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Comment by henryw | Hacker News Reader

> Also, I sleep with a CPAP machine, and I've found that it's enabled me to get by with only five to six hours of sleep, allowing me to be productive during most of my waking hours. Before my CPAP, I was sleeping 9-10 hours a day just to feel normal. It's weird, but my CPAP machine has been the biggest contributor to my productivity gains in the last few years.

This is my first time hearing about CPAP. Has anyone else tried this?

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CPAP is a machine that forces continuous air through your nose via a mask. When you have sleep apnea, you're actually not breathing, thus, wake up during the night. The CPAP machine keeps the air moving, thus, you don't wake up.

I have _mild_ sleep apnea (you go through tests for diagnosis). With a CPAP machine, I've been able to add a solid hour per night of sleep, from about 6.5 hours to 7 .5-8, with it being continuous. Ergo, I don't make the "midnight trip to pee" with it on. With it off, I snore loudly, and wake up at least 1-2 times during the night.

It's possible that Ajay here actually has worse apnea, and the "9-10" hours from before was actually spent waking up, then trying to get back to sleep. Thus, the "6 hours" is just purely continuous sleep, instead of hours of tossing and turning.

Sleep apnea tests are comfortable take home tests. You basically just wear a couple of sensors for a night. If you're not prone to apnea, don't bother with a CPAP. It's not cheap, and some people can't get used to putting the mask on.

Do you have any recommendation for an at-home test? I've considered doing a lab study, but at-home sounds much better. I didn't realize that was an option.

Your local sleep doctor can evaluate your sleep apnea risk factors and prescribe a take-home test. Should be covered under insurance.

I think you can DIY with a cheap pulse oximeter, but I'm certainly not qualified to say how to interpret the results.

The poor man's in home sleep study is pretty simple:

https://news.ycombinator.com/item?id=2030427

https://news.ycombinator.com/item?id=18465509

https://www.amazon.com/CMS50D-Plus-24-hour-Uploaded-Computer...

This is where things get really complicated. The output data of these tests are typically for a specialist to interpret, I'm not aware of "consumer" tests that break down things like "here's here you flipped over to your side" and "this is when you woke up". Specialists can interpret this, and can read past how you might adjust results yourself.

What gets covered by insurance and what doesn't is specific to your situation (what state/country you live in, etc). I just requested it with my primary care physician, who set up the consultation with a sleep center. Because my case isn't considered "problematic", it really helped to have a specialist request the CPAP, because otherwise, I'm pretty sure insurance wouldn't foot the bill. (I might add this is insane, because I'm sure I've added years to my life with the improved sleep. That's healthcare in the US for you.)

My impression is that the kind of tests is up to the sleep specialist to kind of figure out. The take home thing is much cheaper so I think they'll probably go that route first. I do note that they deal with a wide array of problems, like narcolepsy, sleep walking, night terrors, etc., and that's where I think you'll end up in a monitored hotel room.

My knowledge of this is little more than yours, but my understanding is most people use CPAP machines to cure sleep apnea (extreme snoring basically). I've never heard of someone using one as a sort of sleep-hack. I imagine the machine is fairly uncomfortable? Would be curious to hear more about this.

I assumed that the OP was saying as they'd mitigated the effects of their apnea they now managed on only 6hrs of sleep instead of 10 [ie 6h of good sleep is enough, 10h of poor sleep was what they were getting before].

Sleep apnea is actually much more than just snoring. It's actually a period of time during sleep where the person stops breathing.

Just to note, there are two kinds of sleep apnea.

The one you typically hear about that presents with extreme snoring is obstructive sleep apnea. It's pretty much as the name implies: sleep apnea caused by an obstruction. Your body tries to breath, but for a variety of potential reasons, your airway is obstructed. The snoring is your body's attempt at overcoming the obstruction.

Then there's central sleep apnea. With central sleep apnea, there's no obstruction blocking airflow. Your central nervous system just periodically... decides not to breath. Doesn't even attempt to contract the muscles necessary to intake or expel air. Then at some point, it... decides to start back up. There's no snoring or other loud noises involved like there is with obstructive sleep apnea.

They're both sleep apnea, and both have the same impact on the body if left untreated, but they present in almost complete opposite manners. Obstructive sleep apnea is loud because your body is trying real hard to do it's job. Central sleep apnea is generally pretty quiet, because its the absence of your body doing it's job. It just decided to take a little breather from it's typical life-sustaining duties, then (hopefully) after a ~10-30 second break it gets back to doing what it's supposed to do. The loudest you might hear is a bit of deep, heavy, or irregular breathing as it handles the backlog of oxygen needs that built up while it was on break.

I spent years being misdiagnosed with stuff like depression and hypertension, because I'm pretty much the exact opposite of someone at risk of obstructive sleep apnea (don't snore, not overweight, not old). It took paying for a home sleep test out of pocket and giving my physician the results before I finally got any traction from a doctor to explore that route. Turns out I have central sleep apnea, and treating that has been revolutionary on my life. I don't sleep through alarms anymore, I'm learning to love waking up early, I'm not mentally and physically drained at the end of the work day, and all kinds of little things.

You can order a home sleep test online for $150. And if you have an FSA, you can use your FSA dollars on it without even having to go through a doctor. If you're constantly dragging ass during the day, have a wonky sleep cycle, wake up randomly at night, or just happen to be curious. At that price, it's well worth taking a sleep test just to rule it out as a cause.

It helps if you have sleep apnea. If you don't have sleep apnea, I'm unsure you're going to see cognitive or productivity gains, as your brain is already getting enough O2 during sleep.

EDIT: Now if you could find a drug that promoted the ability to more rapidly clear waste using cerebrospinal fluid while you sleep, that'd be a possible route to still maintaining high levels of wakeful productivity with limited sleep (without causing harm later in life).

Right, I do have moderate-to-severe apnea, which is why I use the machine. But still, going from 10-11 hours/night to 5-6 and feeling great has been a big productivity booster.

If you have sleep apnea it's useful.

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