One of the dangerous effects of sleep apnea is that it can increase a person’s risk of being involved in a traffic accident. Heavy truck drivers with sleep apnea are five times more likely to be involved in serious traffic accidents. Fortunately, treatment reduces this risk down to normal.
Truckers with sleep apnea are required to get treatment for their apnea in order to be able to keep driving. Unfortunately, this requirement became a lot more complicated this summer when Philips Respironics, one of the largest manufacturers, issued a recall for many of its CPAP machines.
Why the Recall?
On June 14, 2021, Philips Respironics issued a recall notice for many of its CPAP machines and ventilators.
The problem is that foam used to deaden sound and make it easier for users to sleep while using the machines can degrade. The foam degradation can result in two distinct effects.
First, as the foam breaks down, the pump sucks particles into the CPAP tubing and forces them into the throat, stomach, and / or lungs of users. Another possibility is that the foam might give off toxic gasses that the user would inhale.
Users might notice the presence of particles in the tubing, or they might experience:
- Headache
- Upper airway irritation
- Cough
- Chest pressure
- Sinus infection
Long-term exposure to the foam and/or gasses could result in dizziness, nausea, kidney and liver damage, or an increased risk of cancer. Because of this, Philips Respironics recommends that all users of affected CPAP machines stop using them.
Truckers who rely on these devices to maintain their health certificate for driving are suddenly facing the possibility they need to find a CPAP alternative in order to keep driving.
What Will the Medical Review Board Decide?
The recall issue has created a problem for the Medical Review Board (MRB) of the Federal Motor Carrier Safety Administration (FMCSA). With so many CPAP devices recalled, and so few replacement devices available, there are many drivers who can’t get their necessary CPAP treatment. This is through no fault of their own. Global semiconductor chip shortages make manufacturing new CPAPs harder. It’s unlikely that device manufacturers can make up the shortfall any time soon.
So the MRB has to decide what to do about these drivers. Editors at Overdrive magazine, an insider publication, noted two potential recommendations from the MRB, although it has so far failed to actually make recommendations.
The first recommendation is that the board might not allow drivers with “severe” sleep apnea to drive. This would be a huge blow to drivers, their families, and their companies. And the effects would be felt across the country as a significant secondary effect on top of the global shipping problems still plaguing the economy.
The second recommendation is more reasonable: shift more drivers to oral appliance therapy. While the editors of Overdrive magazine objected that this wasn’t feasible, the option is practical and could potentially be implemented quickly.
Oral Appliance Therapy Can Meet Criteria to Solve Shortfall
The analysis by Overdrive suggests two main objections to oral appliance therapy: cost and a lack of monitoring capability. Neither of these are as big an obstacle as the magazine imagines.
Oral Appliances Are Affordable
Any cost that truckers and trucking companies incur because of this recall is an additional burden. In an industry where margins can be as thin as trucking, this can put companies in trouble.
However, the cost burden is not nearly as great as portrayed by Overdrive. The magazine cites a cost figure of $4500 for an oral appliance. It’s unclear where this figure comes from, but it’s more than twice the cost cited by the American Sleep Association (ASA), which says that oral appliances have an average cost of between $1800-2000. This includes all necessary costs like the appliance itself, dental visits, follow-ups and monitoring. And, while many truckers may have high-deductible insurance, this is still covered by insurance.
Oral Appliances Offer Monitoring
The MRB and insurers require monitoring to make sure drivers use their sleep apnea treatment. If you couldn’t monitor oral appliance use, this would be an objection. However, there are options for integrating monitoring into oral appliances.
Thanks to advances in microsensors, oral appliances can have tracking chips installed. These chips show how often and how long people use their appliances. At least two device manufacturers, SomnoMed and ProSomnus, offer this technology.
Using this monitoring technology, oral appliance manufacturer ProSomnus published a study in June 2021. This study not only showed that they could monitor the usage of appliances, but also that appliances were 13% more effective at treating sleep apnea than CPAP.
Adding tracking devices in oral appliances could hit the same chip shortage barrier as manufacturing CPAP machines. However, manufacturing of oral appliances could still continue. We could then supplement by monitoring sleep efficiency using other devices. Smartphones, FitBits, and other devices offer this capability. Many people already have these or could acquire them at little expense. This is a less-than-ideal solution, but would likely be adequate for the short term. Then truckers could decide if they wanted to go back to CPAP or have compliance monitoring added to their oral appliances once the semiconductor shortage alleviated.
Looking for a CPAP Alternative in Columbus, OH?
Whether you’re a trucker or someone else who needs an alternative treatment because of the Philips Respironics recall, sleep dentist Dr. Michael Firouzian can help. Of course, driving certification will depend on the decision of the FMCSA’s MRB, but we know that people often get results as good–or better–with oral appliances compared to CPAP.
To learn whether an oral appliance is right for your sleep apnea, please call (614) 683-4640 or use our online contact form to schedule an appointment at Firouzian Dentistry in Columbus, OH.
