Feds Moving Closer to Screening Truckers for Sleep Apnea

Soon, the federal government might require all commercial truckers, bus drivers, and railroad workers be screened for obstructive sleep apnea (OSA), a disease that can cause drowsy driving and increase the risk of crashes.

In March 2016, the Federal Motor Carrier Safety Administration (FMCSA) and the Federal Railroad Administration issued an advanced notice of proposed rulemaking (ANPR), “Evaluation of Safety Sensitive Personnel for OSA.” Three public hearings were held and almost 600 comments were filed in the ANPR’s docket.  In August 2016, FMCSA’s Medical Review Board recommended a slate of sleep apnea guidelines that would require truck drivers to take diagnostic sleep studies if they have a body mass index of 40 or higher, have experienced excessive fatigue or sleepiness while driving, or have been in a sleep-related crash.

Larry Minor, FMCSA’s associate administrator for policy, said that if the agency does issue a proposal, it would not come until later this year.

The board also recommended that drivers at risk for apnea may be issued conditional 90-day medical certification pending sleep study and treatment, if diagnosed with apnea.

In addition, the board said that a driver with a body mass index of 33 to 40 should be required to take sleep studies if he or she has three of 11 risk factors, including:

  • Hypertension (treated or untreated)
  • Type 2 diabetes (treated or untreated)
  • A male neck size greater than 17 inches or female neck size greater than 15.5 inches
  • A history of stroke, coronary artery disease, or arrhythmias
  • Loud snoring
  • Micrognathia or retrognathia (small or recessed jaw)
  • Witnessed apnea symptoms
  • Hypothyroidism (underactive thyroid; untreated)
  • Age 42 or older
  • Is male or post-menopausal female
  • Mallampati Scale score of class 3 or 4 (small airway)

In its recommendations, the board said the preferred method of treatment for moderate to severe apnea is PAP, or positive airway pressure, which has been proved as the most effective treatment for apnea. The board said it would allow drivers to treat apnea with oral devices, but it noted that the medical literature reveals that the alternate method of treatment has not yet been proved effective for most moderate to severe cases of apnea.

Airline pilots are already screened regularly for sleep apnea, but no there’s no formal screening for the disease in place for truckers and railroad workers.

A study conducted by the FMCSA and other researchers found that almost 28 percent of commercial truckers have mild to severe sleep apnea. First classified as a sleep condition in 1965, sleep apnea causes brief interruptions of breathing during sleep – these pauses can last ten seconds or longer and can occur up to 400 times a night. Many people with sleep apnea don’t even know they have it. It’s estimated that at least 25 million adults in the U.S. are afflicted with the disease, and the Cleveland Clinic estimates as many as 80 percent of OSA cases go undiagnosed.

The AAA estimates that 328,000 crashes on U.S. road each year, including 109,000 injuries and 6,400 fatalities, involve a drowsy driver. And commercial drivers are more likely to drive drowsy, according to the Centers for Disease Control and Prevention (CDC). The National Transportation Safety Board has found sleep apnea to repeatedly be a culprit in commercial driver crashes.

Don’t wait for the feds to act if you suspect any of your employees are driving with undiagnosed sleep apnea.  Undiagnosed OSA is a health risk to your drivers and a safety risk when those drivers are on the road. Screening for OSA, and treatment if necessary, improves personal health and reduces the risk of crashes.