Study Urges Mandatory Sleep Apnea Testing for Truck Drivers
A recent study has confirmed that obesity-driven testing strategies identify CDL drivers with a high likelihood of obstructive sleep apnea (OSA) and suggests that mandating OSA screenings could reduce the risk of truck crashes.
"Truck drivers with sleep apnea are much more likely to fall asleep at the wheel, and the condition is increasingly common as Americans become more obese," said the study's senior author, Stefanos N. Kales, MD. "Additionally, we found that drivers who suffer from obstructive sleep apnea frequently underreport symptoms and diagnoses and often do not follow through with sleep study referrals and sleep apnea treatment."
OSA is a syndrome characterized by sleep-disordered breathing, resulting in excessive daytime sleepiness, sleep attacks, psychomotor deficits, and disrupted nighttime sleep. It increases the risk of a vehicular accident by two- to seven-fold, and is common among truck drivers. Approximately 2.4 - 3.9 million licensed commercial drivers in the U.S. are expected to have OSA. In addition to being unrecognized or unreported by drivers, OSA often remains undiagnosed by many primary care clinicians despite the fact that OSA increases the risks of hypertension, diabetes mellitus, and heart disease.
The study, funded in part by the FMCSA and published by the Journal of Occupational and Environmental Medicine, has significant policy ramifications, as the FMCSA is already deliberating recommendations to require sleep apnea screening for all obese drivers based on body mass index or "BMI" (BMI is calculated based on height and weight). The Administration requires medical certification of licensed commercial drivers at least every two years. These occupational medicine exams present a unique opportunity for detecting OSA as part of determining a driver's safety behind the wheel.
"OSA screenings of truck drivers will be ineffective unless they are federally mandated or required by employers," said Dr. Kales. In the future, the FMCSA may consider the recommendation as part of a comprehensive medical rulemaking.
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