I'm not one to normally watch The Biggest Loser on NBC. But I did catch part of an episode a couple weeks ago featuring a commercial truck driver named Joe. Apparently, as part of the The Biggest Loser program, contestants meet with a physician. In the segment with Joe and his physician, Joe admitted driving a truck 12-14 hours per day and did not realize he had severe sleep apnea that caused him to stop breathing up to 70 times per hour.
While the trucks themselves can be dangerous, the crash risk for a person with sleep apnea is 242% greater than a person without the disorder according to Charles Czeisler, professor of sleep medicine at Harvard Medical School – according to an article posted at Today'sTrucking.com.
Sleep apnea is a major contributor to daytime drowsiness – a condition that could prove deadly for commercial drivers and involved passenger vehicles. it is a condition where, during sleep, a narrowing or closure of the upper airway causes repeated sleep disturbances leading to poor sleep quality and excessive daytime sleepiness. Since excessive sleepiness can be a consequence of sleeping disturbances, drivers with sleep apnea have compromised driving performance leading to increases in the risk of crashes. According to the Divided Attention Driving Task, a research test designed to mimic driving performance, individuals with sleep apnea perform, on average, as poorly as individuals whose levels of blood alcohol concentration exceed the legal limit.
Symptoms of sleep apnea include (from sleephealth.com):
- Snoring plus "gasping" or stopping breathing
- Excessive sleepiness during wake
- Large neck size
- Obesity
- High prevalence in overweight middle-aged men
- Leading known cause of high blood pressure
- Higher risk of CV disease, hypertension, and stroke
- Higher rate of drowsy driver car crashes
- Most people are undiagnosed
The FMCSA's Motor Carrier Safety Advisory Committee met just last month to discuss the dangers of sleep apnea for commercial truck drivers. The meeting specifically tasked the MCSAC and the Medical Review Board to provide information, concepts, and ideas the FMCSA should consider in developing regulatory guidance to motor carriers and truck drivers regarding obstructive sleep apnea (OSA) and whether drivers with sleep apnea should be medically certified to operate commercial motor vehicles.
The joint recommendations from this task force included:
- New rulemaking to require commercial truck drivers with a body mass index greater than or equal to 35 be evaluated for obstructive sleep apnea using an objective diagnostic test
- A driver diagnosed with obstructive sleep apnea may maintain certification with evidence of appropriate treatment (if available) and effective compliance and if the examiner determines that the condition does not affect the driver's ability to operate a commercial motor vehicle safely.
The joint task force also recommended that the following conditions be grounds for immediate driver disqualification:
- Individuals who experience excessive sleepiness while driving.
- Individuals who have experienced a crash associated with falling asleep.
- Individuals with an apnea-hypopnea index (AHI) greater than 20, until such individual has been adherent to Positive Airway Pressure (PAP). Drivers can be conditionally certified based on the criteria for Continuous Positive Airway Pressure (CPAP) compliance.
- Individuals who have undergone surgery and who are pending the findings in a post-operative evaluation.
- Individuals who have been found to be effectively non-compliant with their treatment.
These proposals will be discusses again later this year when more detailed recommendations will be presented to the FMCSA.
One sleep apnea specialist – Dr. Charles Czeisler of Harvard University Medical School – suggests that drowsy or fatigued driving kills more people on America's highways than does distracted driving. At least one industry safety specialist agrees:
"I would argue that fatigue as a causal factor in truck-involved crashes is underreported, not over-reported," said Don Osterberg, vice president of Safety for Schneider National Trucking. "Absent the commercial driver acknowledging that he or she fell asleep, law enforcement doesn't record the crash as being fatigue-related."
Truck drivers with sleep apnea can spend a full eight hours in bed and get back behind the wheel as sleepy, groggy, and fatigued as if they only got a few hours of sleep. The FMCSA needs to act on these proposed rules to protect truck drivers and to make our highways safer for everyone.
[More on Semi Truck Accidents]
[More on Truck Driver Fatigue]
Read More:
- FMCSA: A Study of Prevalence of Sleep Apnea Among Commercial Truck Drivers
- MCSAC Meeting List
- Sleep Apnea In Truck Drivers: Advisory Panels Recommend Screening For Condition In Obese Drivers [Amanda L. Chan at The Huffington Post]
- Panel Tells FMCSA to Toughen up Sleep Apnea Screening [Today'sTrucking.com]
- Sleep apnea: hidden cause of wrecks [Stuart Watson at Charlotte Observer]
- Fatigue An Issue For Pilots And Truck Drivers
(c) Copyright 2012 Brett A. Emison
Brett Emison is currently a partner at Langdon & Emison, a firm dedicated to helping injured victims across the country from their primary office near Kansas City. Mainly focusing on catastrophic injury and death cases as well as complex mass tort and dangerous drug cases, Mr. Emison often deals with automotive defects, automobile crashes, railroad crossing accidents (train accidents), trucking accidents, dangerous and defective drugs, defective medical devices.
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