couple of days and have a doctor show you how to use it would be a good option to have.
jmpman 6y ago
I bought a wearable blood oxygen meter as I was concerned I had apnea. A previous study was inconclusive (I don’t think I slept the whole night). If I sleep on my back, I’m certain I have apnea, but haven’t validated with the o2 meter. Sleeping on my stomach, my o2 levels were acceptable all night. Once I confirm apnea on my back, I’ll probably get another sleep study (I’ve gained at least 30lbs since the last), and a CPAP... just like my father.

odiroot 6y ago

If only it was so easy. I was told, in Germany, I have to wait 2+ months for the next appointment.

SaintGhurka 6y ago
That's the one consolation to those of us in the maddeningly expensive US system. You can usually find someone who will get you scheduled in very short order. Don't let the wait deter you. If you do need the machine, it can really improve your life.
- jpxw 6y ago
  In my country, the UK, it’s not unusual at all to have to wait 2-3 months for a hospital appointment. People shit on America’s health system a lot (and in many cases for perfectly valid reasons), but I think they don’t quite consider the alternative.
  - vidarh 6y ago
    You can buy your way past the queues either per treatment or with private insurance in the UK and still pay far less than in the US. Most of us wait because the prioritisation is by clinical need, and is usually 'good enough' and some because they can't afford it.
    - downerending 6y ago
      Are you paying less, all in? (e.g., taxes)
      - jpxw 6y ago
        We are, yes. But the average American would be shocked at the "customer experience" the average patient gets from the NHS. No such thing as a free lunch etc. And I think if you have private insurance (i.e: double paying), you'll probably be paying more than the average American. I don't know for sure though.

benwilson-512 6y ago

And even if you're young, if you find yourself waking up at night with your heart racing, excessive snoring, etc, get it checked out. I got a CPAP machine at 20, and it's hard to overstate the impact. You can even just straight up buy them these days and adjust the settings yourself, sometimes the insurance premium on the sleep study is as high as the cost of the machine.

haram_masala 6y ago
How feasible is that, though - to just up and buy one and set it up yourself? I'm honestly asking, not criticizing.
- vidarh 6y ago
  Buying them is easy enough gh at least - you can buy them on amazon
dilatedmind 6y ago
where can you buy them without a prescription?
- TylerE 6y ago
  There are online sites that will sell you one...basically the way I understand it is they will do a phone consult with a licensed physician. The perscription is required if you want your insurance to pay for it. The cost is not insignifigant. Cost of the machine itself is around $1000, and then perhaps $150-200 in supplies every 3 months. Totally worth it though. Life changing.

sillysaurusx 6y ago

When I say the same thing about Prozac, people react with anger. It's strange. A sleep study is definitely one of the best things I ever did. It helped uncover some undiagnosed narcolepsy, and I've been able to manage it since then. Even knowing that it existed was helpful. (For example, lots of stress was caused by getting jobs that expect you to have your butt in the seat from 9am to 5pm. Other jobs exist.) So yes. Sleep study good! Go do one!

wincy 6y ago
I'm glad Prozac worked for you. It made me impotent in my 20s and I felt like I was being dropped down an elevator shaft for months after discontinuing it.
- layoutIfNeeded 6y ago
  > being dropped down an elevator shaft What do you mean by this?
  - nitrogen 6y ago
    Ddg for SSRI withdrawal symptoms.
    - layoutIfNeeded 6y ago
      I knew about SSRI withdrawal symptoms, even experienced "brain zaps" first hand, but never heard about the vestibular thing.
  - Gatsky 6y ago
    It causes vestibular symptoms. This creates the sensation of motion without movement. Incidentally, if you’ve never had true vertigo, it is very disconcerting how much a sensory organ malfunction can affect your perception of the world. It is a kind of spatial psychosis that you can observe objectively.
- Broken_Hippo 6y ago

goldenkey 6y ago

I had a sleep study done but was so uncomfortable I couldn't fall asleep...all the wires and crap. Waste of money.

cachestash 6y ago
Same happened to me. I felt pressured into sleeping and as a result, I could not sleep.
- PhantomGremlin 6y ago
  I was in the same situation, very hard for me to fall asleep. Finally the technician gave me a pill, perhaps Ambien. I fell asleep and they got the data they needed.
SaintGhurka 6y ago
Same for me. It took me 3 goes to get enough data for a diagnosis. Don't give up.

technofiend 6y ago

Getting an APAP (auto-adjusting machine) was automated to the point that the barrier to entry is pretty darn low. An at-home study required me to sit through dead obvious instruction on how to equip and use the machine. Once I was prescribed a machine as a result of the study, the most time-consuming part was picking up a machine and sitting with a nurse to try on various masks. Since the machine itself is set to what the CPAP community calls "lazy doctor mode" meaning it's just set to auto-adjust itself in a range and the newer machines use cell data to automatically upload usage data, once you take it home you're done. My only follow up visit was over the phone. And there is an open source project for reading the data which will appeal to the HN crowd: https://www.sleepfiles.com/OSCAR/ https://www.sleepfiles.com/OSCAR/

elcritch 6y ago
I’m not in a position to do a sleep study. But I’d like to self-monitor my sleep and oxygen levels. Do you know of any DIY projects in that area? In the future fitbits and Apple watches should automatically include sleep / oxygen quality. It’ll take getting past the FDA, but for the low cost of having that info bs the benefits society would gain... well DIy seems like a good way to trail blaze.
- bradstewart 6y ago
  I can't comment on how accurate it is, but my Garmin Vivosmart measures sleep pulse ox.
- spease 6y ago
  The best pulse ox I’ve found is the O2Ring. It’s more comfortable than any other pulse ox I’ve used, it samples at a high rate and produces absolutely gorgeous output. The downsides: I don’t believe it integrates with OSCAR, and it’s a whopping $180. https://www.amazon.com/dp/B07T5L57M4/ https://www.amazon.com/dp/B07T5L57M4/

Phenomenit 6y ago

I suspect I might have some sleep disturbance. It's really hard for me to sleep on my back, I wake up constantly and snoor so I just sleep on my stomach instead.

spease 6y ago
Yeah that sounds like possible sleep apnea. Have you looked into doing a sleep study?
- Phenomenit 6y ago
  No, I have small children at the moment so my sleep is disturbed by that but as soon as they start sleeping normally through the night I'm going to have it checked out.

anonymousab 6y ago

That said, it's not always a magic bullet. I got a cpap after a sleep study found I had 80+ breathing interruptions in the short overnight test window. It easily brought them down to <10, but I feel no better in the morning, and it makes the occasional nap much more of a hassle. The value is absolutely there in the greatly reduced likelihood of death in my sleep, and the white noise is better than snoring when sleeping around others. But I wouldn't want to get people's hopes up about it providing them the bad sleep panacea they desire.

spease 6y ago
Did you ever figure it out?
PhantomGremlin 6y ago
Read forums http://www.cpaptalk.com/CPAP-Sleep-Apnea-Forum.html http://www.cpaptalk.com/CPAP-Sleep-Apnea-Forum.html and http://www.apneaboard.com/forums/Forum-Main-Apnea-Board-Forum http://www.apneaboard.com/forums/Forum-Main-Apnea-Board-Foru... often CPAP requires fine tuning with most doctors can't be arsed to do. Get OSCAR software it will help you fine tune the CPAP settings. https://www.sleepfiles.com/OSCAR/ https://www.sleepfiles.com/OSCAR/ Often people are given the cheapest CPAP machines that won't auto-adjust themselves. Guess what, at least for Medicare it's all the same price so the cheaper the machine the more profit for the DME! The forums will guide you to how to get the best from your machine. I fine tuned my CPAP based on what I learned and it really improved my AHI. You say "<10" but if you mean AHI that's not good enough. Even doctors want <5. Mine is <1.
- bitwize 6y ago
  > Guess what, at least for Medicare it's all the same price so the cheaper the machine the more profit for the DME! The forums will guide you to how to get the best from your machine. Medicare is not "for all" yet, so a lot of people won't be helped by this.
pwdisswordfish2 6y ago
Did you get see different sleep docs after you realised the change with the CPAP was not as dramatic as you had hoped?

cachestash 6y ago

You're all going to think I am a crazy, but I instead elected to tape my mouth closed with 3m tape right when I go to bed. This to me is superior and should be your first port. Not only did it fix my apnoea and huge lack of energy during the day, but also my chronic sinus issues that had plagued me for years. Its also a lot cheaper, much easier to use / travel with and gets me into a good habit of nose breathing during the day. A CPAP machine is still reinforcing the poor habit that may well have contributed to your sleep abnormalities in the first place. Mouth Breathing. It costs $2 for a roll of 3m tape, so it's not like it costs a lot if its really not working for you. Mouth breathing is horrendous for your health and well being. There is a good reason why it was ostracized in the past ("mouth breather" was an insult). It was a clear sign of poor health in an individual. It's one of the best unknown health hacks out there. https://askthedentist.com/mouth-tape-better-sleep/ https://askthedentist.com/mouth-tape-better-sleep/

balfirevic 6y ago
> You're all going to think I am a nutball, but I instead started to tape my mouth closed with 3m tape Wait, while sleeping or during the day? If while sleeping, isn't it dangerous?
- cachestash 6y ago
  No, not at all. I heard it first from a dentist and its quite common, well more common than would be expected. Its also perfectly safe, if your nose becomes congested you rip it off in your sleep. It fixed my apnoea and chronic sinus issues. Seems I was constantly developing nasal polyps from mouth breathing all night. Here is a dentist recommending mouth taping: https://askthedentist.com/mouth-tape-better-sleep/ https://askthedentist.com/mouth-tape-better-sleep/
  - balfirevic 6y ago
    Thanks, that's really interesting. I might try it, if I can figure out how to keep my mustache and beard intact :)

dcolkitt 6y ago

This may sound crazy, but for those who can't tolerate a CPAP, an effective alternative is playing the didgeridoo.[1] Anecdotally my wife and kids were complaining about my snoring, and I bought one for $40 off Amazon. Not only has my snoring improved, but my lung capacity has improved. Plus it's just fun to play. [1]https://www.ncbi.nlm.nih.gov/pmc/articles/PMC1360393/ https://www.ncbi.nlm.nih.gov/pmc/articles/PMC1360393/

tartoran 6y ago
Yes, fixing out the lung capacity, musculature of the diaphragm, throat, tongue, etc is really the cure. And loosing excess weight if that is the case. CPAP, while effective and life changing is a band aid that the medical industry can make money on. I don't hear anyone saying that the CPAP should be used in conjunction with restorative exercises. I'm glad you found this solution.
- unishark 6y ago
  I'm pretty sure healthcare providers everywhere inform people who need to exercise and lose weight that they need to exercise and lose weight. Not really fair to ding them for making money on other treatments for people who can't bring themselves to do it the natural way.
  - tartoran 6y ago
    You may be right, I've never been diagnosed and put on CPAP personally and can't say whether that is true or not. But in general the western medicine has come to a point that it tends to offer solutions that are quite good at reducing the symptoms and generally don't address the underlying cause. It may be incompetence of the system or it may as well be financial incentives, slightly steered towards not providing a cure and but milking the patients for more money with symptom reducers. But on you're right on one thing though, a lot patients are lazy and would choose the quick fix over doing some of the work themselves.
  - westoncb 6y ago
    In my experience this is actually rare. I've heard many similar stories to mine here from friends and family, but briefly, my own recent experience with this kind of thing: I saw four doctors across two states trying to resolve a certain medical condition, which happens to be very common, has very negative effects, and has low recovery rates. They prescribed a couple different medications, and mentioned that the disorder is "associated with" a list of a bunch of things related to lifestyle and diet. (These items were never brought up again by any doctor after their initial brief mention: it was a kind of "going through the motions" with each doctor—part of the obligatory informative synopsis of the disorder.) The medications did practically nothing, and experimenting with briefly removing different items on the list from my life did practically nothing. Meanwhile my life was severely negatively impacted by this for ~4 years. Eventually I decide to "get healthier" in a general way with an improved diet, insistence on regularly getting sufficient sleep, reduced alcohol consumption, and regular strength training. A few months later the condition was at about 50%, and now it's at a point where I'm barely bothered by it. I'm also a Type 1 diabetic and ran into a similar thing there: the recommendations given to me by doctors were incompatible with the blood sugar ranges they described as desirable. So I did my own research and discovered that basically everyone who had really good numbers was doing massive carbohydrate reduction in addition to taking insulin. What it came down to in both cases: doctors will not prescribe lifestyle changes. They may mention them, but their core solution is likely to be a medication + tweaking dosage—even if this is by comparison far less useful. I do think there's a legitimate reason, though: most people are simply not willing to make these kind of lifestyle changes. However, for those who are willing to do it, there's a good chance they'll lack the info on how effective it can be, because it's not what their doctor is going to emphasize. (I'd urge anyone who thinks my cases may be uncommon to try this: if you know someone who resolved a medical condition by general lifestyle improvements like diet, sleep, exercise etc.—see if they made the changes because a doctor recommended it or if the motivation come from somewhere else.)

mancerayder 6y ago

I asked a doctor about it and he said that since I'm not obese nor overweight, and I don't regularly wake up gasping, then I'm not a candidate. I've had fitful sleep as far as I can remember. I wake up (and remember it) probably 4-5 times a night and I've been told I toss and turn all the time. I find if I take a calmant or a substance I can sleep through the night. I have chronic inflammation includes Achilles' pain just as you describe. I'm in my lower 40's. I'm also a weightlifter and I do calisthenics - both of these activities 4-5 times a week. Oh, but I sit in front of a PC 12+ hours a day!

BurningFrog 6y ago
Your doctor is WRONG! I spent 2 extra years barely half awake because I thought that, being thin, I could not have sleep apnea. Nor did I wake up gasping. The 4 main risk factors are overweight, being male, over 40, and current or past smoker. But some get it while being 0/4. Sleep apnea is one of the best serious medical conditions you can have, since the CPAP machine fixes it completely, with very minor discomfort!
- pwdisswordfish2 6y ago
  The CPAP does not "fix it completely" for everyone. That is FALSE. Granted, the machine should make a noticeable difference, but it does not restore "normal" sleep in all patients. I would be interested to see statistics from a "CPAP satisfaction" survey. Instead of solely looking at AHI, ask patients to rate their sleep. There are at least a couple of commenters in this thread who are telling us the CPAP has not restored their sleep to "normal". CPAP may be the "Gold Standard" in OSA treatment but it is not the "Holy Grail" for everyone suffering from sleep disordered breathing.
  - BurningFrog 6y ago
    Sure, I should have added "for most people" and "almost".
Afton 6y ago
Please go see a sleep doctor, not a GP. I was diagnosed in my late 30s, and I was definitely not overweight at the time. In retrospect, many things that I thought were normal (or even positive) turned out to be very clear symptoms of chronic sleep deprivation.

oarabbus_ 6y ago

I got a CPAP for obstructive sleep apnea and it resulted in absolutely zero benefits after several months. It did cost quite a bit and take time to clean, though. I'm very skeptical about the positive effects of CPAP for all but the most severely affected individuals.

pwdisswordfish2 6y ago
One trick you can try which I found really helps is, if you can, to shave before bed. I get a much better seal with a full face mask this way. Over time, you may find the cleaning gets easier. It is crazy how much you have to learn on your own about this condition. You should not have to get advice from random people on the internet; the field of sleep medicine w/r/t OSA treatment is still woefully underdeveloped. Once you get the machine, if your AHI looks good, there is not much more the sleep doc will do for you. The "treatment is working" even though your sleep may continue to suffer, e.g., you continue to wake up throughout the night. A CPAP cannot not measure the time awake after your sleep is interrupted, while you wait to fall asleep again. As far as the CPAP diagnostics indicate, the treatment is working. If you stick with it, you should see some benefits, such that if you cease using it for a night, you will notice the effect. Good luck.

julianeon 6y ago

Thanks for your comment. My doctor did tell me to, and I forgot. Once I feel safer around COVID, I'll schedule my appointment.

lee 6y ago

I remember getting a sleep study where they titrated for my cpap pressure. I woke up leaving that morning feeling like superman. It was as though a long fog was lifted from my brain. I've been using CPAP for 9 years now and I can't imagine my life without it.