[elric]

> also on my relationship with my partner

That's not really much of an issue. There's an adjustment period, and there's a bit of an art to finding an appropriate mask. One that fits perfectly fine for you might have an exhaust port that blows air in your partner's face. Or the one that your partner can't hear at all might sound thunderously loud in your ears.

But all in all, your partner would much rather have you sleep with a mask than choke all night.

[binoct]

Those who can tolerate the general CPAP experience, have bed partners who tolerate it, and don’t experience detrimental effects should absolutely use it when there are no comparable solutions. However there are lots of perfectly legitimate reasons why not everyone can, and having alternatives (which do also come with side effects) to consider is amazing for the community overall. It’s legitimately great that it sounds like CPAP treatment has been effective for you (as it has for me, mostly), but your comments end up sounding quite dismissive of the challenges faced by other patients.

Careful skepticism of new treatments is always warranted, but even if it only helps 5% of patients with OSA in absolute terms that’s a huge population impact.

[elric]

Almost everyone can tolerate CPAP. The problem is that the medical establishment sucks at helping people adjust and is awful at properly titrating them. Followup is abysmal. If they did a better job of that, compliance numbers would skyrocket.

Skepticism is very much warranted. CPAP is the gold standard because nothing has come along that comes even close. I'm much more optimistic about an upcoming generation of micro-implants that stimulate various throat muscles than I am about pharmaceutical treatments using stimulants.

Edit: to be clear, I am not dismissive of any OSA patient's concerns. But most of their issues are a consequence of shitty titration and poor support from their sleep docs.

[aaronblohowiak]

*Apap > cpap, but most people call apap cpap …

[elric]

I disagree. APAP is reactive, by the time it kicks in you've already had an event. But if it works for you, all the better.

[Citizen8396]

You nailed it. CPAP ultimately fails for something like 50% of patients.

[gertop]

> That's not really much of an issue.

Yes yes love conquers everything and whatnot. Doesn't change the fact that some people need absolute silence to fall asleep and a CPAP machine is very disturbing to them. So they have to sleep with earplugs which, again, is an issue for other reasons.

Please don't generalize your own experience with your partner onto all of us.

[genocidicbunny]

Or alternatively, they need the noise, but cannot tolerate rhythmic noise. A CPAP machine to me isn't disturbing because of the noise -- if anything I would prefer some noise to drown out the mild tinnitus. It would be disturbing because it would be a fairly repetitive noise, and my brain would very quickly lock onto it and not allow itself to relax and let me sleep. Even a lot of 'random noise' videos on youtube end up being repetitive enough to trigger this.

I had a friend stay with me for a week or so, and they use a CPAP machine. Due to the poor sound insulation in the house, I could hear the machine from the guest bedroom to mine. It was one of the few times when I had to find some really long-form content on youtube to leave it playing all night on the tv in my bedroom to drown out the repetitiveness of the CPAP machine. For the first few hours of the first night I ended up waking up two or three times an hour because of the repetitive sound of the machine before I realized it.