1 1 2 Year Old In A Single Cab Truck Sleep Apnea in Truck Drivers

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Sleep Apnea in Truck Drivers

Large truck accidents can be serious due to the size, weight and speed of these commercial vehicles. The Federal Motor Carrier Administration’s (FCMSA) Large Truck Crash Study revealed that 50% of such accidents result in death or incapacitation. The truck driver was found to be at fault in 87 percent of these crashes, and in 7 percent the driver admitted to falling asleep while driving. Truck accidents result in more than 5,200 deaths and more than 125,000 injuries each year. These numbers are likely just the tip of the iceberg in the total number of truck accidents caused by driver fatigue. Obstructive sleep apnea is a common disorder among commercial vehicle drivers, with a prevalence thought to be between 17 and 28 percent. With approximately 14 million commercial driver license holders in the United States, OSA is expected to affect between 2.4 and 3.9 million of these drivers.

Unfortunately, OSA is often not recognized or reported by professional drivers and their employers, nor is it diagnosed by doctors. OSA has been shown to significantly increase a driver’s risk of drowsy driving. Medical studies show that drivers with undiagnosed OSA have a higher (2- to 7-fold) risk of falling asleep at the wheel and an increased risk of major health problems such as hypertension, stroke, ischemic heart disease, and mood disorders. Research suggests that commercial vehicle (CMV) drivers have a higher prevalence of OSA than the general population. The chance of developing sleep apnea depended on two key factors – age and degree of obesity – and the prevalence increased with both. FMCSA population projections indicate that the number of older drivers will increase by 50 percent over the next twenty years. Therefore, determining which truck drivers are most susceptible to excessive daytime sleepiness (EDS) must be a top public safety priority.

US federal law requires drivers of commercial motor vehicles to pass medical examinations at least every two years – This section states that the driver must not have an established medical history or clinical diagnosis of a respiratory disorder that is likely to interfere with the ability to control and drive a commercial vehicle. motor vehicle safely.” Nevertheless, the FMCSA medical examination form contains only one question about sleep disorders, even though drivers have strong financial incentives to deny a history or symptoms of sleep disorders. In fact, recent studies have shown that only 15% answered yes to a single sleep-related question among the driver medical evaluation form. of drivers who were later found to be a significant PART.

To address these issues, the American College of Chest Physicians, the American College of Occupational and Environmental Medicine, and the National Sleep Foundation published a consensus document. These criteria were proposed based on a thorough review of the literature to assist clinicians in identifying individuals who may have OSA and thus may require a sleep study, both to protect the long-term health of the driver and to ensure public safety. highways. The proposals consist of the following:

1) definition of sleep apnea;

2) valid regulations, recommendations and instructions;

3) identification and diagnosis of patients at risk for sleep apnea;

4) objective assessment of sleepiness and performance;

5) identification of CMV drivers with sleep apnea and high crash risk;

6) management of sleep apnea in the CMV controller;

7) practical aspects;

8) additional research questions.

In a recent report in the medical literature, out of 134 sleep studies performed according to consensus criteria, 94.8 percent of subjects had OSA. This researcher also looked at 10 major trucking accidents resulting from driver loss of control of the motor vehicle that resulted in claims for at least $1 million against the carrier. Of these ten, a review of pre-accident CDME medical examinations suggests that at least four out of ten would have required an OSA test according to the consensus criteria.

These recommendations suggest certifying a driver at lower risk for sleep apnea for up to three months pending medical evaluation (use evaluations), while drivers with more significant risk factors or a motor vehicle crash likely related to sleep apnea should be disqualified. from returning to work until they receive a medical evaluation (de-evaluations) In addition, the task force suggests that the screening process be expanded to include a much broader medical history and note such risk factors as body mass index, neck circumference, family history of OSA, and history of comorbidities. For those diagnosed with sleep apnea, experts strongly recommend positive airway pressure for at least four hours in a 24-hour period with a machine that can measure the time the pressure is applied. Current guidelines do not specify the minimum use of positive airway pressure.

Not only do the driver and the general public benefit from these recommendations, but large-scale recent clinical research has already shown significant rewards for the employer in terms of reduced medical costs, reduced absenteeism, improved productivity and fewer accidents.

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