Hacker News Board Hacker News, browsed like a classic message board
Live data from Hacker News

Sleep apnea pill shows striking success in large clinical trial

science.org

Post reply on HN
Print view View original

141–150 of 226 posts

Re: Sleep apnea pill shows striking success in large clinical trial

#141

Post by grapesodaaaaa »

morjom wrote: post #135
kimjune01 wrote: post #91

Sleep apnea is a structural issue, either soft or bone. CPAP helps, but it doesn't address the root cause. Fixing it is a matter of airway geometry, with many obstructions along the way. Bodybuilders or wrestlers, otherwise in good health, can suffer from OSA because of too much muscle in their neck. You may not know it, but your tongue may be tied. It is one of many possibilities causing OSA. I made this: Do I have…

Central Sleep Apnea exists aswell.

This sent me down a rabbit hole, but high altitude periodic breathing seems related for some people living at high altitude.

Sleep apnea can be a disqualifying condition for pilots, so I like to be 1000% certain and have plans A, B, and C ready to go before seeking treatment.

Re: Sleep apnea pill shows striking success in large clinical trial

#142

Post by pimlottc »

bagels wrote: post #89
linsomniac wrote: post #31

Has anyone tried the "hostage tape" or similar to force breathing through your nose like Essential Craftsman discussed in his series of videos https://youtu.be/g8JzXEoT9LI?si=rVuZRoMrE_fwL0qv

Seems really dangerous to block the airway. If you get a runny, bloody, stuffed or otherwise blocked nose, seems like you can suffer some bad outcomes.

It’s normally a small piece of tape less than the width of your mouth. It’s more about keeping your lips together than creating an air-tight seal.

Re: Sleep apnea pill shows striking success in large clinical trial

#143

Post by lamp_book »

grapesodaaaaa wrote: post #141
morjom wrote: post #135

Earlier quoted context omitted.

Central Sleep Apnea exists aswell.

This sent me down a rabbit hole, but high altitude periodic breathing seems related for some people living at high altitude. Sleep apnea can be a disqualifying condition for pilots, so I like to be 1000% certain and have plans A, B, and C ready to go before seeking treatment.

If jaw placement is an issue you can get corrective surgery without an apnea diagnosis (AFAIK). There’s a lot of info on Reddit, you can generally tell from your side profile or bite if it is a potential culprit.

Re: Sleep apnea pill shows striking success in large clinical trial

#144

Post by derefr »

EA-3167 wrote: post #111
elric wrote: post #7

I swear CPAP wouldn't get such a bad rep if the media would stop using pictures of men with obscenely large full face masks. The most commonly used CPAP mask is probably the minimalist Resmed P10 [1]. It looks a lot less intimidating than a bulky full face mask. And in most cases, full face masks aren't needed (no sources to cite, but titrating to the correct pressure allows most people to breathe through their noses…

These aren't drugs that I'd choose to take when a proven therapy like the use of a CPAP exist, the list of potential serious adverse reactions isn't trivial at all. Most amusingly insomnia is a known risk of atomoxetine. I understand that this might be a viable option for people who simply cannot tolerate CPAP therapy, have tried alternatives and found them lacking, and aren't surgical candidates... but I certainly h…

> Most amusingly insomnia is a known risk of atomoxetine.

Given that atomoxetine is an sNRI, and norepinephrine modulates both alertness and muscle tone, I would bet dollars to doughnuts that what this treatment is doing is mostly helping people who have inadequate muscle tone in their pharynx at night due to inadequate NE levels, restore that muscle tone, and thereby keep their airways unblocked. These people aren't going to get insomnia from having their NE levels increased — because insomnia in sNRI use is a symptom of excess NE, while in these people, NE is just being brought up to a neurotypical level.

(In other words, the same logic that explains why [correctly dosed] dopaminergic stimulants don't make people with ADHD manic — but applied to NE dysfunction rather than DA dysfunction.)

Re: Sleep apnea pill shows striking success in large clinical trial

#145

Post by jiayo »

sfink wrote: post #104

One thing that I've found very helpful, and wish my doctor had mentioned: when putting on the CPAP (nasal pillows in my case), time turning it one with your breathing such that the machine first kicks in during an inhale. That's it. It sounds trivial. But my biggest problem[1] with the CPAP is that it feels like it's smothering me. I can get more air in, faster, without the CPAP, and I still vividly remember the init…

Similar experience. I liken it to merging onto a freeway: you want to get up to speed first, then change lanes. If you don't, it feels like you're always fighing the pressure. If you equalize the pressure correctly breathing is as easy (easier) than without the mask.

Re: Sleep apnea pill shows striking success in large clinical trial

#146

Post by justinator »

Llamamoe wrote: post #97
kimjune01 wrote: post #91

Sleep apnea is a structural issue, either soft or bone. CPAP helps, but it doesn't address the root cause. Fixing it is a matter of airway geometry, with many obstructions along the way. Bodybuilders or wrestlers, otherwise in good health, can suffer from OSA because of too much muscle in their neck. You may not know it, but your tongue may be tied. It is one of many possibilities causing OSA. I made this: Do I have…

You're right, and Inspiratory Muscle Training is an easier alternative to playing didgeridoo, and it's very important to mention Mandibular Advancement Devices and soft cervical collars(since neck-jaw position matters, this is a big part of why apnea is worse on your back), but the thing is- it's unlikely to be enough. Ultimately, to REALLY fix Sleep Disordered Breathing, usually you want maxillomandibular advancemen…

>usually you want maxillomandibular advancement

Yeah that's the ticket. I use a mouth retainer for this, but I've found more often than not these days that it comes out sometime during the night. I may look into these exercise to supplement.

Re: Sleep apnea pill shows striking success in large clinical trial

#147

Post by VectorLock »

garyclarke27 wrote: post #130
Llamamoe wrote: post #98

Earlier quoted context omitted.

The problem with CPAP is that 40% of patients don't tolerate it even for the 4h/night defined as treatment compliance, while most of the rest use it less than the full duration of the night, with studies demonstrating that treatment compliance depends on efficacy. And this is for traditional OSA in men - people with Upper Airway Resistance Syndrome(mostly identical mechanism as OSA, less oxygen desaturation, more aro…

I never had a problem with adopting CPAP. It's been transformative for me, sleep quality is literally 10 times better than without, I wake up feeling awful if I have a nap without it. Why would someone keep a mask on for 4 hours, then take it off? does not make sense to me.

Congrats to you. 40% of people probably wish they could tolerate it.

Re: Sleep apnea pill shows striking success in large clinical trial

#148

Post by m463 »

garyclarke27 wrote: post #130
Llamamoe wrote: post #98

Earlier quoted context omitted.

The problem with CPAP is that 40% of patients don't tolerate it even for the 4h/night defined as treatment compliance, while most of the rest use it less than the full duration of the night, with studies demonstrating that treatment compliance depends on efficacy. And this is for traditional OSA in men - people with Upper Airway Resistance Syndrome(mostly identical mechanism as OSA, less oxygen desaturation, more aro…

I never had a problem with adopting CPAP. It's been transformative for me, sleep quality is literally 10 times better than without, I wake up feeling awful if I have a nap without it. Why would someone keep a mask on for 4 hours, then take it off? does not make sense to me.

restlessness, semi wakefulness doing dumb actions.

also, I think the default cover-the-whole-nose mask for sleep apnea isn't really good. Maybe people pull it off. I found the nasal pillows a significant improvement (maybe that's what P10 is?

Re: Sleep apnea pill shows striking success in large clinical trial

#149

Post by VectorLock »

elric wrote: post #109
Llamamoe wrote: post #98

Earlier quoted context omitted.

The problem with CPAP is that 40% of patients don't tolerate it even for the 4h/night defined as treatment compliance, while most of the rest use it less than the full duration of the night, with studies demonstrating that treatment compliance depends on efficacy. And this is for traditional OSA in men - people with Upper Airway Resistance Syndrome(mostly identical mechanism as OSA, less oxygen desaturation, more aro…

I will keep beating this horse to death, but the vast majority of those who cannot tolerate CPAP are improperly titrated and/or have a mask that isn't right for them and/or are having leaks. Often all of the above. That 4 hours is just another symptom of a medical establishment that's not interested in treating patients, but is only interested in numbers. If you want maximum benefits from CPAP, you have to wear it al…

I don't know why you're so insistent that anybody who can't tolerate CPAP its a titration or fitment issue. I've talked to people who have loads of interaction with sleep doctors, mask fitment specialists, trying different CPAP/AutoPAP/BiPAP/auto-titration settings and I'm one of them. I'm glad medical science is pursuing other treatments that can help the 40% who can't tolerate CPAP and maybe help some of those who don't want to be tethered to a machine every night.

Re: Sleep apnea pill shows striking success in large clinical trial

#150

Post by 12_throw_away »

evanjrowley wrote: post #82

I must be in the minority of CPAP users who would use it even if I stopped having OSA. Why? A few reasons: 1. Sometimes I hardly notice it. Newer models are very quiet and portable. I'd even go as far as saying the mask is comfortable to wear, like a security blanket for the face. 2. Practically nothing filters out dust and cat hair better than my CPAP. An N95 mask might do better, but would be ridiculously uncomfort…

Yep - my first 4 weeks, I just hated the feeling of air getting forced into my airways. And then 2 weeks ago, it flipped on a dime ... I guess my brain decided "this is what sleepy-time breathing feels like", and now it's a very relaxing sensation.

It all makes some sense, I think - it would be bad, evolutionarily, if we couldn't get used to the sensation of breathing, even if it happens to be slightly weird for whatever reason.

Post reply on HN