Sleep Apnea And Truck Driving

Sleep Apnea and Motor Vehicle Accidents Statistics

According to the National Sleep Foundation, more than 18 million American adults have sleep apnea.  The American Sleep Association reports that “Among the estimated 1.7 to 3.9 million active U.S. commercial drivers, 17% to 28% or 0.29–1.1 million are expected to have OSA (Obstructive Sleep Apnea) based on prevalence studies conducted within the trucking industry. It is estimated that sleep apnea increases the incidence of motor vehicle accidents in noncommercial drivers 1.5 to 4.9 fold.”  According to a study done by the Federal Motor Carrier Safety Association (FMCSA,) “The total economic impact of all motor vehicle accidents in the United States where undiagnosed OSA was a contributing factor was estimated at $26.2 billion in 2015.

FMCSA Proposed OSA Regulations

In March 2016, the FMCSA and FRA published their proposed rule for sleep apnea related to the trucking industry as well as other transportation workers.  The National Transportation Safety Board recommended a higher degree of sleep apnea testing.  However, there was a large opposition from the industry.  Finally, in August 2017 the FMCSA and the Federal Railroad Administration decided against moving forward with a possible regulation that would mandate the testing and treatment of sleep apnea for truck drivers as well as other transportation workers.

Current Status of FMCSA  OSA Regulation Proposals

Currently, there is no national ruling that safety regulations should require comprehensive OSA screening and diagnosis of commercial drivers.  However professional carriers still remain with the right to require sleep apnea screening for their drivers if they choose to do so.

OSA Medications and Driving

Provigil (Modafinil) is a medication used to treat excessive sleepiness caused by certain sleep disorders including obstructive sleep apnea. Provigil has many potential side effects and has many interactions with both common prescription and over the counter medications.  It should be noted that according to the FMSCA website, “Provigil may affect concentration or may hide signs that an individual is tired. It is recommended that until an individual knows how Provigil affects him/her, they may not drive, use machinery or do any activity that requires mental alertness.”

Benefits of Using a CPAP Machine

CPAP stands for continuous positive airway pressure. It is the most popular treatment for obstructive sleep apnea (OSA). It uses air pressure generated by a machine, delivered through a tube into a mask that fits over the nose or mouth.  The American Sleep Association has done a study to find the correlation between those using CPAP machines and motor accident rates.  It was found that “Drivers non-adherent with CPAP had a crash rate for preventable DOT-reportable crashes of 0.070/100,000 miles or nearly five-fold more. On the other hand, drivers adherent with CPAP were no more likely to be involved in preventable accidents than controls who did not have sleep apnea.”  This study shows the importance of using a CPAP machine for truck drivers that have sleep apnea as it can greatly reduce the chance of accidents.

Comprehensive list of Ways to Manage Sleep Apnea

• Avoid alcohol, muscle relaxants, and other depressants

• Quit smoking

• Periodic movement or mild exercise

• Sleep with your upper body elevated

• Sleep on your side, rather than your back

• Sufficient sleep time to feel adequately rested

• Special mouthpiece from a dentist to open your upper airway during sleep

• If the sleep apnea is more severe, in most cases your doctor will recommend a Continuous Positive Airway Pressure (CPAP) machine, which assists with inhaling.

• In more severe cases, a BiPAP machine may be needed, which assists with inhaling and exhaling.

• Another option is a surgical procedure to remove tissue and widen the airway.