Robert Miller leads Daybreak’s push for CPAP alternatives

YARMOUTH, Maine – There’s a new landscape of available sleep apnea treatments, something that Robert Miller, an RSPGT, has seen evolve over his long career, which has included leading roles at major sleep players, including MedBridge Healthcare and, most recently, Apria Healthcare. 

Miller is now senior vice president of commercial strategy for Daybreak, a provider of at-home sleep testing and care, which recently became an affiliate partner of VGM & Associates to introduce its provider members to custom oral appliance therapy as another treatment option.  

“It’s one of those things where if you can't keep the patient on a CPAP device, at least do the next best thing, which is to get them on some form of therapy that they can tolerate,” he said. 

Miller spoke with HME News about his own personal journey with sleep apnea and the consequences of treatment fatigue.  

HME News: What attracted you to the new role at Daybreak? 

Robert Miller: I’ve been on a GLP-1 for about a year-and-a-half and was a very adherent CPAP user for several years, but I noticed as I continued to lose weight that I was becoming non-adherent to my CPAP, sort of pulling the CPAP device off. I didn't need a CPAP any longer, but being a clinician, I wanted to make sure that my airway was still going to be protected. So, I made the decision to try a custom oral appliance, which I've now been on for eight to 10 months. 

HME: What is the process like? 

Miller: The patient will receive an at-home impression kit. They’ll actually send in multiple impressions so that we get the best image, or the best impression for that patient to create a digital scan. That impression is sent over to the lab, where they craft the appliance. Every patient gets a Daybreak At-Home Sleep Test, which is used to measure the correct balance for their oral device. Over the next seven to 10 days, they’ll complete a few guided nights of adjustments, working closely with a Daybreak specialist to fine-tune the device usage for their needs. 

HME: Do you see a growing interest in the marketplace for alternatives to CPAP therapy? 

Miller: When I was at Apria, I was advocating to adopt oral appliances for our patients who were nonadherent or who wanted an alternative to a PAP therapy device. I found a company that provided custom oral appliance therapy via a virtual assessment of the patient. It was something that I personally felt strongly about, witnessing many patients who are experiencing a sense of treatment fatigue – to the verge of abandoning their CPAP therapy.