On December 7, the Motor Carrier Safety Advisory Committee (MCSAC) and the Medical Review Board (MRB) of the FMCSA held a joint public meeting on Obstructive Sleep Apnea (OSA). The meeting, which was also accessible to the public via the web, resulted in two significant recommendations to the FMCSA.
The first recommendation asks the FMCSA to issue new guidance to medical examiners that CDL drivers with a Body Mass Index (BMI) of 35 or greater be evaluated for OSA. BMI, a measurement of body fat based on height and weight, is considered a primary indicator that a person may have sleep apnea. A BMI of 35 was chosen as the “trigger” for screening since the higher the BMI, the greater the risk of sleep apnea.
Under the recommended guidance, medical examiners won’t be required to send drivers with a BMI of 35 to sleep labs, but the guidance would serve as a strong hint. Click here to see your BMI using a BMI Calculator.
In addition, the two committees agreed to approve a recommendation that commercial drivers would be immediately disqualified from driving if they meet any of the following criteria:
- Having reported excessive sleepiness while driving
- Having experienced a crash associated with falling asleep
- Exhibiting Apnea-Hypopnea Index (AHI) scores of 20 or greater until they’re treated with a CPAP (they can be conditionally certified based on the criteria for CPAP compliance)
- Having undergone apnea surgery and pending the findings of a post-operative evaluation
- Being found effectively non-compliant with CPAP treatment
Both recommendations are not official guidance from the FMCSA, but are intended as interim guidance until further rulemaking officially addresses sleep disorders in FMCSA regulations. Before the interim guidance could be “officially” adopted by FMCSA, it would need to be published and put up for public comment.
The FMCSA’s MRB is advisory in nature, and cannot approve its suggestions. The MRB’s recommendations are forwarded to FMCSA, which can choose to adopt, amend or ignore the recommendations.
The two advisory panels (MCSAC and MRB) have formed a joint subcommittee in order to produce recommendations for an eventual rule that could set standards for sleep apnea screening, evaluation and treatment. Another meeting is scheduled for February 6-9 to finalize more detailed recommendations. It’s expected that the FMCSA will receive another joint recommendation by March 2012.
Spotlight on Sleep Apnea
Earlier this year, to educate truckers and motor carriers about sleep apnea, the FMCSA dedicated a section of its website to the disorder. FMCSA’s Spotlight on Sleep Apnea includes a variety of information and resources developed by the National Sleep Foundation. In addition to information on diagnosis and treatment of the condition, the site includes a poster, fact sheet and quiz that carriers can use to educate their drivers. The site also includes a Sleep Diary that anyone can use to help identify factors that may be contributing to sleep problems.
Left untreated sleep apnea puts an individual at greater risk for a variety of serious medical conditions, including high blood pressure, heart attacks and strokes. In addition, the repeated sleep disturbances caused by the disorder often result excessive daytime sleepiness – a major risk factor for motor vehicle accidents. As such commercial motor vehicle drivers diagnosed with moderate to severe sleep apnea are considered medically unqualified until they have been successfully treated for the disorder.
Sleep apnea is often successfully treated through lifestyle changes, medical treatment or a combination of the two approaches. Lifestyle changes shown to reduce sleep apnea problems include weight loss, avoiding alcohol and sleeping pills, quitting smoking and sleeping on your side or stomach. Common medical treatments include CPAP devices, oral appliances and surgery.
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