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Sleep apnea degrades your quality of life tremendously. Even when treated with CPAP you can still have pretty poor sleep due to the mask shifting around while y

Sleep apnea degrades your quality of life tremendously. Even when treated with CPAP you can still have pretty poor sleep due to the mask shifting around while you sleep and other side effects of the treatment, but it's generally much better than the torture of untreated apnea. It's so bad that even with moderate apnea you wake up more tired than when you went to bed. Now allow me a preemptive reply: I suffered apnea with a BMI below 20. Plenty of people don't have apnea because they are overweight; instead, they are overweight because they suffer apnea.

Vaslo 3y ago
Sleep apnea is not the reason people are overweight.
- mort96 3y ago
  Nobody is overweight from one reason alone. But do you dispute the idea that it contributes?
- david-gpu 3y ago
  If you are so confident, try setting up an alarm to wake yo up 15-30 times every hour of every night, for a year. See what happens to your overall health and to your weight in particular. And that is moderate sleep apnea. Actually, apnea is worse because you wouldn't even be breathing normally while you are "asleep".
- anonuser123456 3y ago
  Sleep deficit drives metabolic changes that may result in obesity (e.g over feeding behavior).
hackernoteng 3y ago
I fixed apnea using MAD night guard (pulls jaw forward using a mouth guard device). Made by dentist. Cost about $2000. But it works.
- QuercusMax 3y ago
  You can also try "snore prevention" night guards like ZQuiet and SnoreRX - they're less than $100 and you can buy them online. I find they work just as well as the custom night guard I got from my dentist.
- ted_bunny 3y ago
  When you say fixed, do you mean you no longer need the device?
monktastic1 3y ago
In case this helps anybody: I've been using those BreatheRight strips (extra strength) and they've been incredibly helpful. Not nearly as effective as CPAP, I'm sure, but a milder version of the same effect.
- euroderf 3y ago
  I could not handle the CPAP mask but instead I got a dental appliance (custom) that juts out my lower jaw a bit. Worked great.
  - QuercusMax 3y ago
    I got a custom dental appliance for like $1000 out of pocket, and it broke within a few months, conveniently when I had moved out of state from my original dentist. There are a few over-the-counter options that advertise themselves as just for snoring reduction - SnoreRX and ZQuiet are ones I've tried. I've found that wearing a BreatheRight-type strip along with one of these appliances works as well or better than the one I got from my dentist, and it's MUCH cheaper. I also take an anti-allergy nasal spray, as I have pretty bad allergies also interfere with sleep.
  - euroderf 3y ago
    I got mine thru the city health service, so I only made a token payment. 1000$ ouch.
- wnolens 3y ago
  That's a little upstream of where in one's anatomy is the common choke point - usually the back of the throat/soft palate relaxes and obstructs all breathing. But I have nose blockage issues and use nasal strips nowadays, too. It prevents mouth breathing which is nice to prevent dry mouth in the middle of the night (which even a humidifier on my nightstand can't completely solve in my climate)
- johnbellone 3y ago
  Those never worked for me (mouth breather) but for some they do work wonders.
deleted 3y ago
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bbatchelder 3y ago
CPAP has been life changing for me. For my entire life I struggled getting up in the morning, and I never felt "refreshed". Getting up before 9-10AM was super difficult. I also was often in a sort of fugue state when I would first wake up, I'd often have no memory of any interactions, and apparently was often mean. Now I can easily get up, even at hours that were previously unthinkable, and more often than not feel fully recharged. I have no doubt that played a part in me being unhealthy - though by no means was it the sole reason. As an aside, also getting on a dose of Semaglutide has been similarly life changing. The damn near elimination of "food noise" has been incredible. I know there are a number of folks of the opinion that its somehow cheating. But for me I am left wondering "Is this just how normal people feel?".
- phone8675309 3y ago
  It always bothers me when someone says it’s "cheating" to use a GLP-1 agonist. It helps but the person losing weight still has to clean up their diet and start an exercise routine. There are still major changes they need to make to become successful. GLP-1 agonists help a lot of people make better decisions due to how they fight hunger. Less hunger means less chances to make bad choices when eating, and weight loss progress is a virtuous mental cycle where you keep doing what you’re doing because you see results. None of that is cheating. There are still major changes one must make. Taking Ozempic but continuing to eat a trash-tier diet will yield little to no progress.
  - bbatchelder 3y ago
    Definitely agree, but man, the sheer number of folks who leave just horrible comments on videos/posts people make about how they lost weight on a GLP-1 agonist is so disheartening. In addition to saying that its cheating, they will actively wish harm to the person by saying "just wait til you get X" where X is some side effect (real or imagined). Or just the "well once you stop taking it you'll just get fat again".
    - phone8675309 3y ago
      The people who say "you'll get fat again once you stop taking it" also baffle me. The most difficult part of losing weight for me personally is changing my routine and habits. Setting myself up with a kitchen that's ready to cook. Figuring out what kind of meals I'm happy to have on a weeknight that don't require a lot of cooking. Preparing parts of meals over an hour or two on the weekend to complete some of the more time consuming parts when I'm not so constrained on time. Learning to deal with the urge I (used to) have to "eat my feelings". All of those things don't just magically go away when you stop taking a GLP-1 agonist. Losing a lot of weight isn't just about self-control like if you're just trying to lose five pounds to make your pants more comfortable for going to your 20th high school reunion; you have to rewire your habits and mind and make a life long commitment to those changes. Rewiring your habits and rewiring your brain are things that persist if your intention going into the weight loss was to change your habits instead of just moving the number on the scale. If you are looking to do it only temporarily and are unwilling to lock in those behavioral changes then you're likely going to fail, and that has much more to do with mindset than medication.
Redster 3y ago
As a fairly thin guy in my 20s (I was about 130lbs and 5'6"), I had years of undiagnosed hypopnea. I would wake up with tears streaming down my face and choking, but couldn't figure out why. I was constantly exhausted and yet, couldn't sleep. I would spend more than 12 hours in bed every night, hoping to get as close to 8 hrs as I could. Paid for a sleep study and the doctor walked in the room and said, "You don't have sleep apnea." I was like, " I knew that, but what can I do?" The doctor shrugged and said, "You have hypopnea. You could try a mouthguard...?" trailed off and left. So, with this newfound wisdom I was back at square one. Some things that dramatically helped me in recovering from years of sleep loss: - A chinstrap. - I found a study (n=1, literally) about a patient who didn't fit the typical sleep apnea profile as a thin older man. The doctors treating him wondered if it was "positional sleep apnea" and had him get a chinstrap. This held his mouth shut while sleeping and prevented his tongue from falling back and blocking his airway. I found a chinstrap on Amazon and immediately started sleeping better. - A blood test - My doctor knew that I was dealing with adrenal issues due to not sleeping, Lyme disease, and other issues, so he ordered a blood test. This was fantastic. For me, addressing my underlying magnesium and B-12 deficiency made an enormous difference in sleep quality. I found that taking my B-12 right before bed helped my sleep be so much more restorative. - Andrew Huberman - Andrew Huberman's podcast Huberman Labs is old news, now, but when I found him a few years ago, it was some of the more actionable advice I had ever gotten about sleep, falling asleep, and circadian rhythm. Anyway, there were more things across the way, but these are some things I shared with others that they also found helpful. I now am in control of my sleep and feel decades younger. You can get there! It's worth experimenting and finding a doctor who is going to help you find your problem. The mental clarity, focus, and energy has definitely made up for all the the months of trying to find out what was wrong with me. I hope you sleep well!
- cko 3y ago
  I had sleep apnea and got jaw surgery. But I also have a dysfunctional TMJ, so my mouth opens when I sleep. Every chin strap on the market pushes the chin down into the airway, it seems. Which one did you get?
  - 3y ago
johnbellone 3y ago
I’ve had sleep apnea and CPAP for years. The last several weeks have been grueling because of mask fit, movement, and other factors. My BMI is very high, but I am in minority that will have sleep apnea regardless due to anatomy. That doesn’t mean it won’t help to lose weight.
jonhohle 3y ago
As an additional PSA, sleep apnea may not be the cause of exhaustion, even if diagnosed. I was diagnosed with apnea and CPAP did (still does) little if anything for my energy levels. I finally found a sleep doctor who checked my iron levels, and despite being within the normal range suggested I take an iron supplement (iron polypeptide) and within a week felt normal again. It turns out that people with restless legs, which I’ve had since childhood, experience iron deficiency anemia with much higher blood iron content than the average population.[0] My primary care didn’t consider this. A pulmonologist had no interest in checking this. An oral sleep doctor had no interest in checking this. I had people suggesting getting an implant to force my tongue to stick out when the issue was low iron. Definitely get a sleep study (I’d recommend lab over home). I use a sleep tracker (cheap Garmin “smart” watch, but I’ve also tried an Apple Watch) as a reasonable proxy for REM and deep sleep. And if you think a practice is just trying to sell equipment, they probably are. Fortunately I found a good doctor from acquaintances that I would have never otherwise considered (not part of the local medical systems, though did take insurance). Unfortunately, for many issues it’s not enough to trust the doctor. Do your own due diligence for your health. 0 - https://www.frontiersin.org/journals/neurology/articles/10.3389/fneur.2020.00298/full https://www.frontiersin.org/journals/neurology/articles/10.3...
- SamBam 3y ago
  I have occasional restless leg (once every two weeks or so) and low energy. How would one know if one has iron deficiency despite blood work being normal? Is it just a case of popping iron pills and seeing if you feel better?
  - dj_mc_merlin 3y ago
    Doesn't hurt to try does it? A bit of extra iron is harmless.
    - SamBam 3y ago
      That was partly my question. Looking online, iron is definitely something that you don't want to have too much of. My question is, basically, is having a non-anemic iron deficiency something that can be easily remedied by having low-dose over the counter vitamins, or is it something that requires a higher dose (to make up the difference in what you're missing) and so requires a doctor. And yet it sounds like this is difficult to diagnose.
MuffinFlavored 3y ago
How would one know if they had sleep apnea in any shape/form?
- instagib 3y ago
  Get a sleep study for accuracy. If your partner notices you snore or stop breathing when sleeping. You can record yourself also. You wake with a headache and dry mouth almost daily.
TurkishPoptart 3y ago
Do you think sleep apnea is a condition caused by civilization? I.e. did medieval people suffer from this? And is this a consequence of the American diet and a sedentary lifestyle, or something else?
maxglute 3y ago
Sometimes I wonder if humans need more variability in sleeping positions. Animals sleep in all sorts of positions on all manners of not perfectly even terrain, probably trains nassal to be strong in different orientations. When I had bad heartburn/gerd I'd pass out propped up on the couch or setup a bunch of cushions in the corner of the room, or raise head of my bed up with a few books and getting great sleeps.
elric 3y ago
I wish CPAP manufacturers were a bit better. There has been little innovation, and if anything, there's been a downward trend in quality in recent years. My wishlist: 1. Every CPAP device should be BiLevel. 2. All data they record should be accessible to the user (for tools like oscar). 3. Either more granular pressure controls, or better algorithms (or both). Some people do well on CPAP, others do better when iPAP > ePAP (BiLevel, or EPR), while others do better when ePAP > iPAP (vcom). 4. Better masks. Seriously. It's so hard to find a good mask, and so expensive to experiment with them. A new mask can set you back €150, and if turns you hate it, you're shit out of luck. I've toyed with the idea of personalized 3D printed masks to get a better seal for each unique nose/face shape. 5. Quieter machines. Without the Philips cancer foam. 6. Quieter masks. Some have excellent diffusers in the exhalation port (P10), while others blast out a concentrated jet of air that will wake you up when it hits the pillow, or will lead to divorce faster than your snoring ever did when it hits your bedpartner. 7. Bring back travel cpap devices. The market collapsed post covid. I'd love to keep a small device and super lightweight mask/hose in my bag for sleepover emergencies. I'd pay any price for that, because having to lug a full size cpap around ruins any chance of spontaneity in my bachelor sex life. None of these are rocket science. But Philips Respironics are a bunch of evil cunts, ResMed are goofing off, and the other brands might as well not exist.
- david-gpu 3y ago
  Agreed on all counts, down to having contemplated 3D printing molds to manufacture custom silicone masks. I also wish the tube had a sensor to detect whether you are sleeping on your back to preemptively raise the pressure. Or having better algorithms to detect hypopneas before the air stops flowing altogether. I don't even understand why purchasing a CPAP machine requires a prescription. I'm scared of the possibility of a doctor denying me a new CPAP machine when the current one inevitably croaks. The device is a glorified fan, for goodness sake.
  - elric 3y ago
    The prescription thing is probably location specific, but AFAIK you can just buy them online. I have a few spares I bought online from back when I frequently slept in different places. Masks straps could probably be fitted with an accelerometer to detect positioning. If they can make heated tubing, this isn't such a stretch. Might also be useful in correctly flagging events: my machine often incorrectly marks position switches as periods of hypopnea.
flanbiscuit 3y ago
I have severe apnea and have been skinny most of my life, as I get older (in my mid-40s now) I can gain _some_ weight, but I'm still slim. My apnea is caused by having a narrow airway entrance and thick tongue that just completely blocks the entrance during sleep when my tongue relaxes and falls back. Has nothing to do with my weight, just the genetics I inherited. I use a CPAP that helps. My AHI is really low with it on. Now I just need to make myself go to bed earlier, I definitely have that "revenge nighttime procrastination" thing where I stay up way too late.
deleted 3y ago
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Fire-Dragon-DoL 3y ago
I'll throw this out based on the comments I'm reading, it seems like doctors don't personalize medical advice sufficiently. Glad some people were able to find the good ones that did
dbspin 3y ago
Thank you for this comment which mirrors my experience. Unfortunately CPAP seems to be considered the be all and end all of treatment, although the mask, tubes and reliance on such a bedtime setup can be enormously disruptive of sleep on its own.
- giantg2 3y ago
  I think CPAP is just convenient and inexpensive compared to surgery. If I ever have sleep apnea, I'd want the surgery.
  - alwaysrunning 3y ago
    There is also the mouth guard for apena. https://www.sleepapnea.org/treatment/sleep-apnea-mouth-guard/ https://www.sleepapnea.org/treatment/sleep-apnea-mouth-guard...
  - e40 3y ago
    I have heard horror stories about the surgery. Who knows, but I’m skeptical because surgery presumes the precise cause is known. The number of variables for sleep apnea is large to have certainty.
    - giantg2 3y ago
      "The number of variables for sleep apnea is large to have certainty." Clearly they have to know which part of your airway is restricted. Most of the variables for sleep apnea are not related to the surgey, just factors that make it more likely to experience that restricted airway (drinking, weight, etc).
      - e40 3y ago
        I have sleep apnea and I use a CPAP. During the diagnosis, there were tests but nothing that would/could finger a physical culprit that could be fixed via surgery. My question is, what tools are there to narrow, to a certainty, what would need to be done via surgery? In all my research I have found none. Maybe I missed them. If I did not, then it amounts to a guess by a surgeon. And that's what worries me and has fed a lot of the horror stories I've read about.
on_the_train 3y ago
If it's not weight, what's the common cause? Such a bad impediment on so many people should have a very clear signal. And apparently it's not weight? O never really looked into it
- wredue 3y ago
  The most common cause of sleep apnea is anything that obstructs your airways. Being overweight does that and is far and away the most common cause of sleep apnea.
  - elric 3y ago
    This is such an often repeated trope, but it's not at all as clear cut as that. Sleep apnea *causes* weight gain, the arrow of causality can go both ways.
- kkwteh 3y ago
  One theory is poor facial structure that develops due to faulty breathing technique. Reference https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4686746/ https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4686746/
- schwartzworld 3y ago
  With obstructive apnea, it's mostly hereditary. You inherit the shape of nose from your parents, why not the structures in your airway? Weight gain can make it worse as those tissues also can expand, and any weight on your breathing can help turn a partial blockage into a full one. That weight can include muscle weight, and body builders often suffer from apnea. But the thing to keep in mind is that obstructive sleep apnea isn't so much a condition as a description of what's happening. Apnea means you stop breathing, obstructive means something is blocking it. Maybe it's because your fat belly is weighing you down, maybe it's your tiny nostrils and deviated septum, or maybe the back of your tongue is thick because your dad also had a thick tongue. That's not even including self-imposed factors like central nervous system depressants (alcohol) and smoking, both of which can make apnea worse. Ever notice how drunk people snore?
- 3y ago
HumblyTossed 3y ago
> Plenty of people don't have apnea because they are overweight; instead, they are overweight because they suffer apnea. A lack of sleep means a lack of energy. You're body compensates by getting food energy. Too much stigma around what should just be understood as a biological mechanism.
- pc86 3y ago
  This is stated as biological fact when it's simply not. Sleep apnea doesn't change the laws of thermodynamics - if you are gaining weight you need to eat less or move more. It's not stigma, it's simply the way it is for the vast majority of people (the rest being covered by rare hormonal conditions that require a doctor to treat). Being tired may cause you to eat more but being tired isn't making you gain weight, it's the overeating that is.
  - throwaway11460 3y ago
    Being tired changes how your body uses and stores energy. Your body might be permanently trying to save up for bad times (because the times are always bad) and so you're getting fat even if you eat very little.
    - serf 3y ago
      can you point to examples of otherwise healthy individuals under moderate to high calorie restriction that gain weight due to chronic poor quality sleep? it's not something I have ever been made aware of, and I don't understand how it could be the case.
      - throwaway11460 3y ago
        A lot of things about your body changes when you're extremely tired. I don't have anything specific to link - it's just my own personal experience and what the doctor said. In my own case, I had to eat much more than I theoretically should because my body wasn't able to process the food as well as it should (less than 50% of usual efficiency). And yet I was fat - not obese, but definitely not thin. The body redirected some of my food to storage even though I didn't have enough energy (glucose etc) as measured by blood screening. And it didn't use the reserves properly when I stopped eating.

Vaslo 3y ago

Sleep apnea is not the reason people are overweight.

mort96 3y ago
Nobody is overweight from one reason alone. But do you dispute the idea that it contributes?
david-gpu 3y ago
If you are so confident, try setting up an alarm to wake yo up 15-30 times every hour of every night, for a year. See what happens to your overall health and to your weight in particular. And that is moderate sleep apnea. Actually, apnea is worse because you wouldn't even be breathing normally while you are "asleep".
anonuser123456 3y ago
Sleep deficit drives metabolic changes that may result in obesity (e.g over feeding behavior).

hackernoteng 3y ago

I fixed apnea using MAD night guard (pulls jaw forward using a mouth guard device). Made by dentist. Cost about $2000. But it works.

QuercusMax 3y ago
You can also try "snore prevention" night guards like ZQuiet and SnoreRX - they're less than $100 and you can buy them online. I find they work just as well as the custom night guard I got from my dentist.
ted_bunny 3y ago
When you say fixed, do you mean you no longer need the device?

monktastic1 3y ago

In case this helps anybody: I've been using those BreatheRight strips (extra strength) and they've been incredibly helpful. Not nearly as effective as CPAP, I'm sure, but a milder version of the same effect.

euroderf 3y ago
I could not handle the CPAP mask but instead I got a dental appliance (custom) that juts out my lower jaw a bit. Worked great.
- QuercusMax 3y ago
  I got a custom dental appliance for like $1000 out of pocket, and it broke within a few months, conveniently when I had moved out of state from my original dentist. There are a few over-the-counter options that advertise themselves as just for snoring reduction - SnoreRX and ZQuiet are ones I've tried. I've found that wearing a BreatheRight-type strip along with one of these appliances works as well or better than the one I got from my dentist, and it's MUCH cheaper. I also take an anti-allergy nasal spray, as I have pretty bad allergies also interfere with sleep.
- euroderf 3y ago
  I got mine thru the city health service, so I only made a token payment. 1000$ ouch.
wnolens 3y ago
That's a little upstream of where in one's anatomy is the common choke point - usually the back of the throat/soft palate relaxes and obstructs all breathing. But I have nose blockage issues and use nasal strips nowadays, too. It prevents mouth breathing which is nice to prevent dry mouth in the middle of the night (which even a humidifier on my nightstand can't completely solve in my climate)
johnbellone 3y ago
Those never worked for me (mouth breather) but for some they do work wonders.

deleted 3y ago

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bbatchelder 3y ago

CPAP has been life changing for me. For my entire life I struggled getting up in the morning, and I never felt "refreshed". Getting up before 9-10AM was super difficult. I also was often in a sort of fugue state when I would first wake up, I'd often have no memory of any interactions, and apparently was often mean. Now I can easily get up, even at hours that were previously unthinkable, and more often than not feel fully recharged. I have no doubt that played a part in me being unhealthy - though by no means was it the sole reason. As an aside, also getting on a dose of Semaglutide has been similarly life changing. The damn near elimination of "food noise" has been incredible. I know there are a number of folks of the opinion that its somehow cheating. But for me I am left wondering "Is this just how normal people feel?".

phone8675309 3y ago
It always bothers me when someone says it’s "cheating" to use a GLP-1 agonist. It helps but the person losing weight still has to clean up their diet and start an exercise routine. There are still major changes they need to make to become successful. GLP-1 agonists help a lot of people make better decisions due to how they fight hunger. Less hunger means less chances to make bad choices when eating, and weight loss progress is a virtuous mental cycle where you keep doing what you’re doing because you see results. None of that is cheating. There are still major changes one must make. Taking Ozempic but continuing to eat a trash-tier diet will yield little to no progress.
- bbatchelder 3y ago
  Definitely agree, but man, the sheer number of folks who leave just horrible comments on videos/posts people make about how they lost weight on a GLP-1 agonist is so disheartening. In addition to saying that its cheating, they will actively wish harm to the person by saying "just wait til you get X" where X is some side effect (real or imagined). Or just the "well once you stop taking it you'll just get fat again".
  - phone8675309 3y ago
    The people who say "you'll get fat again once you stop taking it" also baffle me. The most difficult part of losing weight for me personally is changing my routine and habits. Setting myself up with a kitchen that's ready to cook. Figuring out what kind of meals I'm happy to have on a weeknight that don't require a lot of cooking. Preparing parts of meals over an hour or two on the weekend to complete some of the more time consuming parts when I'm not so constrained on time. Learning to deal with the urge I (used to) have to "eat my feelings". All of those things don't just magically go away when you stop taking a GLP-1 agonist. Losing a lot of weight isn't just about self-control like if you're just trying to lose five pounds to make your pants more comfortable for going to your 20th high school reunion; you have to rewire your habits and mind and make a life long commitment to those changes. Rewiring your habits and rewiring your brain are things that persist if your intention going into the weight loss was to change your habits instead of just moving the number on the scale. If you are looking to do it only temporarily and are unwilling to lock in those behavioral changes then you're likely going to fail, and that has much more to do with mindset than medication.

Redster 3y ago

As a fairly thin guy in my 20s (I was about 130lbs and 5'6"), I had years of undiagnosed hypopnea. I would wake up with tears streaming down my face and choking, but couldn't figure out why. I was constantly exhausted and yet, couldn't sleep. I would spend more than 12 hours in bed every night, hoping to get as close to 8 hrs as I could. Paid for a sleep study and the doctor walked in the room and said, "You don't have sleep apnea." I was like, " I knew that, but what can I do?" The doctor shrugged and said, "You have hypopnea. You could try a mouthguard...?" trailed off and left. So, with this newfound wisdom I was back at square one. Some things that dramatically helped me in recovering from years of sleep loss: - A chinstrap. - I found a study (n=1, literally) about a patient who didn't fit the typical sleep apnea profile as a thin older man. The doctors treating him wondered if it was "positional sleep apnea" and had him get a chinstrap. This held his mouth shut while sleeping and prevented his tongue from falling back and blocking his airway. I found a chinstrap on Amazon and immediately started sleeping better. - A blood test - My doctor knew that I was dealing with adrenal issues due to not sleeping, Lyme disease, and other issues, so he ordered a blood test. This was fantastic. For me, addressing my underlying magnesium and B-12 deficiency made an enormous difference in sleep quality. I found that taking my B-12 right before bed helped my sleep be so much more restorative. - Andrew Huberman - Andrew Huberman's podcast Huberman Labs is old news, now, but when I found him a few years ago, it was some of the more actionable advice I had ever gotten about sleep, falling asleep, and circadian rhythm. Anyway, there were more things across the way, but these are some things I shared with others that they also found helpful. I now am in control of my sleep and feel decades younger. You can get there! It's worth experimenting and finding a doctor who is going to help you find your problem. The mental clarity, focus, and energy has definitely made up for all the the months of trying to find out what was wrong with me. I hope you sleep well!

cko 3y ago
I had sleep apnea and got jaw surgery. But I also have a dysfunctional TMJ, so my mouth opens when I sleep. Every chin strap on the market pushes the chin down into the airway, it seems. Which one did you get?
- 3y ago

johnbellone 3y ago

I’ve had sleep apnea and CPAP for years. The last several weeks have been grueling because of mask fit, movement, and other factors. My BMI is very high, but I am in minority that will have sleep apnea regardless due to anatomy. That doesn’t mean it won’t help to lose weight.

jonhohle 3y ago

As an additional PSA, sleep apnea may not be the cause of exhaustion, even if diagnosed. I was diagnosed with apnea and CPAP did (still does) little if anything for my energy levels. I finally found a sleep doctor who checked my iron levels, and despite being within the normal range suggested I take an iron supplement (iron polypeptide) and within a week felt normal again. It turns out that people with restless legs, which I’ve had since childhood, experience iron deficiency anemia with much higher blood iron content than the average population.[0] My primary care didn’t consider this. A pulmonologist had no interest in checking this. An oral sleep doctor had no interest in checking this. I had people suggesting getting an implant to force my tongue to stick out when the issue was low iron. Definitely get a sleep study (I’d recommend lab over home). I use a sleep tracker (cheap Garmin “smart” watch, but I’ve also tried an Apple Watch) as a reasonable proxy for REM and deep sleep. And if you think a practice is just trying to sell equipment, they probably are. Fortunately I found a good doctor from acquaintances that I would have never otherwise considered (not part of the local medical systems, though did take insurance). Unfortunately, for many issues it’s not enough to trust the doctor. Do your own due diligence for your health. 0 - https://www.frontiersin.org/journals/neurology/articles/10.3389/fneur.2020.00298/full https://www.frontiersin.org/journals/neurology/articles/10.3...

SamBam 3y ago
I have occasional restless leg (once every two weeks or so) and low energy. How would one know if one has iron deficiency despite blood work being normal? Is it just a case of popping iron pills and seeing if you feel better?
- dj_mc_merlin 3y ago
  Doesn't hurt to try does it? A bit of extra iron is harmless.
  - SamBam 3y ago
    That was partly my question. Looking online, iron is definitely something that you don't want to have too much of. My question is, basically, is having a non-anemic iron deficiency something that can be easily remedied by having low-dose over the counter vitamins, or is it something that requires a higher dose (to make up the difference in what you're missing) and so requires a doctor. And yet it sounds like this is difficult to diagnose.

MuffinFlavored 3y ago

How would one know if they had sleep apnea in any shape/form?

instagib 3y ago
Get a sleep study for accuracy. If your partner notices you snore or stop breathing when sleeping. You can record yourself also. You wake with a headache and dry mouth almost daily.

TurkishPoptart 3y ago

Do you think sleep apnea is a condition caused by civilization? I.e. did medieval people suffer from this? And is this a consequence of the American diet and a sedentary lifestyle, or something else?

maxglute 3y ago

Sometimes I wonder if humans need more variability in sleeping positions. Animals sleep in all sorts of positions on all manners of not perfectly even terrain, probably trains nassal to be strong in different orientations. When I had bad heartburn/gerd I'd pass out propped up on the couch or setup a bunch of cushions in the corner of the room, or raise head of my bed up with a few books and getting great sleeps.

elric 3y ago

I wish CPAP manufacturers were a bit better. There has been little innovation, and if anything, there's been a downward trend in quality in recent years. My wishlist: 1. Every CPAP device should be BiLevel. 2. All data they record should be accessible to the user (for tools like oscar). 3. Either more granular pressure controls, or better algorithms (or both). Some people do well on CPAP, others do better when iPAP > ePAP (BiLevel, or EPR), while others do better when ePAP > iPAP (vcom). 4. Better masks. Seriously. It's so hard to find a good mask, and so expensive to experiment with them. A new mask can set you back €150, and if turns you hate it, you're shit out of luck. I've toyed with the idea of personalized 3D printed masks to get a better seal for each unique nose/face shape. 5. Quieter machines. Without the Philips cancer foam. 6. Quieter masks. Some have excellent diffusers in the exhalation port (P10), while others blast out a concentrated jet of air that will wake you up when it hits the pillow, or will lead to divorce faster than your snoring ever did when it hits your bedpartner. 7. Bring back travel cpap devices. The market collapsed post covid. I'd love to keep a small device and super lightweight mask/hose in my bag for sleepover emergencies. I'd pay any price for that, because having to lug a full size cpap around ruins any chance of spontaneity in my bachelor sex life. None of these are rocket science. But Philips Respironics are a bunch of evil cunts, ResMed are goofing off, and the other brands might as well not exist.

david-gpu 3y ago
Agreed on all counts, down to having contemplated 3D printing molds to manufacture custom silicone masks. I also wish the tube had a sensor to detect whether you are sleeping on your back to preemptively raise the pressure. Or having better algorithms to detect hypopneas before the air stops flowing altogether. I don't even understand why purchasing a CPAP machine requires a prescription. I'm scared of the possibility of a doctor denying me a new CPAP machine when the current one inevitably croaks. The device is a glorified fan, for goodness sake.
- elric 3y ago
  The prescription thing is probably location specific, but AFAIK you can just buy them online. I have a few spares I bought online from back when I frequently slept in different places. Masks straps could probably be fitted with an accelerometer to detect positioning. If they can make heated tubing, this isn't such a stretch. Might also be useful in correctly flagging events: my machine often incorrectly marks position switches as periods of hypopnea.

flanbiscuit 3y ago

I have severe apnea and have been skinny most of my life, as I get older (in my mid-40s now) I can gain _some_ weight, but I'm still slim. My apnea is caused by having a narrow airway entrance and thick tongue that just completely blocks the entrance during sleep when my tongue relaxes and falls back. Has nothing to do with my weight, just the genetics I inherited. I use a CPAP that helps. My AHI is really low with it on. Now I just need to make myself go to bed earlier, I definitely have that "revenge nighttime procrastination" thing where I stay up way too late.

deleted 3y ago

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Fire-Dragon-DoL 3y ago

I'll throw this out based on the comments I'm reading, it seems like doctors don't personalize medical advice sufficiently. Glad some people were able to find the good ones that did

dbspin 3y ago

Thank you for this comment which mirrors my experience. Unfortunately CPAP seems to be considered the be all and end all of treatment, although the mask, tubes and reliance on such a bedtime setup can be enormously disruptive of sleep on its own.

giantg2 3y ago
I think CPAP is just convenient and inexpensive compared to surgery. If I ever have sleep apnea, I'd want the surgery.
- alwaysrunning 3y ago
  There is also the mouth guard for apena. https://www.sleepapnea.org/treatment/sleep-apnea-mouth-guard/ https://www.sleepapnea.org/treatment/sleep-apnea-mouth-guard...
- e40 3y ago
  I have heard horror stories about the surgery. Who knows, but I’m skeptical because surgery presumes the precise cause is known. The number of variables for sleep apnea is large to have certainty.
  - giantg2 3y ago
    "The number of variables for sleep apnea is large to have certainty." Clearly they have to know which part of your airway is restricted. Most of the variables for sleep apnea are not related to the surgey, just factors that make it more likely to experience that restricted airway (drinking, weight, etc).
    - e40 3y ago
      I have sleep apnea and I use a CPAP. During the diagnosis, there were tests but nothing that would/could finger a physical culprit that could be fixed via surgery. My question is, what tools are there to narrow, to a certainty, what would need to be done via surgery? In all my research I have found none. Maybe I missed them. If I did not, then it amounts to a guess by a surgeon. And that's what worries me and has fed a lot of the horror stories I've read about.

on_the_train 3y ago

If it's not weight, what's the common cause? Such a bad impediment on so many people should have a very clear signal. And apparently it's not weight? O never really looked into it

wredue 3y ago
The most common cause of sleep apnea is anything that obstructs your airways. Being overweight does that and is far and away the most common cause of sleep apnea.
- elric 3y ago
  This is such an often repeated trope, but it's not at all as clear cut as that. Sleep apnea *causes* weight gain, the arrow of causality can go both ways.
kkwteh 3y ago
One theory is poor facial structure that develops due to faulty breathing technique. Reference https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4686746/ https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4686746/
schwartzworld 3y ago
With obstructive apnea, it's mostly hereditary. You inherit the shape of nose from your parents, why not the structures in your airway? Weight gain can make it worse as those tissues also can expand, and any weight on your breathing can help turn a partial blockage into a full one. That weight can include muscle weight, and body builders often suffer from apnea. But the thing to keep in mind is that obstructive sleep apnea isn't so much a condition as a description of what's happening. Apnea means you stop breathing, obstructive means something is blocking it. Maybe it's because your fat belly is weighing you down, maybe it's your tiny nostrils and deviated septum, or maybe the back of your tongue is thick because your dad also had a thick tongue. That's not even including self-imposed factors like central nervous system depressants (alcohol) and smoking, both of which can make apnea worse. Ever notice how drunk people snore?
3y ago

HumblyTossed 3y ago

> Plenty of people don't have apnea because they are overweight; instead, they are overweight because they suffer apnea. A lack of sleep means a lack of energy. You're body compensates by getting food energy. Too much stigma around what should just be understood as a biological mechanism.

pc86 3y ago
This is stated as biological fact when it's simply not. Sleep apnea doesn't change the laws of thermodynamics - if you are gaining weight you need to eat less or move more. It's not stigma, it's simply the way it is for the vast majority of people (the rest being covered by rare hormonal conditions that require a doctor to treat). Being tired may cause you to eat more but being tired isn't making you gain weight, it's the overeating that is.
- throwaway11460 3y ago
  Being tired changes how your body uses and stores energy. Your body might be permanently trying to save up for bad times (because the times are always bad) and so you're getting fat even if you eat very little.
  - serf 3y ago
    can you point to examples of otherwise healthy individuals under moderate to high calorie restriction that gain weight due to chronic poor quality sleep? it's not something I have ever been made aware of, and I don't understand how it could be the case.
    - throwaway11460 3y ago
      A lot of things about your body changes when you're extremely tired. I don't have anything specific to link - it's just my own personal experience and what the doctor said. In my own case, I had to eat much more than I theoretically should because my body wasn't able to process the food as well as it should (less than 50% of usual efficiency). And yet I was fat - not obese, but definitely not thin. The body redirected some of my food to storage even though I didn't have enough energy (glucose etc) as measured by blood screening. And it didn't use the reserves properly when I stopped eating.