That study is from 1985; subsequent studies have found no such utility for nicotine.

Nicotine harms sleep quality. People wearing patches to bed typically experience bizarre nightmares. Then factor in the cardiac risks.

Moreover, the pharmacology of atomoxetine and nicotine are very different.

Clinical effects of locally delivered nicotine in obstructive sleep apnea syndrome https://pubmed.ncbi.nlm.nih.gov/12756424/

Effects of nicotine on sleep during consumption, withdrawal and replacement therapy https://pubmed.ncbi.nlm.nih.gov/19345124/

Polysomnographic sleep disturbances in nicotine, caffeine, alcohol, cocaine, opioid, and cannabis use: A focused review https://pubmed.ncbi.nlm.nih.gov/26346395/

Impact of Nicotine and Other Stimulants on Sleep in Young Adults https://pubmed.ncbi.nlm.nih.gov/30461442/

You might want to consider an oral appliance. There's no guarantee you will tolerate them or get the desired effect, but the same goes for surgery. Oral surgeries often have dentists who are certified in sleep medicine who can create a custom, medical-grade appliance for you.

https://en.wikipedia.org/wiki/Mandibular_advancement_splint

I tried everything I could find on Amazon but obviously that crap doesn't work. I can believe something custom made could help but my orthodontist persuaded me the only really solution was surgery or CPAP.

There are specialized dentists that make appliances. My understanding is custom works much better cause fits perfectly instead of having to mold it. If you can, go to dentist that has experience. They are expensive, mine was $3k.

Insurance will sometimes cover them whole or in part, but it can be a difficult process.

Fluticasone can be especially helpful for people with allergies and/or OSA.

"Intranasal fluticasone treatment may be useful for patients with nasal obstruction-related obstructive sleep apnea to improve sleep quality and limit daytime dysfunction."

https://pubmed.ncbi.nlm.nih.gov/31521518/

"Intranasal steroids and montelukast did not decrease AHI; however, total sleep time and percent of stage R sleep significantly increased. Self-reported improvement could be explained by observed changes in sleep parameters. Larger prospective studies could help elucidate the effects of medical therapy on adult patients with OSA."

https://pubmed.ncbi.nlm.nih.gov/31383235/

I find the most effective nasal sprays also give me terrible withdrawal symptoms. Like, I'd use them for a few days at night, alternating nostrils and then when I stop, my nose is closed shut for the next few days.

Some nasal sprays have salt in them in addition to whatever drug they have, which unblocks the nose immediately but is extremely addictive. The ones that have just the drug don't have this issue in my experience

This is common with Afrin (oxymetazoline). It’s only meant for short term use for this reason. This shouldn’t be the case with fluticasone.

OSA is not always positional. Further, there are patients with normal BMI who also don't drink.

A sleep study. Central and obstructive sleep apnea aren't mutually exclusive, either.

Five events is the threshold at which (mild) sleep apnea can be diagnosed.

You nailed it. CPAP ultimately fails for something like 50% of patients.

It does look interesting, especially for patients with a low arousal threshold (those who are easily disturbed or woken up from sleep).

Unfortunately it isn't approved yet and isn't commercially available as a result.

Correct, but it also sounds like it might become available within the next year, though I did reach out to them and ask and received no response. It looks like the last updates on it were almost a year ago, so it makes me wonder if they've hit some kind of snag. They are planning on releasing their own hardware, but my ENT expects it may become available for many available "autoPAP" machines as a firmware upgrade.

Simple solutions to complex problems often aren't solutions at all.

I didn't intend it like that, it's a lighthearted comment on a forum where people exchange ideas. Just wanted to share something that helped me with snoring and closing of the airways. Does every comment need to be a carefully calculated response that provides complex insights?

Edit: It also occurs to me that a sleep apnea pill sounds like a simple solution to a complex problem if it actually works. And as I read it, looks like it targets the same muscles that are trained by proper tongue posture. So there is something to it, don't you think?

OSA causes high blood pressure; treating it could theoretically result in an overall reduction in blood pressure. If this gets approved, it would likely be at the provider's discretion. I imagine it won't get blindly prescribed to people with severe cardiac risk factors, but it may stop some from getting to that point.