[HN Gopher] Night of the living brain fog dead or how I hacked m...
       ___________________________________________________________________
        
       Night of the living brain fog dead or how I hacked myself better
       via open source
        
       Author : decodebytes
       Score  : 450 points
       Date   : 2023-04-10 11:10 UTC (11 hours ago)
        
 (HTM) web link (decodebytes.substack.com)
 (TXT) w3m dump (decodebytes.substack.com)
        
       | pengaru wrote:
       | If you share a bed with someone you don't need any of this tech
       | b.s. to know you're choking yourself awake dozens of times an
       | hour.
       | 
       |  _Listen_ to the people you actually share a home with if they
       | inform you you 're not sleeping well (and are probably
       | interfering with their sleep too).
       | 
       | - Someone who grew up in an utterly dysfunctional household in
       | the sleep quality department. Denial so deep, unreliable
       | "science" would be abused as "proof" of there not being a
       | problem.
       | 
       | ** hearing loss is another one; if your hearing has become so bad
       | you mishear much of what your family is saying to you... esp.
       | with a bias for the negative/combativeness, often promoted by
       | consistent lack of sleep (surprise!), get an effing hearing aid
       | already. You're destroying your relationships with your family.
        
       | mrtweetyhack wrote:
       | [dead]
        
       | s5300 wrote:
       | Dealing with untreated sleep apnea right now & it fucking sucks
       | 
       | Breathing properly through your nose when awake & asleep turns
       | out to be really important. I'm incredibly curious on how
       | previous generations knew & the term mouth-breather became a
       | thing, as they were obviously (well, if you've never experienced
       | long-term inability to breathe through your nose, maybe it would
       | be hard to understand the severity of the cognitive impact this
       | has) quite right.
        
       | b1c1jones wrote:
       | I saw an otolaryngology, got a sleep study, was prescribed a cpap
       | with the study recommended pressure, and I am fine. I suppose I
       | could have wandered the tech desert, but this is my health we are
       | talking about. I have other tasks I am better suited to do than
       | wander through a field I had zero training in. I approach my
       | cardiology issues the same way.
        
         | joshuaissac wrote:
         | > but this is my health we are talking about
         | 
         | I think that this is the point of the article. In the end, you
         | are responsible for your own health. From the article:
         | 
         | > I am in the system for NHS treatment, but things are so bad
         | that I have not even received an inital letter with a date for
         | a test. It would likely take up to year for the NHS to treat
         | me.
         | 
         | So he could have just waited, trusting that the professionals
         | will eventually diagnose him and give him the right treatment.
         | 
         | But it was his health, so he had a strong incentive to take
         | independent action.
        
         | ruste wrote:
         | The author is in the UK. They noted that they were on a wait-
         | list just to get tested and likely wouldn't be for a year at
         | least so they decided to take it on themselves.
        
       | agrue wrote:
       | Sleep apnea is strange.
       | 
       | Good news! We have a diagnosis, sleep apnea. You're bad at
       | sleeping now, the thing everybody has to do all night long every
       | day since birth. The solution is to wear a modern iron lung
       | whenever you want or need to sleep forever. Many times it's
       | because people are overweight but you aren't.
       | 
       | Is that really all there is for treatment? No throat exercises or
       | therapeutic sleeping positions? No diets? No botox injections for
       | your uvula or a daily pill to obviate breathing while sleeping?
        
         | redundantly wrote:
         | > The solution is to wear a modern iron lung whenever you want
         | or need to sleep forever
         | 
         | Calling it an iron lung is extremely disingenuous.
         | 
         | The Iron Lung uses negative pressure and had to be used 24x7 to
         | keep the patient alive because their lungs weren't able work on
         | their own. They had no mobility and were confined to a bed for
         | the rest of their lives.
         | 
         | CPAP / APAP machines use positive pressure and only assist with
         | breathing while asleep, when apnea events occur. It does not
         | replace lung functionality, it only assists.
         | 
         | Yeah, having to use a CPAP/APAP at night can be bothersome,
         | some people have a very hard time adjusting to using one.
         | However, comparing it to using an iron lung is ridiculous.
        
           | agrue wrote:
           | > The solution is to wear a modern iron lung whenever you
           | want or need to sleep forever
           | 
           | Iron lung use was not 24/7 for all patients. Saying so might
           | be considered by some to be extremely disingenuous or even
           | ridiculous.
           | 
           | https://www.npr.org/2021/10/25/1047691984/decades-after-
           | poli...
        
           | sillysaurusx wrote:
           | It's hyperbole, but the comparison isn't without some merit.
           | My grandma stopped using it because it's troublesome, and
           | I've heard many people voice the same. Getting into an iron
           | lung each night would also be ... troublesome.
        
             | redundantly wrote:
             | You don't climb in and out of an iron lung. If you're using
             | one you're in it 24x7.
        
               | bethekind wrote:
               | Iirc iron lungs are better than CPAP, as the positive
               | pressure caused by CPAP, if too big can stress the lungs.
               | 
               | Iron lungs use negative pressure so they don't suffer
               | from this
        
               | agrue wrote:
               | Iron lung use was not 24x7 for all patients. Saying so
               | might be considered by some to be extremely disingenuous
               | or even ridiculous.
               | 
               | https://www.npr.org/2021/10/25/1047691984/decades-after-
               | poli...
        
         | mabbo wrote:
         | Diagnosed at 24 with sleep apnea. I tried a bunch of things.
         | 
         | What worked for me was regular cardio exercise and daily doses
         | of high absorption magnesium.
         | 
         | The magnesium is absolutely unproven pseudoscience nonsense
         | that can't possibly work. But if I stop taking it my sleep
         | suffers massively.
        
           | scruple wrote:
           | When I'm deep into half-marathon+ training, I (personally,
           | not scientifically) observe that I become zinc and magnesium
           | deficient. I simply will not recover, I will feel extremely
           | fatigued, etc. There's a lot of controversy over this, but I
           | more or less have to take ZMA to sleep at night, to remain
           | asleep at night, and to recover from the training load I am
           | putting my body through (I also carry a 2-3x per week lifting
           | load regardless of my running schedule).
        
           | telchior wrote:
           | I take magnesium for migraine and vertigo. Very much not a
           | believer in supplements -- before this, I went through years
           | of specialists prescribing various pharmaceuticals with
           | various side effects. These days the problem is under control
           | without any meds; I just take magnesium (specifically, a mix
           | of l-threonate, glycinate and taurate), telling myself every
           | day that it's probably unrelated to my feeling better. Like
           | you said, it couldn't possibly be working as well as it seems
           | to. But if I stop, my condition mysteriously gets worse. If
           | it's a placebo.. eh, who cares?
        
             | s5300 wrote:
             | >> Very much not a believer in supplements
             | 
             | ...why?
             | 
             | Vitamin, mineral, and nutrient deficiencies are a very well
             | known science.
        
           | docandrew wrote:
           | I've read that a lot of people, especially men, are deficient
           | in magnesium. It's an essential mineral so I wouldn't call
           | your use of it pseudoscience by any stretch.
        
           | br3akaway wrote:
           | Could you share your magnesium preparation and dose? If you
           | are deficient in magnesium, the mechanism I would guess is
           | that neck muscles are unable to relax and constrict the
           | action of weaker muscles used for breathing.
        
             | mabbo wrote:
             | https://drbvitamins.com/products/doctor-s-best-high-
             | absorpti...
             | 
             | That's the good stuff. Constantly hard to find in Canada.
             | 
             | Edit: also this is literally the first time anyone has ever
             | provided me with any idea if why it might actually work. So
             | seriously, thank you for that.
        
           | akira2501 wrote:
           | > The magnesium is absolutely unproven pseudoscience nonsense
           | that can't possibly work.
           | 
           | With so many systems in the body, you really have to wonder
           | how many people actually have a _single_ issue that's causing
           | _all_ their problems. It's much more logical that your
           | experiences are the result of emergent phenomenon from the
           | interaction of multiple issues. In that case, perhaps you're
           | simply treating a secondary condition that's vastly improving
           | the outcomes with what you view as your primary condition?
        
         | elric wrote:
         | Nothing works anywhere near as well as PAP therapy. Certainly
         | not diets (overweight is often an effect of apnea, not a
         | cause). Sleeping positions can help in the case of positional
         | apnea, but certainly not for everyone. Botox injections
         | anywhere will have to be repeated regularly. Fucking with the
         | uvala (like in UPPP surgery) can actually _worsen_ sleep apnea
         | and has all kinds of nasty infection and side effect risks.
         | 
         | PAP therapy works. The biggest problem with it is that it has a
         | bad reputation, which is largely caused by doctors and sleep
         | clinics not doing their fucking jobs. Patients are often sent
         | home with a CPAP machine, titrated to some semi-random setting
         | which happened to be fine for the night of their sleep study in
         | an artificial environment. And that's it. Goodbye and good
         | luck. That's such a messed up way of treating people with a
         | life-long ailment ...
        
           | agrue wrote:
           | Thanks for your detailed response, but the things I listed
           | were entirely in jest. I don't think the uvula causes sleep
           | apnea and don't believe a pill would be able to obviate
           | breathing while sleeping.
        
         | n8henrie wrote:
         | To me, it certainly seems to suggest an environmental cause (or
         | at least significant contributor). Certainly doesn't seem
         | evolutionarily adaptive for such a large proportion of the
         | population to live with profound mental and physical fatigue.
         | 
         | Obesity is an obvious confounder, but these seemingly frequent
         | front-page HN sleep apnea posts usually abound with anecdotes
         | of normal / thin individuals with significant issues.
        
           | agrue wrote:
           | Thank you, this is what I'm driving at. The conversation
           | includes very little discussion of cause or actual treatment
           | beyond symptom mitigation.
        
           | martindbp wrote:
           | Always wondered if not most of our sleep issues would go away
           | if we spent a few days or weeks camping in the wild without
           | electricity. Unfortunately not a long term solution.
        
         | Jeff_Brown wrote:
         | I lost the ability to change positions while sleeping after
         | having open-heart surgery and having to sleep immobile for
         | months. I wish I knew how to get that back. My searches online
         | yield nothing.
        
         | ignite wrote:
         | There absolutely are therapeutic sleeping positions. Sleep on
         | your side.
         | 
         | Google it for yourself or https://www.sleepcycle.com/sleep-
         | apnea/optimal-sleep-positio....
        
           | acomar wrote:
           | this worked for me for a while but in the last year, I've
           | started getting episodes even though I've taught myself to
           | sleep on my side, breathe through my mouth, keep my airway
           | open by tilting my chin away from my chest, etc.. these kinds
           | of techniques only work so well.
        
         | lmohseni wrote:
         | I read a book called Breath by James Nestor, it's all about the
         | benefits of nose breathing. Anecdotally this has completely
         | fixed my sleep apnea/ snoring/ energy levels/ etc. Highly
         | recommended!
        
           | vaylian wrote:
           | What are the best strategies for increasing nose breathing?
        
             | sanman811 wrote:
             | I would also suggest looking into the Oxygen Advantage
             | system. Just finished reading the Breathing Cure by Patrick
             | McKeown, makes some interesting claims but mostly found
             | helpful exercises to retrain nasal breathing
        
             | stuffuru wrote:
             | Look into the EASE procedure by Dr. Kasey Li
        
               | uptownfunk wrote:
               | Have you tried this? does this work?
        
               | stuffuru wrote:
               | It helped me. I no longer wake up feeling congested. The
               | impact on sleep was more subtle. I had some prior
               | complications so I wasn't able to expand as much as the
               | avg patient.
        
           | EvanKnowles wrote:
           | Wait, people aren't breathing through noses?
        
             | dtech wrote:
             | Nope, usually feel like I don't get enough air.
        
             | amanj41 wrote:
             | I'm not sure if it started this way, but I mostly breathe
             | through my mouth at night due to significant congestion in
             | my nasal passage. If I use a nasal rinse or flonase it
             | helps but if I'm not diligent it regresses immediately.
        
               | khazhoux wrote:
               | Give this a shot for a week or two. Just jam these up
               | there. It will be uncomfortable at first but you get used
               | to it. Really opens you up and takes away a ton of
               | resistance in nasal breathing.
               | 
               | https://a.co/d/18eLtdw
        
             | tsgagnon wrote:
             | I had to have my deviated septum surgically corrected back
             | in my late teens before I was capable of breathing
             | consistently through my nose. Even simple things like
             | chewing with my mouth closed were difficult because I
             | couldn't breath well enough with my nose only.
        
             | senectus1 wrote:
             | I found that I have to consciously close my mouth and "tell
             | myself" to breath only through my nose.
             | 
             | When I do this i sleep better.
        
               | ghusbands wrote:
               | You sleep better by consciously breathing through your
               | nose at night? Or during the day?
        
               | LoganDark wrote:
               | Probably by falling asleep with their mouth closed so
               | that they breathe through their nose for the night.
        
             | stuffuru wrote:
             | lots of people with chronic allergic or non-allergic
             | rhinitis aren't able to breathe through their nose.
        
           | eth0up wrote:
           | His book "Deep" remains one of my very favorite books of all
           | books, and I've turned a fair stack of pages. It's a
           | different kind of medicine though; for me, it revived my
           | soul, if there is such a thing.
        
           | dizhn wrote:
           | I thought I'd get a freebie there (like when you lose weight
           | just by cutting soda - which I already don't drink. Another
           | freebie lost), but when I paid attention I am breathing
           | exclusively through my nose and to make matters worse my
           | tongue is in the mewing position. So this is already the best
           | case scenario for my weight, sleep and jawline. Bummer.
        
         | mkmk wrote:
         | >No throat exercises or therapeutic sleeping positions? No
         | diets? No botox injections for your uvula or a daily pill to
         | obviate breathing while sleeping?
         | 
         | Since OP's apnea is not obstructive, sleeping position, botox,
         | etc. won't make a difference.
        
           | agrue wrote:
           | This is what I was talking about. The patient has apnea type
           | b. The prognosis remains Bad at Sleeping, use iron lung type
           | b with no alternatives.
           | 
           | Most people have type a and use iron lung type a, there are
           | some treatments for this type but most people opt for the
           | iron lung.
        
         | diob wrote:
         | I have sleep apnea, not overweight. I wish there was more
         | research poured into a solution that isn't pseudoscience junk
         | or predatory.
         | 
         | Grateful to the inventors of the cpap though, changed my life.
        
       | tablespoon wrote:
       | > Night of the living brain fog dead or how I hacked myself
       | better via open source
       | 
       | The use of "hacking" in the title is unfortunate, since it
       | strongly brings to mind software engineers confidently loading up
       | on weird supplements to do stuff like "boost intelligence"
       | without much understanding of what they're doing.
       | 
       | This article is very much not that, and is very sensible.
        
         | PragmaticPulp wrote:
         | The article is more about hacking his medical system so he
         | could move through the established process faster.
        
         | oefnak wrote:
         | Me it reminds of that guy who DIY genetically modified a virus
         | to cure his lactose intolerance (for a year).
        
           | LoganDark wrote:
           | > reminds of that guy who DIY genetically modified a virus to
           | cure his lactose intolerance (for a year)
           | 
           | That's awesome, have a link?
        
             | mburee wrote:
             | https://www.youtube.com/watch?v=J3FcbFqSoQY&t=0
        
             | Vingdoloras wrote:
             | Not the original video, but a follow-up one by the same guy
             | talking about results and future plans:
             | https://youtu.be/aoczYXJeMY4
        
       | acyou wrote:
       | Open source is not how we got here. We now reap the benefits of
       | centuries of well organized publicly funded research and private
       | for profit business activities. We should not misunderstand or
       | misconstrue history.
       | 
       | What technology and advancement has open source really given us,
       | that isn't just piracy when it comes right down to it? I realize
       | I am asking a selection of would-be pirates. Genuine question.
       | 
       | We skim the cream off the top and tend to take all the credit.
        
         | makerdiety wrote:
         | You're saying open source is nothing but piracy in the long
         | run? Strange. But if this open source pirate subject just
         | translates to open source technology being a parasite feeding
         | off of organized large scale labor like that from a
         | geopolitical country, then any open source failure would invite
         | the possibility of open source being an optional feature of any
         | intellectual culture. Open source is a failed experiment,
         | perhaps? Open source being a failed experiment would definitely
         | make sense if open source is basically the Soviet Union after
         | Joseph Stalin. On the way to its decentralizing disintegration
         | into new derivatives.
        
       | musha68k wrote:
       | "The John Snow Project has set out some of the growing body of
       | evidence that suggests COVID-19 is having serious adverse long-
       | term impacts on human health. This evidence is, however, being
       | subjected to the same 'doubt as product' approach that was
       | successfully deployed by the tobacco lobby to slow the
       | introduction of public health measures to protect people from the
       | harms of smoking, and the underlying economic incentive is
       | similar to the rationale of the cigarette companies. While
       | attendees at the World Economic Forum in Davos had to be
       | vaccinated, wear masks, undergo regular COVID-19 tests, and used
       | advanced air ventilation, filtration and treatment to reduce
       | their risk of infection, the costs of such protocols to protect
       | the general public are widely viewed as prohibitively expensive."
       | 
       | https://johnsnowproject.org/insights/merchants-of-doubt/
        
       | elric wrote:
       | A couple of things:
       | 
       | 1. Sleeprider deserves to be raised to knighthood or some kind of
       | medal or something. The man is a hero and a living legend, who
       | has helped untold number of people with their apnea. I'm not
       | kidding. Thank you, Sleeprider, for all that you do.
       | 
       | 2. OP really should pursue the NHS route. Maybe it'll take a
       | while, but once the gears are in motion he'll at least get access
       | to a steady supply of ASV machines, for free. There will also be
       | a paper trail of effective treatment, which might be important
       | for insurance purposes further down the line (mortgages or life
       | insurance or whatever which might require a medical checkup).
       | 
       | 3. If you have a bed partner who tells you that you're not
       | breathing, or that you snore loudly: get tested and get treated.
       | Don't shrug it off. Deal with it. The sooner, the better.
       | 
       | 4. CPAP doesn't have to be unsexy. I really don't understand why
       | virtually all CPAP pictures include full-face masks with bulky
       | headgear. The vast majority of CPAP users can get by with nasal
       | pillows with minimalist headgear. Using those pictures instead
       | would reduce the anxiety people feel about getting on CPAP. [1]
       | 
       | 5. AHI is a largely meaningless number. "Mild" apnea can be just
       | as devastating as "severe" apnea. AHI only looks at events/hour,
       | it doesn't look at when the events occur (e.g. during REM), how
       | many are back-to-back, and how much your sleep is actually
       | disrupted. You can have a "normal" AHI of 5 and still get
       | absolutely trash sleep because of un(der)treated sleep apnea.
       | 
       | [1] Nasal pillow mask: https://www.resmed.com.au/healthcare-
       | professionals/products/...
        
       | netman21 wrote:
       | Why not look at the underlying cause? I was diagnosed with sleep
       | apnea when I was 50. An oral surgeon wanted to carve out my
       | tonsils and uvula.
       | 
       | I changed my diet and began exercising. Lost 50 pounds. My sleep
       | apnea went away and I no longer even snore.
       | 
       | The downside of getting diagnosed is my life insurance company
       | dropped me.
        
         | Jeff_Brown wrote:
         | > Why not look at the underlying cause?
         | 
         | Agreed in general, but in this case that's exactly the story.
         | He discovered his apnea is cognitive ("central"), not due to
         | his throat geometry. If we're ever able to figure out and solve
         | the root causes of cognitive problems like that, it will be
         | amazing, and we should, but I don't think we're there yet.
        
         | Jeff_Brown wrote:
         | > my life insurance company dropped me
         | 
         | That ought to be illegal. Could you get re-tested, certified
         | healthy, and restore your insurance?
        
       | zackmorris wrote:
       | There's going to be a lot of variation between people, so I'll
       | just project my experience with this:                 * Mild
       | sleep apnea, ~15 events per hour, undiagnosed until after my
       | severe burnout in the spring of 2019       * Breathe Right strips
       | brought me back to life in just a day or two (no affiliation)
       | * Lightly taping my mouth at night with 1/4" surgical tape (or
       | 1/2 ripped down the center) about 2" long in an X shape (to
       | prevent stretching the philtrum) basically cured me, be sure to
       | do this with a relaxed expression so that the mouth can be opened
       | easily in an emergency to breathe again       * Problem was due
       | to slippage in jaw joint causing misaligned midline, causing my
       | jaw to fall open and tongue to fall towards throat       *
       | Treatment with an Advanced Lightwire Functional (ALF) dental
       | appliance fixed jaw alignment over the course of 9-18 months
       | * I believe that pre-2000s orthodontics and the quest to flatten
       | faces with headgear at too young an age is largely responsible
       | for the outbreak of sleep apnea       * Oral appliances for sleep
       | apnea advance the jaw forward (the opposite action of headgear)
       | and I would wager probably often would work better than CPAP
       | * Invisalign and other aligners (no affiliation) are supposedly
       | working on adding clasps to keep the jaw closed during sleep, and
       | I plan to follow up on this but have been too busy       * Sleep
       | apnea coincided with a breakdown of the gut for me, and I
       | developed food sensitivities to nearly everything I was eating,
       | lingering today with dairy, grains, some legumes and nightshades
       | * My joint pain went away when I quit eating the foods I was
       | sensitive to, so I wonder if sleep apnea -> food sensitivities ->
       | autoimmune diseases like allergies and even arthritis?       * A
       | thick neck increases the odds of getting sleep apnea, If you work
       | out or are overweight, you probably have it (neck is the same
       | size as biceps)       * Adding a 1-2" piece of foam under my
       | pillow inside the pillowcase also helps by keeping the spine in a
       | neutral alignment, since nearly all pillows are too thin for side
       | sleepers       * I'm hoping to be able to sleep on my back after
       | getting a nighttime appliance to hold my jaw and tongue in place
       | * Tongue posture exercises are key, find an Orofacial
       | Myofunctional Therapy doctor online (they teach remotely) perhaps
       | best to start with a local Temporomandibular Joint Dysfunction
       | (TMJ) doctor and get a referral       * Force feeding water by
       | drinking a glass after using the restroom, upon waking and before
       | bed helps greatly as well, perhaps by thinning the blood so the
       | heart and lungs don't have to work so hard
       | 
       | After fixing the physical causes of chronic fatigue, I feel
       | better, but still start from a place of 0 energy and motivation
       | after a lifetime of negative reinforcement and rarely having a
       | win. The only thing that works for me is to stop all internal
       | monologue and observe life passing as sort of a waking meditative
       | practice as I task and adult, to positively reinforce gratitude.
       | 
       | I also discovered that the anxiety from ADHD symptoms (I'm still
       | undiagnosed but check the boxes) feels the same as quitting
       | smoking, and the prolonged agony of it is greatly exacerbated by
       | the increased cortisol load of sleep apnea and work stress. I
       | think about mental health now the same way as weight training,
       | where there is a period of stimulus, deficit, overcompensation,
       | then long slow decline if the stimulus is continued without
       | rest/recovery. Now I consciously monitor my cognitive load, so
       | rather than redlining for 8 hours straight, I sprint for 20
       | minutes and take a short rest, which is basically the Pomodoro
       | method. I also try to get 20 minutes of downtime in each day,
       | ideally as meditation, and have told everyone that Saturday is my
       | me-day for active recovery, to do inner-child work for my
       | survival. I have started to explore other realities like the kind
       | that come while playing music, and have begun to experience the
       | sensation of motivation again, which feels like a blessing.
        
         | inconceivable wrote:
         | +1 for breathe right strips. they're all i need for a good
         | night's sleep. they are kind of expensive but you can buy them
         | in bulk from amazon and a good night's sleep is priceless. i
         | would recommend everyone try it just to see if it helps.
         | 
         | sometimes i wear them while out and about, because i'm at the
         | age where i really don't care what other people think of me.
         | also, a lot of athletes use them while working out.
        
       | 55555 wrote:
       | Okay, serious question: The author of this blog post sleeps with
       | his partner, and then discovered he spent 20 seconds of each
       | minute gasping for breath, 40 times per hour. (Something like
       | ~this). How did his wife not notice and tell him? Now I'm
       | paranoid that I have sleep apnea.
       | 
       | What's the cheapest wearable or device that can probably tell you
       | if you have apnea?
        
         | jrm4 wrote:
         | There are more than a few free apps that can record audio of
         | you the entire night in a zoomable, scrollable way (i.e. you
         | look for the spikes in the waveform and listen to them) I used
         | these for a bit in figuring out my own CPAP needs.
        
           | 55555 wrote:
           | Thank you! This sounds like a very simple and free solution.
        
         | Broken_Hippo wrote:
         | _How did his wife not notice and tell him?_
         | 
         | You don't really understand how heavily some folk sleep - and
         | you can sleep through quite a bit. Including snoring.
        
           | UncleEntity wrote:
           | I can sleep through incoming and outgoing artillery fire, .50
           | cal machine guns and humvees running over land mines
           | (allegedly, they may have been messing with me), people
           | snoring, all kinds of stuff. Someone talking and I'm wide
           | awake.
        
         | daggersandscars wrote:
         | > or my compassionate and frequently anxious wife, would rouse
         | me with the words, "WAKE UP, YOU'RE NOT BREATHING!"
         | 
         | She did notice. The people I have known with sleep apnea were
         | originally alerted by their partners walking them to tell them
         | they're not breathing.
         | 
         | The article mentions the Withings Sleep Analyzer. Is about
         | US$130.
        
         | haliskerbas wrote:
         | Not a doctor but an audio recording of a night of sleep could
         | help while you wait for a different device.
        
           | dghughes wrote:
           | Video cameras on everything now and are so cheap and easy
           | plus you could see yourself gasping. The sound may be too low
           | to pick up and video may supplement the recording.
        
         | [deleted]
        
         | mattnewton wrote:
         | The second paragraph has his concerned wife waking him?
        
         | tablespoon wrote:
         | > What's the cheapest wearable or device that can probably tell
         | you if you have apnea?
         | 
         | Years ago I was once concerned I might have had sleep apnea. I
         | did see a doctor, who said I almost certainly didn't have it. I
         | also bought a $40 pulse oximeter that could do logging, and
         | taped it to my finger over a couple nights. I didn't see my
         | oxygen level drop below 90% (or something, I can't remember),
         | so I figured I didn't have it.
         | 
         | My understanding is oxygen level is one of the most important
         | factors to track for sleep apnea. I am also super-skeptical of
         | movement-based sleep tracking. Since my impression is it's
         | typically half-assing with cheap sensors that aren't very
         | suited to the task (on their own).
        
           | crucialfelix wrote:
           | Smart Watches often can track sleep and approximate blood
           | oxygen levels.
           | 
           | Does anyone know how accurate Samsung or Apple Watch are?
        
             | Levitz wrote:
             | You might want to check this youtube channel:
             | 
             | https://www.youtube.com/@TheQuantifiedScientist
             | 
             | Reviews of health tracking devices, often comparing their
             | performance with medical equipment.
        
       | jutrewag wrote:
       | [flagged]
        
         | world2vec wrote:
         | In some countries it requires medical prescription so maybe for
         | the author it's not really worth the hassle?
        
       | captnFwiffo wrote:
       | [dead]
        
       | Jonovono wrote:
       | > I would have gone to bed dressed in a pink gimp suit, if it
       | meant I might I have got a decent nights kip.
       | 
       | This line had me laughing out loud. Amazing article, glad you
       | found what worked for you!
        
       | ericmcer wrote:
       | Anyone want to join me in making a dating app for people who need
       | CPAP machines to sleep? I am semi-serious haha
        
       | tiku wrote:
       | Why are CPAP machines still so expensive. I saw a teardown of
       | one, it was not that special. Just lots of foam.. (that needs to
       | stay in place haha).
        
       | khazhoux wrote:
       | I sleep with a short silicone tube jammed into each nostril, and
       | I highly recommend it to everyone!!
       | 
       | I get what feels like twice the amount of air, with zero effort.
       | 
       | It was very uncomfortable the first couple of nights, but now I
       | don't even feel it, and I now _always_ use them to sleep.
       | 
       | https://a.co/d/18eLtdw
        
         | tiku wrote:
         | How do you keep them in? I have tried them but they tend to
         | fall out very quick. My nose gets moist and they slip out..
        
       | moremetadata wrote:
       | [dead]
        
       | aszantu wrote:
       | For me, green vegetables seem to trigger nervousness and
       | sleeplessness, when I still ate them, I'd wake up at night and
       | think someone is in my room to murder me. I'd get up and wander
       | through my flat, go pee, and sometimes it took like 3-10 Minutes
       | until the feeling of somebody being there would go away.
       | 
       | Been on an elimination diet and trying around for 5 years now,
       | there seem to be some pointers towards SIBO, but I haven't
       | managed to fast long enough to do the test yet.
       | 
       | When I eat the wrong thing, it usually takes 3-4 days for any
       | effects to show. Would make sense if it's fermentation or rot in
       | the intestines that's triggering this. Hope you'll get well soon!
        
         | swah wrote:
         | If it takes 4 days to show, I would never be able to associate
         | with my eating habits :(
        
       | znpy wrote:
       | > I accumulated a laundry list of attempts to try and resolve the
       | situation, including lots of sleep hygiene 'hacks'.
       | 
       | [long list of mumbo-jumbo tik-tok-style "lifehacks"]
       | 
       | Anything but seeing a doctor?
        
         | [deleted]
        
       | yosito wrote:
       | > The morale of the story, you need to sometimes tackle your own
       | health and take matters into your own hands
       | 
       | The frustrating thing for me is that doing so is often labeled as
       | being anti-science, when the truth is, this guy was actually
       | doing the science himself. It's not anti-science to take your
       | health into your own hands. It's anti-outdated-underfunded-
       | medical-systems.
        
         | colordrops wrote:
         | It shouldn't be controversial that you should be responsible
         | for your own body and health.
        
         | whalesalad wrote:
         | Most people are not good debuggers. Medical. Automotive. You
         | gotta do a lot of things yourself these days.
        
         | hakunin wrote:
         | > It's not anti-science to take your health into your own
         | hands.
         | 
         | It depends on how exactly it was taken into one's hands right?
         | Can't really know if it's pro-science or anti-science until you
         | see what a person is doing. Most people do pretty irrational
         | stuff, based on stories of a doctor in my family.
        
           | pixl97 wrote:
           | Working with the healthcare system is like a marriage, it
           | requires 100% from both sides.
           | 
           | I've had friends with relatively common illnesses like high
           | blood pressure just not take care of themselves via diet,
           | medicine, and exercise, then blame the medical system when
           | their conditions got worse.
           | 
           | At the same time I watched my sisters health degrade over
           | years while she fervently tried to do everything possible to
           | make it better and saw many specialists when they said
           | nothing was wrong and she was being a hypochondriac. It was
           | finally after very effectively documenting everything about
           | her condition and keeping it in a binder and keeping daily
           | charts of her vitals, that a doctor stated "You have some
           | very rare condition, now we have to figure out what it is".
           | 
           | Healthcare is deeply personal and individualized at the end
           | of the day. The problem is we don't have the trained doctors
           | and systems to give the level of care needed. And on the
           | other hand, a lot of individuals don't put for one reason or
           | another, the needed work to ensure they have good health
           | outcomes.
        
           | akira2501 wrote:
           | > Most people do pretty irrational stuff, based on stories of
           | a doctor in my family.
           | 
           | The doctor gets self reported snapshots from a patients
           | memory. It amuses me as an engineer that they detect what
           | seems irrational, but never follow up on it in any meaningful
           | way or ever attempt to observe the actual reality of their
           | patients lives.
           | 
           | The lack of time for real follow up is understandable, but
           | the unwillingness to accept that this fact, more than
           | anything, colors the way they see their patients is a little
           | maddening. So, I always find it understandable when someone
           | decides they'd rather take their care entirely into their own
           | hands.
        
           | AbrahamParangi wrote:
           | Experiments are science, and if we knew how they'd turn out
           | beforehand they wouldn't be experiments.
           | 
           | Sort of definitionally you can get pretty weird or unsafe and
           | if you're comfortable with it not working it's still a
           | totally valid experiment.
        
             | ceejayoz wrote:
             | Experiments are _potentially_ science. Not all experiments
             | are done in a scientific manner.
             | 
             | (And even then, experimentation is only a _part_ of the
             | scientific process.)
        
             | version_five wrote:
             | No, experiments are really only science in the usual sense
             | if you have an expectation of how they will turn out and
             | you run the experiment to test your hypothesis. And
             | properly constructing the hypothesis, to include past
             | knowledge and some causal mechanism is vitally important,
             | the causal part being often neglected even in "real"
             | science.
             | 
             | There was a lot of this during Covid (which I know is a bad
             | example because of it's political baggage, but anyway).
             | Various "x cures / helps with covid" trends (sometimes
             | including studies) but not really based on a anything. It's
             | not really scientific to just imagine something could work,
             | and then try it. Contrast it with vaccines, where,
             | regardless of your view on the covid one, there's an actual
             | plausible causal pathway from being exposed to it to
             | getting immunity, so it's possible and a legit thing to do
             | to run an experiment to see if it works.
        
               | hutzlibu wrote:
               | "so it's possible and a legit thing to do to run an
               | experiment to see if it works. "
               | 
               | I think it is possible and legit scientific to run
               | experiments on allmost anything, no matter how weird.
               | 
               | What matters is how you do the experiment and what is the
               | result - does it work? And if it does, is it
               | reproducible?
               | 
               | Thats the key difference between a scientific and a
               | esoteric experiment.
               | 
               | But you totally can investigate whether divine blessed
               | guano shit cures cancer in a scientific way. Most
               | researchers just won't waste their time with it.
               | Experiments are expensive. This is why most experiments
               | are indeed only conducted, if there is a solid theory
               | about the process and not a shot in the blue.
               | 
               | (And another actually sad part today is, that many new if
               | not most scientific papers out there are actually not
               | reproducible anymore (at least not with the data
               | provided), but no one cares or does something about it,
               | except complaining, because there is nothing to win, from
               | redoing an experiment of someone else. Reputation and
               | grants demand new research.)
        
               | __MatrixMan__ wrote:
               | > Experiments are expensive
               | 
               | I wish there was an app where I could design experiments,
               | and people could opt-in to participating in them. I'd of
               | course participate in other people's experiments . The
               | app could handle the statistical reasoning. Every now and
               | then, there would be a strong enough signal in the data
               | to attract "real" scientists to problems that would
               | otherwise go unexplored.
               | 
               | People are gonna do weird stuff anyhow, we might as well
               | see if some good can come of it.
        
             | PragmaticPulp wrote:
             | The article is about someone following what is basically
             | the established diagnostic and treatment flow for sleep
             | apnea. It's not exactly an experiment. He was pushing the
             | process forward faster than his medical system could, but
             | it wasn't novel or experimental.
        
         | dekhn wrote:
         | This isn't science, it's medicine. Many parts of medical
         | diagnosis are not completely scientific. It's also easy for
         | people managing their own health to make mistakes that
         | professionals would not.
        
           | StrictDabbler wrote:
           | Yes, absolutely. It is worth practicing medicine when the
           | treatment is inherently harmless and going through the
           | medical system has been bottlenecked.
           | 
           | Nobody is killed (or really harmed) by trying a CPAP and the
           | waiting list for sleep clinics can be months or years long,
           | not to mention the expense.
           | 
           | It's one of the rare medical interventions that is relatively
           | safe for an individual. Probably should be otc.
        
             | LoganDark wrote:
             | > Probably should be otc.
             | 
             | Isn't it already, if you can just buy a CPAP machine off
             | the shelf?
        
         | __MatrixMan__ wrote:
         | The people giving the labels need to read Paul Feyerabend.
         | Science is at its worst when coupled with authority.
        
         | A4ET8a8uTh0 wrote:
         | Interesting. With exception of the pandemic, I don't think I
         | encountered that particular view often. If anything, taking
         | medicine into your own hands tends to be a result of quick fix
         | mentality ( which used to be a uniquely American issue ), lack
         | of access to medicine and doctors.
         | 
         | I am not one to defend doctors too much as I did have a moment,
         | where a whole series of trained professionals missed something
         | obvious ( in retrospect ) to the point that made me question
         | whether they were all just trying to drain my insurance as much
         | as they could. It is a problem, as we are still learning how
         | our bodies really work.
         | 
         | << you need to sometimes tackle your own health
         | 
         | That 'sometimes' is important. You want to know the line where
         | supplements and blinds are no longer sufficient.
        
         | ifyoubuildit wrote:
         | If the two options are wearing a label that you don't like
         | (that the labeler might not even understand) but having your
         | health, or wearing a more desirable label but without your
         | health, the choice seems clear.
         | 
         | It's like they say, opinions are like assholes. Everyone's got
         | one and they all stink. At the end of the day, the only one who
         | is really accountable for your health is you.
        
         | bmarquez wrote:
         | Absolutely. I was prescribed an APAP with the default pressures
         | set from 4-20. The doctor claimed that the "machine would do
         | all the work" but I still had poor sleep quality. Ended up
         | downloading Sleepyhead (the predecessor to OSCAR) and self-
         | titrated using a band of 90% reported pressure.
         | 
         | My sleep improved but my doctor got mad because I wasn't
         | listening to medical advice, but going into the APAP clinician
         | settings and changing them myself.
        
         | jrm4 wrote:
         | Exactly this. I've also dealt with the whole CPAP thing, and
         | the extent to which the whole industry is obviously
         | infantilizing-for-profit is infuriating. Over the years, it's
         | gotten increasingly difficult to just "buy the supplies
         | yourself," (aka easily and/or cheaply) and the extremely
         | condescending "reasoning" we get is "oh, it's medical equipment
         | and therefore dangerous so we get to control it."
         | 
         | And _here_ , having done it for years, I can tell you this is
         | nearly absolute BS. It's a hose hooked up to a fan that softly
         | blows somewhat filtered air through a tube. That's IT. There's
         | no remotely signficant way that this thing will _hurt you_ even
         | if used improperly; especially as compared to so much other
         | dangerous OTC drugs and /or medical equipment.
        
           | 015UUZn8aEvW wrote:
           | One way that you can identify rent-seeking disguised as
           | safety is to compare the degree of risk considered acceptable
           | across industries. For example, you can buy and use a
           | chainsaw and similarly-dangerous power tools with basically
           | no constraints whatsoever. But chainsaws are definitely more
           | dangerous than CPAP machines or many prescription-only drugs.
           | I'm sure that professional tree clearing companies would like
           | it if everyone except them was banned from engaging in their
           | line of work, but that's not the case because they have less
           | effective lobbyists than doctors have.
        
             | plagiarist wrote:
             | I think it is extremely important that medical devices are
             | open, especially data, to prevent rent-seeking on the
             | people who need them to live.
             | 
             | However, if I manufactured, say, an insulin pump, there is
             | no way I would allow it to ship with user-configurable
             | settings in a country as litigious as the US. CPAP seems
             | less risky, but not worth chancing anything. The US market
             | seems to be the primary target for many medical devices,
             | the UK might be receiving CPAPs developed primarily for the
             | US court system.
        
           | drpancake wrote:
           | While I agree in general, people who are candidates for ASV
           | have to be screened first by a cardiologist. Certain traits
           | can lead to a much higher risk of death while using one.
        
           | Spooky23 wrote:
           | Actually, there is.
           | 
           | Improperly designed tubes can accumulate or retain moisture,
           | and that small fan will blow mold into your lungs overnight.
           | 
           | Would you trust an Alibaba CPAP sold on Amazon for $50?
        
           | Enginerrrd wrote:
           | >There's no remotely significant way that this thing will
           | hurt you even if used improperly
           | 
           | Eh... I've talked to RT's and the occasional pulmonologist
           | enough about ventilators out of idle curiosity to learn that
           | the pressures involved do need to be carefully set within
           | certain envelopes to minimize risks, and I'm not quite as
           | confident as you are in this statement.
        
             | meindnoch wrote:
             | Ventilator != CPAP machine
        
               | Enginerrrd wrote:
               | Oh, I know that! I'm familar with CPAP's and BiPAPs and
               | ventilators, etc. I was a paramedic before I became an
               | engineer. My point was just that, within the context of
               | ventilators, I learned just how little I actually knew
               | about the field of pulmonology and how many things I
               | didn't think would be an issue are actually quite
               | dangerous. What little I picked up would be enough to
               | give me pause about the confident statement made in the
               | comment I responded to about DIY CPAPs.
        
               | tjohns wrote:
               | Most CPAPs prescribed these days are Auto-PAPs that self
               | calibrate as you sleep.
               | 
               | They often don't even do a titration study to figure out
               | the right pressure range anymore. They just give it to
               | you with a reasonable default setting, let the machine
               | figure things out automatically, and tell you to come
               | back in a month to check the logs to see if your apnea
               | got better.
        
               | jrm4 wrote:
               | I'm considering the _relative /marginal_ danger (e.g.
               | against actual apnea) and I just don't see it?
               | 
               | You set your controls HORRIBLY wrong on an off the shelf
               | CPAP -- and, what? It's not like you're going to explode
               | your lungs. Your own inability to breathe properly will
               | make you take it off. Or you keep it on and you fart more
               | in the morning (true story, by the way, I've never heard
               | anyone mention this side effect of CPAPs)
        
               | xtrohnx wrote:
               | lungs might not explode, but they can bleed if the
               | pressure is set incorrectly. i've heard horror stories
               | about people turning it up to 11 and throwing up blood in
               | the mornings.
        
         | ianai wrote:
         | It could also be labeled "self advocacy" with a light
         | scientific oversight. Ie don't do the same thing twice and
         | expect different results, and detailed, intricate logs, etc.
         | "Giving a crap" about your health is definitely not anti-
         | science.
         | 
         | I've routinely had to do this with my own health. It was
         | especially bad before Botox for migraine was around. Heard a
         | lot of "men don't get migraines, I don't believe you" from
         | neurologists.
         | 
         | For sleep apnea, it was an adverse reaction to a medication
         | that led me to strongly request my doctor send me for a sleep
         | study. Found out during the sleep study that I needed a good
         | bit of air pressure and I've been benefiting greatly since. But
         | it did take me doing some online research into side effects of
         | the medication (from high quality sources), being insistent,
         | and establishing some report with my doctor through logs,
         | candor, and listening.
        
           | kurthr wrote:
           | I agree and think it's interesting that we find a very
           | similar article about finding a slow electrical leak in a
           | car. Most of the experts are interested in taking the cream
           | off the top of diagnosis, because most of the time you have
           | the common condition that responds to the common treatment.
           | 
           | https://news.ycombinator.com/item?id=35513636
           | 
           | But when it's not and they have to look at a lot of details
           | and spend a lot of time figuring out the problem many aren't
           | interested, if only because they're pressed for time (by
           | insurers) and trying to reduce cognitive load.
        
           | yosito wrote:
           | I'm sorry, but "don't do the same thing twice and expect
           | different results" is not science at all, and might even be
           | described as anti-science.
        
         | LoganDark wrote:
         | I was never diagnosed with ADHD because medical professionals
         | never noticed any symptoms on the outside. But inside, I was
         | always suffering, I just didn't know what it was called. Once I
         | learned about ADHD and that I checked every box, I started
         | taking stimulants (even without an ADHD diagnosis) and they
         | solved everything.
         | 
         | I think my case was just so severe that nobody saw me
         | _struggle_ with it, because it was impossible to fight. Plus, I
         | 'm autistic, so a lot of things were written off as autism.
        
           | Mezzie wrote:
           | > I think my case was just so severe that nobody saw me
           | struggle with it.
           | 
           | Same with me but PTSD. Like the fact that I'm remarkably
           | functional in crisis mode doesn't mean that it's not a
           | problem I live there all the time. A surprising amount of
           | medicine relies on having a stable baseline against which to
           | compare and if that's not there, the tests don't work.
        
             | WaxProlix wrote:
             | What - if any - nontraditional treatments have you ended up
             | gravitating towards for that?
        
             | LoganDark wrote:
             | > Same with me but PTSD. Like the fact that I'm remarkably
             | functional in crisis mode doesn't mean that it's not a
             | problem I live there all the time.
             | 
             | Exactly! I wanna fix something _wrong with me_ , not
             | something _preventing me from becoming a work slave_. I
             | want to be _happy with myself_ , not just _useful to
             | society_. My own happiness should trump most metrics of
             | functionality.
        
               | Mezzie wrote:
               | It's crazy-making, isn't it?
               | 
               | I realize in hindsight how much of my resistance to help
               | was resistance to 'help': I've grown up surrounded by
               | adults/authority figures offering 'help' with no
               | consideration of my actual desires or wellbeing. I _know_
               | that one. Of course I was wary: I had a good reason.
               | 
               | You're right that it all relies around making people
               | functional, not whole people who have come to terms with
               | who they are and are a psychologically stable human
               | organism.
        
         | PragmaticPulp wrote:
         | He recognized the signs of sleep apnea and pursued treatment
         | with sleep apnea devices, getting confirmation of the problem
         | with the help of his doctor. The DIY part was largely related
         | to pushing the process forward, not doing novel
         | experimentation.
         | 
         | Nobody would call that "anti-science".
         | 
         | Anti-science would be something like ignoring the common
         | treatments and trying to solve the problem with natural
         | supplements or something. Going this route often delays people
         | from getting to proven treatments because they spend a long,
         | long time trying underpowered or unproven things that don't
         | work.
        
           | Levitz wrote:
           | >He recognized the signs of sleep apnea and pursued treatment
           | with sleep apnea devices, getting confirmation of the problem
           | with the help of his doctor.
           | 
           | It actually baffled me that it wasn't his doctor who picked
           | this up. A person waking up several times with confirmation
           | from someone sleeping besides him that he has stopped
           | breathing, I'm no doctor and gee maybe it's because there are
           | a few cases in my family but that screams "sleep apnea" to
           | me.
        
             | groby_b wrote:
             | Absolutely no cases in my family, and it's still screaming
             | sleep apnea. I mean, apnea _literally_ means  "stops
             | breathing".
             | 
             | A doctor who doesn't recognize that is maybe not the best
             | possible doctor. To put it very mildly.
        
             | Spooky23 wrote:
             | Especially now. Sleep apnea is a big cash cow for medical
             | networks.
             | 
             | Normally if you mention a problem even somewhat in the
             | neighborhood of sleep apnea you're shoved into the funnel
             | for sleep studies and CPAP devices.
        
           | rdiddly wrote:
           | Trying things is science, and any experiment can be retried
           | to see if results replicate. People who aren't scientists or
           | don't have time or equipment to be scientific about a thing
           | have to decide where the balance lies, between how much
           | science they're capable/willing to do vs. how many
           | assumptions they're willing to make based on other people's
           | science.
           | 
           | There's no belief system called science and you can't be pro-
           | or anti-science. Science ironically is pretty questioning and
           | skeptical, so questioning some piece of science, is
           | scientific.
           | 
           | Certainty and the temptation toward it is your enemy if you
           | would maintain a "scientific" worldview. Politics demands
           | certainty, simplicity. Fascism, especially so.
        
             | blix wrote:
             | > There's no belief system called science
             | 
             | There are two belief systems called science.
             | 
             | The less common one is the one you outline immediately
             | after denying its existence: it's about asking questions
             | and trying to establish evidence-based models to make
             | predictions and testing/validating the assumptions in those
             | models. It's probably more accurate to call this belief
             | system empiricism.
             | 
             | The more common one is a deferral to expert authority,
             | where experts are designated by certain established
             | scientific institutions. Because many lack the
             | time/will/ability to independently verify claims made by
             | authoritative figures, this deferral requires substantial
             | trust in these institutions to come up with good answers.
             | 
             | This second belief system is what most people mean when
             | they label themselves or others as pro- or anti-science.
             | Paradoxically, even though the authoritative institutions
             | ostensibly produce information empirically, expressing
             | skepticism and asking questions is often perceived as a
             | lack of faith, and therefore anti-science.
        
           | Out_of_Characte wrote:
           | On the flipside, there are also a small selection of unproven
           | treatments that work better than standard care.
        
             | rendaw wrote:
             | If they're unproven, how do you know they work better than
             | standard (=proven) care?
        
               | Spooky23 wrote:
               | Unproven doesn't mean ineffective. Cranberry juice isn't
               | FDA approved to help with urinary tract infections, but
               | is frequently recommended by urologists and works.
               | Another example is that isopropyl alcohol, which is an
               | effective disinfectant, doesn't meet the EPA standards
               | for being a pesticide... which is because it's existence
               | predates the process.
               | 
               | It's expensive to go through that rigorous process, and
               | there's no economic incentive to go through that for
               | something that isn't patentable. In the case of cranberry
               | juice, it's not sold as medicine. In the case of alcohol,
               | you can buy very expensive wipes that have a
               | certification if you need it for some industrial process.
        
               | Levitz wrote:
               | There is a certain weight to experience and prevalence,
               | you can go wrong, sure, but it's often worth it to try.
               | 
               | Parachutes aren't scientifically proven to work on
               | humans.
        
             | nawgz wrote:
             | ...
             | 
             | That's not the flipside, that's the "exception to the
             | rule". Of course the system's not perfect, but people don't
             | live way longer now because our medicine is worse than
             | before...
        
               | StrictDabbler wrote:
               | "The exception proves the rule" refers to a logical/legal
               | situation where a rule has been posted with specific
               | exceptions.
               | 
               | A sign that says "no parking on Sundays" logically
               | implies that parking is allowed all other days.
               | 
               | The concept you're looking for is closer to "any
               | statistical group has outlier cases".
        
               | nawgz wrote:
               | I did not use the word "proves"; the "exception to the
               | rule" fallacy is when you see a singular case violating
               | some rule and you use that to assume the rule doesn't
               | hold in general, or you make generalizations from a
               | singular case.
               | 
               | The commenter I'm replying to is advocating for homeo- /
               | naturo-pathy because of some statistically insignificant
               | and probably actually not causally based relationship
               | they've witnessed, which is generalizing from a ~singular
               | case
        
             | PicassoCTs wrote:
             | And if they survive rigorous testing, they become "standard
             | care". Sience is the borg of all ideas, the good ones get
             | integrated, the bad ones stay outside. Opposition to the
             | borg is appreciated, as it raises the assimilation value.
        
             | PragmaticPulp wrote:
             | The standard of care doesn't mean it's optimal for
             | everyone. Doctors will often explore alternative treatments
             | when the first-line measures aren't working optimally.
             | 
             | It's a mistake to ignore proven, first-line treatments and
             | skip straight to less proven alternatives, though. Some
             | people have built an anti-mainstream bias that puts too
             | much emphasis on the unproven, alternative treatments while
             | downplaying the most proven treatments.
        
               | ipaddr wrote:
               | The biggest mistake anyone can make is to blindly jump
               | into medical treatments first when common home treatments
               | with lower side effects can handle the job. If you do
               | that you'll be in blood pressure meds by 35 instead of
               | reducing your salt.
        
             | 8ytecoder wrote:
             | Doctors do often recommend those - they just won't touch
             | anything that might requires FDA approval and doesn't have
             | it. I have indigestion issues and it's my doctor who
             | recommended a supplement with peppermint oil and castor
             | oil. Worked like a charm for me. I had tried a whole suite
             | of meds prescribed by my GP but the GI specialist went
             | straight to the supplement.
        
             | lapetitejort wrote:
             | Can you share an example of an unproven treatment that
             | works better than standard care?
        
               | heisenbit wrote:
               | Adoption of new methods takes a considerable time in
               | medicine. Some methods may be considered unproven by the
               | majority but are being adopted by pioneers. Now if you
               | could distinguish pioneers from quacks easily...
        
               | Spooky23 wrote:
               | One of the issues with specialty medical care is that you
               | aren't seen as a whole person.
               | 
               | The orthopedic guy sees you as a candidate for surgery a,
               | b or c. He may miss that something else is going on. A
               | treatment may be "unproven" for a symptom, but perfectly
               | acceptable for a root cause.
        
               | aantix wrote:
               | Rinsing with baby shampoo and iodine for the treatment of
               | sinus inflammation.
               | 
               | Vs antibiotics and/or saline rinses.
        
               | ipaddr wrote:
               | Reducing salt vs taking blood pressure meds.
               | 
               | Aloe vs cortisol for skin issues.
        
               | Out_of_Characte wrote:
               | I can come up with examples but know its ironic to try to
               | proof treatments that are, scientifically or medically,
               | not verified.
               | 
               | Theres diet, sleep, exercise. Which require no studies to
               | know that taking better care of yourself will help you
               | regardless of the pathology.
               | 
               | Then there's the somewhat strange case of orthodontist
               | John Mew, who advocates for setting your tongue posture
               | to the roof of your mouth in order to close the jaw
               | properly, to prevent standard treatment of various
               | braces, teeth alignment issues and corrective jaw
               | surgery.
               | 
               | Other strange therapies that I've come across that seem
               | unhealthy but have some backing are intentional sleep
               | deprivation to improve depressive symptoms. prolonged
               | fasting to reduce scar tissue. Or one I personally use
               | alot, extremely cold showers after allergene exposure.
               | 
               | There are alot of silly things the human body can do that
               | at first glance might seem irresponsible or dangerous but
               | are about as dangerous as people in the 1900's might
               | imagine airplanes would be.
               | 
               | One more thing I might add, standard care does not mean
               | 'in your best interest' some standard practise might be
               | too cruel to accept, like chemotherapy. Even though its
               | proven to extend your life, it might not be proven to be
               | in your best interest.
        
               | SketchySeaBeast wrote:
               | I would say that diet, sleep, and exercise have been
               | proven to help many conditions and it would be non-
               | controversial and not anti-scientific to suggest them.
        
               | sawyna wrote:
               | I used to have pretty bad sinus. I used to take
               | antibiotics for 10 days a month and would be good for 20
               | days and this goes on each month. After 6 months, my
               | immunity has gone to shit. The doctor recommended
               | clearing out my sinus by a surgery but apparently that
               | doesn't solve the root cause. It can happen again and
               | again.
               | 
               | I tried multiple doctors, treatments, tips etc and etc
               | nothing worked. I finally visited a homeo doctor who
               | diagnosed it right. It's deviated septum which is causing
               | sinus infections because of regular coconut water intake.
               | I just stopped drinking coconut water and it's been 10+
               | years and not another recurrence of sinus so far.
               | 
               | Proper diagnosis is hard and requires skill. The OP
               | figured it by himself and in my case, someone did.
        
               | hutzlibu wrote:
               | "homeo doctor"
               | 
               | Homeopathy doctor?
        
               | Weatebob wrote:
               | [flagged]
        
               | Levitz wrote:
               | Research is currently being done and this is of course
               | anecdotal (I mean, if it wasn't it would be proven
               | treatment, wouldn't it?)
               | 
               | That said, my depression was improved more by a couple of
               | magic mushrooms trips than by more than a year of
               | psychology. The results have been so good that it feels
               | wrong to share it, makes it sound like some miracle stuff
               | and I think any depressed person would go for it in a
               | heartbeat completely ignoring risks.
        
               | tayo42 wrote:
               | Yeah idk if that's the same, psychedelics are getting
               | mainstream attention as helping depression. And like you
               | said real research is being done. Research used to be
               | done before the governments got in the way.
               | 
               | I think the stuff people are talking about are like when
               | Steve Jobs did the fruit diet thing to cure cancer
        
               | GistNoesis wrote:
               | Getting to the root causes is often preferable.
               | 
               | For example if your air quality is bad and/or ventilation
               | is bad and may cause sleep apnea (like high CO2
               | concentration often makes you feel drowsy).
               | 
               | But the seller of CPAP machine will not monitor your air
               | environment.
               | 
               | With medical problems there are often multiple factors,
               | and when a solution is found that fix the symptoms, care
               | is no longer taken to find the other causes, specially if
               | the solution is generating recurring revenues.
        
             | Angostura wrote:
             | Prove it.
        
           | dylan604 wrote:
           | isn't that the scientific process though? trying things to
           | see the results sounds like the definition of experiment to
           | me.
        
         | VikingCoder wrote:
         | We all need to be our own advocates, in lots of areas.
         | 
         | What's concerning is when people ignore the experts completely.
         | 
         | Steve Jobs ignoring the advice for pancreatic cancer treatment
         | comes to mind.
        
         | toss1 wrote:
         | >>doing so is often labeled as being anti-science, when the
         | truth is, this guy was actually doing the science himself.
         | 
         | Yup, it is. Because like a cargo cult, most of the external
         | signs are similar. The difference is in the depth of knowledge
         | used, the rigor applied to the evidence, whether the person is
         | actively avoiding or seeking confirmation bias, etc. So, yes,
         | much of the time, it is actually anti-science.
         | 
         | That said, there is no reason to hide a person's own data from
         | them. Even if statistically, they are more likely to abuse it.
         | 
         | The fact that he had to go get a gray-market machine hacked to
         | use open-source to get his own data is unconscionable. It
         | should simply be required that all medical devices have an
         | _easy_ method to provide data to the user /patient, such as a
         | Patient_SDCard_Slot, or Patient_USB_port. Obviously it wouldn't
         | provide access to the internals, but provide a parallel output
         | data stream that they could use or not use as they choose.
        
           | toss1 wrote:
           | Edit, meant to type "it sometimes is", not it is
           | 
           | (didn't check my writing, too late to edit)
        
       | jonhohle wrote:
       | I'm going through this right now and it feels like everything
       | Americans have complained about socialized healthcare is now true
       | in the US as well: long wait times to see providers, providers
       | that churn through patients like their doing oil changes,
       | providers that just push you along to the next step in a playbook
       | without considering individual needs.
       | 
       | I've been dealing with fatigue for about two years and had to
       | preempt a yearly physical to be able to talk to my GP about it in
       | December. That gave me the referral I needed to get a sleep
       | study, which identified moderate apnea. It's the middle of April
       | and I would have just been getting a provider prescribed auto PAP
       | had it not been for a friend who had an unused one.
       | 
       | Like the author, CPAP is doing nothing for me, so next month the
       | specialist will probably recommend another sleep study, followed
       | by several more months of waiting for appointments and DME
       | providers.
       | 
       | Meanwhile, my wife found that one of the medicines I had been
       | taking had recent studies indicating effects on sleep. I went
       | from 10-20mins of REM a night to 2-2.5 hours by cutting it out
       | prior to any PAP therapy. It should have been done under Dr.
       | supervision, but I can't ever see my Dr., so I said screw it,
       | found a typical tapering protocol and did it myself.
       | 
       | For shorter term things - sick visits, etc., it is impossible for
       | my wife or me to see anyone at the network of our GP (one of the
       | largest in the state) and have to go to urgent care. The last
       | time my wife wanted an appointment she asked if she could go to
       | another location to get in sooner. They denied the request
       | because of continuity of care. So she went to a minute clinic
       | that is completely unrelated to the network - how does that
       | provide continuity?
        
         | jonnycomputer wrote:
         | It's been like that in the US like forever. Once you actually
         | have medical problems. The main difference is the whole going
         | bankrupt thing.
        
           | LoganDark wrote:
           | > The main difference is the whole going bankrupt thing.
           | 
           | US healthcare really does seem to want to bankrupt people. As
           | an example, most insurance doesn't cover dental care, which
           | is (in)famously one of the parts of the body that needs the
           | _most_ maintenance.
           | 
           | My insurance doesn't cover my ADHD meds because I have to
           | take more than 1 pill a day. $80/mo for the rest of my life
           | if I want to treat a disorder. (My case is pretty bad, too.)
           | 
           | I (hopefully?!) have decades of life left, and $80/mo is
           | almost $1,000/year. Not super cheap. I actually can't afford
           | this on my own income and have to rely on a family member to
           | help.
        
             | arghnoname wrote:
             | Most work plans include a separate dental plan, for which I
             | am thankful. However, near worst-case scenarios for dental
             | issues are comparatively affordable ordeals. My routine
             | dental care is covered for me, but it's affordable either
             | way. I had to have a root canal and crown, which would have
             | been annoying to pay for, but certainly not something that
             | would bankrupt me. If I remember correctly, it was in the
             | ballpark of $2k in the DC metro area. It's still possible
             | to set money aside for possible dental issues and self-
             | insure.
             | 
             | Because dental costs are more reasonable, insurance
             | premiums don't tend to be very high and can be purchased
             | outside of your main health plan. If primary medical costs
             | were more on par with dental costs (as it probably did once
             | upon a time, when the offerings were much more primitive),
             | insurance wouldn't be such a big issue.
        
           | kick_in_the_dor wrote:
           | I'm a US expat living in London for 1.5y. I find the opposite
           | is true.
           | 
           | US healthcare moves much faster and turnaround to getting a
           | new appointment with a specialist is a fraction of the time
           | in the UK (NHS only).
           | 
           | My SO had a personal health issue that she attempted to get
           | help for in the UK. She had to wait months for a GP
           | appointment with the NHS, only to be told "let's monitor the
           | issue" instead of actually doing anything. We went home to
           | the US (making an appointment <2w in advance) and we saw a
           | doctor who immediately found the underlying issue and had it
           | fixed.
           | 
           | I could go on about the health system in the UK...
           | 
           | edit: Ha even the article talks about this! "I am in the
           | system for NHS treatment, but things are so bad that I have
           | not even received an inital letter with a date for a test. It
           | would likely take up to year for the NHS to treat me."
        
             | dv_dt wrote:
             | As far as I can follow, the NHS has been severely and
             | intentionally undermined of resources by the ruling party.
             | They are in the cusp of doctors going on strike.
        
               | kevviiinn wrote:
               | They're trying to get things privatized like they did
               | with rail. You can see how well that turned out
        
         | version_five wrote:
         | I don't have any experience with US healthcare, but presumably
         | having insurance and whatever conditions they enforce is
         | basically a form of socialized healthcare, no?
         | 
         | If one wanted to, couldn't they find a provider they could pay
         | to deal with whatever issue immediately?
        
           | aidenn0 wrote:
           | There are three main types of insurance in the US: HMO, PPO,
           | and EPO.
           | 
           | HMO works a lot like my understanding of the UK system
           | (except the government doesn't pay for it); if you want to
           | see a specialist, you need to get permission from the
           | insurance provider, either directly, or (more typically) by
           | having your GP (a.k.a "primary care provider) write you a
           | referral.
           | 
           | PPO and EPO do not require referrals. A PPO typically has
           | high deductibles for doctors that are not contracted with the
           | PPO, and an EPO does not provide any coverage for doctors
           | that aare not contracted with it (the P vs E is "preferred"
           | vs "exclusive").
           | 
           | PPOs tend to have the highest premiums. Anecdotally, HMOs
           | used to be a pretty good deal. From my earliest memories of
           | how health-care worked HMOs didn't add too large of a delay.
           | However, more recently it has been harder to get a referral,
           | and once I get the referral, there are so few local places
           | that accept the HMO (perhaps because of below-market rates
           | paid out?) that a 6+ month wait list to see a specialist is
           | not uncommon (some things like physical therapy having such a
           | long wait-list that it's hardly worth it; I was quoted an 8
           | month wait list for PT for a shoulder injury, at which point
           | I just googled for exercises I could do).
           | 
           | Also _twice_ now I have been hit by the HMO refusing to pay
           | for emergency care because even though the ER I took my kid
           | to was  "in-network" one of the doctors who saw the kid at
           | the ER was an independent contractor which isn't covered by
           | the HMO. Over $1k out-of-pocket each time.
        
             | arghnoname wrote:
             | This is a good summary. What's interesting to me to observe
             | here is your PT story is the system working as designed.
             | This intention is not hidden. If one could just google the
             | solution to their problem instead of using scarce
             | resources, as the common phrase goes, that's a good thing
             | actually.
             | 
             | We do an awful lot of rationing in these sorts of ways.
             | It's maddening to me that I pay the astronomical premiums I
             | pay and yet, end up having to play mini-doctor by asking
             | the internet for answers. I do not have any illusions that
             | I'm able to provide sound medical advice to myself or
             | others, but just due to these sorts of issues and also
             | doctors visits that are practically conducted via drive-
             | through, Google MD is often my doctor / PT person / etc of
             | first resort.
        
         | drewcoo wrote:
         | > everything Americans have complained about socialized
         | healthcare
         | 
         | > long wait times to see providers, providers that churn
         | through patients like their doing oil changes, providers that
         | just push you along to the next step in a playbook without
         | considering individual needs
         | 
         | I don't have any idea what that has to do with "socialized
         | care." If anything, most of those factors resemble the way
         | businesses scale up.
        
           | version_five wrote:
           | I disagree- socialized care is like insurance. The incentive
           | is to pay out as little as possible. This is true whether
           | it's a government health care program or actual health
           | insurance.
           | 
           | An actual "market" system encourages consumption and competes
           | on price and quality.
           | 
           | Health insurance (public or private) makes sense for
           | catastrophic events (major illnesses) but for regular ongoing
           | things like GP visits and common prescriptions, it's just a
           | middleman that drives up prices and discourages prevention
           | and primary healthcare.
        
         | abecedarius wrote:
         | Totally agreed about the problem of long latencies due to
         | bufferbloat in our medical system. I ran into it last year and
         | I believe it significantly raised my risk of death.
         | 
         | A suggestion in case it's unfamiliar: there are doctors who
         | don't take insurance. I can always see mine within a few days,
         | for $80/month. (I set this up after the above experience.) It's
         | absurd that I have to do this and also pay for insurance
         | separately (paying much more than I did before the Affordable
         | Care Act made insurance plans for _catastrophic_ medical costs
         | illegal) -- but that 's where we are.
        
         | goodpoint wrote:
         | > everything Americans have complained about socialized
         | healthcare is now true in the US as well
         | 
         | With the added bonus of paying completely insane amounts.
        
       | lunderdog wrote:
       | I had surgery to expand my upper jaw and palate three weeks ago,
       | and the improved ability to breathe during the night and day is
       | absolutley life-changing. I used to wake up multiple times a
       | night with a pounding heart, and could never get a restful sleep.
       | Within a few days after surgery, I could sleep through the night
       | and my blood pressure dropped enough to start weening off my
       | hypertension medication.
       | 
       | If somebody is struggling with obstructive sleep apnea, I would
       | suggest consulting with an oral maxillofacial surgeon or
       | otolaryngologist (ENT) to have your jaw and nasal airway examined
       | to see if there's another option besides using a CPAP.
        
         | ericmcer wrote:
         | My friend had that surgery, it also gave him a more robust
         | jawline which was a bonus.
         | 
         | He used to snore shockingly loud. It sounded like a jet taking
         | off, if I tried to mimic it intentionally I was unable to get
         | as loud.
        
         | diob wrote:
         | Wishing you the best of luck, but when I looked into this 10 or
         | so years ago the long term success rate of surgery seemed
         | dubious to me.
         | 
         | I read that scar tissue ends up building up and making the
         | problem worse than before, so it ends up being a solution that
         | works until then.
         | 
         | I did end up having turbinate reduction / deviated septum
         | surgery, so at least I can use comfy nasal pillows now. The
         | turbinate reduction definitely destroyed most of my fine sense
         | of smell, which is unfortunate. Wish I'd known that ahead of
         | time.
         | 
         | Anyways, sleep apnea sucks. Wish I could fix my anatomy.
        
           | lunderdog wrote:
           | Thank you, I had not heard of the issue related to scar
           | tissue building up. I will look into that more and ask my
           | doctor when I see them later this week. I knew going into the
           | surgery that it was not a sure thing that it would improve my
           | breathing. The primary reason I had it done was to correct a
           | bad underbite and crossbite that causes me to struggle with
           | eating.
        
       | mancerayder wrote:
       | I have a chance of having sleep apnea since my sleep is atrocious
       | and extremely light, but I'm not overweight and I also can't
       | sleep on my back or side, meaning a machine with mask ain't gonna
       | cut it. Thus I've not even bothered. Also I wouldn't fall asleep
       | in a sleep study location (I can't sleep outside of my bed, with
       | any noise, lights, etc)
        
         | david2ndaccount wrote:
         | There are home tests. That's how my sleep apnea was diagnosed.
        
         | elric wrote:
         | Not being overweight has zero impact in your ability to have
         | sleep apnea. Get tested anyway.
        
         | DMell wrote:
         | This is similar to my situation. I am a fit individual that is
         | in the gym five days a week, runs marathons, backcountry skis
         | multiple times a week, etc. and have diagnosed sleep apnea.
         | However, I can't for the life of me get through a single night
         | with the machine to the point where it has sat in a closet for
         | months. I also sleep on my side or stomach so I immediately
         | wake up to the mask blasting air at me due to a seal. The nose
         | pillows didn't work as well.
        
           | AuryGlenz wrote:
           | Have you tried a mandibular adjustment device? You can get
           | them pretty cheap online. They push your lower jaw forward.
           | The only real downside is that they can screw with your teeth
           | a little.
        
             | rewgs wrote:
             | I have mild sleep apnea due to TMJ and went through an
             | odyssey trying out a mandibular adjustment device. It
             | absolutely _wrecked_ my jaw, made my TMJ far worse than it
             | was prior to using it. It also did more than  "screw with
             | my teeth a little," it quite literally pushed my bottom
             | teeth forward and destroyed my bite.
             | 
             | The device was fitted by apparently one of the best docs of
             | their kind in SoCal. And yet, after looking into it, my
             | experience seems quite common.
             | 
             | At this point I've just accepted my TMJ and mild sleep
             | apnea. Nothing I've tried has helped at all.
        
               | mancerayder wrote:
               | I have bruxism myself... What's the link with sleep apnea
               | exactly? The jaw's position pushing the tongue back?
        
               | nanidin wrote:
               | I'm not sure which way the arrow of causation points -
               | one of the body's reactions to stopping breathing while
               | unconscious is to grind the jaw.
        
       | mattgreenrocks wrote:
       | Curious: can the Apple Watch detect this sort of thing?
        
         | jonhohle wrote:
         | It can detect bad sleep patterns, and modern versions can
         | detect pulse-ox, but not specifically apnea, AFAICT. It is
         | definitely a useful too, and there are cheaper alternatives
         | (I'm using an $80 Garmin) that give "good enough" info for
         | personal tracking, but in my experience, Drs. don't care about
         | it.
        
         | ccooffee wrote:
         | According to an Apple support page[0],
         | 
         | > With Apple Watch Series 3 or later with watchOS 8, you can
         | measure and track your Respiratory Rate.2 With Track Sleep with
         | Apple Watch turned on, when you wear your Apple Watch to bed,
         | it will automatically measure and record the number of times
         | you breathe in a minute.
         | 
         | I assume that this information is enough to warrant "go see a
         | sleep specialist", but possibly not much more than that. There
         | is at least one watchOS app that claims to use the Apple Watch
         | data to detect sleep apnea[1], though it may not be a
         | completely reliable source[2].
         | 
         | With Apple's increasing focus on the health for the Apple
         | Watch, I would not be surprised if future watchOS updates (or
         | future Watch hardware) focus on sleep apnea detection as a
         | flagship feature.
         | 
         | [0] https://support.apple.com/en-us/HT211685
         | 
         | [1] https://9to5mac.com/2022/05/10/napbot-sleep-apnea-analysis/
         | 
         | [2]
         | https://www.reddit.com/r/SleepApnea/comments/vxkkxx/napbot_a...
        
         | btreesOfSpring wrote:
         | For WatchOS, you would start by running the Sleep App[0] and
         | notice that there is an issue with your sleep stages.
         | 
         | Next you might move onto an app, like SnoreLab[1] where you
         | record the audio of your sleep each night and can listen back
         | to where you are having sleep interruptions. At that point, you
         | would likely hear your breathing process.
         | 
         | Moving onto the Withings Sleep Analyzer[3] (as shown in the
         | article) will fill out your data but by step 2, you will should
         | probably already be setting up an appointment with your doctor
         | for sleep apnea.
         | 
         | [0] https://support.apple.com/guide/watch/track-your-sleep-
         | apd83... [1] https://www.snorelab.com/ [3]
         | https://www.withings.com/be/en/sleep-analyzer
        
       | sinuhe69 wrote:
       | When I read the first lines of the article, "sleep apnea" already
       | jumped to my mind. Good for the author of finding and fixing the
       | root cause of his sleep deprivation. No ways a few hours of sleep
       | could be normal.
        
       | elkos wrote:
       | I'm a sleep technologist by trauning and profession for the last
       | 18+. I wish all our patients were so much aware about their
       | conditions and our doctors had the opportunity to spend enough
       | time with those that would.
        
         | aszantu wrote:
         | do you know, by any chance, about the connection between eating
         | vegetables green and onions seem to trigger sleeplessness? I
         | think it's a gut issue, but I can't find any doctor that knew
         | this yet
        
           | acomar wrote:
           | might be FODMAP sensitivity.
        
       | hellohihello135 wrote:
       | CPAP works great for many people who have severe sleep apnea.
       | It's much more difficult to help people who have mild OSA / UARS.
       | They don't benefit from CPAP to the same degree.
        
         | elric wrote:
         | Do you want to elaborate on that? AFAIK CPAP absolutely
         | benefits people with mild OSA or UARS, so I'm not sure what you
         | mean?
        
       | maxehmookau wrote:
       | How strange that the only way to get one of those devices is via
       | the NHS. Usually if you have to wait too long, or something isn't
       | available in the UK, there's a private medical service more than
       | willing to take your money!
        
         | decodebytes wrote:
         | OP here. I purchased the first device privately from resmed
         | (one of the main cpap vendors), but the actual one i needed was
         | an ASV and this was refused privately and only available via
         | the NHS. Reading between the lines, I expect the NHS is one of
         | their main customers and had ordered a huge backlog, so they
         | got priority.
        
           | drpancake wrote:
           | I commented on this above but I think this is because ASV
           | users need to be screened for heart issues first!
        
           | henearkr wrote:
           | I would love to see an open-source and open-hardware project
           | for an ASV...
           | 
           | Moreover it could easily be coupled with the sensors and soft
           | required to work as a sleep analyzer, in order to help
           | diagnose central apnea vs obstructive apnea, etc.
        
       | rolisz wrote:
       | Anyone got any other experiences with things that cause brain
       | fog? I don't think I have sleep apnea (my wife often falls asleep
       | after I do and she doesn't report any kind of weird breathing
       | issues for me, nor snoring).
       | 
       | But even though I generally sleep 8 hours a night, I am quite
       | tired during the day and I often have trouble focusing. At night,
       | I fall asleep like a log and I don't wake up during the night.
        
         | docandrew wrote:
         | Could be a hormone deficiency/imbalance or any number of other
         | things. I'd start with a blood test and go from there. If your
         | doctor doesn't want to order it, you can order your own labs
         | online and take them to a local lab draw facility (at least in
         | the US).
        
         | JoeyJoJoJr wrote:
         | For me the biggest causes are bread, pasta, and coffee.
         | 
         | If I eat a gluten free vegan meal for lunch I avoid the 3pm
         | slump and the associated brain fog.
        
         | oh_sigh wrote:
         | Sounds similar to me,and I don't see anyone saying this yet, so
         | I'll throw in my experience: I believe I was sleeping _too
         | much_. I was generally in bed for 9 hrs and got 8 hrs and felt
         | that way, but after my kids were born and I started getting 5-7
         | hours, I 've felt much perkier quicker(even if I don't need to
         | do anything with the kids in the morning). Before it would
         | literally take me half or more of a day to start feeling awake.
        
         | david2ndaccount wrote:
         | Get a sleep study. You can still suffer from reduced airflow at
         | night even if it doesn't translate to actual obstructive
         | events. Or it could be something else.
        
         | Levitz wrote:
         | You might be getting poor sleep and there are many reasons that
         | might be happening.
         | 
         | Then there is also depression or hormone problems.
         | 
         | For me personally it tends to be caffeine preventing me from
         | getting good sleep, which in turn makes me want to take
         | caffeine to focus more, which prevents me from getting good
         | sleep, rinse repeat.
        
           | rolisz wrote:
           | It's not depression - I've had that a couple of years ago,
           | I'm not feeling anything remotely similar.
           | 
           | I don't think caffeine is an issue. I try not to drink coffee
           | on weekends and I still feel like this on Monday
        
         | ignite wrote:
         | How are the CO2 levels in your room? Do you sleep with a window
         | open?
        
         | swah wrote:
         | Same. Also not super tired, can go through with coffee, etc.
         | But I don't feel rested when I wake up, almost never. [1]
         | 
         | The things I never tried: giving up caffeine completely,
         | eliminating sugar completely, eliminating carbs completely,
         | losing 20 kgs (I'm a bit overweight like BMI 27).
         | 
         | What didn't work: Ritalin, Venvanse, Modafinil...
         | 
         | [1] I feel like it could just be "stress" ie don't know how to
         | relax and let go (beer does work but I wake up worse). I cling
         | to small stuff like "will my wife remember to pick up the
         | clothes later?" (making up a real example that has _zero_ bad
         | effects if it doesn 't happen today)
        
           | mgraupner wrote:
           | 1. Check your Vitamin D levels, if deficient use liquid drops
           | to supplement. Lot of people suffer from this in winter,
           | especially in the northern hemisphere.
           | 
           | 2. Do you suffer from a stiff neck? If 1 does not help to
           | release muscle tension, check for Intracranial hypertension
           | or Intracranial pressure
           | (https://en.wikipedia.org/wiki/Intracranial_pressure).
        
           | alx__ wrote:
           | Unfortunately, there are many things it could be.
           | 
           | Doctors are only so helpful (and most are even less so)
           | 
           | Here's a list of things I tried that sorta helped with my
           | tiredness spells. Recommend doing any of these changes
           | separately:
           | 
           | - Sugar fast for 4 weeks (helps reset your cravings)
           | 
           | - Switched from coffee to green tea
           | 
           | - Reduced caffeine intake to one a day or 3x a week
           | 
           | - Acupuncture
           | 
           | - 15 min walks or bike ride every day
           | 
           | - Omega 3 oils
           | 
           | - Higher intake of minerals I was deficient in (eating more
           | green vegetables)
           | 
           | (spoiler alert, I had undiagnosed ADHD which contributed to
           | my high anxiety, which gave me waves of alert/exhausted)
        
             | rolisz wrote:
             | Sugar fast.... Seems impossible. Most I've done is one week
             | and it was absolutely horrible. I was always hungry,
             | despite eating a lot.
        
         | eigenrick wrote:
         | > Anyone got any other experiences with things that cause brain
         | fog?
         | 
         | Allergies and Food sensitivities.
         | 
         | These are often incredibly hard to diagnose because there are
         | foods that we eat so commonly, we don't have a good
         | control/variable separation for experimentation. In addition,
         | allergies and food sensitivities don't develop all at once.
         | They increase over time. This makes discovery even more
         | difficult.
         | 
         | But it's almost always this.
         | 
         | As for myself, I had severe brain fog and fatigue. It turns out
         | I was allergic to coffee. Looking back, I now see that it was
         | something that became more and more severe over about 10 years.
         | 
         | It took me quitting coffee for several weeks for an unrelated
         | reason to discover that it was the problem. When I started
         | again, the stark difference in how I was felt made it much
         | easier to diagnose. I got lucky really.
        
         | tootie wrote:
         | Talk to a doctor. Idk why OP spent so much time solving what a
         | doctor could tell them. I had similar symptoms and doc pinned
         | it on narcolepsy before I could finish explaining. Googling
         | symptoms never turned it up. Getting tested for sleep apnea is
         | very easy with an at-home device. Narcolepsy is more involved.
         | Long COVID is another candidate. So is thyroid which requires a
         | blood test.
        
         | galleywest200 wrote:
         | When I first wake up in the morning it feels like I have
         | indigestion, and when I get indigestion I get really bad
         | brainfog. It feels like I am thinking really hard but the
         | thought is blank.
         | 
         | Usually after an hour or two (and a few big gurgles from the
         | gut later) it resolves itself.
        
         | pbourke wrote:
         | > Anyone got any other experiences with things that cause brain
         | fog?
         | 
         | Vitamin B-12 deficiency due to lack of intake (a risk for
         | strict vegan diets) or pernicious anemia, an autoimmune
         | disorder. The former is addressed by over the counter
         | supplements and the latter by injections.
         | 
         | Deficiency can be diagnosed through a blood test.
        
       | pbourke wrote:
       | Are there no sleep clinics in the UK?
        
         | [deleted]
        
       | prakashrj wrote:
       | [dead]
        
       | xlii wrote:
       | I find it somewhat odd that modern medicine don't screen for
       | stuff like sleep apnea or ADHD (and similar).
       | 
       | They're quite frequent (sleep apnea - 17% from the article, ADHD
       | - 5-20% depending on the study) and impact peoples' lives quite
       | severely both on quality and productivity fronts.
        
         | marcosdumay wrote:
         | Both are expensive to diagnose. ADHD also has a problem in that
         | a wrong diagnostic can harm people.
        
           | tootie wrote:
           | The new sleep apnea device he used is really simple and easy.
           | I think we'll see it utilized a lot more often.
        
           | xlii wrote:
           | Diagnose - sure, but screening - I'd argue about that.
           | 
           | Withings device mentioned in the article costs around 170$
           | and probably could be shared beyond few times use. Is it that
           | expensive?
           | 
           | ADHD is very visible in certain cases (and still not
           | diagnosed) and probably could be screened on class level with
           | normalized questionnaires. Hand results over to parents and
           | let them decide if they want to pursue diagnosis or not.
        
       | bitL wrote:
       | Some people seem to have luck by taking 100mg vitamin B1 before
       | sleep for central apnea:
       | 
       | https://www.cpaptalk.com/viewtopic/t176555/Found-a-vitamin-t...
       | 
       | Given B1 seems to be working similarly to acetazolamide but
       | appears to be much safer, I am wondering if anyone is using it
       | for altitude sickness? Doping up a few grams of thiamine just
       | before climbing?
        
         | denimnerd42 wrote:
         | almost not worth trying for me given how well a low dose of
         | acetazolamide works for everyone I know but would be
         | interesting to know.
        
       | ThinkBeat wrote:
       | > The morale of the story, you need to sometimes tackle your own
       | health and take matters into your own hands
       | 
       | I am not a doctor, nor am I a lawyer.
       | 
       | This is, in general, horrible, and dangerous advice. The problem
       | being how to know if this is one of those times. I am happy it
       | worked for sure. But embracing the idea might well kill people.
        
         | telchior wrote:
         | A recent opinion I saw from a doctor that made sense to me was:
         | the reason they tell people to absolutely not do a lot of
         | things is because there is a certain percentage of people who
         | aren't competent to do anything on their own. The example given
         | was Q-tips: we all know the advice that you shouldn't put them
         | in your ears... even though that's literally what they're
         | designed for. The doctor's explanation was that something like
         | 10% of people actually will burst their own eardrums with a
         | Q-tip, so you advise 100% not to use it to avert the harm to
         | that minority. (If anyone knows where I saw this feel free to
         | say; I can't recall.)
         | 
         | In general, if someone's reason for tackling their own health
         | is because doctors (including specialists) have failed to help,
         | I don't see why or how you'd argue against that. Even if you're
         | bursting your own eardrums with cotton swabs, at some point
         | you've got to do something.
        
       | jimnotgym wrote:
       | I have sleep apnea after covid... and burn out. Cpap was a
       | revelation but not a silver bullet.
       | 
       | The link between sleep apnea and weight is a vicious circle. Stop
       | up every night and see if you fancy exercising after a couple of
       | weeks!
        
       | drivers99 wrote:
       | This tracks with what I have. Still waiting to obtain my ASV (the
       | second machine he tried; I also have central and obstructive
       | sleep apnea). I had a home sleep study, then a sleep study with a
       | CPAP, then another sleep study with an ASV the following week.
       | Been waiting 6 weeks since then for a call back from the sleep
       | clinic to actually get the ASV. I tried calling them after 2
       | weeks and they said I had to wait for them to call me which takes
       | 2 to 4 weeks (it's been 6; I'll call them tomorrow).
       | 
       | I actually had a a disnosis and a CPAP two decades ago but I
       | could never sleep with it. I did exactly what he said he did:
       | throw the mask across the room. Since I made myself stick with it
       | in the sleep study thanks to his breathing tips (and not really
       | having an option), I'm sure I can sleep with it now. Also the ASV
       | and the masks available now seem to work a lot better.
        
       | tru3_power wrote:
       | Wow awesome! I never knew about that home device you could order
       | off of Amazon. Helps you rule out sleep apnea fairly easily!
        
       | jnwatson wrote:
       | In the US, the author would have had a sleep study done and it
       | would have been diagnosed in a day. Do they not have those in the
       | UK?
        
         | nerdix wrote:
         | Isn't a full sleep study test pretty expensive in the US?
         | 
         | I went to a sleep specialist once and the cost of a full
         | overnight polysomnogram was nearly $3000.
         | 
         | I opted for a much cheaper at home test from my GP. Showed no
         | signs of sleep apnea but I worry about the accuracy compared to
         | a full study.
        
           | Smaug123 wrote:
           | They're pretty damn expensive in the UK, certainly - around
           | PS2500 a couple of years ago in central London. (It would
           | have been much cheaper for me to just buy a CPAP and try it
           | out, than to have a polysomnography, but it's notionally
           | forbidden.)
        
           | amanj41 wrote:
           | I'm in US and took both a home test and overnight
           | polysomnogram. Both were fully covered my by insurance. My
           | current insurance is definitely not top of the line either
        
         | qwytw wrote:
         | They do. You just have to either pay for one yourself or wait
         | half a year (or maybe way more?) for NHS to provide it.
        
         | sfteus wrote:
         | Anecdotally, my wife was diagnosed in the US with sleep apnea
         | about 2 years ago. This included multiple GP visits to even get
         | an at-home sleep study that came up negative, us having to
         | purchase an additional at-home sleep study out of pocket that
         | came up positive, and an overnight sleep study. The overnight
         | results gave a diagnosis of severe sleep apnea. The entire
         | process from start to finish took at least 3 months.
         | 
         | Her insurance fought every step of the way, despite having
         | half-decent insurance as a hospital employee. They claimed that
         | her BMI was not high enough to have sleep apnea, and ignored
         | the family history (both parents, 3 grand parents, one sibling,
         | three cousins).
        
         | leviathant wrote:
         | In the US, I went in for a sleep study and had to fight for it.
         | "You're not obese or old" yes but both my parents (admittedly
         | old, but not obese) have CPAPs, and my wife says I stop
         | breathing at night. "Are you sure?" Well, sir, that's why I
         | would like to do a study.
         | 
         | I had an overnight sleep study scheduled several weeks later,
         | during which time my insurance provider at work changed, and I
         | had to do the process again, and this time only got a take home
         | kit, and just missed the criteria for getting a CPAP.
         | 
         | Years later I went looking for alternate routes, which means
         | paying out of pocket for a CPAP and accessories... But sleeping
         | better and being more healthy.
        
       | henearkr wrote:
       | It would be interesting to find out the root cause of this
       | central apnea.
       | 
       | Maybe that's the only risk of short-circuiting the medical
       | establishment, that now the author is satisfied with the solution
       | he found for the central apnea which is one symptom, without
       | being concerned with solving its cause (that could have other
       | consequences)?
        
       | fxtentacle wrote:
       | "the National Health System have yet to even send me a letter"
       | 
       | That's the crucial point here. Health care failed him, but
       | luckily he was rich enough to privately purchase multiple medical
       | devices just to try it they might help.
        
         | orzig wrote:
         | You're not wrong on the facts, but if you're implying that we
         | should not feel good about this story, I disagree.
         | 
         | One crab has managed to climb out of the bucket. The rest of us
         | should celebrate for a minute and then redouble our efforts to
         | get everyone to the same place, leveraging the lessons he's
         | passed on. Upwards!
        
           | goodpoint wrote:
           | There's more to that. Building open medical devices and
           | knowledge in general helps humanity as a whole.
        
           | arcticfox wrote:
           | Yep.
           | 
           | I happened to help another crab and I think it may be the
           | single best thing I've ever done.
           | 
           | My wife's family was constantly making fun of my father-in-
           | law for falling asleep during the day, falling out of chairs
           | etc. One day I noticed he was fluttering in and out of sleep
           | while driving me so I asked him if he wanted to try my travel
           | CPAP that night - I have very mild apnea and can get by
           | without it.
           | 
           | He tried it and after the first night he was a completely
           | different person, it was almost like someone drugged him up
           | with PEDs. The home remodelers that were working there were
           | jokingly peeved because he started helping them and they said
           | he was going to put them out of work.
           | 
           | Just transformative, I feel so good about it.
        
           | fxtentacle wrote:
           | Agree. We very much should be happy for him. And thankful
           | that open source granted him access to understanding these
           | machines.
           | 
           | And in addition to that, it would be great if we could
           | improve access for people who are less fortunate.
        
           | [deleted]
        
         | porphyra wrote:
         | Considering how terrible sleep apnea is for the health, you
         | would think that all healthcare systems and insurance companies
         | would take it seriously. The costs of treating heart problems
         | and stroke are much worse. But in practice it seems like no
         | healthcare system puts in more effort than begrudgingly
         | ordering a sleep test and then maybe a basic cpap after much
         | hesitation. There are stories of people literally begging their
         | doctors to give them a cpap.
        
           | jimnotgym wrote:
           | I have cpap on the NHS. I got a quality machine, quality
           | advice and quality follow up. It took a very long time to get
           | it but the care itself was very good.
        
             | GordonS wrote:
             | I had a CPAP machine on the NHS a few years back. The
             | machine was OK, a low-mid range model. But they supplied
             | _everyone_ with a  "medium" size of mask, so I had to buy a
             | bigger mask myself.
             | 
             | I'd say the quality of care I got was... shit. A very bored
             | and uncaring nurse gave me some brief instructions, and got
             | almost angry with me when my mask didn't fit and air hissed
             | out the sides.
             | 
             | I figured it out myself, and had zero follow ups for the 2
             | years I used the machine. They even made it difficult to
             | give the machine back!
        
           | Levitz wrote:
           | Well, just to offer some pushback in the thread, I can
           | imagine one reason why.
           | 
           | My father has sleep apnea, he is overweight, a heavy smoker
           | and I reckon his daily intake of coffee could kill a small
           | rodent. We are Spanish and public healthcare has blessed us
           | with a CPAP machine...
           | 
           | That he just won't use. He refuses to, complains that he
           | feels too uncomfortable with it. I can't recall the last time
           | he slept 8 hours in one go.
           | 
           | And I wonder how common that is. The machine is noisy, does
           | look like pulled out of a teenage horror movie and takes
           | accustoming to. There is heavy friction for its use and that
           | might be a serious problem to consider.
        
       | theonething wrote:
       | > This meant I would have no way of seeing results for myself,
       | instead I would to pay out PS150 each time to get the consultant
       | to analyse for me.
       | 
       | I think I would have just paid the money (at least for a few
       | months to see if I'm getting my money's worth) rather than going
       | through all that trouble of trying out different machines, etc.
       | 
       | That's just me though. I realize some people are more comfortable
       | with taking matters into their own hands and enjoy getting into
       | the nitty gritty.
       | 
       | I'm also the kind of person who would much rather hire a trusted
       | plumber, mechanic, etc to just get it done than muck about it
       | myself.
        
       | JoeAltmaier wrote:
       | Medicine according to averages (almost all practicing medicine)
       | may be wildly inappropriate for some. Not usually; that's why
       | averages are sensible to use. But if it isn't working for you,
       | time to try something else.
        
       | [deleted]
        
       | orangepurple wrote:
       | The word iron did not show up a single time in this article. It
       | is extremely important to make sure your iron and ferritin levels
       | are sufficient or you will feel tired and depressed all the time.
        
         | cj wrote:
         | Do either have a connection to sleep apnea?
        
           | ccooffee wrote:
           | "Iron deficiency and sleep - A scoping review"[0] did a
           | literature review and found many studies linking Iron
           | Deficiency to poor sleep outcomes for various particular
           | sleep disorders. It summarizes the findings with:
           | 
           | > iron investigation and supplementation should be considered
           | in patients presenting with sleep disorders
           | 
           | [0] https://pubmed.ncbi.nlm.nih.gov/32224451/
        
         | quickthrower2 wrote:
         | Blood panel was done
        
           | orangepurple wrote:
           | CBC won't show low ferritin. You can feel awful if your
           | hemoglobin is OK but your ferritin is low.
        
             | di4na wrote:
             | They should. At least here they do. I know this is how we
             | detected my mom's hemochromatosis.
        
               | [deleted]
        
               | riceart wrote:
               | A CBC is a specific and very common lab test and does not
               | include a ferritin level. It's a separate test.
        
             | n8henrie wrote:
             | Interesting!
             | 
             | DellaValle DM, Haas JD. Impact of iron depletion without
             | anemia on performance in trained endurance athletes at the
             | beginning of a training season: a study of female
             | collegiate rowers. Int J Sport Nutr Exerc Metab.
             | 2011;21(6):501-6. Accessed April 10, 2023.
             | https://www.qxmd.com/r/22089308
        
             | justsocrateasin wrote:
             | Any doctor worth their salt should and will do this if you
             | come in complaining about fatigue. They did with me.
             | Someone presenting specific symptoms isn't going to get
             | just a CBC.
        
               | orangepurple wrote:
               | I give a moment of silence to all the people on
               | antidepressants who are actually iron and/or vitamin
               | deficient and don't know it.
        
       | mordae wrote:
       | Here's a story.
       | 
       | We lived in a "commie block" and we could hear our neighbor
       | snoring super loudly during summer when we all had our windows
       | open for the night.
       | 
       | One night, we heard him repeatedly stop breathing and then gasp
       | for breath. So when I've seen him the next day by the elevator I
       | told him: "Sorry to bother you, but we can hear you snoring" and
       | he has gotten super apologetic. But I continued, "yeah, we are
       | used to it so don't sweat it. The trouble is, you are stopping
       | breathing recently. You may have sleep apnea. Go see a doctor,
       | STAT. You don't want your brain to die off due to a lack of
       | oxygen."
       | 
       | He told me in a couple of weeks he's got a CPAP and is working to
       | shed some weight off. In a year he went back to a more normal
       | weight.
       | 
       | He also started dating our neighbor. Curse those open windows...
       | :-)
        
         | notahacker wrote:
         | I remember sharing a room with my snoring grandfather as a kid,
         | and the shortness of breath pauses, which were much, much more
         | disturbing than the snoring itself, especially to a young
         | person who's aware that old people sometimes die in their
         | sleep. Wasn't until a lot later I made the sleep apnea
         | connection (he lived another couple of decades to a grand old
         | age. When the cancer did get him, the neighbours said the
         | cessation of his notoriously loud daytime sneezes should in
         | hindsight have been a giveaway about the change in his general
         | health...)
        
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