Sleep Review

Italian Researcher Says Sleep-Breathing Screenings Should Be Required for Truckers

A survey of 905 Italian truck drivers has shown that approximately half have at least one sleep-related breathing problem that potentially can cause drivers to fall asleep at the wheel.

In a presentation at the European Respiratory Society International Congress entitled”Obstructive sleep apnoea screening the truck driver population,” Luca Roberti, president of Apnoici Italiani (the Italian Sleep Apnoea Patient Association), called for it to be made compulsory for European haulage companies to test drivers for sleep-related breathing problems.

“Considering that drivers are in charge of transport vehicles weighing several tons, companies have a great moral and civic responsibility to ensure their employees are safe to drive and are not at risk of suddenly falling asleep at the wheel. This would also be in line with European Union legislation that regulates the renewal of drivers’ licenses for people suffering from obstructive sleep apnea,” he said.

The European Union Directive 2014/85/EU, created to limit accidents arising from OSA, requires drivers with moderate or severe OSA to seek medical advice before their licenses can be issued or renewed; drivers may be advised not to drive until confirmation of a diagnosis and steps are taken to control the condition. One of the main risk factors for OSA is being overweight.

Roberti and colleagues conducted their study in 2018 after being asked by an Italian truck driver cooperative, Federtrasporti, to carry out a health survey of truck drivers. On 44 days between March and December, volunteer expert patients, doctors, and nurses questioned drivers at truck dealerships, 50 companies that were part of Federtrasporti, at driver training days and at a truck driver show.

They measured height, weight, and waist circumference, took details of medical conditions, such as diabetes, and of lifestyle factors, such as whether the drivers smoked or took drugs. They asked about their length of time as a haulier, distances covered, whether they drove national or international routes, and the types of goods they transported. Their questions about sleep included:

  • do you sometimes stop breathing and have sleep apnea at night?
  • do you snore?
  • do you wake up needing to urinate urgently?
  • are

Oventus Medical: The War on Snoring, Spousal Homicide and the Mouth Guard that Caught Alan Moss’ Eye

The Health Kick Podcast with Tim Boreham chats with Chris Hart, founder, managing director and CEO of Oventus Medical.

The company’s key focus is its range of medical devices that improve comfort during sleeping for patients suffering from various ailments including sleep apnoea and snoring, as well as secondary effects such as tooth decay and gum disease.

from Sleep Review…

Philips Consumer Sleep Products Suite Aims to “Address 80% of All Sleep Issues”

Revealed at the CES tradeshow in January 2019, Philips expanded SmartSleep suite of consumer-facing sleep solutions is now available in the United States. The products address sleep issues such as difficulty falling asleep, snoring, and simply not getting enough quality sleep. By expanding its suite of consumer sleep solutions, Philips states that its aim is to ultimately address 80% of all sleep issues globally.

“Everyone sleeps, but unfortunately sleep doesn’t come easily for everyone. There are a host of issues that impact sleep—from trouble falling asleep to snoring to chronic conditions like sleep apnea,” says Mark Michels, business leader, Healthy Sleep Solutions at Philips, in a release. “Using our nearly 40 years of deep clinical expertise in sleep technology, we continue to enhance the solutions available for people who experience common issues that negatively impact the quality of their sleep. Our suite of solutions aims to provide consumers with access to clinically backed innovations that will help them get a better night’s sleep to achieve more productive days ahead, while also increasing awareness to the importance of sleep health. All of this comes with the hope of positively impacting the consumer and clinical sleep industries alike.”

Philips SmartSleep suite of solutions is comprised of a mix of existing and new solutions, which aim to make better sleep accessible to everyone:

  • SmartSleep Analyzer: It provides personalized analysis of users’ sleep based on an online questionnaire to identify sleep challenges and recommend sleep solutions personalized to the user. This triage tool was developed in collaboration with sleep physicians, specialists, and researchers to identify the most common sleep challenges, helping to support Philips strategy to amplify awareness around the role sleep plays in consumers’ health and wellbeing.
  • SmartSleep Snoring Relief Band: This wearable device is a personalized solution for positional snoring. Derived from clinical technology, a small, discreet positional monitor detects when the wearer begins to shift to their back and delivers adaptive vibrations that prompt them to sleep on their side.
  • SmartSleep Better Sleep Program: Rooted in the principals of cognitive behavioral therapy for insomnia (CBT-I), the SmartSleep Better Sleep Program combines

Sleep as a Vital Sign: Kristina Weaver, EMT-P, RPSGT

Kristina Weaver, EMT-P, RPSGT, ensures medical center colleagues across all specialties play the sleep advocate.

By Greg Thompson | Photography by Dani Nichol Photography


Kristina Weaver, EMT-P, RPSGT, cares deeply about her patients, but she’d rather not see them back at Parrish Healthcare. As director of Care Navigation for the Sleep Navigator/Educator Program at the Titusville, Fla, health system, Weaver has managed a 30% reduction in readmissions for newly identified sleep apnea patients over the last four years,1 a result of healthier patients with positive outcomes.

The improvement comes courtesy of what Weaver calls a more person-centered approach, with screening and education throughout the continuum of care. A person-centered approach gets patients actively involved in their own care, helping them take ownership of their treatment.

“If you have sleep apnea, you cannot effectively treat other comorbid conditions,” Weaver explains. “Take heart failure as an example. When a patient comes into the hospital with left ventricular heart failure and [has] untreated sleep apnea, that left ventricle has to work even harder because it lacks oxygen due to the sleep apnea. Getting that patient to understand how those things work together, and want to fix the problem for themselves, is vital.”

Before Parrish Healthcare started its Sleep Navigator program, many colleagues in the hospital did not even know an on-site sleep center existed. But now, according to Weaver, the mindset throughout the various subspecialties has dramatically changed. “Now when a heart attack patient comes into the [emergency room] who complains of chest pain, or complains of fatigue and poor sleep, they immediately think of sleep medicine,” she says. “In the past, the two and two may not have been put together. No matter if it’s in our diabetes support group, pulmonary rehab, physician practice—anywhere in our network—we treat sleep as a vital sign.”

Sleep Support Group


Once patients get treatment for their sleep apnea, they are often referred to the sleep support group, dubbed “Brevard A.W.A.K.E (Alert, Well and Keeping Energetic).” Of course, in this context, Weaver wants to see her patients again.

The group often attracts 40 to 50 people

Snoring Nose No Limits: UAB Experts Advise How to Cut Noisome Snoring

Kirk P. Withrow, MD, shares some causes and solutions to snoring.

While the nose generally is not the direct source of the tissue vibration, nasal obstruction – like that from congestion due to cold or allergy – can play a role in snoring. This contributes to snoring due primarily to the change in position of the structures in the throat that occurs with mouth breathing, namely displacement of the tissue toward the back wall of the throat.

“Alleviating nasal obstruction and transitioning away from mouth breathing can improve or eliminate snoring,” Withrow said. “Such treatment can include allergy management or surgery to correct structural defects in the nose.”

from Sleep Review…

Study Questions Routine Sleep Studies to Evaluate Snoring in Children

A new finding suggests that the pediatric sleep study, used to diagnose pediatric sleep apnea and to measure improvement after surgery, may be an unreliable predictor of who will benefit from having an adenotonsillectomy.

About 500,000 children under age 15 have adenotonsillectomies every year in the U.S. to treat obstructive sleep apnea. The American Academy of Pediatrics (AAP) recommends the surgery as a first-line therapy to treat the condition, which can cause behavioral issues, cardiovascular problems, poor growth, and developmental delays. The premise is that surgically removing or reducing the severity of the obstruction to the upper airway will improve sleep and reduce other problems caused by the disorder.

In 2012, the AAP recommended that pediatricians should screen children who snore regularly for sleep apnea, and refer children suspected of having the condition for an overnight in-laboratory sleep study. The group also recommended an adenotonsillectomy based on the results of the test. But results from the new UMSOM study, published in the September issue of the journal Pediatrics, call into question those recommendations because the data they analyzed found no relationship between improvements in sleep studies following surgery and resolution of most sleep apnea symptoms.

“Resolution of an airway obstruction measured by a sleep study performed after an adenotonsillectomy has long been thought to correlate with improvement in sleep apnea symptoms, but we found this may not be the case,” said study lead author Amal Isaiah, MD, PhD, an Assistant Professor of Otorhinolaryngology — Head and Neck Surgery and Pediatrics at UMSOM. “Our finding suggests that using sleep studies alone to manage sleep apnea in children may be a less than satisfactory way of determining whether surgery is warranted.”

Get the full story at 

from Sleep Review…

Great Lakes Releases the New Medley Sleep Oral Appliance

Great Lakes Dental Technologies has announced the release of a new oral appliance for obstructive sleep apnea and snoring.

The new device, the Medley Sleep Appliance, features a platform with dual configuration options that can accommodate different advancement mechanisms including; rigid nylon links, elastomeric (EMA) straps, or telescopic Herbst rod sleeve arms. Medley offers personalized advancement options without treatment delays or the need for multiple appliances, according to a press release from the manufacturer.

“The Medley Appliance serves the needs of a vast majority of my patients who suffer from sleep apnea and nighttime snoring. I have used this appliance almost exclusively for five years. I am also thrilled to partner with Great Lakes Dental Technologies as the sole laboratory to manufacture my sleep appliances for distribution in the United States and Canada,” Robert Rogers, DMD, DABDSM, inventor of the Medley, says in a statement.

This appliance offers three different design applications to treat a variety of patients.

from Sleep Review…

FDA Seeks Pulmonary and Dental Sleep Experts for Medical Devices Advisory Committee Panels

The US Food and Drug Administration (FDA) issued a notice requesting nominations for voting members to serve on the Medical Devices Advisory Committee (MDAC) device panels, which reviews data on the safety and effectiveness of marketed and investigational devices and makes recommendations for their regulation.

The notice, published on Aug. 30, indicates that expertise is needed for the Anesthesiology and Respiratory Therapy Devices Panel of the MDAC, including anesthesiologists, pulmonary medicine specialists, or other experts who have specialized interests in ventilator support, sleep medicine, pharmacology, physiology, or the effects and complications of anesthesia. FDA is also seeking applicants with pediatric expertise in these areas. There is only one vacancy on this panel, and the approximate start date is Dec. 1.

The FDA also seeks expertise for the Dental Products Panel of the MDAC, including dentists, engineers, and scientists who have expertise in the areas of dental implants, dental materials, oral and maxillofacial surgery, endodontics, periodontology, tissue engineering, snoring/sleep therapy, and dental anatomy. There are 11 vacancies on this panel, and the approximate start date is Nov. 1.

Nominations received on or before Oct. 29, 2019, will be given first consideration for membership on the panels of the MDAC. Nominations received after Oct. 29, 2019, will be considered for nomination to the committee as later vacancies occur.

from Sleep Review…

Sick of Snoring?

The ZYPPAH is an anti-snore mouthpiece that uses a patented elastic that acts as “a seatbelt for your tongue.”

The brand claims that this will stop our tongue from falling back into our airway, which will result in a quiet night with no snoring.

Along with holding our tongue in place, this anti-snore mouthpiece also repositions the lower jaw, using a process known as mandibular advancement, to move it forward to open our airway even more.

from Sleep Review…

Glidewell Dental Oasys Hinge Appliance (PDAC Approved)

Glidewell Dental has released a new mandibular advancement device, the Oasys Hinge Appliance. This oral sleep appliance is Medicare and PDAC (Pricing, Data Analysis and Coding) cleared under code E0486 to treat patients with mild to moderate obstructive sleep apnea (OSA).

“Snoring is a warning sign that should not be ignored,” says Randy Clare, director of brand and product management at Glidewell Dental, in a release. “An estimated 50% of US adults snore and 30 percent of people are habitual snorers. In addition, adults over the age of 65 are at an increased risk of obstructive sleep apnea, which can be very serious if left untreated. Two common symptoms of OSA include loud, chronic snoring and daytime sleepiness.”

The Oasys Hinge Appliance is designed to gently shift the lower jaw forward during sleep, which activates the airway muscles and ligaments to prevent the airway from collapsing. The device is custom-made for each patient. It’s micro-adjustable (0.25 mm increments), with up to 10 mm of advancement based on the patient’s needs. The telescope-style hinge allows for natural jaw movement and can be adjusted chairside or at home. Patients with Medicare insurance qualify for reimbursement of their oral appliance, making it easy and affordable to get treated.

“Oral appliance therapy is a simple and effective method for achieving a more restful night’s sleep, resulting in renewed energy during the day,” says Clare. “As dentists welcome more integrative solutions for treating patients, the Oasys Hinge Appliance will become the go-to sleep device to prevent snoring and obstructive sleep apnea.”

from Sleep Review…