Shot fired :) What about SOL or Tezos?

When I first heard of sleep apnea, I was under the impression that this is more of a "larger" person disease. However, as despite me having sub-10% body fat, I still had it; it turns out sleep apnea can affect basically anyone.

One of the main criteria for sleep apnea diagnosis is the number of blood oxygen saturation drops per hour. However, there's two competing standards of how to define an oxygen saturation drop. One is 4%, another is 3%. Insurance uses 4% as their standard, as it helps them avoid paying for treatment. Doctors prefer to use 3%. The difference is dramatic. Under the 4% definition, I was "near normal," under the 3% definition, I was in the *most severe* category. Unfortunately, most at home sleep tests use the 4% definition and don't give you the raw data to re-run this by yourself. I had to go to a lab. You can try a very basic O2 saturation night meter , but it’s not the most accurate.

Now, based on other symptoms, my sleep apnea was actually severe. I had bad insomnia, as my body didn't actually want to go to sleep. I didn't wake up refreshed. I ground my teeth at night. One of the key contributors to sleep apnea for me was an under-developed jaw. Causes of an under-developed jaw are many, but they include insufficient chewy foods in childhood, allergies, exposure to mold, various forms of tooth damage and bad orthodontics. One's jaw can either be too far back of too narrow, both were the case for me. Now, a few small at home things that *can* help this. Having a very thin pillow and not elevating one's head too much can help with sleep apnea. Occasionally, I just have a pillow under my neck and not my head. "Sleeping position" is another one of those surprisingly tough to make choices. Sleeping on one's back make sleep apnea worse, however sleeping on one's stomach makes shoulder tension worse.

I wanted more permanent solutions, so I decided to fix my jaw with medical help. For the jaw being too far back, one clean solution for me was Apnodent. It's a more sophisticated way to hold your lower jaw forward compared to older "mandibular adjustment devices." Those "MAD" devices came with some very frustrating side effects, such as TMJ pain, which made them tricky to use long term. For the jaw being too narrow, there are several quasi-surgical solutions, such as "Maxillary Skeletal Expander," which is currently in progress for me. You occasionally can get some small expansion through Invisalign, however you can only push teeth a very small amount if you are not changing jaw bones. There is a lot of complexity in each individual case, as sometimes you may want to align teeth before attempting surgeries, sometimes not. I spent a couple years with various devices and my sleep is way better now. Insomnia is gone and I wake up readily without wanting to snooze for a few hours.

I use Clearly Filtered and I have a much easier time convincing myself to drink regular water than before. After some time of using it, my wife and I could taste the difference between tap water and filtered water in some places. Recently I also got a basic whole house water softener and a sediment pre-filter, which help with the longevity of finer downstream filters and pipe damage.

Improper bone growth is the most "medically" visible of postural issues because it will show up on the X-ray, which many chiropractors can give you. I have gone to a couple chiropractors. Their general perspective is that you can get so tense chronically and your body gets so tired in holding up particular positions, such as a forward head posture, that you basically begin to grow new bones on your vertebrae to “lock” yourself into a position. Chiropractors can undo some of the damage to the bones, which is good, but problems can frequently come back if the most root causes are not addressed.

Sleep Hacks are ways to improve your sleep, getting a full night's rest with little insomnia. None of these are likely as important as full blown sleep apnea issue, but worth trying for every % of better sleep.

a) Light blocking curtains.

b) check for mold in your house. Some amount of mold is common everywhere however large amounts can interfere with your sleep and cause serious throat inflammation. If you do find mold, depending on the amount / strength, it might be worth calling a specialist. At home solutions for it, include using a UV light, air purifier, deep cleaning carpets, air ducts and reducing moisture from the walls.

c) some people swear by mouth taping , night-time nose cavity strips and nasal spray as sleep hacks. These may indeed be good, however if they are giving you a very large benefit, it's definitely worth checking for sleep apnea and seeing you can get a more permanent solution with jaw modification.

d) shut down your electronics. Before sleep we turn off wifi and all the electricity to the bedrooms at the circuit breaker. If you have a large house, you might actually find it helpful to completely separate sleeping areas from any daily use electronics what-so-ever.

e) meditation before bed can calm you and get you to "turn off" your mind from worrying.

Posture is more than just sitting up straight vs slouching. Perhaps when you hear "posture" you just straightened your back very hard now as you read this, perhaps a little too much. However, I have come to see “posture” as an extremely broad subject that combines trauma, anxiety, awareness, muscular development, bone growth and many other aspects. I suspect that postural issues are extremely endemic in the culture. “Back pain” or related fatigue / anxiety issues don’t have to be a symptom of adulthood.

My 10000 ft general view of how postural problems evolve is below:

Physical Trauma, Emotional Problems or Asymmetric Activity ->

Negative physical feeling or being stuck in the same position ->

Reaction through muscular tension ->

Chronic muscle tension ->

Improper bone growth / loss of capacity to sense one’s body

The bad news is that many people, myself included can get so tense that they lose a lot of ability to feel the problems in the first place, making it hard to believe that your problem is actually “posture.” The good news is that there are many solutions which diagnose and target basically every particular cause.

My take-away from my 10-day Vipassana retreat is that their style of Vipassana body scan is meant to interrupt the pattern of "negative sensation" -> "reaction." By training yourself to observe "negative sensation" without judgement, you can basically short cut the process of "tension” at a fairly early stage. Another thing it can do is help you with the general "awareness of body" that may have been damaged by chronic pain. Vipassana and related meditation is trying to work at the more "root" causes of the postural and other issues rather than the more physical adjustments of other therapies.

Their idea is that being able to sense specific sensations without judging them, then you would be able to "intercept" a painful feeling *before* it transitions to either muscle tension or some other reaction you might not like in your life.

At the retreat, despite having lots of trouble with their sub-optimal diet, I did feel pretty relaxed towards the end. 10-day retreats are not for everyone, also many people’s experiences vary a lot and improvements, if any, are frequently not as physical as for me. For an at-home practice, the first 20 min – 1h of meditation per day give a lot of benefit with muscle relaxation and after that its effectiveness falls off and likely other methods become more important at least with regards to posture.

Postural Restoration Institute (PRI) has one of the most interesting perspectives on posture. They looks at "left right asymmetry" as the core postural issue. Left right assymetry frequently takes the forms of pelvic tits, rib cage twists and shoulder twists. Together they produce a potentially large amount of tension.

Left right asymmetry can be originally caused by many things, such as using right hand too much over the left in manual or computer work. This can result in asymmetric breathing and tense breathing that uses shoulders and neck too much instead of the diaphragm. The whole set of ideas it really worth checking out. This channel is a good starting point.

There are many symptoms of whether you need PRI and are suffering from the left-asymmetry they tend to focus on. some examples:

i) you seem to have a chronic clusterfuck of tension around the left shoulder blade (or any un-even back pain for that matter)

ii) one of your shoulders is visibly different from another (higher or tilted forward differently)

iii) you sit at the computer a lot and use the mouse.

iv) after trying the most basic PRI exercise you feel amazing.

v) your neck has a lot of trouble bending or rotating sideways.

vi) you find that during mediation your body "relaxes into" a twist.

In essence, the important thing to watch out for is not "just" forward head posture or slouches, but rather "asymmetry," which can manifest as holding very tense "twists" of your body. For example, I tend to have pelvic twist to the right and a rib-cage twist to the left, which is a common anti-pattern addressed by PRI.

PRI’s recommendations of what to do about this are a form of physical therapy, where they recommend specific exercises to correct the situation. You can find the basic one’s here, but many of the other exercises are going to be slightly specialized to your case. Many of PRI's recommendations are fairly intuitive, they frequently ask you to move your body into the opposite position of your chronically stuck position and breathe deeply to improve mind body connection.

PRI’s view is that postural issues and accompanying muscle tension are affected by basically every interaction with have with the environment. Jaw tilts or open bite, for example, can wreack havoc throughout the body. Another issue that I had was bad shoes that were too narrow. I also used to rock climb, using very tight shoes. All of those cause toes to bend inwards, which creates tension in one's legs and contributes to pelvic tilts. My solution was to get better shoes and use a toe spreader from time to time.

I have struggled with very serious migraines since the age of 10.

Originally, my strategy to deal with them was a better diet. Eliminating sugar, wheat and alcohol seemed to have had the most improvement, however even after moving the full paleo diet the headaches have not fully disappeared.

My second strategy was combating over-heating. My theory was that having “inflammation" for any reason, then any amount of extra heat might make the situation worse. Some very basic anti-overheating techniques helped me with reducing headaches. They were: a slightly cold shower, a glass of cold water, walking around in cold air.

However, despite all that, the headaches didn’t disappear until I tried the final strategy: Neuro-Cranial Restructuring (NCR) http://drdeanhowell.com/. NCR's stance on posture has a lot of similarity with Postural Restoration Institute, except they look at asymmetry originating in the skull rather than in the diaphragm. By slightly adjusting bones in the head, they move the head to be more symmetrical which reduces the muscle activity required to hold it up. NCR involves a body-work component similar to massage and an adjustment component of the skull bones using a nose balloon (yes, really!). The interesting thing about NCR is how amazing you feel immediately afterwards. Very few therapies can compare in the before and after subjective feeling. NCR is similar to chiropractors in some ways; however, I am more likely to recommend it because it works on parts of the body that are really hard to correct with other methods. After 5 NCR sessions, my life-long headache are gone.