My arch nemesis when it comes to sleep is obstructive sleep apnea. I have some soft tissue redundancies (long uvula and turbinate hypertrophy) as well as skeletal deficiencies (recessed jaw and narrow nasal cavity), and I had to have multiple surgeries in addition to PAP therapy to get reasonable (but not great) sleep. When I first started having unrefreshing sleep a couple of years ago, I tried everything under the sun when it comes to sleep hygiene (which helped a bit), but there comes a point when you really need medical interventions.
