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ADVANCE Perspective: Respiratory Views

OSA: Deadly Consequences

Published January 27, 2017 12:04 PM by ADVANCE for Respiratory Care & Sleep Medicine
In October 2016, New Jersey Transit issued a policy change addressing engineers who suffer from sleep apnea, the Associated Press reported on Nov. 21.

On Sept. 29, a train crash in Hoboken, N.J. killed one and injured more than 100 and obstructive sleep apnea on the part of the engineer was later found to be a factor.

According to a feature prepared for ADVANCE by Colleen Lance, MD, assistant professor of medicine, University Hospitals, Case Medical Center, Cleveland, the alternatives for treating obstructive sleep apnea (OSA) to date have been limited. 

"Continuous positive airway pressure (CPAP) therapy has been the gold standard and still remains the foundation of the therapeutic approach to the patient with sleep-disordered breathing," wrote Lance. "However, recent data show that only 50% of patients initiated on CPAP therapy are considered compliant."

Fortunately, other options have been developed for those who cannot, or will not, use CPAP therapy, explains Lance.

"Oral mandibular advancing dental appliances have been proven to be an effective mode of therapy for some, for example. Advances in otolaryngological surgery have also proven to be of some benefit; but for most, the surgical options are not curative for obstructive respirations. "

In this article, Lance reviews therapeutic options for OSA patients who struggle with CPAP with particular emphasis on a new upper airway stimulation treatment.

According to the Associated Press, the revised New Jersey Transit policy requires engineers suffering from sleep apnea to have the disorder under control before operating trains. The previous policy allowed engineers with sleep apnea to keep working as long as they were being treated.


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