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Comment by kimjune01 | Hacker News Reader

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 tongue tie? Self assessment https://do-i-have-tongue-tie.vercel.app/

Didgeridoo playing as alternative treatment for obstructive sleep apnoea syndrome: randomised controlled trial https://pmc.ncbi.nlm.nih.gov/articles/PMC1360393/

Myofunctional Therapy to Treat Obstructive Sleep Apnea: A Systematic Review and Meta-analysis https://pmc.ncbi.nlm.nih.gov/articles/PMC4402674/

Jawhacks on Youtube, discussing Airway health https://www.youtube.com/@JawHacks/search?query=sleep%20apnea

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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 advancement - to move your jaws forward, which physically enlarges your pharyngeal airway which is where the actual collapse happens. Collapse that shouldn't be able to reach the point of increased airway resistance with a skeletally sound airway.

Many people also have nasal breathing issues, and while this can be caused by a deviated septum or severe turbinate hypertrophy,usually nasal throughout correlates with the cross-section of the nasal cavity, which is most effectively addressed by bone-borne(not tooth-based!) palatal expansion.

>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.

The only maxillomandibular advancement with which I'm familiar is a surgical procedure, rather than an exercise therapy. It involves repositioning both the mandible and your upper jaw (as the name implies) by cutting and repositioning both.

Chances I'll be getting surgery are 0%, so it's retainer and exercises for me.

> CPAP helps, but it doesn't address the root cause. Fixing it is a matter of airway geometry, with many obstructions along the way.

It's not as simple as you make it seem. There are some things that are "easy" to fix, like a deviated septum, but surgical treatments are often very complex, very expensive, come with a lot of risks of complications, and in some cases only last for a limited amount of time.

> Didgeridoo playing as alternative treatment

Apart from the practical issues (who wants to spend half an hour playing the didgeridoo every day?), it's not a solution. The majority of participants in the trial still had an AHI of 11. Their sleep is still shit, their long term health is still impacted.

> Myofunctional Therapy to Treat Obstructive Sleep Apnea

Same thing. A reduction in AHI of 50% is impressive at face value, but it's not a solution.

It would be great if everyone on CPAP would be offered a comprehensive programme to strengthen their airway. If this could lead to reduced pressures for instance, that would be great. But neither study looked into that, which is a shame.

What do you former wrestlers do?

Idk how to target loss in just my neck.

Im pretty sure my neck from teenage wrestling and my adult hobby of bjj is messing me up a little .

Also annoying for getting fitted shirts lol

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.

The FAA decided not to medically clear me over my severe apnea last year. Soul crushing moment.

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