Recall Aftermath: Considering CPAP Alternatives
In the summer, Philips announced a huge recall of an estimated 3 to 4 million of their CPAP machines globally.1
As a woman with sleep apnea using CPAP therapy, this news was shocking.
A cancer risk had been detected in certain CPAP models due to the breakdown, and possible inhalation, of noise dampening foam particles. I have spoken to people affected by the recall, and many are questioning what CPAP alternatives might be available for them in the meantime.
Mandibular advancement devices
Most people would not consider going to their dentist to treat a medical condition. However, sleep apnea is one condition where dentists can provide some valuable insight.
The upper airway, after all, is right in a dentist's realm of expertise. A mandibular advancement device is a small dental appliance that holds the bottom jaw, along with the tongue and soft tissue, forward and out of the airway.
An option for mild or moderate sleep apnea
The FDA has approved mandibular advancement devices, which are "custom-fitted by a specialist dentist" for people whose sleep apnea is considered mild or moderate. These oral appliances are usually not recommended for those with a more severe case of sleep apnea.
Numerous studies have shown that CPAP is more effective in lowering the number of times a person stops breathing per hour than oral appliances. However, compliance is low. This means that fewer people stick with CPAP therapy long-term, and that's a significant problem.2
Finding a specialist dentist
Not all dentists are trained in sleep dentistry and finding an expert is essential. The American Academy of Dental Sleep Medicine has a searchable database to find its members and diplomates within certain geographical parameters. The last part of being fitted for a mandibular advancement device should always be a follow-up sleep study to check that the device is working to reduce the sleep apnea events to an acceptable level.
The Inspire implant
The Inspire implant is a small device, which looks similar to a pacemaker. It treats sleep apnea by moving the tongue out of the airway.
This implant is inserted in the patient's chest in a simple surgery. Tiny wires run from the device up to the nerves controlling the tongue. As the person breathes in at night, the device causes the tongue to move clear of the airway. The implant is activated at bedtime using a small and portable remote control.
Eligibility for Inspire
Inspire is not right for every person with sleep apnea. People with BMIs over 35 are often excluded from this treatment option. Insurance companies usually require a candidate for the Inspire surgery to have tried and failed to use CPAP before they are eligible for Inspire. The good news is that many people with severe sleep apnea, who can't use some other CPAP alternatives, may be eligible for Inspire. Inspire can be used for people with AHIs, the number of breathing pauses per hour, as high as 65.3
A healthy lifestyle
Lifestyle improvements can also be enormously helpful to people with sleep apnea. There isn't a magic formula for this but moving more and eating healthy foods is a great place to start.4
My sleep specialist encouraged me to incorporate more vegetables on my dinner plate. This doesn't sound like much but increasing the proportion of vegetables makes me feel full and satisfied while getting in essential nutrients.
Have you been affected by the CPAP recall? Has the controversy made you consider CPAP alternatives? Have you thought about lifestyle changes that might help you in the wake of the recall? Share in the comments below.
Do any of your family or friends have sleep apnea?