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As a first-line treatment, I urge anyone who either snores, or is just fatigued after sleep, to try a nasal stent/dilator. This isn't the strips which go on the outside of the nose, although those work for some people, they're less effective. I use the Rhinomed, but there's several brands, that's just the first one I got, and if you drop them in a small bowl of water in the morning and rinse them off a few hours later, they'll last forever. It's just a little piece of medical-grade plastic which you stick in both nostrils, and it props them open.

Some people are are going to need a CPAP, but trying the nasal stent doesn't take a sleep study, insurance, or a machine which you plug in and maintain: it takes twenty bucks. Probably don't jump straight in to using it every night, it takes the nostrils awhile to get used to them, but I have no discomfort at all starting around the second week of using them.

I would even go so far as to say everyone should just pick them up and try them out. One benefit that never occurred to me is that when I have mild congestion, the mechanical action of the stent will drain it, and no one sleeps well with a stuffy nose. Getting more oxygen per breath while sleeping has no downsides, even if you think you don't need it. If you ever wake up with one sinus filled with mucus, definitely give it a try.

I don't understand how these types of devices are supposed to help, as it's not my nostrils that get blocked, but the far back of my throat.

They mechanically open the nostril, which resists sinus closure, and that has knock-on effects for the rest of the respiratory tract. Nostrils basically don't block unless you stick something in them, but sinuses do, and opening the nostril helps directly with that. As a sinus starts to fill or close, it gets harder to pull air through the nostril, and noses are pretty flexible, so the passage narrows, which further narrows the sinus. Eventually you have a blockage, and start mouth breathing, and that's what triggers the blockage you're referring to. Sinuses serve an important purpose in humidifying air, which is important for the proper function of tonsils, especially the adenoid: adenoidal swelling is the major cause of apnea, and dry air from mouth breathing can easily trigger it.

It doesn't work for everyone, and some people are just going to need a CPAP. But it's a no-commitment intervention of negligent cost, and if it works, that's a much better outcome than needing a CPAP and everything which comes with it.

But there are actual, demonstrable reasons why it can serve as an alternative to the CPAP for some number of people, it isn't just woo. I hope I've done a good job of explaining why that is.

Don't forget about humidification, If you wake up with dry mouth, a CPAP machine can also help with that. Having a dry mouth causes all sorts of other crap as well. It makes it easier to get sick, and can cause issues with your teeth as well.

Humidifier and air filter is huge for sleep.

So is dropping your bedroom temperature.

Our bodies drop temperature before sleep to signal sleep as well, and the timing of that seems to be important to consider when sleeping.

>Our bodies drop temperature before sleep to signal sleep as well, and the timing of that seems to be important to consider when sleeping.

I find this so annoying because I notice. Oh shit I'm cold, it's that time of night my body temperature is dropping and I'm definitely not going to be in bed in the next 15 minutes. And then I'm awake for the next 5 hours and have terrible sleep because I missed my window.

Waking up with a dry mouth in the morning can happen from drinking too much water per day without sufficient electrolytes (i.e. more than 5 liters of water a day)

After the recent CPAP recall, and keeping in mind that many problems don't result in a proper recall, I would suggest avoiding a CPAP if your reasons are trivial.

You can't get a CPAP without a prescription (at least in the US).

You can get over-medicated by shopping around for a bad doctor, and with kick backs, you often don't have to shop very hard.

Bleh. I did exactly this and got a CPAP. I just can't fall asleep with it.

I've heard of possible surgery. Or that implantable device. Maybe I'll look into those.

I recently started using CPAP and one thing I noticed in the sleep study, besides all the other reasons it was hard to fall asleep, was that when they were doing the titration test to find the best initial pressure, they set it very low and then let it climb up once I stopped breathing at that setting.

The problem was, I actually found it difficult enough to breathe through my nose at that pressure that I would just keep myself awake because I couldn't relax with the mask on. It was kind of horrible and my technician didn't change it for hours. Eventually I started just intentionally snoring while awake to try to get her increase the pressure. No idea if she did but eventually exhaustion won out after around 4 hours.

So just a thought, but if you're using an autoset machine (APAP) maybe discuss with your doctor and make sure the initial pressure is high enough that you're able to breath comfortably through your nose when fully relaxed.

And also, you can experiment with different mask types depending on your sleep position.

My machine has user comfort settings. One of those is to adjust the ramp-up time. I set mine to zero - GIVE ME MY AIR!!! After that change I was able to easily fall asleep. It was difficult prior to that.

I can also adjust the humidity setting. I had to increase it a notch because I woke up in the morning with my nose running and sore - which means I was dehydrated (yeah, that wasn't how I interpreted that symptom).

After those two changes I was able to fall asleep quickly and not wake up with a sore and runny nose.

Had the exact same experience. I hated my CPAP at first, then after a couple weeks of pressure adjustments with my sleep doc, it was damn near perfect. Can't sleep without it now.

Get your tonsils taken out if you haven’t already, along with the uvula. The volume of other tissues in the back of your throat can be reduced, and a turbinate reduction can improve nose breathing as well. A good ENT can advise.

A good ENT will also advise against these surgeries if possible. It's very much last resort. Removing the Uvula can create serious swallowing issues for people and in general the surgery success rate is essentially a coin flip, with noticeable regret. But yeah, some people (pretty small percentage) just can't make a CPAP machine work.

Some ENTs might, others will advocate for the surgery depending on the patient. As always, get second opinions and do one’s research.

A key potential advantage of the surgical route is no need (or at least a many years delay for the need) of a CPAP machine, a very significant advantage. Also, the discussed surgeries have a high rate of success in reducing snoring in individuals who don’t have sleep apnea, which is another health benefit for both the patient and the patient’s sleep partner. Snoring is an under-treated condition.

You're also deep sixing part of your immune system. There are consequences you can read about, which studies you decide to believe is a personal choice. A better initial road to travel is to wonder why one carries so much inflammation in the first place and relentlessly fix it.

What kind of mask are you using? They first tried giving me the nasal pillows but I much preferred a full mask since it lets me breathe through my nose and mouth when I want. Your medical supplier should have a range of options for you.

If it's relatively minor apnea, the oral appliances do work. My wife has told me that my snoring has completely stopped when I wear it, and the snoring comes back if I forget. In combination with a fair amount of weight loss (about ~55lbs over the course of a year), I feel a lot better.

I use the walmart-brand breath-right nasal strips every night as well. I don't know if they actually do anything for me, but they're also inexpensive and they're not uncomfortable, so I figure it's an extremely cheap and harmless placebo if nothing else, and they certainly feel like they're doing something.

My wife wore those strips for years and is now having several cancerous lesions removed right where the adhesive was.

Huh, not saying you're wrong but I can't seem to find any studies into this.

Obviously I don't want cancer on my nose, so I would actually like to see how correlated these things are.

+1 on the oral appliance. They took a mold of my teeth/jaws and it took a couple of weeks to get it.

All it did was make my lower jaw jut out a bit. It sufficed. Apnea kaputt!

Out of curiosity, how much of what a CPAP addresses could also be addressed with weight loss and increased fitness levels?

(I have many similar issues to the symptoms you describe, but I know they're all essentially attributable to my personal fitness level.)

CPAP machines are pretty incredible. Sleep Apnea also destroys your lungs and puts you at much higher risk of a variety of lung diseases over time. Your heart, lungs, mouth, and significant other will thank you.

I don’t have an SO to notice this but I should do this (or at least record myself sleeping). Brushing off things with “getting older” (…who above the age of twenty isn’t?[1]) when they can be dealt with is a shame. Dying too I guess.

[1] Yes the age 25 seems to be the general peak, but people under that age can still complain about wrinkles.

As a quick smoke test to see how bad your snoring is, you may want to look into the smart alarm app 'Sleep Cycle', which records snoring events.

Any voice recorder would do, even a digital one on any smartphone.

Thank you, this was exactly what I was planning to search for later. And now that I know what to install I will go through with it too instead of procrastinating.

Sleep Cycle is great, +1 to this rec! I’ve learned a lot about my sleeping patterns from it, including breathing / coughing and depth of sleep too.

check out SnoreLab (https://www.snorelab.com/), i've used it and can recommend it

i know this might be a personal question, but are you overweight?

In the article it has been mentioned that obesity is not a risk factor for sleep apnea.

not my experience in clinic

You can be overweight without being obese.

The strange things is why has there been a huge change in so many people being diagnosed to get cpaps?

I had a snoring problem, I was asked to take the test and failed it, no cpap.

Turns out I may have just been not sleeping enough.

might have a physical issue with my nose like I mentioned to everyone.

Conspiracy Theory backed up by almost no proof: CPAPs MAY soon not be regulated as a medical device, so CPAP companies are partnering and opening more sleep centers and pushing for more sleep studies so they can get their ($800-2000) for what is basically a fan that blows a low pressure stream of air into your nose/mouth.

I have a CPAP, I've not noticed anything better about my quality of sleep, or the soundness of my sleep. The only thing it has prevented is my snoring. My sleep studies (did 2 of them - one didn't record my blood oxygen) showed I get ~10 (8 on first, 11 on second) apnea events a night. I still do (according to CPAP) (1.12/hr on average).

As a comparison, my wife gets 3/hr now, and her sleep study showed she had over 200 events per night. She LOVES her CPAP.

Interesting. Maybe it's not just about not being a regulated medical device, but who pays for it (insurance). So maybe the conspiracy that's tru is the payers can be expected to not want to have to pay so much, or so often.

I'm very happy for who CPAP works for.

I have lots of friends who's quality of life it improves.

Had a doctor friend even recommend it to me.

I took the CPAP test from a said sleep centre as referred by my doctor just to be present. Wore the machine 3 times.

The folks who in my life swore I had some issues with sleep (including my partner), including loud inter floor snoring, oddly reduced or resolved themselves to some degree as soon as I started paying attention to my sleep and body.

Snoring it turns out can also be a magnified by being over tired.

I just wasn't sleeping enough, and while I felt sharp enough to work and live, my body needed a breather when there hadn't been a vacation for a few years. A few days off here and there yes, but sometimes that's not enough.

My source, I know an engineer that works on them.

First of all they are medical devices, some people can't safely sleep without them, and those people might be unconscious, in surgery, and/or heavily medicated. So that means audits, special testing requirements, etc.

Next medical requirements are quite varied, some are just "assist", some are constant velocity but variable pressure, others are constant pressure and variable velocity, some control breaths per minute, and other setting control total volume. Various health problems, surgery recovery, etc have different requirements. There can be temperature and humidity requirements as well.

So you need a pretty healthy fan to handle all the static and dynamic pressure requirements that are sometimes constant RPM or variable.

Of course all the above need accurate sensors, failures could hurt someone's lungs. Good sensors require laminar flows. Laminar flows get harder with a wide range of pressures, speeds, and volumes.

So it ends up quite a bit more than "a fan that blows a low pressure stream".

Every smart watch/wearable device has some kind of sleep tracker now. Newer ones have pulse oxymeters.

Even if they are inaccurate, they are making a lot of people self-conscious about their sleep.

- Why is my sleep score only around 50?

- Why is my HRV lower than everyone elses?

- Why does my pulse ox regularly fall to the 80s?

Some of these people are going to seek medical advice, and some will be prescribed CPAPs.

As far was why people seem to be having sleep apnea more, I like the theory that it's related to weaker jaw muscles in proportion to our bone structure, caused by the modern diet of eating softer foods. But it's a current area of research.

Great point.

I thought about Oura rings as well, heard good things about them

Along with what everyone else is saying I think there are a few additional factors:

- The population is getting older

- The population is getting heavier

- There's a greater general awareness of sleep apnea and its seriousness

- Today's CPAP machines are smaller, quieter, and easier and more comfortable to use than those of yesteryear, so doctors know their patients will be more receptive to the treatment

It goes without saying, but for places where there's public healthcare, Demand for CPAPs are also a business.

Having good oxygen to breath, and being able to breathe it are really important.

Some people discover they may have a deviated septum or something else so anything physiological is good to get right long before you need it.