According to WDAZ 8, commercial truck drivers have expressed concerns regarding new federal regulations on sleep apnea testing.
“This affects every trucking company,” said Arik Spencer, executive vice president of North Dakota Motor Carriers, which represents truckers in the state.
It might affect others, too, given that at least one of Fargo’s sleep centers is now more crowded, though the Sanford Health clinic attributes that to a growing population and not directly to trucker regulations, said Kevin Faber, medical co-director of the center.
Last year, the Federal Motor Carrier Safety Administration established a medical examiner registry, a list of doctors who have taken an online course and are therefore certified to conduct physicals for truck or bus drivers.
Spencer believes many of these doctors are recommending sleep apnea tests based solely on the driver’s neck size. Romero was recommended for a study after his neck was measured at 18.5 inches. The cutoff is 16, 17 or 18, depending on who you ask.
#1. I find it hard to believe that out of 365 Truck Drivers that “no one had sleep apnea” – what I would believe is that “no one” admitted to anyone else that they had sleep apnea. #2. The fact that Mr. Romero doesn’t feel any different does not mean that he wasn’t properly diagnosed and treated. He may in fact be doing much better and driving much more alert and safer. #3. Home sleep studies are much less expensive and may be an effective cost reduction mechanism? Thusly, out-of-pocket expenses shouldn’t be such a barrier to safer roads/safer drivers.
Your article is full of errors.
Doctors on the “registry” not only took an online course but also had to pass an examination to demonstrate their knowledge of recommended medical guidelines and regulations.
Scientific studies (I am aware of 3 such studies) regarding the risk of someone having sleep apnea reveal that if a male has a body mass index of 35 or greater and a neck circumference of 17 inches or greater they have a 90%+ chance of having sleep apnea (neck circumference or weight alone is not an indication for a sleep study). It is the experience of many examiners that most drivers who are found to have sleep apnea were unaware they had the disorder. AND, after diagnosis and treatment for several weeks find that they feel more alert and energized. Studies also indicate that drivers with Obstructive Sleep Apnea who are untreated have an accident rate about 6 times greater than those without sleep apnea.
Given this information, I would ask those complaining about drivers with significant risk of Sleep Apnea being required to have a sleep study if they “would want their loved one driving on the interstate in the vicinity of a driver with undiagnosed and untreated sleep apnea?
There isn’t room for detail on the subject here. So, I suggest those unfamiliar with the FACTS on Obstructive Sleep Apnea learn the FACTS and not respond to the emotional reaction of others. Just because it’s in print doesn’t make it correct.
FYI there are home sleep studies available that are far less expensive ($150.00) than quoted in this article.
Darrell F. Powledge, MD, MPH
Part of the push back from drivers is that the research on sleep apnea crash risk in cmv operators in the US is “mixed at best” JCSM April 2015.
The Fmcsa’s own Sleep apnea crash risk study found no statistical correlation between untreated osa and increased crash risk in cmv operators. Two other studies from a Literature review in Sleep found cmv drivers with untreated osa were SAFER (hard to believe).
Remember this was a main stream media story.
Sleep Review has covered this topic with a couple of articles.
The article does give a “flavor” of the push back.
I have evaluated many truckers who were not happy that they had to have a sleep study because of their BMI and or neck size. They deny snoring and any other symptom. Very often their studies have come back with severe apnea, and fragmented sleep. Some were grateful when they realized this may have saved their life because they were a heart attack waiting to happen.
The problem with home sleep tests is the driver can do several things to not have an abnormal test. They might have some one else wear it-or they can stay awake in a recliner all night watching TV.
Ultimately, their willingness to use CPAP, depends on them being educated about OSA, the effects on their heart, HTN and risk of diabetes, and to have their studies explained to them.
We should not expect that they, or other patients will be compliant with only a home sleep test, followed by being placed on an auto-titrating unit with a random mask that doesn’t work well for them, with little or no support.
If requires a lifestyle change- and if that were easy to achieve, then obesity and apnea would no longer be an issue!
Compliance may only require 4 hours of use at night- but that is far from adequate to include REM sleep, and effectively normalize the sleep and restore them to full alertness for safe driving.
Education and support are vital for it to be successful!
The latest bulletin from FMCSA on sleep apnea which was covered in Sleep Review does require home studies to establish chain of custody.
Any reputable sleep physician interpreting an hst without a position channel and giving a no sleep apnea diagnosis for any patient has issues.
Hst can and is used effectively in trucking when done properly. With reasonable safeguards falsification can be prevented.
I’ve published articles on the topic.
Sleep apnea in trucking is a complicated issue.
This was main stream media.
This topic has been discussed in other articles in Sleep Review.
The article is from a main stream media outlet not Sleep Review so the accuracy on details.
It does give a flavor of the push back from drivers.