Untreated Sleep Apnea in Truckers Increases Risks of Wrecks, Study RevealsDecember 5, 2017
Truck drivers must obtain a certificate verifying their medical fitness for duty before they are legally permitted to operate commercial motor vehicles.1 While various conditions, like blindness or deafness, can be prevent truckers from meeting the medical fitness requirement, other conditions – like sleep apnea – are not barred but still can present a significant risk to the driving public.
This is according to a recent study that examined how untreated sleep apnea in truckers can impact the risk and incidence of truck wrecks. The findings have led some medical experts to urge the Federal Motor Carrier Safety Administration (FMCSA) to institute new mandatory screening for sleep apnea among commercial truck drivers.
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Background: What Is Sleep Apnea?
Sleep apnea is a disorder that causes people to repeatedly stop and start breathing while sleeping. Marked by snoring, abrupt awakenings and morning headaches, sleep apnea can cause people to experience excessive drowsiness during waking hours because they are not getting enough restful sleep at night (even when sleeping for a full night).
While this drowsiness can cause concentration problems and difficulty staying awake during the daytime, it can also increase the risk of other health problems, like:
- Hypertension (high blood pressure)
- Heart problems
- Type-2 diabetes.
The most common form of sleep apnea is obstructive sleep apnea (OSA), which was the focus of the truck crash risk study discussed herein. Commonly, OSA and other forms of sleep apnea are treated with positive airway pressure (PAP) machines and masks that work to keep the airways open and promote continuous, uninterrupted breathing.
Details & Methods of the Study
Entitled Nonadherence with Employer-Mandated Sleep Apnea Treatment and Increased Risk of Serious Truck Crashes, this study analyzed more than 3,600 commercial truck drivers. The drivers included in this study were matched for experience and job tenure. About 44 percent had been diagnosed with OSA while the other 56 percent were controls who had not been diagnosed OSA and who were deemed “unlikely” to have this condition.
In evaluating the crash risk associated with treated versus untreated OSA in truckers, researchers divided the participants into four categories, including subjects who:
- Fully complied with sleep apnea treatment (use of a PAP machine at home and in sleeper berths)
- Partially complied with this treatment
- Did not adhere to treatment at all
- Served as the control group (i.e., those without OSA).
Compliance with treatment was assessed by downloading information from memory chips in PAP machines that were supplied to participants.
Following their data analysis, researchers found that:
- Truckers with OSA who did comply with treatment were five times more likely to be involved in serious, preventable truck wrecks than the control group and the group of truckers with OSA who partially or fully adhered to treatment.
- The crash risk for truckers who partially or fully complied with OSA treatment with statistically similar as the risk associated with the control group (i.e., those without OSA).
Commenting on these findings, lead author Stephen V. Burks, PhD, explained that:
The most surprising result of our study is the strength and robustness of the increase in the crash risk for drivers with sleep apnea who fail to adhere to mandated treatment with positive airway pressure therapy… The results of our study support the establishment of obstructive sleep apnea screening standards for all drivers through the commercial driver’s medical exam.
Dr. Nathaniel Watson, President of the American Academy of Sleep Medicine, expressed similar concerns, noting that:
This study emphasizes that untreated obstructive sleep apnea is a pervasive threat to transportation safety… It is critical for transportation companies to implement comprehensive sleep apnea screening and treatment programs to ensure that truck drivers stay awake at the wheel.
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1: FMCSA requirements for truckers’ medical fitness for duty