Obstructive sleep apnea affects around 20 million Americans and can lead to hypertension, heart attack, stroke, depression, muscle pain, fibromyalgia, morning headaches, and excessive daytime sleepiness.

Friday, October 8, 2010

FMCSA Rules Present Challenges for Dental Appliance Therapy

At a September 28 meeting considering a 2009 fatal large truck accident in Oklahoma, the National Transportation Safety Board (NTSB) cited mild obstructive sleep apnea as a contributing factor to the driver's fatigue. The accident that killed ten people were killed and six people (including the truck driver) were injured. This tragic accident might have been prevented if the driver's sleep apnea had been treated, making him less susceptible to fatigue while driving.

Commercial drivers with sleep apnea are twice as likely to be involved in an accident, according to studies cited by the Federal Motor Carrier Safety Administration (FMCSA). Treatment of sleep apnea virtually eliminates this increased risk, but so far the only permissible treatment for commercial motor vehicle drivers is CPAP. Although surgery is considered a possible treatment for obstructive sleep apnea, many surgery patients still need CPAP after surgery.

Although FMCSA advisers considered dental appliance therapy, the alternative was rejected because:

  • Randomized clinical studies did not show it reduced crash risk
  • Compliance monitoring is a challenge

Therefore, in order to prove that dental appliances are an acceptable treatment option for truck drivers, advocates must overcome these two objections. Continued studies can probably overcome the first challenge, but the second is harder, although some appliances might be modifiable with pressure-sensors to monitor that they are being used.

Although dental appliances are not approved for use by commercial truck drivers, they have been shown to be an effective treatment for mild to moderate sleep apnea for most people. To learn more about this alternative to CPAP treatment, please contact a local sleep dentist today.


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posted by Dr. Candelaria at 9:30 AM