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Comment by grubbs | Hacker News Reader

Bleh. I did exactly this and got a CPAP. I just can't fall asleep with it.

I've heard of possible surgery. Or that implantable device. Maybe I'll look into those.

I recently started using CPAP and one thing I noticed in the sleep study, besides all the other reasons it was hard to fall asleep, was that when they were doing the titration test to find the best initial pressure, they set it very low and then let it climb up once I stopped breathing at that setting.

The problem was, I actually found it difficult enough to breathe through my nose at that pressure that I would just keep myself awake because I couldn't relax with the mask on. It was kind of horrible and my technician didn't change it for hours. Eventually I started just intentionally snoring while awake to try to get her increase the pressure. No idea if she did but eventually exhaustion won out after around 4 hours.

So just a thought, but if you're using an autoset machine (APAP) maybe discuss with your doctor and make sure the initial pressure is high enough that you're able to breath comfortably through your nose when fully relaxed.

And also, you can experiment with different mask types depending on your sleep position.

My machine has user comfort settings. One of those is to adjust the ramp-up time. I set mine to zero - GIVE ME MY AIR!!! After that change I was able to easily fall asleep. It was difficult prior to that.

I can also adjust the humidity setting. I had to increase it a notch because I woke up in the morning with my nose running and sore - which means I was dehydrated (yeah, that wasn't how I interpreted that symptom).

After those two changes I was able to fall asleep quickly and not wake up with a sore and runny nose.

Had the exact same experience. I hated my CPAP at first, then after a couple weeks of pressure adjustments with my sleep doc, it was damn near perfect. Can't sleep without it now.

If it's relatively minor apnea, the oral appliances do work. My wife has told me that my snoring has completely stopped when I wear it, and the snoring comes back if I forget. In combination with a fair amount of weight loss (about ~55lbs over the course of a year), I feel a lot better.

I use the walmart-brand breath-right nasal strips every night as well. I don't know if they actually do anything for me, but they're also inexpensive and they're not uncomfortable, so I figure it's an extremely cheap and harmless placebo if nothing else, and they certainly feel like they're doing something.

My wife wore those strips for years and is now having several cancerous lesions removed right where the adhesive was.

Huh, not saying you're wrong but I can't seem to find any studies into this.

Obviously I don't want cancer on my nose, so I would actually like to see how correlated these things are.

+1 on the oral appliance. They took a mold of my teeth/jaws and it took a couple of weeks to get it.

All it did was make my lower jaw jut out a bit. It sufficed. Apnea kaputt!

What kind of mask are you using? They first tried giving me the nasal pillows but I much preferred a full mask since it lets me breathe through my nose and mouth when I want. Your medical supplier should have a range of options for you.

Get your tonsils taken out if you haven’t already, along with the uvula. The volume of other tissues in the back of your throat can be reduced, and a turbinate reduction can improve nose breathing as well. A good ENT can advise.

A good ENT will also advise against these surgeries if possible. It's very much last resort. Removing the Uvula can create serious swallowing issues for people and in general the surgery success rate is essentially a coin flip, with noticeable regret. But yeah, some people (pretty small percentage) just can't make a CPAP machine work.

Some ENTs might, others will advocate for the surgery depending on the patient. As always, get second opinions and do one’s research.

A key potential advantage of the surgical route is no need (or at least a many years delay for the need) of a CPAP machine, a very significant advantage. Also, the discussed surgeries have a high rate of success in reducing snoring in individuals who don’t have sleep apnea, which is another health benefit for both the patient and the patient’s sleep partner. Snoring is an under-treated condition.

You're also deep sixing part of your immune system. There are consequences you can read about, which studies you decide to believe is a personal choice. A better initial road to travel is to wonder why one carries so much inflammation in the first place and relentlessly fix it.

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