Sleep apnea is an often-undiagnosed disorder causing one or more pauses in breathing or shallow breaths while you sleep. When this happens, your sleep is interrupted repeatedly during the night, causing you to be tired during the day. Doctors usually can’t detect the condition during routine office visits, and no blood test can help diagnose the condition.
Truckers experiencing daytime drowsiness behind the wheel are a danger to themselves and other drivers on the road. Since 2009, the U.S. National Transportation Safety Board (NTSB) has been calling for better screening of truck drivers, and for more than a year, federal officials have been working on guidelines for diagnosing sleep apnea in transportation workers.
Although the Federal Motor Carrier Safety Administration (FMSCA) says “A motor carrier may not require or permit a driver to operate a commercial motor vehicle if the driver has a condition, including sleep apnea, that would affect his or her ability to safely operate the vehicle,” at this time there are no federal regulations for tracking or treating sleep apnea in transportation workers.
Research Links Sleep Apnea to Truck Crashes
A study conducted in 2016 by researchers at Harvard T.H. Chan School of Public Health, University of Minnesota, Morris, and Brigham and Women’s Hospital showed that truck drivers with obstructive sleep apnea (OSA) who failed to adhere to treatment had a rate of preventable crashes five times higher than that of truckers without the condition. The researchers estimated that up to 20 percent of all large-truck crashes result from drowsy or fatigued driving. The study’s findings suggest that, to continue driving, commercial truck drivers should be regularly screened for sleep apnea and required to treat it if they have it.
Sleep Studies Accurately Diagnose Sleep Apnea
Truck driving is a solitary job that can lead to being overweight and other health problems. Because sleep apnea tends to occur in those who are overweight, two Federal Motor Carrier Safety Administration (FMCSA) advisory committees– the Medical Review Board and the Motor Carrier Safety Advisory Committee–recommended requiring sleep tests for overweight drivers with a Body Mass Index (BMI) of 35 or higher; however, the FMCSA has failed to act on that recommendation.
Sleep studies are the most accurate tests for diagnosing sleep apnea. Once sleep apnea is suspected, a doctor will measure a patient’s nighttime breathing with a home-based portable monitor called a polysomnogram (PSG) that records brain activity, eye movements, heart rate, blood pressure, the amount of oxygen in the blood, air movement though the nose, snoring, and chest movement that shows whether a patient is struggling to breathe.
Current Treatments for Sleep Apnea
Once diagnosed with sleep apnea, changes in daily activities may be all that is needed. A doctor may advise a patient to lose weight, avoid alcohol, sleep on the side rather than the back to help keep the throat open, and quit smoking. In cases of mild sleep apnea, a doctor may recommend a mouthpiece, fitted by a dentist or orthodontist, that adjusts the lower jaw and tongue to help keep the airways open during sleep. Patients with moderate or severe sleep apnea are given a CPAP mask to wear at night that fits over the mouth and nose or just over the nose. The CPAP gently blows air into the throat to keep the airway open. Those with severe sleep apnea may need surgery to widen breathing passages.
Carriers Require Trucker Sleep Apnea Testing for Employment
Even without federal regulations requiring trucker sleep apnea testing, some carriers are testing their drivers. However, smaller trucking companies may not offer health insurance, or drivers who are independent contractors may be told to pay for the testing, which averages about $1,200.
In April 2017, the U.S. Supreme Court decided not to hear a case from a driver who claimed a carrier violated his rights by requiring him to be tested. The driver had appealed a lower court decision that Crete Carrier Corp. didn’t violate his rights under the American with Disabilities Act (ADA) by requiring him to be tested for sleep apnea because he had a Body Mass Index (BMI) of 35 or higher. He had given the company a note from his personal doctor saying testing wasn’t necessary, but he was fired after he refused to take the test.
After the Supreme Court’s rejection of the appeal, with less threat of lawsuit, carriers will be more likely to monitor their truck drivers with more work rules surrounding sleep apnea and testing for the condition.
In August 2017 the administration put the brakes on a year-old effort to find ways to diagnose truckers who may have sleep apnea, a serious health condition linked to crashes.In its zeal to block and limit regulations, the administration determined not to issue a notice of proposed rulemaking on sleep apnea as a cause of truck crashes, and the Federal Motor Carrier Safety Administration (FMCSA) said that “the current safety programs” and other rules “addressing fatigue risk management are the appropriate avenues to address the issue.”
