Comment by elric | Hacker News Reader

Comment by elric | Hacker News Reader

CPAP isn't anywhere near as awful as people make it out to be. I suspect many of these "CPAP sucks" stories come from people who (for whatever reason) are given a cheap, shitty mask and a cheap, shitty & loud machine. Masks used to be really bulky and unpleasant. Machines used to be pretty loud. These days, machines are nearly whisper quiet and masks come in more varieties than I care to list. I mean sure, there is an adjustment period. And sure, given a choice, I'd rather not have to wear one. But as far as annoyances go, it's pretty minimal.

If you're ever put on CPAP, take your time (and dime) looking for a mask that feels right for you. If your doctor/insurer/whatever only covers shitty ones, then pay for it out of pocket (or try to work out a deal). There's a ~100% chance the first mask you try won't be right for you.

Edit/addendum: the article talks about loud snoring. That's true for many, but definitely not all. You can have sleep apnea without snoring.

It's been 10+ years since I tried CPAP, but I could never get to a place where I'd sleep through the night with it on. I'd always take the mask off in my sleep. I tried more than a half dozen different masks and I could never get one comfortable enough to sleep with. It always felt like it made the situation worse.

Over the years I think I've been to 4 different doctors for sleep apnea. Had 3 in lab sleep studies and a few take home ones. I always came away somewhat skeptical of any data obtained from the sleep studies, especially the in lab ones. The situation was just so different from how I'd normally sleep.

I only have mild sleep apnea and I'm not overweight. So I ended up going in for surgery twice, with different doctors. Got a turbinate reduction, so I could breath through my nose better and they somewhat straightened a deviated septum. Had the pillar procedure, and got a mouth guard made.

The mouth guard has changed my bite, but overall it does improve my subjective sleep quality, and objectively, the stake home sleep study showed substantially improved numbers. Though I'm told I'll still stop breathing and gasp for air in my sleep. So It's improved on the issue but not eliminated it.

> I only have mild sleep apnea

Disclaimer: I don't want to rain on your parade, and I'm happy that you feel better. But for everyone who isn't you: the way I understand it, there's no such thing as mild sleep apnea. I mean sure, everyone gets a couple of apneas every night, that's fine. But "mild" apnea is defined by 5-15 apnea/hypopnea events per hour. That's an average over the whole night. Usually apnea is worse during REM sleep. And each event comes with a (micro-)arousal. If you're waking up 5-15 times (or more) during REM sleep, you're not getting much actual REM sleep, and your sleep quality is destroyed anyway. Reglardless of the "mild" diagnosis. REM seems to be an important part of sleep.

As an aside: I wish it were easier to get a deviated septum fixed. Seems like the Russians have a laser treatment which can (non-invasively) increase the plasticity of the cartilage so it can be straightened, but AFAIK it's only available in Russia.

The problem starts with the doctors. Regardless of who paying, if your doctor says "here's a thing, use it" you assume (because they are a knowledgeable specialist) that it's the "right thing". Most people don't/won't know if they've actually been prescribed the best option.

Not too long ago I went through this adventure and my experience with the ENT was terrible. Fortunately I was in a position where I could do an end run around the system and get something better, both machine and mask.

I still had a not-great experience, even with better gear. The adjustment period just never went away. Maybe a better doctor would have solved it, but I'm sure that for some people, the CPAP's just aren't a great experience at the best of times. Options are always good.

The biggest up-side to this mouth guard option is that it can be available to a lot more people for a lot lower cost.

I agree. You pretty much have to be your own doctor. With sleep apnea at least, it's pretty easy. There are tons of great resources out there. The CPAP machine captures a lot of useful data which you can use to tailor your experience (insert big fat disclaimer here).

When my allergies act up, I increase my pressure. When the air is dry, I decrease my pressure. When I've got a cold, I use a full face mask. When I'm feeling fine, I use a nasal mask. These are super simple things for me now, but these are non-obvious for someone who just got sent home with a CPAP machine -- and who is often told to never touch the pressure settings.

Getting my sleep apnea treated was probably one of the best choices I've ever made, but there's no denying the fact that it comes with downsides. I have to bring a machine to wherever I sleep, I have to maintain it decently, I will suffer worse sleep whenever I have no possibility of connecting the machine to electricity (i.e hiking). I will gladly use it, but I would prefer a cure over constant ongoing treatment.

It took me a month to get used to CPAP. But my apnea was so severe I knew I'd die without it, so I stuck it out. On day 31 something in my brain clicked and from that point on I couldn't sleep without my CPAP.

That was 20 years ago. My latest CPAP is the size of my hand and doesn't need a water tank. Its only problem is that it uses 20VDC so I need to build a boost converter that will run it from RV power when I camp.

Truth.

My CPAP machine is the best thing that ever happened to me!

Also, a lot of people may not just need a CPAP machine but a more advanced bipap machine that also pulls instead of just pushes.

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