Should Truck Drivers be Tested for Sleep Apnea?

Quick answer: the Federal Motor Carrier Safety Administration (FMCSA) does not have a specific regulation mandating sleep apnea screening for all commercial drivers, but its 2016 advisory and the Medical Review Board recommendation establish that certified medical examiners may require OSA evaluation when risk factors are present -- typically BMI of 33 or higher, neck circumference over 17 inches in men or 16 in women, witnessed apneas, or excessive daytime sleepiness. Drivers diagnosed with moderate-to-severe OSA (AHI of 15 or higher) typically require documented PAP therapy adherence to maintain their CDL medical certification. Adherence documentation is the same standard as Medicare (4 hours per night on at least 70 percent of nights). Untreated severe OSA in commercial drivers is associated with significantly higher crash risk -- a Sleep journal meta-analysis estimated 2-7x increased rate -- which is why the workplace-safety case for screening remains strong even without a federal mandate.

In light of the car crash last month that seriously injured comedian Tracy Morgan, more attention is being drawn to the grave safety issue of truck drivers nodding off on the job.If a motorist has sleep apnea--a health condition that impairs quality of sleep and increases drowsiness--the risk of an accident is even greater.

Accidents resulting from sleep apnea are well-documented. Late last year, a train on New York City’s Metro North Line slipped off a curve and crashed, killing four people and injuring 63. The accident occurred because the engineer was asleep at the wheel—a result of his undiagnosed sleep apnea. In another case, a school bus driver was filmed nodding off while driving a bus-full of children. According to the National Transportation Safety Board (NTSB),fatigue resulting from sleep apnea is a nationwide problem encompassing commuters, truckers, pilots, and marines.

Obstructive sleep apnea (OSA)is a disorder in which airflow is restricted during sleep, leading to reduced oxygen to the brain and poor sleep quality. As a result, patients with the condition suffer from impaired concentration and drowsiness during the day. When combined with a long and monotonous task like driving a vehicle, it can lead to them nodding off at the wheel, with the potential for immense damage to property and human life.

Part of the problem, however, is that many drivers do not know they have the condition.

The National Transportation Safety Board has published a set of recommendations advising that pilots be tested for sleep apnea and that further research be conducted. However,there is currently no nationwide program or standard in place for screening drivers for sleep apnea, though informal attempts have been made to implement one.

Requirements for sleep testing in the transportation industry have met with opposition from industry groups, such as the American Trucking Association (ATA) and the Owner-Operator Independent Drivers Association (OOIDA). Last year, the ATA backed a bill that was signed into law by President Obama in October. The new law requires that the Federal Motor Carrier Safety Administration use a formal regulatory process if it chooses to implement across-the-board sleep testing (as opposed to merely using agency guidance, which is not subject to public approval). Truckers and engineers are concerned that drivers could be forced to foot the cost of an expensive test that they cannot afford (in-lab sleep testing can cost as much as $2500).

The Federal Motor Carrier Safety Administration is currently conducting research on the dangers of fatigue resulting from sleep apnea and exploring the possibility of required sleep testing.

Regardless of one’s occupation, sleep apnea can be a dangerous and medically serious condition. If you think you might have a sleep disorder, discuss with your doctor if you need a sleep study or request a call/email.

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Other posts you may find interesting:

• Veterans with PTSD are at Higher Risk for Sleep Disorders
• Driving Drowsy vs. Driving Drunk: the Fatal Mistake Most People Make
• How does the Affordable Care Act Treat Sleep Apnea?
• The Health Hazards of Sleep Apnea in Women
• Does My Dog Have Sleep Apnea?

Previous comments on Sleepdr.com/blog:

Westly Chandler

8/12/2014, 8:13:48 AM

I think it is a no brainer. Why not take the safer, and more health beneficial route. No harm could possibly come out of testing for Sleep Apnea

Frank Spinazzola

3/16/2015, 6:01:47 AM

Being a truck driver I think that of all the hundreds of regulations that we have to follow, this one makes the most sense. I am not over weight, 5' 9" 166 lbs, but I think that I would like to be tested.

Julia Rodriguez

3/18/2015, 8:16:23 AM

Thank you for your comment--it's great to get insight from someone who is in this position. Given the prevalence of sleep apnea and the dangers of driving sleepy, it's a good idea for people who drive/operate machinery for a living to get tested, even if it's not required by law.