Inside Sleep

Addressing Apnea in Truckers

• By Edward Grandi
• Apr 01, 2010

Truckers and sleep apnea. For many in the sleep field, the need for diagnosis and treatment of this group is obvious. In general, truckers tend to be male, middle-aged and overweight. And all three of those characteristics are prime markers for obstructive sleep apnea in adults. With the millions of commercial driver’s license holders across the country, that means there are potentially many sleepy truckers out there.

Addressing the problem of sleep apnea in this population poses at least three challenges. First, the character of the driver himself presents difficulties. He tends to be independent, self-reliant and somewhat suspicious of “big brother” tactics. Second, many truckers, particularly those who work long-haul routes, can be on the road for days, which makes scheduling an overnight sleep study at a clinic a nightmare. The third problem is that current regulations work against identifying the problem because they prevent truckers diagnosed with sleep apnea from renewing their commercial driver’s licenses until they can demonstrate compliance with therapy. Further, drivers are concerned about a proposed regulation to use a fixed Body Mass Index minimum to determine if mandatory screening is required. Given the perceived expense of diagnosis and treatment by this population, it is no wonder that little progress has been made on this increasingly visible health and safety concern.

The Federal Motor Carrier Safety Administration, the agency within the Department of Transportation charged with promulgating the regulations governing who is fit to hold a commercial driver’s license, is in the process of revising the rules for how DOT-certified medical examiners are to determine whether a driver is at risk of OSA. The current regulation is still in place and a new regulation has not been implemented to replace the old one. The proposed regulation exists as a guideline for the medical examiners to use, but it is not the “law of the land” yet.

Against this backdrop, the American Sleep Apnea Association, a national health organization dedicated to educating the public and supporting those with sleep apnea, decided to organize the first ever conference in this topic, the Sleep Apnea & Trucking Conference. The purpose of the conference is to bring together all the stakeholders with an interest in this serious issue. This includes trucking company executives and the people within their organizations charged with driver health and safety, medical examiners, federal agency personnel, insurance companies, and the sleep community. Our goal is to achieve a common level of understanding about the problem of OSA and to present new ways to address it in the trucking workplace.

To be held May 12 at The Westin Baltimore Washington, the meeting will have two parts. The first part will provide a foundation for common understanding. Benisse Lester, M.D., the chief medical officer for FMCSA, will provide an overview of the current and proposed regulations governing sleep apnea and commercial drivers. Other presentations will cover current data and needed research, the perspective of the DOT-certified medical examiner, and legal considerations from an attorney who specializes in defending trucking companies. And so everyone understands the basics of the disease, a sleep physician will explain OSA, how it is diagnosed, how it is treated and why it is important to address this serious health concern.

While the morning sessions will provide the foundation, the afternoon presentations will address the possibilities and challenges of sleep apnea management programs in operational settings, specifically, diagnosis, treatment and monitoring compliance. Starting with the health and safety perspective of a successfully treated and compliant truck driver, the afternoon sessions will highlight innovative sleep apnea management programs in trucking that are either cost-effective, convenient and/or tailored to trucking’s unique needs.

Building on talks that refl ect what is currently available and possible, trucking executives from Schneider National and J.B. Hunt will discuss the internal decision-making and implementation processes involved in getting a sleep apnea management program off the ground and a representative of Owner-Operator Independent Drivers Association will focus on the real-world challenges of putting a program in place for smaller companies.

While a one-day conference will not address all of the complex issues associated with sleep apnea and the trucking industry, ASAA expects to continue building consensus among the stakeholders and to make progress toward safer highways for everyone. For more information, visit the conference Web site at www.satc2010.org.

This article originally appeared in the Respiratory & Sleep Management April 2010 issue of HME Business.