By Sree Roy

Tremblors from the Philips CPAP recall continue to shift the therapy landscape in sleep medicine. Like earthquake aftershocks, the size and timing of events feel somehow simultaneously expected and unpredictable.

In January, Philips Respironics announced it was discontinuing its DreamStation Go CPAP, along with a slew of other sleep and respiratory therapy and diagnostic devices. Just as we began regaining footing, the Big One hit: Philips reached an agreement with the US Department of Justice on the long-looming consent decree, which states that the company cannot sell any positive airway pressure devices in the United States until it meets all conditions. That is expected to take years.

It feels surreal that a leader in sleep therapy devices has been knocked out of place (by its own mistakes, no less). 

I worry about CPAP shortages continuing, negatively impacting sleep apnea patients. I anticipate the number-one CPAP device maker, ResMed, will step up like it did after the original recall announcement and during supply chain shortages. I also expect React Health to up its presence. React Health even recently introduced a Luna TravelPAP—good timing for patients who would have purchased the DreamStation Go. 

A potential silver lining of these seismic shifts could be more patients having their sleep apnea therapy customized. I am seeing signs of this shift now.

A research study at Flinders University in Australia experimented with giving obstructive sleep apnea (OSA) patients an oral appliance first, which worked in about 50% of participants. From there, they customized add-on therapies “informed by the findings of a detailed sleep study that we did which tells us exactly why each person gets their OSA,” says Danny Eckert, PhD, director of the Flinders Health and Medical Research Institute-Sleep Health, in a release. These add-ons included oxygen therapy and medications, and they worked in almost all the remaining participants. Only a few were prescribed CPAP as a “last resort,” Eckert says.1

I also expect research results that could sway the therapy landscape even more. ProSomnus and Vivos are conducting clinical trials comparing their oral appliances head-to-head with CPAP. (ProSomnus is also comparing its devices head-to-head against neurostimulators.) “If validated, [The First Line Obstructive Sleep Apnea Treatment study] should represent an important contribution toward a more patient-centric approach to treating OSA and away from the current one-size-fits-all modality,” says Len Liptak, co-founder and CEO of ProSomnus.

Next issue, we’ll have more perspectives on how to rethink diagnostic and treatment plans—from sleep studies to positional therapy and of course the status of oral appliances and CPAP. The aftershocks are likely to keep rumbling.


  1. Aishah A, Tong BKY, Osman AM, et al. Stepwise add-on and endotype-informed targeted combination therapy to treat obstructive sleep apnea: a proof-of-concept study. Ann Am Thorac Soc. 2023;20(9):1316-25.

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