I got interesting news from the fedora accessibility room today! this concerns blind and visually impaired #linux users exclusively, however: For a bit of time, specifically pipewire >=1.4, one can start pipewire as root. That includes the regular daemon and the alsa layer, because jack emulation...
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does this also happen with pure alsa (i.e. no pulse or pipewire)
Right, need to check that.
Do you have FluidSynth installed? I had similar issues recently - I just have a script that restarts pipewire automatically on login.