Safety & Compliance

DOT Seeking Sleep Apnea Input

March 08, 2016

By David Cullen

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The Federal Motor Carrier Safety Administration and the Federal Railroad Administration jointly announced on March 8 that the agencies are seeking public comment during the next 90 days on the impacts of screening, evaluating, and treating CMV drivers and rail workers for obstructive sleep apnea.

FRA and FMCSA will host three public listening sessions to gather input on OSA in Washington, DC, Chicago, and Los Angeles. 

The agencies said their Advance Notice of Proposed Rulemaking, a.k.a. a “pre-rule,” is “the first step” in considering whether to propose specific requirements around OSA. 

The pre-rule (RIN 2126-AB88 and 2130-AC52), titled “Evaluation of Safety Sensitive Personnel for OSA,” specifically seeks “data and information concerning the prevalence of moderate-to-severe obstructive sleep apnea among individuals occupying safety sensitive positions in rail and highway transportation.”

The agencies are also requesting information about the potential economic impact and safety benefits associated with “regulatory actions that would result in transportation workers in these positions, who exhibit multiple risk factors for OSA, undergoing evaluation by a healthcare professional with expertise in sleep disorders, and subsequent treatment.”

Regulatory action around OSA has long been in the works. FMCSA’s Medical Review Board began issuing recommendations back in 2000 on the screening, diagnosis, treatment and monitoring of truckers afflicted with sleep apnea.

The current pre-rule activity is in line with legislation passed by Congress in 2013 that instructs FMCSA on the regulatory approach it must take regarding OSA.

That law does not require the agency to issue any sleep-apnea policy or regulation. Rather, the bill states that no policy can be issued without the agency first conducting a thorough analysis of the prevalence of OSA among commercial drivers; the range of possible actions to address the problem; and the costs and benefits that may result.

In their latest announcement, the two agencies noted that the National Transportation Safety Board had recommended that the U.S. DOT “take action to address OSA screening and treatment for transportation workers.”

Sleep apnea is often viewed as a safety concern because it can cause general fatigue and result in drowsy driving.

FMCSA currently recommends that medical examiners refer any CMV drivers who are detected to have a respiratory dysfunction, such as OSA, for further evaluation and therapy. 

The agency issued a bulletin in January, 2015, to remind healthcare professionals on the agency’s National Registry of Certified Medical Examiners of the current physical qualifications standard and advisory criteria concerning the respiratory system, including specifically how the requirements apply to drivers who may have obstructive sleep apnea. 

To read the joint ANPRM on OSA and provide comments, click here.

About Apnea  

According to the National Institutes of Health, sleep apnea is a common disorder, usually chronic, in which a person has one or more pauses in breathing or takes shallow breaths while asleep. The breathing pauses can last from a few seconds to minutes and may occur 30 times or more an hour. Typically, normal breathing then starts again, sometimes with a loud snort or choking sound.

The condition disrupts sleep in such a way that the sufferer will move out of deep and light sleep. That results in poor-quality sleep, which makes for daytime fatigue and excessive daytime sleepiness.

The most common type is OSA, which is distinguished by the airway collapsing or becoming blocked during sleep. “When you try to breathe, any air that squeezes past the blockage can cause loud snoring,” states NIH. “Obstructive sleep apnea is more common in people who are overweight, but it can affect anyone.”

Per NIH, besides increasing the chance of having a driving or work-related accident, untreated sleep apnea can:

  • Increase the risk of high blood pressure, stroke, diabetes and obesity
  • Increase or worsen the risk of heart failure
  • Make arrhythmias (irregular heartbeats) more likely

The goals of treating sleep apnea are to “restore regular breathing during sleep and to relieve symptoms such as loud snoring and daytime sleepiness.”

While sleep apnea is a chronic condition that requires long-term management, NIH points out that lifestyle changes and/or the use of an oral appliance (“mouthpiece”) may relieve mild sleep apnea.

Those with moderate or severe sleep apnea may need to use CPAP (Continuous Positive Airway Pressure) breathing devices or undergo surgery. A CPAP machine gently blows air into the throat through a mask that fits over the mouth and nose or just over nose. That air pressure helps keep the airway open during sleep.

As to surgery, NIH says the type required and how well it works will depend on the cause of the sleep apnea. Surgery to widen breathing passages usually involves shrinking, stiffening, or removing excess tissue in the mouth and throat or resetting the lower jaw.

NIH notes that physicians diagnose sleep apnea based on taking medical and family histories, conducting a physical exam and reviewing sleep-study results. A primary-care physician may evaluate symptoms first and then decide if a patient needs to see a sleep specialist. 

Comments

  1. 1. Drew [ March 08, 2016 @ 04:20PM ]

    Read my go fund me page link included. I think it is patently wrong to force this on Municipal Employees who have to have a CDL to Keep their Jobs.

    www.gofundme.com/x3sgv24k

  2. 2. Keith Kitchen [ March 09, 2016 @ 03:49AM ]

    If the FMCSA was as concerned about the time spent sitting at Shippers and Consignee's (for free), as they are about sleep apnea, a lot more drivers could have a quality of life sleeping at home. Who, may I ask, at the FMCSA, or their cronies, will profit from this regulatory faux paux?

  3. 3. TA [ March 09, 2016 @ 05:11AM ]

    Another infringement (COST( on the average working class citizen who is supporting the majority of this country. It's time to turn things around so the power is in the hands of the working class

  4. 4. Curtis Anderson [ March 09, 2016 @ 05:56AM ]

    Hot Springs, Arkansas
    After using my cpap for the first two months, I feel no different than before ever trying one. The sleep center, and the supplier of my cpap both assumed i had sleep apnea before testing due to my size. Sorta like, i was being railroaded into being forced to use one. I have lost 106lbs since 8/26/2015 day of my physical, and even with that and wearing a cpap 7 hrs a night, there is no big difference. maybe there is with the weight loss, but as far as being tired all day, i've never felt that way. i think it was bogus. and to hear them explain why you need to wear one, sounds like a sales pitch. now, im sure that there are some people that truly would benefit, so far i dont feel as if i have. but i'll keep wearing it, and hope that one day i will say wow, i do feel better. until then, i'm not one that wants to buck the system.

  5. 5. Lee K [ March 09, 2016 @ 06:15AM ]

    Wer, if any study has been done, or would it be shown, how many actually wear this thing all night.

  6. 6. Lee K [ March 09, 2016 @ 06:15AM ]

    Wonder, if any study has been done, or would it be shown, how many actually wear this thing all night.

  7. 7. Steve P [ March 09, 2016 @ 08:39AM ]

    If they would change the hours of service, to be able to split your time. then you could take a nap when feeling tired .But No the Government would rather push all this B S on you than Admit that they have no Clue as to what they are doing.

  8. 8. judy [ March 09, 2016 @ 08:51AM ]

    This is the most discrimitory idea yet, then you better start testing Fed Ex, UPS , every law enforcement that is driving on the road, every salesman that drives all day every day, etc.

  9. 9. Frank D'Andrade [ March 09, 2016 @ 11:52AM ]

    It is very hard to gave onest comment ,about any thing, when been force to do so. As one.person said ,as drivers our jobs are on the line. Dose of whom makes the law does not live by DRIVING. Sometimes the tings we should do First. We often does it last. T

  10. 10. Tom Mosbacher [ March 09, 2016 @ 12:11PM ]

    I sleep with a good looking woman. I am not coming to bed looking like a WW II bomber pilot wearing some ridiculous breathing apparatus. I have been breathing and sleeping for over 52 years, I'm not trying to brag but I do both very well. I don't need the Government telling me how to breath.

  11. 11. The General [ March 09, 2016 @ 02:03PM ]

    I've been in the trucking industry for 40-years and gone thru alot of changes. As an employer of 14-drivers and growing, this is a bunch of CRAP.The is no statistics that Sleep apnea is the problem... So far I have 3-drivers that are having to go thru this process of BS, myself being one of them. We do local deliveries within 100-miles. We already do Drug testing, physical's every 2-years and now this??? Who else does that??

    If your going to do Commercial drivers, then anyone who drivers should be tested... TOTAL BS, LET'S FIGHT THIS...

  12. 12. The General [ March 09, 2016 @ 02:09PM ]

    If anyone has already started any action to fight this, please feel free to contact me, I would love to join in... you can contact me at: [email protected]

    we are seeking legal services to see options.

  13. 13. Morga [ March 09, 2016 @ 02:56PM ]

    I was doing OK until they put me on the cpop fuck that fucking thing now I'm swimming on bills
    I am 260 but there is a lot of 400+ and they are doing OK pissed me off, one more way to ripped us out even if you have insurance they not COber the cost
    Let's fight it

  14. 14. Shadow [ March 10, 2016 @ 03:31AM ]

    When are the public going to wake up and realize that all these restrictions and requirements all increasing their food bills and everything else they purchase ? All this testing and physicals will one day be required of them but most are too dumb and heads up their asses to realize it.
    I say shut down for the week of July 4 th for a weeks vacation and to rest up and get that sleep the government seems to know we need.
    After no freight, food or fuel hitting the markets for a week I think we would have the publics support and the governments attention.
    Time for war man and woman !

  15. 15. Nina [ March 10, 2016 @ 05:27AM ]

    Sleep apnea is an issue which needs to be addressed for everyone. People with apnea have very poor quality of sleep and have reduced reaction times and trouble concentrating. CPAP is the most common treatment but other options exist for some individuals. Untreated sleep apnea increases your chance for high blood pressure, stroke, diabetes, and can even cause death. Get off your pedestalsite and quit complsining. Your bed partners will get better sleep when you are no longer snoring, snorting, and gasping fit air.

  16. 16. Harold Clumpner [ March 10, 2016 @ 05:12PM ]

    We are in critical need of common sense on trucking rules and regs. We seem to think everything can be put in a one rule fits all. This has already cost more money than anyone realizes and we just continue to make trucking more and more ridiculous. How are we to continue to find drivers who will put up with this. I won't. Good luck

  17. 17. lee lenard [ March 12, 2016 @ 05:07PM ]

    Curtis, Judy and others....good correct comments. FMCSA creates some dreamed up problems to justify positions, departments and hierarchy systems so they make big $$ in the 9-5 jobs and most Friday afternoons off. This is another one!!! Yes there are some few cases that exist. I know of some. most can be handled with a physical or definitely discussed and tested for during the DOT physical....another extremely expanded system ABSOLUTELY IS NOT NEEDED !!! We ALL need to start working thru our local Congressman/Senators to stop this.

  18. 18. Eddie [ March 25, 2016 @ 08:32PM ]

    Sleep apnea is a real problem for many people, not just drivers, what about police, fire and emergency responders, even medical professionals. They all also have jobs that safety is very important in also, testing and treatment shouldn't be placed only on CDL drivers, train, plane, any job that involves other people's lives in any way should all have to be tested. And there also needs to be government programs to help people pay for the testing and also for the treatment, we're talking several thousand dollars between test, having test diagnosed, getting treatment, cpap machines run into the thousands of dollars, there are cheaper units, but, they don't come equipped with a card that can record and be removed and took to your doctor to show your usage of the machine. It only shows the day, time and hrs you used your machine, it doesn't show any change in your sleep pattern or breathing. And just because you have a neck that's over a certain demintion around doesn't meen you have Sleep apnea , and it also doesn't meen people with small necks and skinny can't have sleep apnea. At the present time us overweight out of shape drivers, imagine that, a truck driver not eating right, sitting for hrs being woke up to move your truck then back to sleep while waiting to unload then woke up to get your bills and get off receivers property and then try to find place to park and finish your break what few hrs you have left, then up and drive on for 10-11 hrs. And they wonder why drivers are tired. Sleep apnea is a hoax in my personal appenion, it's not lack breathing it's the job that disrupts sleep. My dad drove for years, snored like a freight train, but never once had any type of accident. I myself have drove for 33 years now, I snore but I sleep also, yeh, sometimes I get tired while driving, it's just part of the hrs and the job, I've never had any kind of accident of violation of any kind, my csa score is clean, not one point against me, how do I handle it, first when you start to feel tired, don't push on trying to be a company hero, don't let the dispatch push you to keep going, your responsible for the load and for keeping safety number one. If your tired, stop and take a nap, 30 - 60 minutes can make a big difference. A difference between killing someone, or a family, yourself or loosing the load. Putting a 1500.00 air hose on your face making you uncomfortable and restlessly tangling in the air line isn't the answer, let the driver take time for rest if he or she needs it, only the driver knows how he/she feels and when to stop and take a break. I would like to see one of the desk jockeys that's making up these rules come out here in the real world, drive and perform a drivers job for a couple weeks straight night and day with no regular routine of sleep and then tell us it's a breathing problem why we get tired. I could go on and on but I think I've expressed my opinion enough, and I know a lot of old school drivers will agree with me. Not all the accidents CMV are involved in are the drivers fault, very few actually. What's good for a CDL driver should be good for any or all drivers on the road. Nuff said, be safe.

 

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