Sleep apnea: carcinogenic Philips devices?

[Mis à jour le 7 février 2022 à 20h10] On July 12, 2021, Philips released a security notification concerning CPAP devices, respirators intended for patients suffering from sleep apnea or requiring respiratory assistance at home. A risk of degradation of soundproofing foam in the form of particles that can be ingested or inhaled by the user. Problem: degraded foam could form potentially carcinogenic volatile organic compounds (VOCs) (azoxymethane). Other potential hazards that arise from emitted compounds include: headache/dizziness, irritation (eyes, nose, respiratory tract, skin), hypersensitivity, nausea/vomiting… To date, Philips has not received any reports concerning the impact of VOCs on patients. But as a precaution, all the devices concerned, i.e. 370,000 models in France, had been recalled, indicates theMedicines Agency in November 2021. These devices were supposed to be replaced however, some patients have continued to use the devices in question, having not been made aware of these risks. (Only 6% of devices would have been returned to Philips). On February 7, 2022, RMC published an article in which he shares the testimonials of users of Philips devices against sleep apnea. Among them, a patient diagnosed withlymph node cancer, in January 2022, became aware of this case by chance and now wants to know if there is a link between his cancer and these machines. Other patients are worried and also ask themselves questions about this possible link. Pending responses from Philips and ANSM, un Facebook group was created for all users of these devices. In the meantime, the ANSM has told patients what to do:

• We recommend, in consultation with health professionals, not to stop your treatmentregardless of the type of device used.
• Your pulmonologist or home healthcare provider has contacted you or will contact you to arrange for the repair or replacement of your equipment, depending on the availability of equipment.
• In case of headache, irritation (skin, eyes, respiratory tract), inflammatory reactions, cough, chest pressure, asthma and sinus infection, or other symptoms that may be related to the use of the device , contact your doctor.
• In the event of such undesirable effects, we also invite you to A declaration on the reporting portalspecifying the full serial number of the device (your doctor can help you make this statement).

Also called “obstructive sleep apnea-hypopnea syndrome (OSAS)”, sleep apnea is a nocturnal breathing disorder. It is characterized by the occurrence of pauses in breathing of at least 10 seconds which can be repeated sometimes more than 100 times per night. This respiratory dysfunction is caused by the obstruction of the respiratory ducts in the back of the throat. Sleep apnea was first described in 1972 by French professor Christian Guilleminault.

• The classic symptoms are a abnormal fatigue on waking after a night’s sleep and headaches upon rising. A abnormal and frequent drowsiness during the dayafter meals, in front of the television, at the cinema, while reading, in meetings or even while driving.
• Behavioral disorders can be observed: irritability, difficulty concentrating, memory loss, lack of energy and depression.
• Decreased desire and erectile dysfunction can be observed.
• The multiplication of apneas causes a decrease in blood oxygenation. This decrease in oxygenation has severe repercussions on health by favoring the appearance of arterial hypertension, myocardial infarction or cerebrovascular accident.
• the snoring is very often permanent. It begins at the onset of sleep and is interrupted by pauses in breathing, often described by the spouse. The resumption of breathing is noisy and is accompanied by body movements.
• The appearance of night sweats is frequent and episodes of sleepwalking can occur in about 10% of cases.

A risk of road accident multiplied by 6

Sleep apnea is caused by obstruction of the upper airways, the causes of which can be multiple: dilation of the pharynx, obstruction of the nasal passages, increase in the size of the tonsils, the tongue or the uvula. It is often accentuated by the lying position on the back which causes the tongue to go down the back of the throat. Heredity would also be a risk factor.

Lack of restorative sleep causes a state of abnormal tiredness. It is manifested by frequent drowsiness during the day, especially while driving. The risk of a road accident would thus be multiplied by 6 in people prone to sleep apnea. According to Dr. Samia Tahraoui, sleep specialist in Paris “sleep apnea can lead to serious long-term complications (hypertension, stroke, diabetes, overweight) increasing the risk of cardiovascular mortality. This is a real public health problem unfortunately currently under-diagnosed”. It is in fact estimated that nearly 80% of people who suffer from sleep apnea go undiagnosed. It would therefore be more than 20% of the population who would be affected by these disorders and no longer only 5 to 10%.

“The diagnosis is made in two stages, the first essential of which is the Berlin questionnaire, carried out by the doctor, explains Dr. Tahraoui, the answers to this questionnaire allow him to assess the probabilities of sleep apnea, and in the event of a high probability, two types of examination are then offered to the patient. These exams are:

Ventilatory polygraphy : ambulatory medical examination which records breathing rate, snoring and body movements during sleep using a small portable device called an ambulatory polygraph.

Polysomnography : which also records heart rate, electroencephalogram (brain activity) and electromyogram (muscle activity) and body temperature.

30% of people refuse devices dedicated to sleep apnea

Before starting treatment, it is essential toeliminate factors that can cause or worsen sleep apnea. In case of overweight or obesity, losing weight is an essential measure that must be taken as soon as sleep apnea syndrome is diagnosed. The relationship between overweight and weight gain is indeed important. Nearly one obese person out of two has a sleep disorder.

• Avoid the consumption of substances that aggravate snoring: alcohol, tobacco, taking sedatives or painkillers.
• Sleeping on the side and no longer on the back can sometimes reduce the frequency of sleep apnea and improve sleep.

Many people with sleep apnea syndrome are offered the Continuous Positive Pressure (CPAP) device. Unfortunately, nearly 30% of patients do not accept this treatment and a significant percentage of those who use it do not plug it in throughout the night. As a result, they do not benefit from the minimum number of hours required for the treatment to be effective. The success of CPAP treatment is based on rigorous therapeutic education so that he and his family, especially his spouse, accept this restrictive device. The prescribing doctor and the service provider who installs the device must provide a certain amount of information that is essential for the smooth running of this treatment. This step allows you to become familiar with and better accept the device.

Also called anti-snoring gutter, the mandibular advancement orthosis (OAM) is used in cases of moderate sleep apnea. This custom-made mouthguard made by an orthodontist must be worn all night. It has the function of keeping the tongue and lower jaw forward to prevent obstruction of the airways.

They are rarely offered as a treatment for sleep apnea, and are only offered to correct a possible morphological defect of the jaw, palate or base of the tongue. They are quite painful and often ineffective.

Thanks to Dr. Samia Tahraoui, sleep specialist in Paris