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Sleep apnea pill shows striking success in large clinical trial

278 포인트작성자: pseudolus4일 전

29 comments

kimjune014일 전
Sleep apnea is a structural issue, either soft or bone. CPAP helps, but it doesn&#x27;t address the root cause. Fixing it is a matter of airway geometry, with many obstructions along the way. Bodybuilders or wrestlers, otherwise in good health, can suffer from OSA because of too much muscle in their neck.<p>You may not know it, but your tongue may be tied. It is one of many possibilities causing OSA.<p>I made this: Do I have tongue tie? Self assessment <a href="https:&#x2F;&#x2F;do-i-have-tongue-tie.vercel.app&#x2F;" rel="nofollow">https:&#x2F;&#x2F;do-i-have-tongue-tie.vercel.app&#x2F;</a><p>Didgeridoo playing as alternative treatment for obstructive sleep apnoea syndrome: randomised controlled trial <a href="https:&#x2F;&#x2F;pmc.ncbi.nlm.nih.gov&#x2F;articles&#x2F;PMC1360393&#x2F;" rel="nofollow">https:&#x2F;&#x2F;pmc.ncbi.nlm.nih.gov&#x2F;articles&#x2F;PMC1360393&#x2F;</a><p>Myofunctional Therapy to Treat Obstructive Sleep Apnea: A Systematic Review and Meta-analysis <a href="https:&#x2F;&#x2F;pmc.ncbi.nlm.nih.gov&#x2F;articles&#x2F;PMC4402674&#x2F;" rel="nofollow">https:&#x2F;&#x2F;pmc.ncbi.nlm.nih.gov&#x2F;articles&#x2F;PMC4402674&#x2F;</a><p>Jawhacks on Youtube, discussing Airway health <a href="https:&#x2F;&#x2F;www.youtube.com&#x2F;@JawHacks&#x2F;search?query=sleep%20apnea" rel="nofollow">https:&#x2F;&#x2F;www.youtube.com&#x2F;@JawHacks&#x2F;search?query=sleep%20apnea</a>
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elric4일 전
I swear CPAP wouldn&#x27;t get such a bad rep if the media would stop using pictures of men with obscenely large full face masks. The most commonly used CPAP mask is probably the minimalist Resmed P10 [1]. It looks a lot less intimidating than a bulky full face mask. And in most cases, full face masks aren&#x27;t needed (no sources to cite, but titrating to the correct pressure allows most people to breathe through their noses).<p>Looks like they buried the lede:<p>&gt; possible side effects from atomoxetine such as signs that sleep isn’t as restorative while on AD109 or an increase in blood levels of C reactive protein [..] “Atomoxetine also increases heart rate and diastolic blood pressure a little bit,”<p>That&#x27;s ... unsettling. So you&#x27;re reducing events at the cost of increased blood pressure and heart rate? That&#x27;s not good.<p>&gt; the treated participants experienced 56% fewer instances during sleep where their breathing grew shallow or ceased<p>That sounds impressive at face value, but is probably pointless? So you have an AHI of 40, and now you have an AHI of 18? You&#x27;re still getting crap sleep. Correctly titrated CPAP reduces events by ~99%.<p>&gt; In addition, 22% of the treated patients achieved complete control of the disease, defined as fewer than five airway obstructing events per hour.<p>That sounds much better. Can these 22% be identified based on some criteria? So that they can be treated in this way?<p>&gt; AD109 caused a “meaningful” reduction in the depth and duration of patients’ periods of low blood oxygen<p>&quot;Meaningful&quot;? If there is any significant saturation, your sleep is going to be shit. Again, correctly titrated CPAP eliminates desaturation entirely.<p>As far as I can tell, there&#x27;s no polysomnography data to be examined anywhere. How was this tested? Are they just looking at AHI? In which case this is meaningless. Are these folks&#x27; sleep architectures restored? Or are they still having a bunch of events during REM which renders their REM sleep useless?<p>[1] <a href="https:&#x2F;&#x2F;www.cpaponline.com.au&#x2F;wp-content&#x2F;uploads&#x2F;2020&#x2F;05&#x2F;cpap-online-resmed-airfit-P10-for-her-pillow-fitting-front-1024x683.jpg" rel="nofollow">https:&#x2F;&#x2F;www.cpaponline.com.au&#x2F;wp-content&#x2F;uploads&#x2F;2020&#x2F;05&#x2F;cpa...</a>
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piperswe4일 전
Atomoxetine can have some super nasty side effects, and I wouldn&#x27;t be surprised if it only works for some people. It&#x27;s a fickle drug in my experience.
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pedalpete4일 전
When looking at any of these studies in CPAP, and sleep in general, we need to be looking deeper than just the AHI (hypopnia index, how many times you stopped breathing), and directly at EEG measures of restorative function and other biomarkers.<p>This shows an improvement in AHI, but no change in any markers of actual sleep restorative function (I&#x27;d use the term &quot;quality&quot; but the sleep health industry has stolen that term to mean measures of sleep time).<p>When looking at sleep time the study shows no change in most of the sleep architecture, but a significant decrease in REM time, which can have effects on emotional wellbeing, irritability, and potentially depression.<p>This study showed no change in ESS (subjective measures of daytime sleepiness), but did show a change in PROMIS, which is a longer term measure of fatigue.<p>I&#x27;ve been recommending to anyone on CPAP that they give mandibular splint, which is a biteplate which shifts the jaw in order to hold the airway open, and is much easier, lower cost, and effective for many people. It also does not show a reduction in REM.<p>However, I also don&#x27;t believe there is any reason that a sleep study which has full PSG relies only on sleep time, and none of the bio&#x2F;neurological measures of health which are easily available, such as HRV, delta power, spindle activity, etc. etc.
sfink4일 전
One thing that I&#x27;ve found very helpful, and wish my doctor had mentioned: when putting on the CPAP (nasal pillows in my case), time turning it one with your breathing such that the machine first kicks in during an inhale.<p>That&#x27;s it. It sounds trivial. But my biggest problem[1] with the CPAP is that it feels like it&#x27;s smothering me. I can get more air in, faster, without the CPAP, and I still vividly remember the initial months when I would rip it off in frustration just to be able to breathe.<p>The thing is, I wasn&#x27;t wrong. When I go to bed, I move around a little to adjust my pillow and lean over to grab the headpiece and turn it on, and all that movement means my oxygen requirements are temporarily higher. Putting on the CPAP immediately restricts airflow, so of course I hate it even though I can forcibly breathe through it.<p>But timing it so that it <i>adds</i> airflow (during an inhale) makes me feel like it&#x27;s helping, not smothering. I can still breathe a little harder while settling down, but psychologically it feels way better to have it helping me breathe instead of fighting me. I wish someone had suggested this early on.<p>I don&#x27;t have an answer for my upcoming 12-hour overnight flight, though. Other than a long series of 5-minute half-naps, watching a lot of movies, and sacrificing the first day to stumble around and catch up on rest. (Which, to be fair, I&#x27;d be doing anyway with the time change.)<p>[1] Well, the other problem is the noise. My partner is a light sleeper, and if she&#x27;s suffering during the night from my noise, I&#x27;ll be suffering during the day. We&#x27;ve largely resolved that with a white noise machine closer to her, and learning how to maintain a proper seal with various strap adjustments and position shifts. I only get a shove in the night once every few months at this point. It&#x27;s almost like she feels entitled to sleep at night too...
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ProllyInfamous4일 전
I am a fattie (BMI 36.5). I also have sleep apnea. Wearing a CPAP, I couldn&#x27;t ever get <i>any</i> sleep (toss&amp;turner).<p>Things that&#x27;ve helped:<p>1) Using body pillows to force sleeping on side, which straightens the neck (versus face-down) — also lessens low-back pain<p>2) DENTAL GUARD (a 3D-printed plastic insert which form-fits my teeth, slightly opening jaw-angle&#x2F;mouth)<p>3) Losing weight — YES, sleep apnea is worsened by excess weight<p>4) Pseudoephedrine (an hour before sleep) — but be careful cause too much and you <i>won&#x27;t ever</i> sleep<p>YMMV; I am not a doctor (just fat guy with apnea).
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evanjrowley4일 전
I must be in the minority of CPAP users who would use it even if I stopped having OSA. Why? A few reasons:<p>1. Sometimes I hardly notice it. Newer models are very quiet and portable. I&#x27;d even go as far as saying the mask is comfortable to wear, like a security blanket for the face.<p>2. Practically nothing filters out dust and cat hair better than my CPAP. An N95 mask might do better, but would be ridiculously uncomfortable by comparison.<p>3. It&#x27;s a humidifier strapped to my face. No more discomfort trying to sleep through dry weather seasons.
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N00dlesHead4일 전
I cant use a cpap so anything else worth trying is good for me. I have nocturnal seizures, need a sports guard to keep from biting chunks off my tongue while sleeping, plus a deviated septum. Cpap doesnt work for me theres no air flow,so Im waiting on both surgery on my nose (going on 3 years) and a mouth guard to pull my jaw forward which is taking forever as well. I havent had a decent sleep in years
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gp4일 전
I worry about developing sleep apnea, not only for the effects on my health, but also on my relationship with my partner.<p>A medicine that treated sleep apnea would be revolutionary for so many people.
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petercooper4일 전
<i>“Atomoxetine also increases heart rate and diastolic blood pressure a little bit,”</i><p>This reminds me of some studies I read about weird uses for nicotine. Trials have been run where people with sleep apnea wore nicotine patches with a reduction in episodes. The theory is it keeps the brain stimulated allowing, paradoxically, people to get better sleep. Things like this: <a href="https:&#x2F;&#x2F;pubmed.ncbi.nlm.nih.gov&#x2F;3965253&#x2F;" rel="nofollow">https:&#x2F;&#x2F;pubmed.ncbi.nlm.nih.gov&#x2F;3965253&#x2F;</a><p>Doctors have no desire in getting people hooked on nicotine though, even if there&#x27;s a net benefit, so it&#x27;s great if they&#x27;re finding other medications for the task.
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jonmagic4일 전
After nearly 14 years of using a cpap (<a href="https:&#x2F;&#x2F;theprogrammingbutler.com&#x2F;blog&#x2F;archives&#x2F;2014&#x2F;02&#x2F;13&#x2F;sleep-apnea-survivor&#x2F;" rel="nofollow">https:&#x2F;&#x2F;theprogrammingbutler.com&#x2F;blog&#x2F;archives&#x2F;2014&#x2F;02&#x2F;13&#x2F;sl...</a>) and then bipap religiously I was able to switch away recently.<p>All I do now is use now is a piece of kinesthetic tape to make sure my mouth stays closed and that somehow works. I’d just done another sleep study to see if I had options other than the bipap because it’s been filling me with air since I was intubated and put on life support overnight a few years ago. I’ve been miserable the past few years and doctors couldn’t figure out how to fix it. Bipap helped a bit but not completely.<p>I’d even turned down the cpap and then bipap to the lowest settings, which was enough to help me have a great night of sleep, but still the balloon effect. Then I was chatting with a family member and they mentioned trying and liking taping, something they saw on TikTok, and I told them it was a terrible idea. They assured me it was helping them avoid the snore and they woke up less dehydrated and better rested.<p>So I gave it a go. I wear my Apple Watch when I sleep and have been able to confirm on at least 3 occasions before I started taping that the sleep apnea stats always lined up with when I was experiencing the effects of apnea. The first night I taped but still used the mask and was fine the next day albeit filled up with air. Then I tried a night taping without my cpap and someone to monitor me and make sure I didn’t die and I couldn’t believe when I woke up in the morning completely rested and not feeling awful from the balloon effect.<p>I’m not suggesting what worked for me will work for anyone else, but thought I’d share as my quality of life has gone way up the past few months.
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zomg2일 전
more relevant for this audience is the digital health platform and wearable apnimed has developed to support their clinical trials. i saw their presentation &quot;Sensor-Based Digital Health Technology Enables Digital Medicine for Sleep-Related Breathing Diseases&quot; recently at ATS 2025 in san francisco.<p>* <a href="https:&#x2F;&#x2F;www.healio.com&#x2F;news&#x2F;pulmonology&#x2F;20250518&#x2F;platform-linked-to-ring-pulse-oximeter-monitors-analyzes-nighttonight-sleep-metrics" rel="nofollow">https:&#x2F;&#x2F;www.healio.com&#x2F;news&#x2F;pulmonology&#x2F;20250518&#x2F;platform-li...</a><p>* <a href="https:&#x2F;&#x2F;x.com&#x2F;atscommunity&#x2F;status&#x2F;1923417506460455360" rel="nofollow">https:&#x2F;&#x2F;x.com&#x2F;atscommunity&#x2F;status&#x2F;1923417506460455360</a><p>* <a href="https:&#x2F;&#x2F;www.eurekalert.org&#x2F;news-releases&#x2F;1083591" rel="nofollow">https:&#x2F;&#x2F;www.eurekalert.org&#x2F;news-releases&#x2F;1083591</a>
refurb4일 전
It&#x27;s definitely an interesting outcome and nice to see such a significant improvement in a clinical trial.<p>And as the article states, there are questions that aren&#x27;t addressed - does the reduction in obstructive events change the clinical symptoms such as daytime sleepiness? Intuitively you would think it does, but it should be measured in the trial. I also didn&#x27;t see anything about adverse events during the trial. Seems like taking a stimulant might cause insomnia in some patients.<p>&gt; In addition, 22% of the treated patients achieved complete control of the disease, defined as fewer than five airway obstructing events per hour.<p>This surprised me - 5 obstructive events per hour is &quot;complete control of the disease&quot;?<p>It looks like this is the clinical trial: <a href="https:&#x2F;&#x2F;clinicaltrials.gov&#x2F;study&#x2F;NCT05813275" rel="nofollow">https:&#x2F;&#x2F;clinicaltrials.gov&#x2F;study&#x2F;NCT05813275</a>
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cjbgkagh4일 전
It is Tirzepatide which is a GLP-1 agonist, like Semaglutide (Ozempic). I don&#x27;t know how much of the co-occurring issues from sleep apnea are caused by the sleep apnea or are comorbidities for something else. I suspect quite a lot of the later. I think we&#x27;re going to find that GLP-1 agonists are really good for a lot of things beyond obesity including many auto-immune conditions which I think underlies many mental conditions.
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mmmBacon4일 전
I would love to try this. I couldn’t tolerate CPAP. I used a dental appliance and that worked really well for a while, although was not perfect. I’m now on a path to have jaw surgery to move my lower and upper jaw by 1cm. I’ve started with extensive orthodontic treatment and it’s super uncomfortable. The thought of the surgery is also fairly terrifying. So if there’s a pill that could help, I’d sign up in about a millisecond.
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linsomniac4일 전
There&#x27;s also a new &quot;KPAP&quot; (KairosPAP) that is a different air delivery algorithm that people tend to find much more comfortable. Rather than being a constant air delivery, it&#x27;s a little kick at just the right time, is my understanding. <a href="https:&#x2F;&#x2F;sleepdoctor.com&#x2F;pages&#x2F;cpap&#x2F;kairospap-kpap" rel="nofollow">https:&#x2F;&#x2F;sleepdoctor.com&#x2F;pages&#x2F;cpap&#x2F;kairospap-kpap</a>
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IAmGraydon4일 전
&gt;One of the medications, atomoxetine, approved by the U.S. Food and Drug Administration (FDA) in 2002 for attention-deficit&#x2F;hyperactivity disorder, increases levels of the excitatory neurotransmitter norepinephrine by blocking its reuptake from neuronal synapses.<p>Guessing this will never see the light of day as insomnia is going to be a major side effect. Preventing sleep apnea by preventing sleep is not exactly a great trade-off.
gonzo414일 전
Or try, no booze, lose a bit of weight, increase cardio activity and sleep on your side. This works pretty well for obstructive but sadly not central apnea.
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wincy4일 전
Zepbound is actually FDA approved for the treatment of sleep apnea. It’s helped me sleep much better after losing 60 pounds due to this drug.
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rowanseymour4일 전
I&#x27;ve had problems with obstructive sleep apnea for a couple of years. Tried CPAP&#x2F;BPAP for a month and hated it so much I&#x27;m now trying to see what I can fix with surgery even though surgeries like maxilofacial sound horrific. I currently have a MARPE device installed to slowly splitting my palate bone down the middle to expand that. A pill sounds wonderful..
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lzy4일 전
This looks promising, especially for folks who can&#x27;t tolerate CPAP. Wonder how it performs long-term and if it messes with REM cycles. Also curious about cost and insurance coverage—sleep treatments tend to get expensie fast. Hope follow-up studies confirm these results without major side effects.
nanipunani4일 전
People using a CPAP - have you looked at Inspire? [1]. My pulmonologist friend highly recommends it. The device has very high success rate and is now in the 5th generation of development.<p><a href="https:&#x2F;&#x2F;www.inspiresleep.com&#x2F;en-us&#x2F;" rel="nofollow">https:&#x2F;&#x2F;www.inspiresleep.com&#x2F;en-us&#x2F;</a>
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linsomniac4일 전
Has anyone tried the &quot;hostage tape&quot; or similar to force breathing through your nose like Essential Craftsman discussed in his series of videos <a href="https:&#x2F;&#x2F;youtu.be&#x2F;g8JzXEoT9LI?si=rVuZRoMrE_fwL0qv" rel="nofollow">https:&#x2F;&#x2F;youtu.be&#x2F;g8JzXEoT9LI?si=rVuZRoMrE_fwL0qv</a>
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polishdude204일 전
I don&#x27;t have sleep apnea but during allergy season my nose does like to get stuffed at night causing my mouth the get really dry which causes me to wake up a few times.<p>I&#x27;ve been using nasal strips for the last few weeks and those events have stopped. I swear I also feel better during the day.
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xyst4일 전
I’m all for more options to improve sleep quality for OSA. However gains seem minimal over existing alternative therapies (ie, &quot;mandibular advancement devices&quot;).
jmclnx4일 전
&gt;Atomoxetine also increases heart rate and diastolic blood pressure a little bit,<p>I believe most people with Sleep Aonea tend to have High Blood Pressure, this could be concerning.
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klevertree4일 전
Wrote about this in the context of repurposing, which is a pet interest of mine: <a href="https:&#x2F;&#x2F;trevorklee.substack.com&#x2F;p&#x2F;another-entry-for-the-repurposing" rel="nofollow">https:&#x2F;&#x2F;trevorklee.substack.com&#x2F;p&#x2F;another-entry-for-the-repu...</a>
jacekm4일 전
Noob question: could this drug help with snoring as well?
kazinator4일 전
Death apnea is proving much more elusive.