Fitful nightly sleep linked to chronic inflammation, hardened arteries
news.berkeley.edu
news.berkeley.edu
If, as a result, they tell you to get a CPAP, get it. Those things are life-changing.
I felt like an old man at 50 years old. My back was so stiff I couldn't put on my socks. When I got out of bed in the morning I felt so fragile, like my joints were all inflamed - especially my Achilles' tendons. I was too tired to do anything beyond 6 pm.
Now, 51, I feel totally normal again. And that change was pretty much overnight once I started using that wretched machine.
All I got in return is a $500 inconclusive.
I also got an inconclusive, but my dad has apnea and a sleep study basically changed his life. The possibility of that is clearly worth 500$
CPAP machine, however, is upon deductible, so I have postponed it upon I'll have spent the deductible on something like CT.
Here's a video showing how to install the monitor:
https://www.youtube.com/watch?v=FHvydhYu85o
It is still a "developing area" but I think it will be the norm eventually. It *should reduce the cost (but YMMV, as US healthcare costs don't conform to normal logic).
The sleep studies are similar. Someone getting an inconclusive result doesn't negate all the folks that have been helped by it - and honestly, doesn't rule it out. The money bit is just a shameful side effect of the health care system where you live and I'm guessing it is part of the sting of an inconclusive result.
I do encourage you to keep trying if you have reason to think you have sleep apnea. Maybe get a home O2 monitor to help you decide if it's worth spending the money on another sleep study.
So damned frustrating.
A lot of it is comfort. So try switching from a full-face to nose pillow-style mask. Or alternative headgear. Or even talk to your doctor about lowering the pressure if it is the noise (better to have less effective treatment, than none at all).
PS - A lot of, frankly, older doctors are still not prescribing Auto-CPAPs for people who may be suitable. If you're currently set on a fixed pressure, and your machine is a common Auto-CPAP (variable pressure) maybe seek a second opinion from a different (younger?) doctor. Auto-CPAPs are medically certified for many Sleep Apnea suffers, doctors just haven't adapted or haven't been re-trained, so they're chronically under-prescribed. Auto-CPAP improves your comfort, not your treatment, which improves adherence.
So may people find their CPAP uncomfortable when they first use it, that it's unlikely they'll use it properly. Having a first use under the watchful eyes of a physician could be a good idea.
Then again, some people also get one and then don't use it, so maybe it's more of the same.
Also, a doctor can show you how to use one, you would not necessarily be completely on your own.
Sleep studies are just such a hassle (and expensive, depending on where you live), and if you have a weird sleep schedule it can be difficult to even fall asleep in time.
Being able to just rent a CPAP machine for a couple of days and have a doctor show you how to use it would be a good option to have.
Any recommendation?
Don't let the wait deter you. If you do need the machine, it can really improve your life.
Most of us wait because the prioritisation is by clinical need, and is usually 'good enough' and some because they can't afford it.
And I think if you have private insurance (i.e: double paying), you'll probably be paying more than the average American. I don't know for sure though.
You also have to factor in the (very large) public expenditure on healthcare in the USA. Americans also pay for part of their healthcare through taxes.
On top of that UK private insurance is much cheaper because it is 'top up' - you're usually expected to see NHS GP's first etc. and use NHS emergency rooms.
As such while it is possible to end up paying more if you're very high income, very few people in the UK will pay more even with private insurance.
So I took the test and got the results 2 days later and saw the specialist. He showed me the full scan said it's all clear. He then asked if I had insurance. I said no... he walked me to the billing desk and said no charge. What a legend.
Turns out chest pains was from GERD.
Here in Croatia, I could wait a couple of months or I could pay around $300 to have it done privately.
The cost is not insignifigant. Cost of the machine itself is around $1000, and then perhaps $150-200 in supplies every 3 months.
Totally worth it though. Life changing.
A sleep study is definitely one of the best things I ever did. It helped uncover some undiagnosed narcolepsy, and I've been able to manage it since then. Even knowing that it existed was helpful. (For example, lots of stress was caused by getting jobs that expect you to have your butt in the seat from 9am to 5pm. Other jobs exist.)
So yes. Sleep study good! Go do one!
What do you mean by this?
Incidentally, if you’ve never had true vertigo, it is very disconcerting how much a sensory organ malfunction can affect your perception of the world. It is a kind of spatial psychosis that you can observe objectively.
I'm horribly sorry you've had such an extreme reaction. Hopefully, though, you've found some things that work for you.
An at-home study required me to sit through dead obvious instruction on how to equip and use the machine. Once I was prescribed a machine as a result of the study, the most time-consuming part was picking up a machine and sitting with a nurse to try on various masks.
Since the machine itself is set to what the CPAP community calls "lazy doctor mode" meaning it's just set to auto-adjust itself in a range and the newer machines use cell data to automatically upload usage data, once you take it home you're done. My only follow up visit was over the phone. And there is an open source project for reading the data which will appeal to the HN crowd: https://www.sleepfiles.com/OSCAR/
I got a cpap after a sleep study found I had 80+ breathing interruptions in the short overnight test window.
It easily brought them down to <10, but I feel no better in the morning, and it makes the occasional nap much more of a hassle.
The value is absolutely there in the greatly reduced likelihood of death in my sleep, and the white noise is better than snoring when sleeping around others. But I wouldn't want to get people's hopes up about it providing them the bad sleep panacea they desire.
Get OSCAR software it will help you fine tune the CPAP settings. https://www.sleepfiles.com/OSCAR/
Often people are given the cheapest CPAP machines that won't auto-adjust themselves. Guess what, at least for Medicare it's all the same price so the cheaper the machine the more profit for the DME! The forums will guide you to how to get the best from your machine.
I fine tuned my CPAP based on what I learned and it really improved my AHI. You say "<10" but if you mean AHI that's not good enough. Even doctors want <5. Mine is <1.
Medicare is not "for all" yet, so a lot of people won't be helped by this.
So I decided not to buy it after the week of the free test drive.
Mouth breathing is horrendous for your health and well being. There is a good reason why it was ostracized in the past ("mouth breather" was an insult). It was a clear sign of poor health in an individual.
It's one of the best unknown health hacks out there.
Wait, while sleeping or during the day? If while sleeping, isn't it dangerous?
It fixed my apnoea and chronic sinus issues. Seems I was constantly developing nasal polyps from mouth breathing all night.
Here is a dentist recommending mouth taping:
Just keep putting it on at night, and before you know it you will wake up in the morning and have completely forget you still have it on.
https://www.forbes.com/sites/ninashapiro/2019/10/18/keep-you...
Dr. Li does surgery for sleep apnea. I was referred to him once for evaluation for a surgical procedure only he does (EASE/TPD) and which I was told that the referring doctor had seen a lot of effectiveness in improving sleep apnea in their patients. He seemed like he knew his stuff and was very up-front about being conservative about making predictions in my case.
It does sound a little crazy, but only because I'm surprised there's not a more comfortable solution. Tape on my mouth would prevent me from falling asleep.
Is there not some sort of mouthguard that blocks airflow, and thereby achieves the same result in a more comfortable, less sticky situation?
https://www.everydayhealth.com/sleep/mouth-taping-cheapest-l...
A CPAP does not require mouth breathing. Nasal pillows require you to breathe through your nose. If necessary they shut your mouth with a chin strap. A piece of 3m tape sounds dangerous for someone if the problem is nasal obstruction or rhinitis rather than their mouth dangling open. They might not be able to gasp for breath and experience an even worse apnea.
My wife and waking up feeling like I did after a nights sleep as a child.
Tape your mouth at night! On your easy runs, breath solely through your nose.
For the record, I am an ultra runner. Nose breathing is hugely beneficial for endurance athletes. I have seen my pace come up while heart rate / perceived effort remains the same.
I did the last years entire Montane Spine Challenger just breathing through my nose (108 mile race).
1. Jog slowly at a pace that is comfortable while breathing through your nose. 2. Speed up pace until you feel like you will need to breathe through your mouth stay there for 10-20 seconds. 3. Slow your pace back down to where it's comfortable. 4. Adjust your pace up and down between these zones in intervals. 5. Over time increase pace and interval length.
- It's ok to take some mouth breaths as you continue practicing. The goal is to increase % of breathes via nose. - When you get the hang of that try it while jumping a rope.
Seated breathing exercise, do with shirt off to observe abdominal and chest region while practicing: 1. Sit comfortable, good upright posture. 2. Breathe in fully and hold for 2 seconds. 3. Sip in as much more breathe you can and hold 2 seconds. 4. Sip in the final amount you can and hold for 2-3 seconds. 5. Exhale out fully and hold for 2 seconds. 6. Exhale out tiny bit more and hold for 2 seconds. 7. Exhale out tiny bit more and hold for 2-3 seconds. 8. Repeat from step 2.
- I found this really good to do in a park or in nature.
These two where my main exercises on top of using that in boxing. - In a fairly short amount of time I was able to get a full lung breathe through the nose easily.
Good luck.
It's only crazy that you're not using a medical device that's built for this! Your head's in the right place, though. ;)
https://goodmorningsnoresolution.com/
> Mouth breathing is horrendous for your health and well being.
I completely agree with this, but using an APAP and breathing through one's mouth are unrelated. There are full-face masks that let one breath through the mouth, but the mask that came included with my machine was a nose pillow. Since air is continually being pushed through my nose, breathing through the mouth is very hard to do.
You don't need to spend $90 on some patented thing. Use simple 3M Micropore Surgical Tape 2.5cm x 9.14m, its what every one else uses for mouth taping and its exactly what a lot of dentists will suggest is used, although a few more folks are using SomniFix Sleep Strips as well. Tape works absolutely fine though, and its the consensus go to by most users.
I can't attest to relatively popularity, but this device was independently suggested by both my dentist and my ENT. It works really well.
Tape seems like a great option too, but it seems like it'd come off easily? I might give it a shot.
The tape stays on very well. You want Micropore Surgical Tape - 2.5cm x 9.14m. Also it helps if you don't have a beard. This was the only down side for me, but I will take the better sleep / improved health over a beard.
(Whatever works for anyone of course. If other methods still leave bad sleep, by all means use a machine!)
Anecdotally my wife and kids were complaining about my snoring, and I bought one for $40 off Amazon. Not only has my snoring improved, but my lung capacity has improved. Plus it's just fun to play.
I saw four doctors across two states trying to resolve a certain medical condition, which happens to be very common, has very negative effects, and has low recovery rates.
They prescribed a couple different medications, and mentioned that the disorder is "associated with" a list of a bunch of things related to lifestyle and diet. (These items were never brought up again by any doctor after their initial brief mention: it was a kind of "going through the motions" with each doctor—part of the obligatory informative synopsis of the disorder.)
The medications did practically nothing, and experimenting with briefly removing different items on the list from my life did practically nothing. Meanwhile my life was severely negatively impacted by this for ~4 years.
Eventually I decide to "get healthier" in a general way with an improved diet, insistence on regularly getting sufficient sleep, reduced alcohol consumption, and regular strength training.
A few months later the condition was at about 50%, and now it's at a point where I'm barely bothered by it.
I'm also a Type 1 diabetic and ran into a similar thing there: the recommendations given to me by doctors were incompatible with the blood sugar ranges they described as desirable. So I did my own research and discovered that basically everyone who had really good numbers was doing massive carbohydrate reduction in addition to taking insulin.
What it came down to in both cases: doctors will not prescribe lifestyle changes. They may mention them, but their core solution is likely to be a medication + tweaking dosage—even if this is by comparison far less useful.
I do think there's a legitimate reason, though: most people are simply not willing to make these kind of lifestyle changes. However, for those who are willing to do it, there's a good chance they'll lack the info on how effective it can be, because it's not what their doctor is going to emphasize.
(I'd urge anyone who thinks my cases may be uncommon to try this: if you know someone who resolved a medical condition by general lifestyle improvements like diet, sleep, exercise etc.—see if they made the changes because a doctor recommended it or if the motivation come from somewhere else.)
It still seems problematic to have it just missing from the presentation of options[0] merely because most people won't follow through, though. The ones who are willing to follow through (probably the ones who care most deeply about resolving the thing) aren't given a fair opportunity.
Additionally, it seems like a self-perpetuating problem: I would bet a significant part of the unwillingness to make lifestyle changes in order to treat medical conditions is a consequence of Americans' expectation that illnesses are treated by medications (which comes in a large part from doctors emphasizing this). The entire situation has a kind of consumerist framing: you get sick, you purchase a thing which you then consume which treats you. That kind of perspective was strongly instilled in me until my experience with type 1 diabetes. Growing up in the U.S., I just thought that's how things worked: our medicine was that good, and it covered most illnesses.
If you go into it with that kind of expectation, it comes off as a very tall order to say, give up pizza. There's this feeling of, "I took my time and money and paid for a doctor, they didn't give me anything, and now they're asking me to do work?"
So maybe it's just a kind of a broken, self-reinforcing cycle. But I suspect it's a little more insidious than that too: there is an obvious financial incentive for things to be structured this way. I have a hard time imagining that has no impact.
[0] Not that it wasn't "brought up," it was in both of my cases. But: not only was it relatively un-emphasized, it was described as "possibly having an effect". The accurate presentation would have been: this can be much more effective than the medicine I can prescribe—but it will also require much more effort from you.
Slow and steady usually wins the race, but magic bullets pay better.
Look at the rebellion that doctor started in New York, with his youtube videos about how futile and absurd it was to ventilate lucid/non-distressed SARS-CoV-2 patients, solely on the basis of their oxygen saturation meter readings. Later reports from the front line said 'hey we're doing much better not ventilating our COVID-19 patients even when their oxygen saturations are super-low...'
> and even then, a large percentage who reject it outright (e.g. the number of people who reject that calories are the primary determinant of weight).
/methinks it is simplistic and wrong to decree that a calorie is a calorie.
My working hypothesis is that bad medical advice is the primary etiological factor behind most cases of morbid obesity. Decades ago the medical industry decreed saturated fats as the cause of heart disease, and advocated fat-free diets, or low-saturated-fat diets failing that.
Butter has been vindicated of the charges against it, but I have yet to see an official apology for giving bad advice. Indeed, the heart profiteers are still [1] flogging a dead horse [2].
My retired-MD uncle recently came to visit, and shared that he now makes his own salad dressing to avoid the cheap oils in commercial salad dressings. He had some great stories of patients he'd helped (trauma from car accidents and knifings), but also of exercises in medical futility (e.g. cancer).
Why doesn't conventional medicine warn patients of the hazards of cheap oils? Now is the perfect time. You could refer to Wikipedia's article on Prostaglandins [0], and speculate that minority America's overconsumption of Omega-6 oils is one factor in their susceptibility to the SARS-CoV-2 (emotional stress is another factor).
[0] https://en.wikipedia.org/wiki/Prostaglandin
[1] https://www.heart.org/en/news/2018/05/01/advisory-replacing-...
I was 18 and near the height of physical perfection.
As far back as 10 years old I remember feeling miserable every single morning even after getting a full night's sleep.
At age 35 I got a CPAP and finally fixed a quarter century of piss-poor sleep.
I remember reading not too long ago on HN an article about our dental health in modern times: https://www.scientificamerican.com/article/why-we-have-so-ma...
It could be our diet contributing to smaller jaws/palettes that increase the prevalence sleep apnea?
This book was published in 2018, and it's not yet common knowledge. Doctors I have been to don't get it, I have doctors in my family that don't get it.
It's historical and scientific, but it has a lot of practical implications for raising children too. A child's facial structure is surprisingly malleable (by lifestyle), and it determines how they breathe, which in turns affects everything else. Just like food, breath is at the base of your physiology, and affects all aspects of your health (dental health, mental health, and more!)
-----
Summary:
Agriculture and diet are fundamental reasons behind recent and huge changes in our jaw and airway development. They change us faster than our genes do. (epigenetics)
Another profound change that is faster than evolution is the development of speech.
In other words, apes and dogs don't have sleep apnea because they don't have agriculture, and they can't vocalize like we do. It's a crazy problem that requires an explanation -- your throat and neck tissue literally strangles you while you're sleeping, giving you heart attacks and many other problems.
There are a lot of practical implications, like breathing through the nose rather than the mouth (another article about this was recently on the front page of HN), and what foods you and your children eat.
[1] https://www.amazon.com/Jaws-Hidden-Epidemic-Sandra-Kahn/dp/1...
There are a bunch of other books that touch on the related subjects, like "The Dental Diet", "Sleep Interrupted", etc.
Part of the thesis is that braces and wisdom tooth removal are overapplied. People who disagree with that have to answer why ancient people and animals don't need similarly large amounts of dental work (answer: their jaws are a lot healthier than ours due to their environment.)
A related but separate issue in children is mouth breathing, and the chain of causation is also explained in the book.
I've asked my optometrists and orthodontists what cause these problems and just got shrugs and big bills.
I was a HUGE snorer and rarely felt fully rested from 8 hours of sleep, woke up sore etc. Now my quality and quantity of sleep is totally different, it's really amazing.
It might not solve everyone's problems, especially if you have something really badly wrong, but it's a near-free, easy intervention and it probably won't hurt you to try it for a few nights. They make fancy tape, purpose-built for this, such as [0], but you could probably also use scotch tape or masking tape or whatever you have.
Also interestingly, after 2 weeks of taping, I developed the habit of sleeping with closed mouth even without the tape, so arguably this has cured my snoring permanently. This is the closest thing to "one weird trick" which I've ever seen in real life.
I found surgical micropore tape to be best. It's cheap, breathable, and easy to obtain. From trial and error, my two main recommendations are to first apply it to the back of your hand to reduce the adhesiveness, and fold a corner over before applying. Both of these make it much more convenient to remove, particularly if you need to do so in a hurry (e.g. needing to sneeze).
I use dminder to track my estimated vitamin d levels.
Incredibly uninformed.
This is a really dangerous comment.
Yes, it's true that, for some, weight loss is all that's needed.
There are people who need CPAP and no sort of 'lung capacity' and musculature exercises will help. A former coworker even had central sleep apnea. Exercise that.
Exercise helps with everything, but it doesn't mean one will be cured and stop needing CPAP. CPAP isn't that profitable even, considering how long the machines last and that supplies can be found elsewhere, so there's little incentive for medical providers to push them. In fact, in some countries, you'd be hard pressed to find insurers providing CPAP machines, as they are expensive.
The only ROI they might have is with less future hospitalizations due to serious conditions. Untreated sleep apnea can massively increase the chances of heart attacks, strokes and many other conditions.
There are specific swimming exercises you can do, as part of a routine, that build lung capacity.
(Results may not generalize. It worked for me.)
Not that I don’t love didgeridoo music :-/
[1] https://www.amazon.com/Meinl-Percussion-DDG1-BK-Didgeridoo-P...
I love the didgeridoo. One of my favorite albums to listen to while working is Aphex Twin's 'Digeridoo'. It's worth checking out.
I've had fitful sleep as far as I can remember. I wake up (and remember it) probably 4-5 times a night and I've been told I toss and turn all the time. I find if I take a calmant or a substance I can sleep through the night.
I have chronic inflammation includes Achilles' pain just as you describe. I'm in my lower 40's. I'm also a weightlifter and I do calisthenics - both of these activities 4-5 times a week. Oh, but I sit in front of a PC 12+ hours a day!
It’s worth getting checked out. I ended up going the dental appliance route because CPAP machines feel like a torture device to me. Anecdotally it’s made a noticeable difference. Haven’t had a nap in ages.
[0]: https://somnomed.com/en/dentists/somnodent/somnodent-air/
My 5 days a week, btw, is not 5 days of very long workouts. This is a tangent but I used to do 3 days of 1.5+ hour workouts including heavy weight training (squats), and HIIT or other conditioning. All functional movements, no bodybuilding or anything. Now, I do 5 days a week of short 25-35m workouts. My body composition is way better and I feel less pain overall.
I spent 2 extra years barely half awake because I thought that, being thin, I could not have sleep apnea. Nor did I wake up gasping.
The 4 main risk factors are overweight, being male, over 40, and current or past smoker. But some get it while being 0/4.
Sleep apnea is one of the best serious medical conditions you can have, since the CPAP machine fixes it completely, with very minor discomfort!
Then a week of CPAP machine for free to feel if it's helping (I feel no improvement, although wife said there was no snoring with the machine).
If you stick with it, you should see some benefits, such that if you cease using it for a night, you will notice the effect. Good luck.
I've been using CPAP for 9 years now and I can't imagine my life without it.
https://www.wordnik.com/words/fitful
I am not a native speaker and had to look it up.
I'm being totally serious here. If you carry a wallet around in the back pocket of your trousers/pants/jeans whatever, and it's full of junk - even if it's not - and you have chronic back pain, stop doing that! Put it in your front pocket or jacket. Anywhere. I assure you, it's very likely to be causing problems for your lower back.
As a test, just switch the wallet to the other side and sit down. It will either feel great or hurt immediately.
> UC Berkeley sleep scientists have begun to reveal what it is about fragmented nightly sleep that leads to the fatty arterial plaque buildup known as atherosclerosis that can result in fatal heart disease.
This is a causal claim, emphasis mine, which contradicts:
> “To the best of our knowledge, these data are the first to associate sleep fragmentation, inflammation and atherosclerosis in humans,” said study lead author Raphael Vallat
which is a correlative claim, emphasis also mine, and they use "linked" throughout the article, which is also correlative.
So does fitful sleep "lead to" chronic inflammation and arterial plaque, or are chronic inflammation and arterial plaque simply typical of people in poorer health and/or overweight, which can itself potentially cause sleep disorders, ie. a correlation? I'm not sure we know the actual root causes here.
> “Indeed, these associational results in humans mirror recent data in which experimentally manipulated sleep disruption in mice led to higher levels of circulating inflammation that caused atherosclerotic lesions in the rodents,” added Vallat.
...which sounds like the real research.
1. To demonstrate a causal pathway
2. There was not a previous correlative claim that this merely strengthened
Also, given it's in an open access journal, you can trivially verify from the source rather than rely on a press release. "we describe a pathway wherein sleep fragmentation raises inflammatory-related white blood cell counts (neutrophils and monocytes), thereby increasing atherosclerosis severity" [https://journals.plos.org/plosbiology/article?id=10.1371/jou...]
> "A first limitation is that our analyses were constrained by the use of cross-sectional data, which precludes definitive assessment of directionality of associations. For example, it could be that cardiovascular disease (or associated treatments) may also drive sleep fragmentation in addition to, or rather than, the other way around."
I take Webber Super Sleep (available at Costco). Has Melatonin, 5-HTP (serotonin precursor), and L-Theanine. Seems to help
Now I just need to get my diet under control and exercise regularly...
Although, I wonder _if_ the false dichotomy were entertained, what will contribute to quantity and quality of life more.
You should absolutely get your diet under control and build a consistent exercise routine in the long run. But both of those things will be very hard to do without the proper dose of high quality sleep every night. Without proper sleep you'll be fighting your own body every step of the way. Every positive health outcome gets harder to achieve without sleep, not easier.
For most people, making major, permanent lifestyle changes is much harder than using a CPAP machine. For people with chronically disrupted sleep, that gap is even wider.
Healthy diet and exercise are free in principle, but you have to choose extremely cheap options for them to actually be cheaper than a CPAP machine in practice.
It's not really "better for" someone with OSA because lifestyle changes alone only have a small effect on OSA severity. It's like going on a low-sodium diet when you have hypertension: it's not a bad idea, and it's almost always good for a few points of improvement, but only an utterly incompetent doctor would recommend it as the sole treatment.
I'm grateful it worked for me and hate that it didn't work for you. I hope you find a solution that does work because it will change your life.
We were more of a cat family and I was too young to remember when we got our dogs. I did not understand that romcom trope of buying a man a puppy to see how he'd fare as a father.
Then we got a puppy. Ho. Lee. Shit.
New puppies make it about half again as long as a baby before they wake you up, and take much less time to settle down to 6+ hours of peace and quiet (where you can go to bed early and your partner can do the late shift), but man are you a zombie for a while.
The Dalai Lama, when asked what surprised him most about humanity, he said:
“Man.
Because he sacrifices his health in order to make money.
Then he sacrifices money to recuperate his health.
And then he is so anxious about the future that he does not enjoy the present;
the result being that he does not live in the present or the future;
he lives as if he is never going to die, and then dies having never really lived.”If you don’t mind can you share what the disease/effects are and why you think it’s caused by lack of sleep when younger?
It is not easy to say what begets what effect, but it's true that sleeping well and working/commuting less has been the only way to take back control of my life.
It stays on for me (medium to large size head, or so I think) -- tends to ride up on my forehead a bit over time but never had it fall off. It's got some adjustments that can be made to tighten/loosen the fit, on top of which there is some elastic in part of the band.
My specific issue: I get up in the night to urinate consistently at least 1-2 times per night, and then usually have a very difficult time getting back to sleep -- since my body seems to think it's time to wake up at that point, and starts thinking about literally everything. I'm a fairly anxious person by nature as well, which doesn't help my situation.
It seems as though there's a vicious cycle that I don't know how to deal with well, where I have a bad night of sleep, then try to go to bed early the next night, but it doesn't seem to help, and it messes up my sleep schedule a lot, which leads to even more problems.
I'm in the middle of what dreem calls their "sleep restructuring program", which is based on CBTI. What it's having me do right now is basically restrict my sleep to a short 6 hour and 45 minute window, with emphasis on a consistent wake time. The idea is to focus on increasing sleep efficiency -- basically time asleep divided by time in bed. As you increase sleep efficiency it gradually widens the sleep window.
In addition it's having me form other habits around night time awakenings like not staying in bed if I can't get back to sleep to short circuit the association between wakefulness and being in bed.
I can't say whether it's helped for sure yet (my sleep efficiency has gone up in the past 2 weeks from 70ish percent to mid eighties), but even with the reduced time in bed I do seem to have about the same energy as I did when spending much more time in bed.
I've found this book (https://www.amazon.com/Mind-Illuminated-Meditation-Integrati...), at least the earlier stages to be quite helpful in regaining control of my thoughts.
After being burned a few times, I've resolved to make hardware purchasing decisions based only on what a device can do using built-in/self-hosted software without any external services...but vendors make this difficult or impossible to figure out from the marketing glossies.
And honestly that's fine for me. I don't plan on using this forever, I mainly got it since it is far cheaper than going through an actual therapist to do CBT for insomnia, so I figured I'd try this first.
Another thing to consider: It's definitely a wear item. It's got a fabric construction on the outside that seems to me like it will collect body oil + dirt/grime and it can't easily be cleaned. On the whole it feels kind of delicate. To be fair though, I don't know if it's possible to make a long lasting eeg based sleep tracker that's also comfortable to wear.
https://www.reddit.com/r/ouraring/comments/e3l1jl/30_nights_...
Just found this code online for a 20% off NOOEONDVV
Chronic dietary inflammation (which just means foods that your body doesn't like) can have a whole host of subtle effects you would never notice until they are absent.
Sleep routine is the most essential thing to fix if you have resolved all your basic needs. It creates a feedback loop that helps to reduce stress and improve health.
I've learned this the hard way - you shouldn't have to.
How did you fix it? I suffer from asthma and frequent urination issues, both of which wake me up several times a night. It doesn't seem to matter much what my routines before sleep and after waking are if I am involuntary woken during sleep, and I'm stymied for a solution.
1. https://www.wsj.com/articles/the-healing-power-of-proper-bre...
2. https://www.colorado.edu/today/2019/02/25/novel-workout-impr...
Thanks! I've been interested in that WSJ article, which I've seen elsewhere, but it's paywalled. Do you know if the relevant breathing exercises are discussed elsewhere?
Hoping you can find a solution!
* don’t drink before bed
* During the day, practice going longer between peeing
* When you go pee, sort of imagine yourself still dreaming, and stop all daytime thoughts. Goal being to get back to sleep more easily
* Check light sources and anything else which may disturb sleep. Often you may need to pee upon waking and yet it may not have been the reason you woke
* A sleep tracker is always useful to help troubleshoot
* Talk to your doctor if you haven’t. Nocturia is associated with other health issues and early mortality.
I also suffer from asthma, you shouldn't be woken multiple times a night from it! That's very severe if it's happening with any regularlity and you should speak to a GP about it.
I agree. Unfortunately I don't have a GP, and now's a hard time to get in as a new patient.
See earlier comments on CPAP machines.
I also have a daily exercise regimen (road biking) which has - somewhat counter-intuitively - led to a decrease in asthmatic symptoms (I still take meds, just a lot less frequently).
Also, as mentioned here and everywhere, alcohol destroys sleep. I've (mostly) stopped drinking for sleep reasons, and drink nothing at all 1.5 hours before bed.
[1] https://www.amazon.com/gp/product/B07DSTZ4KM/ref=ppx_yo_dt_b...
I recorded myself overnight and heard quite a bit of snoring, so I picked up a at-home sleep study kit, convinced that I had sleep apnea. The results were that I didn't, classified my O2 intake as normal, and my snoring threshold as low.
I'm at a loss as to what do now. I have been practicing good sleep hygiene and exercising, but now I'm at the point where I'm asking my doctor for a prescription because I'm just so desperate for a night of sleep.
And is there a reason to suspect causality goes in the direction implied in the article (i.e. bad sleep -> plaque) and not (i.e. X -> plaque and X-> bad sleep, where X could be stress or emotional state, etc.)?
There are plenty of milder, better-researched solutions suitable for longer term use without associated cognitive problems of cannabis. An extremely low dose of Trazodone, for example.
Any recommendations for a good sleep tracker?
edit:- already answered https://news.ycombinator.com/item?id=23431549
tl;dr dreem is the best sleep tracker you can buy currently. Review at reedit https://www.reddit.com/r/ouraring/comments/e3l1jl/30_nights_...
You can use the promo code to get a 20% off NOOEONDVV
https://peterattiamd.com/matthewwalker1/
The single best thing that improved my quality of sleep was a ten-minute meditation before bed. I have anxiety (albeit officially undiagnosed) and meditation helps me stay calm. It also helps me stay asleep. Without it, I wake up in the middle of the night.
It's too bad they did not tease out the effects of taking antiinflammatories as well as sleep aids like benadryl, quill,etc.