• Sleep hacking

    Almost exactly two years ago, I experienced symptoms of sleep apnea. It lasted a couple nights, then disappeared until late December 2017. Naturally, I suspected nothing at the time, it being a one-off. In hindsight, it suggests my condition is not a few months old, but a couple of years.

    It is indeed possible, according to the sleep expert in Calgary with whom I’ve corresponded. Sleep apnea can begin in mild, even intermittent form and gradually worsen over time, as one ages.

    That’s a reasonable theory for my case. If true, it means my body has had a couple years to get good at responding to breathing difficulty during sleep. When my airway is blocked, it now rouses me, quite expertly, to consciousness if my sleep isn’t deep enough.

    But, does it matter exactly how my airway is blocked? I don’t see why. My sleeping brain should react with the same panic.

    Well, guess what? Provent therapy, which I’ve mentioned before works by restricting the airway on exhalation only. The point of this is to increase internal pressure that keeps the airway open. It does so with carefully crafted valves one applies to the nostrils with adhesive patches. They allow inhalation with little resistance, but exhalation is highly restricted. It’s ingenious, and there is evidence it can be effective for obstructive sleep apnea. See this systematic review and meta analysis.

    The starter kit comes with two nights each of low and medium resistance patches, to help get used to the more extreme, therapeutic level patches. According to feedback from my wife, those worked pretty well for me. For the first time in years, I didn’t snore, she said. That’s by no means scientific evidence of reduction in apnea events, but it is consistent with it.

    However, the standard, therapeutic level resistance is, to my taste, extremely restrictive. Except when I’m in deep (and, to date, Ambien-aided) sleep, my subconscious brain reacts the same way as to an apnea event. It wakes me up, and does so to consciousness more often than I’d like. Maybe one can get used to this. But it is darn hard to train one’s subconscious mind to relax and not panic during breathing restrictions.

    Sleep hacking is hard … because you’re asleep!

    So, it seems, at least until I get a more effective treatment (next week) I can choose my poison: wake up to apnea events (without Provent) or wake up to self-inflicted exhalation resistance (with Provent). Not much of a choice.

    But there’s a third option. I can intentionally degrade Provent’s resistance by introducing some air gaps that partially bypass the device—basically trying to mimic the low-to-medium level resistance with the high resistance patches I have left. (I haven’t seen lower level resistance patches on the market. Anyway these things are expensive, so I’m not sure I’d buy them, having already invested in the starter kit that comes with ~30 pairs of standard resistance ones.)

    Maybe I can find a balance between raising airway pressure enough to reduce apnea events, but not enough that my brain panics. I crudely experimented with this last night, but it was not a great test. More to come.

    This is another way sleep hacking is hard. You can only experiment during the same type of sleep you’re having trouble with. That may only happen a few hours per night. There’s no way to speed up the cycle of innovation.

    @afrakt

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