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Flipping the model presents a new way to treat sleep apnoea

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Re: Flipping the model presents a new way to treat sleep apnoea

#31

Post by jrm4 »

robbiep wrote: post #9
renewiltord wrote: post #5

Has anyone used an oral appliance off the market? I googled and found this thing called snoreRx. Any recommendations or reviews? I would prefer to just go get something like this which I can pay for directly rather than have to navigate insurance etc. so if there's a DTC brand that has worked for someone that would be a great plus.

There’s a reason why this sort of thing is managed through someone medically guiding you and that’s because it’s complex, and there is a lot that snoreRx is not suited for. Unless you feel like you have a firm physiological foundation on which to base your need for some sort of treatment, you’re really doing yourself a disservice. There’s also no harm in discussing this with your doctor either

And as someone who's dealt with the ins and outs of CPAP and sleep apnea, increasingly, I believe that reason has very little to do with safety or expertise.

I'm not saying experts can't be valuable, but there's too much obvious bullshit in this space to take at face value what is supposed to be "best practices."

The price fluctuations, the differing bits of information, the restrictions on who can and cannot get what without a prescruption, etc are often quite absurd (when, e.g. compared to the potential danger of MUCH other OTC stuff.)

Example: that it's made condescendingly artificially difficult to adjust your own pressure in a CPAP. It's a damn fan with a release; if you're otherwise healthy, it strongly appears as if the worst possible dangers here are, your sleep will continue to suck and/or you'll fart more.

Re: Flipping the model presents a new way to treat sleep apnoea

#32

Post by kthejoker2 »

renewiltord wrote: post #5

Has anyone used an oral appliance off the market? I googled and found this thing called snoreRx. Any recommendations or reviews? I would prefer to just go get something like this which I can pay for directly rather than have to navigate insurance etc. so if there's a DTC brand that has worked for someone that would be a great plus.

Tried 4 kinds, 3 built and bites and one based on dental impressions.

I would recommend trying out a boil and bite just to see if it helps at all. The cheap ones wear out faster but with SnoreLab and such you can evaluate the difference for the first couple of weeks. They also fall out of your mouth easier and are pretty bulky.

The one I would recommend is VitalSleep, it just seemed to have a nicer build quality and it has adjustable screws for different jaw sizes. No major complaints.

I also had success with SnoreRx but it caused a bit more discomfort, sometimes got stuck on my lip, and I woke up with way worse dry mouth / drooling.

I'm using ClearGuard now which is a way sleeker build. I wouldn't say it works any better or worse but it definitely feels better.

For the record, my best results were with one of those things that stuck on your tongue to keep it forward but they fall out if you look at them funny and your tongue feels pretty beat up so I was concerned about long term effects.

Re: Flipping the model presents a new way to treat sleep apnoea

#33

Post by MagicMoonlight »

I think the solution is a stent inserted into the airway to prevent it collapsing during sleep. This would permanently treat the condition with no side-effects and no daily upkeep.

Unfortunately I have no way of implementing this so I’ll never know for sure.

Re: Flipping the model presents a new way to treat sleep apnoea

#34

Post by MagicMoonlight »

wincy wrote: post #25
taeric wrote: post #2

The number of people that are using a CPAP is honestly mind boggling to me. The number that have gotten one, and then refuse to wear it is even crazier. I remember when I first got one, I assumed it was some niche thing that was going to be unheard of from everyone I talked to. Turns out, not so much. I don't think it has been a miracle device, by any measure. But I'm curious what makes it so hard to stick to for so…

When I wear it I wake up in the middle of the night and feel like I am suffocating. Like it’s smothering me in my sleep. Even the expensive biPAP makes me feel this way. I have no such issues when I sleep without one.

That sounds like you’re not using it properly. Let me guess, a doctor set it up for you and set the pressure to 4cm or something ridiculously low. They love doing things like that.

Re: Flipping the model presents a new way to treat sleep apnoea

#35

Post by lcuff »

taeric wrote: post #2

The number of people that are using a CPAP is honestly mind boggling to me. The number that have gotten one, and then refuse to wear it is even crazier. I remember when I first got one, I assumed it was some niche thing that was going to be unheard of from everyone I talked to. Turns out, not so much. I don't think it has been a miracle device, by any measure. But I'm curious what makes it so hard to stick to for so…

I sweat where the mask contacts my face, so that's one issue. As others have said, it can be noisy. I find the noise highly variable based on how it sits on my face and if there are things (a pillow, a sheet, my hand) in front of the discharge vent. At times it feels claustrophobic. I feel vastly better in the morning if I've used the device for more than half the night, so I'm very motivated to make it work.

Re: Flipping the model presents a new way to treat sleep apnoea

#36

Post by elric »

The only reason why CPAP has such abysmal failure rates, is because followup is an absolute joke. Patients are titrated in a sleep centre, typically for one night, and are then sent home with a machine, probably the shittiest mask the sleep centre had on hand, and a kick out the door. With some luck, patients have to come in once a year, usually to prove that their therapy is compliant with whatever harebrained scheme their insurance has set up. If they're really lucky, the physician will actually look at the machine's data, and if they really strike gold, they might even adjust therapy as needed.

One initial visit, then once a year. For something you have to wear every night for the rest of your life. It's a joke. Everything else, you'll have to figure out on your own. Is it any wonder people give up? They're likely on the wrong pressure, using the least comfortable mask, and have no idea how to make things better.

It's a good thing there are resources like Apneaboard [1], Lanky Lefty's youtube channel [2], and software like Oscar [3] to help people out. If these didn't exist, failure rates would be even higher. And if the medical industrial complex would get their heads out of their arses and actually tried to help patients, compliance would be through the roof.

[1] https://duckduckgo.com/?t=ffab&q=apneaboard&ia=web [2] https://www.youtube.com/@Freecpapadvice/videos [3] https://www.sleepfiles.com/OSCAR/

Re: Flipping the model presents a new way to treat sleep apnoea

#37

Post by fnordpiglet »

DrAwdeOccarim wrote: post #7

Totally agree. My journey started with TMJ disorder. Turns out bruxism (teeth grinding) is common in sleep apnea patients; I assume because it forces the lower jaw forward. I started with a mandibular advancement device and it was amazing. It completely relived my debilitating TMJ jaw pain and fixed my sleep apnea. I couldn’t believe how amazing I fet every morning. Unfortunately, and which was clearly communicated t…

I want to emphasize the importance of seeming an ENT. I also saw an ENT, but very early in my journey. I also had sinus surgery. After recovery was the first time in my life I could breathe fully through my nose. I had no idea - it was like being blind and being able to see for the first time, except I had no inkling others could see. That actually opened up a realization that the sinus issues they fixed had led to chronic infections, which upon over a year of various treatments I finally cured, leading to an incredible uptick in life quality. Turns out some non trivial percent of people have chronic sinus infections due to poor nasal air flow, and having an infection next to your brain doesn’t make you feel very good. But they’re also very hard to diagnose.

The ultimate treatment that worked was daily sinus irrigation plus a treatment of sinus irrigation with a specific type of topical antibiotic that can break down biofilms. I would mix the antibiotic with saline and topically irrigate the sinuses. The benefit was it wasn’t a systemic antibiotic so it didn’t screw up my entire system. I eventually read this book:

Harvard Medical School Guide to Healing Your Sinuses (Harvard Medical School Guides) https://a.co/d/dpDZwba

And they had a brief section on topical antibiotics. I asked my ENT and he said it’s a vastly superior treatment but most people refuse to do sinus irrigation so he just gives pills - which he said are usually partially effective, and thus temporary, due to the presence of biofilms.

Anyways long story - I recommend everyone assume they have a sinus infection and visit an ENT for a check up, and to take up the practice of sinus irrigation as a preventative measure especially during and after an upper respiratory infection. Apparently when baths were the common way of cleaning (especially before modern plumbing, using rivers and lakes), sinus irrigation was generally part of the routine by just dunking the head and filling the sinuses then expelling the water and other stuff. There’s a now lost English word for it that I can’t recall any more, but with showers and modern Victorian hygiene that dispensed with a lot of traditional hygiene, we’ve lost the practice.

Re: Flipping the model presents a new way to treat sleep apnoea

#38

Post by elric »

MagicMoonlight wrote: post #33

I think the solution is a stent inserted into the airway to prevent it collapsing during sleep. This would permanently treat the condition with no side-effects and no daily upkeep. Unfortunately I have no way of implementing this so I’ll never know for sure.

Such stents exist, like the Nastent [1]. They're expensive, more or less single use, and shoving a tube down your nose sounds very unpleasant. CPAP seems a lot more attractive to me.

Unless you mean a permanent stent, in which case I doubt it'll happen. You need the airway to be flexible (including for speech) in various places. It's hard to pinpoint which bits of airway are responsibe for an individual's apnea. And surgeries, especially in the throat/neck/airway area sound very risky.

[1] https://www.breathewellmedical.com/product/nastent-classic/

Re: Flipping the model presents a new way to treat sleep apnoea

#39

Post by elric »

gmiller123456 wrote: post #19
taeric wrote: post #2

The number of people that are using a CPAP is honestly mind boggling to me. The number that have gotten one, and then refuse to wear it is even crazier. I remember when I first got one, I assumed it was some niche thing that was going to be unheard of from everyone I talked to. Turns out, not so much. I don't think it has been a miracle device, by any measure. But I'm curious what makes it so hard to stick to for so…

Mine is a pretty high pressure, and a full face mask. The high pressure means the mask has to be strapped pretty tight. It also makes it tough to get into a regular breathing pattern, making just the act of breathing a major chore. You can't talk, or cough. You have to stay in certain positions to prevent the air from leaking out. The air echoes down the tube. I was a stomach sleeper before, which is impossible with…

Once you're above 15 cmH2O, you probably qualify for BiLevel, which some people tolerate better than CPAP.

Re: Flipping the model presents a new way to treat sleep apnoea

#40

Post by ricardobeat »

kthejoker2 wrote: post #32
renewiltord wrote: post #5

Has anyone used an oral appliance off the market? I googled and found this thing called snoreRx. Any recommendations or reviews? I would prefer to just go get something like this which I can pay for directly rather than have to navigate insurance etc. so if there's a DTC brand that has worked for someone that would be a great plus.

Tried 4 kinds, 3 built and bites and one based on dental impressions. I would recommend trying out a boil and bite just to see if it helps at all. The cheap ones wear out faster but with SnoreLab and such you can evaluate the difference for the first couple of weeks. They also fall out of your mouth easier and are pretty bulky. The one I would recommend is VitalSleep, it just seemed to have a nicer build quality and…

I found three or four different products branding themselves as “ClearGuard”, and they all look pretty much like my old anti-bruxism splint - hard and very uncomfortable. Do you have any links to the one you had success with?
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