Gabe Brosbe (GSB) works as a seller for Figma. In his off hours, he is culturally omnivorous and writes about the intersection of food and travel at Snackventures. We used to work together and he was always guaranteed to make me laugh. - Noah (NRB)
Gabe here. I’ve struggled with sleep my entire adult life. So much in fact, that when I was younger, my friends lightheartedly threatened to create a feed called “Gabe Sleeps SF” peppered with pics of me dozing off at bars around the city. I’d diligently get 8 hours and yet still find myself conking out in the evening, hitting the wall in afternoon meetings, and just generally feeling very, very tired!
When I moved to New York, I thought I’d take a crack at solving this, and seek the city’s world class medical experts. A sleep study at Weill Cornell culminated in a suggestion of Adderall. I passed. Many hours logged on Headspace, the phone kept outside of the bedroom, and various sleep hygiene hacks led to little reprieve.
Something about making plans to get married makes you feel like more of an adult, so when I kicked off 2024 with my wedding around the corner, I decided to take another crack at this thing. This “thing” being how darn tired I am all the time. The audacious plan was to not give up. Continue to meet with doctors until I get an answer that satisfies me. Some conversations with friends had led me to believe I had a deviated septum, so that was going to be my opening angle at my next primary care physician appointment.
Why is this interesting?
The appointment with the physician who I had highlighted my sleep issues to many, many times was different when I suggested a deviated septum. This self-diagnosis turned out to be a secret password to a referral to an ENT (ear, nose, and throat doctor). That ENT suggested a Cat Scan. The Cat Scan revealed nasal polyps from lifelong allergies—think speed bumps on what should be a smooth road—and a slightly deviated septum. Allergy shots were suggested, and I accepted them: a 2-3 year commitment that began with weekly three-hour sessions and quite a bit of discomfort.
Reviewing the scan results, my ENT was confused, because my sleep issues were more severe than what the deviated septum and polyps should have caused. He referred me to another ENT. If that ENT said I should get surgery, then that’s where we’d go next. “He’s the best. He’ll know what do next,” ENT #1 said.
So I walked into the office of the top ENT in NY, and probably in the world. (New York or nowhere, baby.)
After he arrived, 25 minutes past my appointment time, we spoke for 5 minutes before he said:
“I want you to know that allergy shots aren’t really going to help you. And I can do the deviated septum surgery and remove the polyps, but that won’t really help you either.”
Me: “Why not?”
Doctor: “Well you have extremely narrow nasal passages”
Me: “Pardon me?”
Doctor: “Yep - your nasal passages are just extremely narrow. When you breathe in, your nose seals completely, which is why you don’t get enough oxygen when you sleep. You never go into that deep, truly restful sleep stage, which is why you are tired all the time. I could see it looking at you for 30 seconds.”
Me: 🤯
Doctor, walking out the door: “So, just use Breathe Right strips for now, and we’ll work on scheduling a surgery where we can widen your nasal passages. I’ll take care of the deviated septum and the polyps at the same time.”
In the last five months, I’ve gotten the best sleep of my adult life. For the cost of 40 cents a night, I apply the Breathe Right strip and start the next day with more energy and feeling far better rested than ever before.
Even if I only get five hours of sleep due to life stuff, those five hours are better than eight or nine in my pre-stripped life.
I’m still working on scheduling the surgery, that is a whole other goat rodeo, but this new lease on life has been nothing short of amazing. I have recently wondered whether they don’t teach the nose unless you’re studying to become a top ENT. I would have assumed that my primary care physician would have learned about it in Medical School as well, since it is part of the anatomy, but as they say—never go to bed angry. (GSB)
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Why is this interesting? is a daily email from Noah Brier & Colin Nagy (and friends!) with editing help from Louis Cheslaw about interesting things. If you’ve enjoyed this edition, please consider forwarding it to a friend. If you’re reading it for the first time, consider subscribing.
just adding a plus one to both breathe right (not, btw the generic drug store version(s)) and to mouth tape. Both Look /feels weird, but absolutely work, in my experience.
I've been to a number of ENTs. Deviated septum, an enlarged turbinate, narrow passageways, a large air vacuole that makes the passageways even narrower, etc. etc.
I was given two possible solutions. 1. Burn the insides of the nose to create scar tissue that would effectively act as a structure "holding open" the passageway. 2. Insert a small plastic part that would act in the same way: force and keep open the passageways. Meanwhile, they would also shave down the turbinate, fix the septum, and pop the vacuole. I have not followed up: that's a lot of work in such a small space, and I was leery.
I wear and have worn the XL Tan Breathe Right strips for years. There's no sleeping without it, but I also worry that their effectiveness has worn off. Maybe it's time to revisit surgery.