For patients with obstructive sleep apnea, a malady affecting many truck drivers, the standard treatment has long been the C-PAP device, a continuous positive airway pressure. But many find it cumbersome, and some companies market oral appliances to treat the condition. Will they meet new federal guidelines for treating apnea?

I asked David McKinney, founder of California Occupational Medical Professionals, who's very knowledgeable about the regulations on driver health qualifications. (He helped develop the National Registry of Certified Medical Examiners.)

The present situation, he said, is that if they work, they are acceptable treatment for obstructive sleep apnea. But the driver still has to be diagnosed and followed. In others words, they cannot just get an oral appliance and say "I'm treated."

However, if diagnosed with OSA and the condition is properly treated with the device, it is an option.

The present guidance suggests that compliance for treated OSA is that the driver be treated for at least four hours a night at least 70% of the time (seven out of 10 nights). Some of the companies producing the dental appliance have/are developing a compliance data chip, much like the ones present in the C-PAP machines currently available, McKinney says.

"It remains very important to note that treatment and compliance is the key, and that will be the real marker for continued commercial certification."

Oral appliances also have their own set of nuisances, he pointed out. They are definitely cheaper and less cumbersome, but as with any dental appliance, they constantly shift in your mouth and frequently require some adjustment.

"So again, since using the device is the key and a poorly fitting oral appliance may not be tolerated, making compliance a problem," McKinney told me. "In my experience, at least, I follow these individuals in the same way I follow anyone with OSA. In other words, they have to prove they are compliant."