The American Academy of Sleep Medicine (AASM) commends the Department of Transportation’s (DOT) Federal Motor Carrier Safety Administration (FMCSA) and Federal Railroad Administration (FRA) for seeking public comment on how to respond to the health and safety risks associated with untreated obstructive sleep apnea among commercial motor vehicle drivers and train operators. The AASM urges the agencies to develop and adopt policies that promote individual health and transportation safety through the diagnosis and management of sleep apnea.

The FMCSA and FRA announced that the agencies are seeking public input during the next 90 days on the impacts of screening, evaluating, and treating rail workers and commercial motor vehicle drivers for obstructive sleep apnea. The joint Advance Notice of Proposed Rulemaking is the first step as both agencies consider whether to propose specific requirements. FRA and FMCSA will host three public listening sessions in Washington, D.C., Chicago, and Los Angeles to gather input about obstructive sleep apnea.

“Sensible, evidence-based management plans have great potential to improve the health of commercial motor vehicle drivers and train operators while reducing the devastating accidents that can result from untreated sleep apnea,” says AASM president Nathaniel Watson, MD, MSc. “The comprehensive development and swift implementation of evidence-based sleep apnea policies is necessary to protect the well-being of transportation operators and maximize public safety.”

According to the AASM, federal rules currently provide insufficient guidance for medical examiners and sleep specialists in the diagnosis, evaluation, and ongoing management of sleep apnea among transportation operators. Obstructive sleep apnea (OSA) is a chronic disease that afflicts at least 25 million adults in the United States, including more than 20% of commercial truck drivers. A frequent warning sign for sleep apnea is excessive daytime sleepiness, which can manifest as drowsy driving.

While drowsiness caused by sleep apnea represents a pervasive threat to roadway safety, it also is a danger on the railway. In December 2013, four individuals were killed and at least 61 people were injured when a Metro-North passenger train derailed in Bronx, New York. The National Transportation Safety Board (NTSB) determined that the train engineer had fallen asleep on duty due to undiagnosed, severe obstructive sleep apnea.

“Healthy sleep and optimal alertness are essential for transportation safety,” says Watson. “Across the US, thousands of board-certified sleep medicine physicians are available to provide high quality, patient-centered care for people who have sleep apnea, which helps to keep our roads and railways safe.”