MRB issues guidance for drivers and MEs regarding CPAP recall

The Medical Review Board (MRB) has issued recommendations to certified medical examiners (CMEs) and drivers of commercial motor vehicles (CMVs) for responding to a recall of Phillips or other recalled CPAP machines.

Drivers with untreated moderate to severe sleep apnea, defined as having an Apnea-Hypopnea index (AHI) of 15 or greater, are not medically qualified to drive CMVs per current advisory guidance. Drivers who rely on a CPAP machine will need to seek out another treatment option if their CPAP machine was recalled.

The MRB suggests drivers consult with their physicians to see if they are a candidate for oral appliance therapy (OAT), positional therapy, tracheostomy, or jaw surgery.

For drivers who have a recalled CPAP device, cannot use the device in the interim, and are a candidate for switching to OAT:

• A trial device can be ordered and fitted at home. A more permanent device may be obtained within 2-3 weeks. A sleep study would be performed after about a week of adjustment to the device.
• The appliance must be worn a minimum of four to five hours a night at least five times per week.
• The OAT should include a way to monitor compliance for reporting to the treating physician.

CMEs who examine drivers with sleep apnea and are good candidates for treatment with OAT per a sleep specialist:

• May give these drivers a 90-day medical certification to provide the drivers time to complete a sleep study and start treatment. This guidance does not apply to drivers with previously diagnosed sleep apnea.
• Also, a 90-day card is only an option if the driver does not have symptoms and is not considered high risk. Extensions are not permitted.

OAT is accepted for recertification of drivers only until CPAP machines are again available.

Affected drivers, carriers, and MEs should refer to MRB’s report online for more specific information: MRB Task 21-3 Report: Recommendations to Medical Examiners and CMV Drivers When There Is a CPAP Recall (September 29, 2021) (dot.gov)