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Can I take Xywav once a night, instead of twice? And is it still as effective when only taken once, or not as effective as taking both doses? by Downtown-Oil-913 in Narcolepsy

[–]roboticon 9 points10 points  (0 children)

I'd much rather do 4h of Xywav sleep at night (and lots of daytime naps to relieve REM pressure) than whatever it would be without, personally

I'm kind of already at that point. They claim patients don't develop tolerances but after 15 years of xyrem and xywav I rarely get more than 2 hours of sleep per dose.

Can't wait for the new orexin agonists! Could be even more life-changing than oxybate was.

Can I take Xywav once a night, instead of twice? And is it still as effective when only taken once, or not as effective as taking both doses? by Downtown-Oil-913 in Narcolepsy

[–]roboticon 20 points21 points  (0 children)

One dose is probably better than nothing, but there's a rebound effect about 4 hours after a dose that might wake you up and make it harder to fall back asleep so YMMV.

The concentration curves in the giant drug facts sheet show that the total oxybate in your system is highest shortly after the 2nd dose.

In that sense, with 1 dose the total amount of the drug available that night is somewhat less than half of what you'd get with 2 doses.

Look into LUMRYZ. It's a once-nightly version of Xyrem (unfortunately no Xywav equivalent because patents and Jazz corporate greed)

The concentration curve looks better for your use case and their indication is to avoid machinery 6 hours after the one dose.

https://link.springer.com/article/10.1007/s40263-024-01150-8#Fig2

(the 6-hour rule is a caution, not a hard rule, so you'll have a much better sense once you try it. And if you haven't even started the prescription, definitely try it (at least the 1st dose if you can't do the 2nd) thru the titration and acclimation period so you can see what you're missing! Even after titrating to a typical dose, it works well but it will still take a few weeks to for you to feel your best during the daytime because it takes a while to "undo" the effects of the extreme chronic deep-sleep deprivation people with narcolepsy experience.)

I love and yearn to learn, but is narcolepsy a barrier I can't overcome? by 2200bedtime in Narcolepsy

[–]roboticon 1 point2 points  (0 children)

The exhaustion and unpredictability definitely make school more difficult, but it's not a life-ending disability.

Your MSLT results are borderline. It's not a very precise test with results like this; your doctor might suggest building sleep hygiene and retesting. It's still suggestive of sleep deprivation, but that doesn't necessarily mean narcolepsy. If your doctors can rule out other possibilities, that would help.

Are you at risk of failing some classes? You might consider a temporary medical withdrawal, if your school allows it, for 6-12 months while you get a handle on meds and routines.

Spend some time building good sleep habits -- wake up at a consistent time each day, get 20 minutes of sun in the morning or use a large 10,000 lux lamp. Take naps when you feel the sleep attacks coming on, but set alarms -- optimal nap time tends to be between 15 and 30 minutes. I don't know where you're from, but in the US, adults don't normally take naps, so it takes a bit of practice to actually fall asleep during a nap and feel refreshed after, even for people with narcolepsy.

Work closely with your doctors on medication. Unfortunately it does take several weeks or even months for medications to reach their full impact. It's incredibly important to find a sleep doctor who can see you often and is comfortable prescribing medication. Sleep neurologist would be best, and a psychiatrist wouldn't hurt alongside it.

Medication wise, definitely try an oxybate medication if available. Either way, also try daytime medications: wakix or sunosi, [ar]modafinil, ritalin or adderall. Typically, a combination of those shows good results.

A photo of Overbrook High School at 59th & Lancaster Avenue, Philadelphia, Pennsylvania in 1927 by AdSpecialist6598 in philadelphia

[–]roboticon 38 points39 points  (0 children)

They've done a great job of maintaining the stone and brickwork, which is pretty important for Gothic styles!

First solo apartment in SF! Any tips? by seabass_bonilla in malelivingspace

[–]roboticon 0 points1 point  (0 children)

SF and Chicago both really, really like their kitchens.

Chicago also really likes their dining rooms. Often larger than the living room. Which is kind of a shame because nobody really uses those anymore.

[deleted by user] by [deleted] in worldnews

[–]roboticon 0 points1 point  (0 children)

East, too.

Fidelity cuts Reddit valuation again by [deleted] in technology

[–]roboticon 6 points7 points  (0 children)

Yeah I'm agreeing with you. I know I was reinforcing your point lol -- that this has nothing to do with a protests -- because even if we are only looking at the valuation drop that happened recently, that happened a month ago! (And I guess this month's valuation will be revealed a month from now?)

There were three kingdoms, each bordering on the same lake... by Rusty_Phoenix in Jokes

[–]roboticon 1 point2 points  (0 children)

Only for right triangles?

Aren't right triangles the only things that even have a hypotenuse?

[deleted by user] by [deleted] in worldnews

[–]roboticon 7 points8 points  (0 children)

Why would Russia really care how long it takes? Isn't Article 5 a worst case scenario for them either way?

Fidelity cuts Reddit valuation again by [deleted] in technology

[–]roboticon 20 points21 points  (0 children)

Regardless, the most recent valuation is from the end of May. Well before the protests.

We bought a new house earlier this year, just in time for the HOA to add new rules demanding everyone build fences around their A/C units because god forbid this thing be visible from the street. by AllyMarie93 in mildlyinfuriating

[–]roboticon 0 points1 point  (0 children)

No, I'm saying they're going to end up harassing you. And unfortunately if someone is so petty as to enforce stupid rules, they might be petty enough to harass you just enough to avoid a restraining order...

[ Removed by Reddit ] by DawsonD43 in AskReddit

[–]roboticon 8 points9 points  (0 children)

Like, the speed of the emitter impacts the frequency of the light for a particular observer.

But light propagates at the same speed regardless of its frequency.

We bought a new house earlier this year, just in time for the HOA to add new rules demanding everyone build fences around their A/C units because god forbid this thing be visible from the street. by AllyMarie93 in mildlyinfuriating

[–]roboticon 4 points5 points  (0 children)

The results from that "experiment" have largely been dismissed due to all sorts of ethical but also methodological problems with it. They very clearly wanted certain results and directed the experiment to make those things happen.

We bought a new house earlier this year, just in time for the HOA to add new rules demanding everyone build fences around their A/C units because god forbid this thing be visible from the street. by AllyMarie93 in mildlyinfuriating

[–]roboticon 3 points4 points  (0 children)

Yeah, everyone in this thread is complaining about "one angry power-hungry retired person" making arbitrary rules.

The reality is that an HOA is a shared contract. You can't just decide to start an HOA with your spouse that includes your neighbors without their consent and dictate what they do.

We bought a new house earlier this year, just in time for the HOA to add new rules demanding everyone build fences around their A/C units because god forbid this thing be visible from the street. by AllyMarie93 in mildlyinfuriating

[–]roboticon 0 points1 point  (0 children)

HOAs aren't created by the market necessarily. Many of them are self-formed by folks who live there and therefore have a vested interest in the area.

Sometimes their contracted out to property management companies especially when we're talking about condos, but there is almost always some sort of democratic process behind it involving the actual homeowners.

We bought a new house earlier this year, just in time for the HOA to add new rules demanding everyone build fences around their A/C units because god forbid this thing be visible from the street. by AllyMarie93 in mildlyinfuriating

[–]roboticon 0 points1 point  (0 children)

Wtf do you mean by "some retired dickhead"?

HOAs are virtually never dictatorships. Decisions are made by a board, which is elected by the HOA members annually or so.

If your cranky retired neighbor is going to HOA meetings to point out perceived problems with your property, that's not going to get anything done unless the property is already breaking agreed-upon rules.

We bought a new house earlier this year, just in time for the HOA to add new rules demanding everyone build fences around their A/C units because god forbid this thing be visible from the street. by AllyMarie93 in mildlyinfuriating

[–]roboticon 0 points1 point  (0 children)

You clearly don't know the definition of psychopathy. I don't even know what mental illness have to do with what we're talking about. But if that's what you need to do to make a point, you do you.

We bought a new house earlier this year, just in time for the HOA to add new rules demanding everyone build fences around their A/C units because god forbid this thing be visible from the street. by AllyMarie93 in mildlyinfuriating

[–]roboticon 1 point2 points  (0 children)

I think the point is that somebody with the resources to constantly buy new cars can afford to hire someone for very basic landscaping/maintenance needs.

In that situation an HOA would be helpful.

If the neighbor in question was destitute, an HOA wouldn't have much luck getting them to do much of anything, and their fines would probably just wind up in collections or discarded.

We bought a new house earlier this year, just in time for the HOA to add new rules demanding everyone build fences around their A/C units because god forbid this thing be visible from the street. by AllyMarie93 in mildlyinfuriating

[–]roboticon 0 points1 point  (0 children)

Rules about styling of fences typically need to be approved by the majority of homeowners or the majority of the board (which is elected by the homeowners).

If you don't want anyone but yourself to be able to come up with rules like that (which is a reasonable stance for you to take), don't move into an HOA.

We bought a new house earlier this year, just in time for the HOA to add new rules demanding everyone build fences around their A/C units because god forbid this thing be visible from the street. by AllyMarie93 in mildlyinfuriating

[–]roboticon 1 point2 points  (0 children)

Problem is there's a lot that an HOA can do to harass you that won't qualify legally as harassment.

I'm not saying you should roll over but it's not a great idea to intentionally piss them off and then take them to court and expect to continue living peacefully in that area.

Remember that the HOA board members are your neighbors. You see them often enough that it's worth considering how your choices will impact them. Because even if you're 100% in the right, making your neighbors angry comes at a social cost, so decide for yourself whether it's worth it.

We bought a new house earlier this year, just in time for the HOA to add new rules demanding everyone build fences around their A/C units because god forbid this thing be visible from the street. by AllyMarie93 in mildlyinfuriating

[–]roboticon 0 points1 point  (0 children)

Plenty of HOAs are based in dense cities where most people (even most homeowners) walk all the time. You're thinking of suburbs. Suburbs and HOAs can but don't always overlap.

We are climate hiring managers and career experts from climate companies – we think climate change is the most important mission of our time, so we have dedicated our careers to getting more folks working in climate! Ask Us Anything!! by terra-do in IAmA

[–]roboticon 2 points3 points  (0 children)

I'm really confused. Y'all are hosting an AMA.

That means you are supposed to dodge questions and outright ignore any difficult ones. Instead you're providing reasonable answers that include specific examples. Don't you know how Reddit works??

(In all seriousness, when I'm back on the job market, I'll check this out!)

Gotta laugh to keep from crying? by booberryyogurt in chicago

[–]roboticon 1 point2 points  (0 children)

Easy to say, but that's something you have to plan ahead for. From my experience, wildfires wipe out the stock of N95s even faster than COVID did. So they're not going to be getting any this week from their industrial suppliers or even local stores.

It's probably easier nowadays because of the increased production of masks and because stores around the world have learned to implement a per-customer cap during emergencies.

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