1. Yes, we should regulate manufacturers intensely.
2. No, we shouldn't regulate to whom companies should be allowed to sell them. The defaults are good enough for most. Provide an easy to use control for max pressure and people will figure it out. Perhaps a knob?
I claim: During the past decade, the risk of being maltreated by a personally set-up CPAP unit has been far, far smaller than the risk of not being treated at all. (Ways to access these menus have been been shared online for 10+ years, many use them.)
I wonder how many premature deaths happen every year because of this - including secondary victims from traffic accidents.
These things should be $500 mass-market consumer units that you pick up at Target, Walmart, etc.
The health industry as a whole is insane. I support the use of regulation and law where it ensures safety and efficacy but in the U.S. it's currently a patent and legal minefield. So much of it comes directly from special interests who want gatekeeping to keep out new/disruptive competition.
On the other side, as a consumer, I don't really want "new/disruptive competition" - I want stability and a legal guarantee my rights aren't being trod all over.
Large companies e.g. Google/Apple are just inherently untrustworthy in this regards, smaller overseas ones are no better (little to no regulation).
So please, no, stay the ** out of my health, thanks.
You can have gains in both today if certain issues are addressed. Innovation doesn't mean a lack of liability or responsibility for negligence.
In the U.S. you already have relatively minimal rights in healthcare. Your stability and legal guarantees are already compromised compared to your worldly neighbors. I too distrust tech companies in healthcare due to their differing motivations and organizational cultures.
I want the red tape to go away, but I also want strong regulations and safety nets to ensure the drugs and devices we are prescribing to people are effective and safe.
> I want the red tape to go away, but I also want strong regulations and safety nets
I'm not certain those goals can be both met. You can have innovation, but some red tape is necessary.
Of course you could get into arguing that "not all red tape is made equal", but deterring cheap "innovation" from a tech shop trying to make a quick buck is absolutely necessary and useful. The barriers exists for very good reasons, not only as you said they have a different motivation and organizational culture, but they have different qualifications.
That's the cool thing about competition though - you can continue spending your money on the current super expensive option if you like. But others who may not value that stability can choose something else.
Personally, I consider big pharma companies the absolute least trustworthy, and I would never choose to purchase anything from them if I would not literally otherwise die. Regulations are not fundamentally bad, but the current situation is obviously a case of regulatory capture.
When it comes to healthcare, that's a lot more complicated though.
Wider competition with less control/accuracy will often mean that fads get more profitable: for instance "gluten free" sells enough that it makes sense for random makers to slap the label on their product even if they don't really care to follow the most rigorous rules.
Letting the market decide will result in the minority (those actually affected by the products) to get shafted, as more and more companies will move to the lower standards they can get by, instead of keeping high priced products that don't sell as well.
That doesn't mean that the status quo is great, but at least we need to be pretty cautious on the direction we want to go. "Let's just do something and see how it goes" isn't a desirable strategy when people are at risk.
You can have the regulators choose who can slap a "gluten free" sticker on their product but still give people the freedom to buy products without the sticker.
Competition does not mean getting rid of or even lowering standards, just that if those standards are misaligned with real people's needs we're not stuck with them.
Maintaining a known-flawed status quo is not being cautious. People suffer severely every day from inaccessible medical care. We can always return to the current system if we don't like a change, but until we actually try it we don't even know how much damage the status quo is doing.
Stability doesn’t always help. For example Phillips had to recall their latest CPAP machines because of disintegrating foam that patients potentially inhaled all night for months, with unknown long term health effects. Who can trust big companies that avoid scrutiny and accountability just due to their size and power?
Yeah I have two of those machines that i bought myself (with prescription).
It's been 4 years and Phillips has yet to replace them. They also don't answer any kind of contact about it. I'm glad the local authority gave me a resmed but I still want those Phillipses replaced.
Google, Meta et al ARE FAR worse than anything might complain about Apple. Between the sleep apnea and hearing aid/hearing loss features you should be applauding these features to the world. As a consumer I have family members that will be leveraging these features immediately, including myself.
> During the past decade, the risk of being maltreated by a personally set-up CPAP unit has been far, far smaller than the risk of not being treated at all.
There have been over 500 confirmed deaths due to the Philips CPAP. The number of unconfirmed deaths would be an order of magnitude higher, in my opinion.
Thing is, the CPAP issue could be argued for both sides:
"See how a small manufacturing defect could cause so many deaths? We definitely need to regulate this heavily!"
OR
"See how many people died due to Phillips because they didn't have alternatives?"
The Philips CPAP deaths were caused by a faulty machine, not by anything the users did wrong. Whether it was bought OTC or prescribed by a doctor would have no impact.
Not only that, but it wasn't a problem with the pressure settings or anything related to the function of the device, it was chunks of the sound deadening foam breaking off and people inhaling them in their sleep.
They don't advertise themselves as such, for obvious reasons, but there is at least one online CPAP dealer in the US that will sell to you without prescription verification. (Why should I wait 3 months for an appointment, drive an hour round trip, and $50 copay, to renew my rx so I can buy more masks, which wear out after a year or two?)
I don't know who will do it without any kind of prescription, but it's pretty trivial to get an at-home test from someone like 1800cpap and they'll write a prescription based on the results. I bet they have a nearly 100% rate of writing prescriptions, given the obvious conflict of interest.
> I bet they have a nearly 100% rate of writing prescriptions, given the obvious conflict of interest.
Even if they are honest I'd expect near 100% - people who don't expect they have issues are not going to be getting the at home test in the first place.
I'm just happy that the "service mode" screens are easy to get to. Changing the ramp-up from 10 minutes to 45 minutes made a big difference for me.
(I'm honestly surprised someone doesn't make the vendors require a 1000 character passphrase that locks you out of the device after 2 failed attempts.)
That should have been done from day 1. Now, however, there are 1000s of doctors who make fat stacks prescribing CPAP machines, and they'll fight tooth and nail to not lose their whole business.
The car salesman who we worked with leasing our Lexus had a bad flu and didn’t wear his mask ONE night and died in his sleep. We found out when we went back to the dealer. He left wife and a special needs son. I lie my father before me suffer from extreme sleep apnea. I want to make sure my sons have the detection this will bring.
>The car salesman who we worked with leasing our Lexus had a bad flu and didn’t wear his mask ONE night and died in his sleep.
My dad's friend died like that, not a flu, but was traveling overnight and didn't take his machine and died in his sleep. Although I almost wonder if this heavy reliance on cpap machines causes people to lose some innate ability to recognize when they stop breathing or at least delays the normal instinct to wake up and breathe.
I hope there's some insight beyond what I've got, but just from my experience: Sometimes having it blasting at the pressure you need while trying to get drowsy makes that process uncomfortable, but, after you've gained drowsiness it's not going to interrupt you and wake you (unless it starts leaking pressure against your face)
I'd argue the problem is gatekeeping access to medicine, since I don't think this is unique to CPAP. It should be easy to get in to a doctor, receive a test and diagnosis for sleep apnea (or anything), and proceed to treatment. Regulation is an after effect of the system. Maybe sane defaults are good most of the time, but no-one should be in a spot where they have to rely on defaults for care.
It's the same with hearing aids, they are finally getting around to understanding that people can figure out if a device is helpful to them or not without needing a licensed doctor involved.
> 2. No, we shouldn't regulate to whom companies should be allowed to sell them. The defaults are good enough for most. Provide an easy to use control for max pressure and people will figure it out.
I'm iffy on the machines themselves for this, mostly because I'm just ignorant about the risks and potential issues. But this absolutely should be the case for the consumable/wear items that go along with it. There's been a lot of push-back on retailers being able to sell things like the masks, the hoses, filters, etc. to the public at large that can't be used without a machine anyway.
> These things should be $500 mass-market consumer units.
Fundamentally yes. I'd be fine with it being something as simple as the local pharmacy can keep them in the back and you bring in the prescription from the doctor and they file it away saying that you're allowed to buy/replace it if there's some reasonable evidence that they need some modicum of control for safety of people. It shouldn't be any harder than getting some antibiotics.
As it is now I'm using a 10+ year old machine because I've changed insurance companies multiple times since and my current one wants a full sleep study before they'll sign off on anything at all (like allow the doctor to prescribe or let me order one). And they wouldn't tell me if they'd cover the sleep study or not.
You should have a Dr who keeps track of all your medical information. I want my doctor to know each time I take an Aspirin or put on a bandage. Most of the time those are meaningless activities (and I don't tell my doctor), but once in a while there is something more going on and I need to be forced into the ER.
My experience is that doctors don’t even care about the data they have now. There are a lot of charts and info already available digitally to them and they mostly skim things and make basic diagnoses that are unhelpful and obvious. I keep finding myself in the position of pointing at them at things in the data to get better care. I think doctors are mostly a tax, and a barrier. At least primary care. Specialists also need to be managed in the same way though, and even in an ER situation I’ve seen them be very casual in their understanding of complex situations.
There is too much data for a human to know it all. We need to give doctors help. When I way I want my doctor to know, that shouldn't be understood as read the update every time it happens. I want tools to analyze all the data and look for patterns - which may or may not exist - and if something "interesting" shows up alert my doctor to take a closer look.
Most of what doctors do should be basic checklists - this is the same thing millions of other people have and should be treated by checklist in best practice. It is the exceptions where you are that 1 in a million case and so there is no checklist that you need doctors to read all the data and think.
> I want my doctor to know each time I take an Aspirin or put on a bandage.
What do you think your doctor will do based on this data? How do you think your doctor will filter out the signal from all the noise? (Is there even a signal?)
> but once in a while there is something more going on and I need to be forced into the ER.
In other countries you can buy a top of the line automatic self configuring APAP off the shelf. Here you have to pay (through insurance) thousands for a sleep study that is completely useless, since you can just have your machine figure out the right pressure. The cost, the delay in treatment from inconvenience, and the repeated burden of prescriptions every year is an insane government enforced protectionism of otherwise useless “doctors” and companies with no innovation.
Absolutely, but most safety departments will happily do low probability kills over massive population over high probability kills over low population. You can lose thousands to the former to save 10s to the latter.
Yeah you should be able to rent them instead of wasting months diagnosising or trying to find time in a sleep lab. Take it home for a whirl, if you sleep much better, and other QoL indexes improves, congradulations.
I generally agree with this, as a small-L libertarian. However, the results of the Philips Respironics problems killing people and badly damaging lungs would indicate that we need some amount of better tracking and observation of things like this. See this old HN discussion: https://news.ycombinator.com/item?id=39223982
I generally agree with you but even people with a prescription who have sleep apnea have a lot of trouble using their CPAP consistently and correctly, even after it is titrated by professionals in an overnight session.
Some people obviously are capable of diagnosing and solving their own medical problems and are willing to learn and do the work but most people aren't.
I don't think that opening up CPAPs to the masses would suddenly "solve" sleep apnea, most people will still need to go through a similar process that exists now.
Regulation that streamlines the involvement of insurance providers would probably be enough IMO, they are the real reason it is difficult to get a CPAP most of the time.
> Regulation that streamlines the involvement of insurance providers would probably be enough IMO, they are the real reason it is difficult to get a CPAP most of the time.
The obvious solution is to bypass the insurance providers.
Also: when it comes to fitting masks to faces and figuring out the optimal pressure rates - these seem like pretty obvious application of machine learning algorithms, don't you think?
> these seem like pretty obvious application of machine learning algorithms, don't you think?
Anecdotally, my impression is that most CPAP users are using APAPs at this point, like the very popular Resmed AirSense 10. Titration amounts to giving it a pretty wide range and letting the machine itself figure out the right pressure. It's not a complex learning algorithm, but seems to do the job.
I think APAP's are more about comfort and less about effectiveness, although making them more comfortable to use does make them more effective.
The algorithm is more about detecting that you aren't asleep and thus don't need the full pressure at the moment and less about altering the target pressure setting on the fly.
I could be wrong though, I use is a bipap which works a bit differently than CPAP or APAP.
I have personal experience with the Airsense 10 and it doesn't detect sleep/awake, as far as I can tell. At least not for me; it starts at low pressure, ramps up over a set time to the bottom of the range, and then adjusts as necessary. Low flow or an apnea event will get it to increase the pressure. Sometimes if you are breathing kinda slow lying there awake you can trip it up and feel it start pulsing the pressure to get more air moving.
To my understanding (no personal experience), Philips APAPs have a different algorithm to try and achieve the same goal, and are regarded as less aggressive about it than Resmed.
There's also a new Resmed Airsense 11 out but I don't know anything about it and what changed.
BiPAPs are definitely a different beast, for sure. My dad used one of those. Not automatic at all, right? Constant pressure, but different between inhale and exhale?
The pulsing is not to get the air moving but to see what kind of obstruction event it is. It's quite annoying to me and unfortunately it can't be turned off even in the full therapist menu :(
> The obvious solution is to bypass the insurance providers.
That is one solution but I think it would be better to make it easier for people to go through the current process rather than making them pay out of pocket (assuming that it what you meant by "bypass the insurance providers").
Assuming that we aren't going to also fix the entire American medical system, making it easier for people to use the insurance they already have to get a medical device they need seems like the best approach to me.
> Also: when it comes to fitting masks to faces and figuring out the optimal pressure rates - these seem like pretty obvious application of machine learning algorithms, don't you think?
Yes but I don't think that means we should take the human expert(s) out of the loop.
I rather quickly changed the pressure settings on my bipap in the hidden menu after the titration but many, maybe most, people aren't like me and need there to be someone they can just say "this isn't working for me" to instead of being left on their own.
> I don't think that opening up CPAPs to the masses would suddenly "solve" sleep apnea, most people will still need to go through a similar process that exists now.
A $200 CPAP with a knob that lets you control pressure absolutely would solve sleep apnea for much more people than gatekeeping it behind an insane price + having to make a doctor's appointment through insurance just to get them to turn the knob for you.
Because those who can't turn a knob themselves would still be able to schedule an appointment with a knob-turner without making the rest of us have to do it as well.
I got a hand me down CPAP from my dad, bought a mask off Amazon, played with the knob a bit, and within a week I cured my central sleep apnea. It's just not hard for anyone who doesn't think the doctor has divine capabilities over what they could do themselves (turning a knob).
But instead we infantilize everyone by requiring them to do the equivalent of taking their car in for a licensed professional to check their oil dipstick. And, of course, making them or their insurance pay $300 for the pleasure.
I'm not an qualified expert, but I spend a lot of time reading about and using this stuff and I'm extremely skeptical sleep apnea detection is very accurate without the pulse oximeter functionality.
But gosh, I hope this is accurate across the Watch's wide user base.
I wouldn't say it's likely, but I do wonder if the pulse oximeter is being used surreptitiously. In any case, if you could use the pulse oximeter, this functionality would immediately become much more powerful.
IIRC the pulse oximeter isn't all that useful for sleep apnea detection anyway, because on the watch it does not run continuously. Just takes measurements every X minutes. I think the oxygen level drop happens on a short enough timescale that you need the continuous monitoring to pick up on it.
Watch Sp02 detection is usually at rather long intervals to conserve battery and typically have not resulted in any sort of detection of low 02 (in my experience, I have very bad sleep apnea)compared to a pretty dependable and accurate $30 on the finger oximeter.
The watch can ramp the detection up for periods of time if it chooses, such as when doing a workout. But also, people with sleep apnoea tend to have their O2 trend low not just go briefly low.
There's a ton of cleverness involved in keeping an extremely compact device with radios and sensors running for tens of hours on a tiny battery while making it seem like it's always awake and ready to go when you need it to be.
But the reality is that everything that needs any kind of power is being aggressively idled down and time sliced and being made sample-based as can be gotten away with. You can easily get a sense of this with heart rate monitoring, if you dig into Apple Health and observe the pattern of samples it takes.
Almost certainly, running the sensor at such a high frequency that you could call it "constant" would drain the battery long before you woke up.
To be frank: I think what you're saying is true only of the Apple Watch, and Apple is wrong to believe that their priorities are the ones which would resonate most with their customers. Bands from Garmin, Whoop, and others have 24/7/365 sensor collection, with battery life measured in days and weeks.
Apple instead prioritizes 3000 nit displays, laptop-class processors, and 60fps touch interactions. These are all characteristics which make for great keynote slideshows, and maybe even close a lot of "first time smartwatch" sales, but I simply don't encounter anyone who wouldn't trade much of that for an Apple-made device that lasts 3+ days and has higher resolution sensor collection. The sleep apnea detection alone is, while interesting, something of a farce when it was followed up with a "18 Hour Battery Life" slide; yes you can make it work, but its an active decision by Apple to ask you to, and it doesn't have to be this way.
Didn't see the slide by my apple watch definitely lasts way longer than 18 hours. But, I also have the screen default to off instead of always on (lets be real, who spends all day staring at their watch; motion activated turning on seems like not even a compromise).
The Series 10 is confirmed for 18 hours, like the Series 9 before it. The Ultra will definitely last longer. The Series 9 can as well, if you turn off features which Apple advertised the Apple Watch as having, and if you do not record a single exercise throughout the day. If you use the watch how it was advertised, it will last ~18 hours, which means if you charge it overnight, wake up at 7am, are awake for 16 hours, it will not survive the night.
Its not helpful, productive, or useful to state that you turn off headline features people paid to have in order to get greater battery life than even Apple advertises the device as having. Please adjust your discourse and do not repeat your behavior.
1. Because of the lawsuit around the pulse oximeter intellectual property, as other commenters mentioned.
2. That would require more battery life than the Apple Watch offers.
There are third-party options that do constant monitoring that either directly or indirectly support Apple Health. You'll need some additional intelligence, in the form of an app or something, to analyze that data. WatchOS won't do it at present.
At-home sleep studies measure heart rate (maybe ekg, some probe is on your skin), blood oxygen, sound, and the direction of gravity relative to your testing device (to classify results by "back", "side", "prone", etc.)
I did one of these and it was the worst night of sleep I ever had. It's somewhat invasive. Meanwhile, I sleep with my watch every night with no problems.
Amusingly my Apple Watch pulse ox showed low so I did a sleep study. It's invasive, but it plugs into your nostrils (and in my case held them open). Slept like a baby. Next day 99% was the lowest reading. No problem. Now I use these sleep strips from this company called Intake. Sleep well. Holds nose open. I have a deviated septum, apparently. I think it's from falling off a tree onto my nose as a child, and being hit in the face by basketball numerous times. But probably not.
What was funny was that at-home sleep study was damned good sleep because it held my nose open!
I think this depends on your doctor/clinic and where you are. The last one I took home just had an oxygen sensor and the skin probe/patch. The doctor said they get (hand wavey) 95%+ of the same diagnostic capability from the simpler setup and far fewer claims of poor quality sleep caused by the equipment.
They really clamp your finger in the pulse oximeter probe, and it's taped with one-time-use adhesive. So there is no taking it out when it hurts, you just have to live with it and try to sleep. The instructions say "it's not that bad, you'll be fine".
If I had to venture a guess, maybe it's an industry regulation or power usage issue. Simply being able to assess sleep apnea isn't enough, it has to pass the regulatory burdens as well.
I wouldn't put a ton of stock into this, but it could still be useful. The WatchPAT device is purpose-built for this test and includes a full fingertip oximeter and while it's FDA-approved, it's still not very accurate. It's also a notoriously tricky condition to diagnose and can't really be done just by looking at numbers. I think there's value in the test being accessible to so many more people, it will likely have a positive outcome on detection and treatment, but I would not expect you to push a button and get a confirmed diagnosis.
If it's sensor accuracy a single night might not be enough, but if it detects the condition averaging over a few weeks even unreliable measurements can be made more reliable (given they're just noisy).
Not a doctor, but I was given a diagnosis of severe sleep apnea from an overnight in-lab study. Sought a second opinion who decided it wasn't sleep apnea at all. AHI or T-90 are convenient indicators, but pulmonologists will actually look at the shape of your graph and listen to symptoms. All humans are different and don't always conform to formulas.
That being said, your observation that a nightly watch user can collect lots of data is an interesting one. If Apple (or whoever) can come up a more heuristic analysis than just computing AHI, they may end up with something better.
Also, not that you asked, but my sleep situation is a bit complicated and I actually ended up with a CPAP anyway.
That's why a sleep study is not just done with a watch but with ECG, video, breathing band, finger SpO2 clip etc. I was like a cyborg going to the bathroom, so many wires and devices clipped to me :) it's unreasonable to expect a watch to do the same.
(OP here) a third category: downstream complications of sleep apnea, primarily car crashes and heart attacks. Diagnosing and treating people with undiagnosed sleep apnea would prevent these entirely, which is obviously much healthier for the person and reduces medical cost for the entire system (including the patient themselves for co-pays, taxpayers for government costs, etc).
Thanks, I think it would be informative if you put this spelling out in the article. People like myself not immersed in health fields won't immediately know what you mean without it.
Considering they use accelerometer for it, nothing really stops them from adding this feature to all Apple Watches, potentially even the Series 1, right?
Reserving it to Series 10 and 9 really exposes their lack of hardware innovation. I mean, we were talking about them measuring glucose levels for years and this is what we get as a new flagship feature?
nothing really stops them from adding this feature to all Apple Watches…
I’m confident there’s more to it than just sensor availability. Compute power for starters, as well as the fact that a Series 1 accelerometer may not have the necessary resolution, etc.
Reserving it to Series 10 and 9 really exposes their lack of hardware innovation.
Ah, the ol’ “Apple didn’t build what I want, ergo, Apple doesn’t innovate” trope.
They absolutely could be segmenting features by generation even if they could introduce them into earlier products and it's pretty normal across the industry to do so, but "well, it seems to use the accelerometer" provides no evidence of that on its own.
Without knowing more details about the implementation, it may rely on combining data from other sensors as well, it may need a certain frequency/resolution from a sensor that's not available in earlier generations of hardware, it might place too much demand on compute or power to maintain prior products' expected behavior, etc
> , it might place too much demand on compute or power to maintain prior products' expected behavior, etc
Love it or hate it, this mentality of "the feature is technically possible but we won't enable it because we're not happy with the compromises it demands" is, by design, exactly the sort of logic that Apple is known for.
I suspect they also need oxygen saturation (introduced in the Apple Watch Series 6 in 2020) in order to make their overall sleep apnea detection algorithm work. Given that it only works with the Series 9 or above, it's possible they're also using the the temperature sensor as another input into their algorithm.
They explicitly only mentioned accelerometer. If they used more sensors, in particular temperature sensor, it's hard to imagine they wouldn't mention in, especially that it would justify them limiting the feature to Series 9 and 10.
However, reading on PAT (Peripheral arterial tone) and existing FDA-approved devices using that, they indeed use oxygen but not temperature. See for example "WatchPAT ONE" device.
No. I was very curious to see if it might be a last minute thing where it came back but the pages for the series 10 clearly don’t list it and if you use the comparison tool it’s highlighted as gone.
I hope it’s just still disabled. It would suck for someone to buy a new watch, the fix the dispute in 2 months, and you never get the feature until you buy another new watch.
They’re clearly not bending. I don’t know if they’ve given up or waiting on an appeal or maybe home a new administration will tell the ITC to go away or what.
Non-US watch series 10 specification pages mention it still, so it's there and just disabled. I wonder though if they could legally enable it after the fact on watches imported while the ban was in effect
It wouldn't surprise me if they did the latter. The oxygen saturation sensor is fundamentally just another optical sensor with a different wavelength of light -- so if you feed all three wavelengths, plus the accelerometer, into a neural network, you may be able to pick up on oxygen-related physiological signals without explicitly processing an oxygen timeseries.
Sure it probably comes down to sensor specs, but the same question can be asked about Apple Ingtelligence and the new iPhones. If the model is in a private cloud, why is it restricted to newer iPhones? Surely the preprocessing isn't so intensive that only the latest iPhones can do it. It's artificial segmentation in the interest of driving (historically weakening) sales.
It’s not all in a private cloud. Much is on device, and as we all know AI stuff loves CPU and RAM.
They appear to have restricted it to 8 GB of RAM devices or more (when those appear).
During The Talk Show interview at WWDC with John Gruber an Apple exec (Joz?) said they did it because of user experience issues, seeming implying speed.
And given how hard AI hits hardware I think that’s relatively believable.
Yeah, I thought the same when they announced it. All in all, I feel that artificial segmentation is more frequent than ever and this can't be good indicator for their future growth, can it?
It's definitely a sign of the decline of hardware innovation. It's not for lack of trying, however. Apple has experimented with Touch Bars, VR, and LIDAR cameras, largely to little effect. They just aren't disruptive enough. So how then do they segment if not hardware? Software.
I think that growth is going to slow no matter what they do. Western and Japanese markets are saturated, and Chinese markets (once most promising) are bringing fierce competition both from local competition and the government.
Probably requires the newer generation accelerometer.
There are also other issues like power consumption overnight. Older watches have smaller batteries and slow charging. People will update the software, use the new features, and complain that Apple software updates are killing the battery (waking up to low battery plus slow charing means not being able to charge up before leaving for work). This has the effect of Apple only backporting new features if they don't consume too much battery.
Amazing that you can get much the same functionality in a off brand $30 watch these days - at least monitors sleep and blood oxygen - although it explicitly does not do medical diagnosis. Still every senior should have one for many reasons.
I’d be VERY careful with those. There are cheap Chinese “smart watches” that simply show fake values for SpO2. People have put them on bananas and the watch still “took a reading” and showed oxygen saturation to be “95-100%”. With these watches, the LEDs at the bottom flicker, but there’s no sensor to take an actual reading.
I have extremely severe sleep apnea with 60-100 events per minute, and baseline blood oxygen is low to start with because I live at altitude. I'm very into wearables and have tested most of the top SpO2 capable watches and none of them detect my sleep apnea outside a very rare detection of low O2.
Sleep apnea is very easily fixed. You have to increase blood pressure on the head by a lot, for a little bit of time each day, half an hour to an hour and it is 100% fixable.
Additionaly increasing blood pressure on the head helps for sleeping more. I do that and sleep for an average of 10 hours a day. 12 hours or 14 hours/day of sleep for me, is not rare either.
Also increasing the blood pressure on the head helps fix myopia 100%, like that woman astronaut who returned to earth and her eyes worked perfectly again.
Raising the foot end of the bed eg with a few thick books under the mattress is supposed to give health benefits by stopping the blood pooling in the lower legs where DVT blood clots most likely occur. Wondering if it also benefits by increasing blood pressure in the head?
Yep, exactly that, or similar. Use gravity to pull blood towards the head. It's not rocket science, although if you want to do that on space, you may need to learn a little bit of rocket science.
In space that's the default situation. The heart pulses maniacally to keep blood circulating all around, but in no gravity places the legs are a pretty small organ, they don't need that much blood. So in space, a lot of blood ends up on the head. We can simulate that on earth for half an hour/day and it has numerous benefits.
How is increased head pressure 30-60min a day going to change the fact that your soft tissue at the back of your throat closes the airway when you're sleeping?
Any other solution to clear out liquids from nasal airways doesn't make sense. Nasal sprays for example are total garbage. Measuring how much the airways are blocked doesn't make any sense either.
The goal is to clear out stuff from the airways and there are several ways to achieve it, all of them much worse than what i describe. They all hover in 5% efficacy to 20% or 30% efficacy.
The only other solution with such a high percentage of efficacy, is to chew 10.000 times a day, which is very inefficient.
Monkeys when climbing on trees, turn upside down hundred times a day. People who climb trees and turn upside down hundred times a day, have no sleep apnea problems.
Instead of climbing on trees, there is a way to simulate that effect on the industrial age.
No, but that was a popular torture fathers did to kids some decades back. I know several people, all men, whom their fathers tied the legs to a rope and hung them upside down for some hours, when they were boys. Pretty funny!
Much simpler actually. Just hung your head lower than your body, from a bed, a sofa, or even a motorcycle as much as you can, 10 minutes or half an hour.
It is a good idea to exercise at the same time, your strongest muscle on your body, your jaw muscle, by chewing imaginary leaves. That will help blood to flow on the head much quicker, and much more of it as well.
Back when we were monkeys, we chewed a lot of leaves. According to my estimations, we moved our jaw up and down, more than 10.000 times per day. That helped move blood up, towards the head, while nowadays we chew 100 times per day.
It is a non-issue for me with the Apple Watch 9. It's charged super quick e.g. if the battery is low after waking up you can plug it in do your morning routine and pick it up. Vice versa in the evening before going to sleep.
Also did some bike packing this year and charging it with a power bank was also not an issue. At one point my power bank was empty and my apple watch ran out of power as well - this has been the only time I whined for more battery life.
I picked the Apple Watch Ultra mainly for the extended battery life. I charge it 15 minutes or so every other day. One of the more useful features I've discovered is it will give you a low battery warning if it detects that you need to charge before bed to maintain overnight power rather than just a fixed percent based warning. That's made it very easy to keep it topped up for tracking my abysmal sleep.
I keep the charger plugged into my computer. I slap the watch onto the charger every morning as I drink my coffee and read my e-mails/news. It's... not difficult to imagine...
I find that integrating it into my routine made my current watch (SE1) battery a non-issue. I wear it starting in the morning, charge it on the way to work, and then to bed. Repeat ad infinitum. Battery usage at night is way lower in my experience, and it usually survives til morning or close to it.
I can only speak for my S7 but with the fast charging mode it doesn't take long. My routine is I wake up, take off my watch, scan my phone for a bit, and take a shower. Almost every day it's fully charged by that point.
I used to charge my watch every time I took a shower, which was every morning. Never had to think about battery life or charging the watch "out of band". But then again, it wasn't an Apple Watch.
This is a neat feature. I read Reddit and r/applewatch shows up in my feed a lot. 99% of the questions are "do I have sleep apnea?" At least the watch can give them my cut-n-paste response "you should talk to your doctor about a sleep study" now.
I don't mouth-tape, and I use a CPAP. However, since I prefer the nasal cushion type, I did run into issues with my partner regarding my mouth falling open and horrible "pumping air through your sinuses" noises emanating from my face hole. Instead of spending more from the home health shop, I just grabbed headband that came in some past 5K race bag, and I strap it around my head prior to the CPAP head gear.
In my particular case, that very slight amount of pressure keeps my mouth closed (and spouse happy.) I have to wonder if just using the chin-strap would be enough to turn off the damnable machine.
Given the results with the chin strap, I have considered mouth taping, but I'm not about to shave just for that test.
I have a beard and use GrifGrips sports tape to mouth tape. I've found the level of adhesiveness to be a perfect balance of strength and removability. Not the cheapest, but quality stuff.
Because medical science was in its infancy in 1870 and you should only trust medical advice from then if it is obvious, like don't light yourself on fire, or it has been substantiated and backed up with peer reviewed science at some point in the last 150 years.
Your argument is just a mix of the appeal to nature fallacy and noble savage trope that people use to justify all sorts of medical treatments with no proven benefits.
> Why do you think how to live healthy is a modern invention? Don't you think people had to figure that out ages ago, or else we wouldn't be here?
Not really, no. They had many ideas about health that we know are false now. And we still don't know a lot. Generally people died really young in those days.
But these things don't really matter for the population continuity if people get sick after they get kids, and they used to have them really early in those days (and many). They just didn't usually live until their 90s.
And of course knowing how to live healthy and actually doing it are different things too. It's something we really struggle with as a society and me too.
You’re right, medical advice from the 1870s and TikTok videos, what could go wrong?
But I did “look into ‘mouth taping’” as you suggested, and I’ll bet half the page titles were “Mouth-taping: is it safe?” or “…does it work?” At what point does Betteridge’s Law of Headlines[0] kick in?
> You’re right, medical advice from the 1870s and TikTok videos, what could go wrong?
Have you read the book? Do you think I'd be recommending something that didn't have a very strong dataset backing it?
> At what point does Betteridge’s Law of Headlines[0] kick in?
Nothing is easier to manipulate than digital symbols. Thus, when talking about patterns one finds in digital symbols, one much be very very careful to build a trusthworthy dataset. Do you have a trusthworthy dataset on Betterridge's headlines?
> Do you really think someone would do that? Just go on the internet and tell lies?
— Buster Baxter (written by Matt Steinglass, 2005)
People make stuff up, especially online. If you expect others to believe you about your "very strong dataset", you should provide that very strong dataset (complete with provenance).
That's what you call a "very strong dataset"‽ It doesn't have a single controlled experiment! No studies of individuals in a population. It's just a series of anthropological observations, and then the author's guesses at the reasons for those observations. The book has stronger evidence for the harms of alcohol than mouth-breathing.
This author is one of the good 19th-century anthropologists (as judged by his scathing criticism of the institutions of 19th-century anthropology), but he's still a 19th-century anthropologist. The books' framing device is the idea that “the Tribes of North and South America” (including Sioux! with horses!!) lived in a “primitive condition”: while his observations are careful, and believable, his conclusions are incredible leaps of logic.
I can confidently assert that mouth-breathing does not deform the spine.
That's an unusual use of language. Even by your standards, though, the book fails. The data mentioned in the book, while interesting, doesn't justify the author's claims.
There are no randomized controlled trials showing parachutes work.
A working model of nature >> a large symbolic dataset >> a large personal dataset >> anecdotes.
This is a bit of #1 and #3.
Sure, #2 would be great, but #1 (mouth breathing bad) seems highly likely given both studying anatomy and modeling the physics of breathe and also given his dataset #3.
None of the evidence in that book supports this claim. (It's a mixture of unrelated anthropological observations, and appeal to nature.)
I agree that mouth breathing is probably bad. I don't agree that it causes spinal deformation or smallpox. I really don't think taping the mouth shut is a safe treatment for sleep apnea.
I just skimmed the whole book. Could you point out any of these "datasets" you think exist in the book and how you think they support the claim that all these ailments stem from not closing our mouths while we sleep.
"During my Ethnographic labours amongst those wild people I have visited 150 Tribes, containing more than two millions of souls ; and therefore have had, in all probability, more extensive opportunities than any other man living, of examining their sanitary system ;"
1. Yes, we should regulate manufacturers intensely.
2. No, we shouldn't regulate to whom companies should be allowed to sell them. The defaults are good enough for most. Provide an easy to use control for max pressure and people will figure it out. Perhaps a knob?
I claim: During the past decade, the risk of being maltreated by a personally set-up CPAP unit has been far, far smaller than the risk of not being treated at all. (Ways to access these menus have been been shared online for 10+ years, many use them.)
I wonder how many premature deaths happen every year because of this - including secondary victims from traffic accidents.
These things should be $500 mass-market consumer units that you pick up at Target, Walmart, etc.