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DOT Wants Sleep-Apnea Data

December 17, 2015

By David Cullen

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Photo: Volvo Group
Photo: Volvo Group

A Department of Transportation data-collection request on the prevalence of obstructive sleep apnea (OSA) among truck drivers and other transportation workers – as well as the potential impact of any future OSA-related regulatory actions – has been filed with the White House Office of Management and Budget.

Issued jointly by the Federal Motor Carrier Safety Administration and the Federal Railroad Administration as an Advance Notice of Proposed Rulemaking, a.k.a. a “pre-rule,” the request could be the first step toward federal regulation of the testing and treatment of truck drivers and others for the sleep disorder. Sleep apnea is often viewed as a safety concern because it can cause general fatigue and result in drowsy driving.

The pre-rule (RIN 2126-AB88), 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.”

The OSA rulemaking process was initiated on Oct. 1, prompted by an administrative decision. The date for publication in the Federal Register is projected to be January 11.

This is not the first time FMCSA has commented on OSA. The agency’s own 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.

More About Sleep 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.”

According to 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.

Related: Sleep Apnea in Truckers Continues to Confuse

Comments

  1. 1. Kenny [ December 18, 2015 @ 04:50AM ]

    Wonder why we have a large deficit. Let's see the Fmcsa made a rule that all Doctors must be certified. In my city we have 2 places to get a dot physical. One is a chiropractor and a PA( physician assistant ) and I know for a fact they both do it wrong. No Family practice doctors in a city of 100000 took the certification because it was stupid. Log book changes, how much money has been spent and how much more will be spent and the Fmcsa still has not addressed the real problem. Sleep apnea and the Federal government need I say more. Every single stress in my life is caused by the Federal Government. Truck companies need to hire fit smart healthy drivers but wait a minute they cannot keep anyone because the pay level is so small which brings it back to Deregulation the creation of all this and more. The Federal Government got it right the first time so they are not all bad but just like people of money they just can't help their selfs.

  2. 2. Ron [ December 18, 2015 @ 05:01AM ]

    If we think about it why aren't the people making the rules subject to the same harassment as the people they make the rules for. Aren't we at the point the point the government can start deleting the rules? I think they have covered them all. Its about job justification more than safety.

  3. 3. Jean [ December 18, 2015 @ 05:58AM ]

    Well I had to jump through the hoops. I was told that I had severe sleep apnea. I had no symptoms other than the "profiling" that the examiner did. Makes me wonder because they took their good old time getting me a machine. I actually had to threaten them. So that system needs work. On a positive note I will say that once I got the machine I still had some hoops to jump through, but overall I don't mind it and I'm getter better sleep. I never thought I would say that. The only problem I have is since I started using the machine is that my hands go tingly numb, and I'm not the only one. So solve one problem - start another. I think I'll start being anorexic. They don't f... with skinny people nearly as much.

  4. 4. bob [ December 18, 2015 @ 06:13AM ]

    They said i had it i took my dog to the vet that night never used it and they said at kaiser i had sleep apena what a joke its all about $$$exvept for mabye a few.
    They are shoving 50 people an hour through there clinics nice scam kaiser

  5. 5. tim [ December 18, 2015 @ 08:01AM ]

    I was one of the few that had it when they were a skinny kid growing up. I gained weight do to a on the job injury that the dr. said was minor but over time became steadily worse.THe annual then quarterly jumping thru hoops took time and excessive money out of my life till i finally said to hell with it. With other health problems directly related to driving a truck and the long hours i became disabled.Once someone is on the cpap they should leave them alone and not put them thru the stress of having to go thru the motions of having to keep up the physical part of the endorsement . The constant stress or driving a semi and dealing with all the crud included in the job plus the poor pay and unreasonablle demands by the customers,trucking companies and govt pushed me out . Me a self taught driver with over 20 years experience.Now they are whining because they got drivers who can barely speak english,have no driving skills and could possibly be terroists. I'm sitting here now laughing my *ss off!

  6. 6. Roy [ December 18, 2015 @ 08:59AM ]

    They have no rights to the information shared between me and my doctor.

  7. 7. Ray [ December 18, 2015 @ 12:01PM ]

    Ya I had the machine when I got out of the army but I could never get any sleep with it and quit using it. When I got out and went into truck driving I was tested for apnea and was told I was good and didnt have apnea by Maverick even tho I snore and am still tired sometimes. I am a city
    Driver now and am home everyday and get plenty of sleep anyway. So anyway do I have apnea or not? If I had to guess I would say maybe but it does not effect me even if I did and untill they come up with a better way than a mask on my face I wont be using it.

  8. 8. Joe [ December 18, 2015 @ 12:42PM ]

    I took the sleep test, worst experience of my life. I couldn't use the machine and was told it had a 50% success rate, no one thought it was funny when I reminded them that means it has a 50% failure rate. Talking to drivers it seems that for some it is the greatest thing in the world for others not so much. In my case I figured out the problem started when we bought a new mattress. Once I got a different mattress I started sleeping much better. Of course it didn't matter to the doctor. My med file still shows me as having sleep apnea. However, if I want to pay several thousand dollars for a new test they would be happy to reconsider. Don't drive anymore so it doesn't matter anymore.

  9. 9. kay [ December 18, 2015 @ 01:39PM ]

    My Son drove for a big carrier and they said he had sleep apnea and so he went and did testing and got the machine and then they said he got the wrong one. So after out of pocket of 3000. they made him buy another for 400 and this one they could never get to work right. So every time he did a download for the company he was not in compliance and was going to have to pay for the testing and getting the machine fixed again so was facing another 3000 out of pocket. So instead he left that carrier and has not been bothered by having to use it anymore. I don't think he has it and for the BS he went though it is only a matter of time when people figure out that this is for the money not for safety. They should have fixed the problem for free since it wasn't his fault he wore it every night like he was suppose to and still registered that he was not compliant. No one would help to fix problem for free. This is not something that has caused any problem for him he sleeps well without. I think better then with it. Now he has 2 machines that are worthless to him.

  10. 10. matt [ December 18, 2015 @ 04:14PM ]

    I sleep just fine, never sleepy. Because of my weight doc sent me for testing. Everyone I've talked too that takes the test needs one. All the medical people make money, I think it a scam. I wake up at night to pee. Is DOT going check you for enlarged prostate?

  11. 11. Ken [ December 18, 2015 @ 05:13PM ]

    The FMCSA Medical Review board is, and has been since 2000, loaded, loaded, loaded with doctors who are specialists in the sleep study and sleep industry. Funny that.

  12. 12. George [ December 18, 2015 @ 08:26PM ]

    I wear mine the minimum required 70% .... so 90 says would be 63 days. And equal to or greater then 4 hours

  13. 13. Brian [ December 18, 2015 @ 10:16PM ]

    With every rule they add, they get closer and closer to running drivers out of the industry. I've been out her ten years over the road. No accidents, no violations, no load claims...nothing. I turn in my 120,000 miles a year, scratching out my living as an independent. Everything is geared towards getting me and my kind out of thus business. I'm on the ropes. I've about had it. Someday they will figure out that truckers are actual'll y vital to thus country. Until then they will continue to destroy what they depend on...both fir life and for their own jobs.

  14. 14. James [ December 24, 2015 @ 09:30PM ]

    A few weeks ago I went for my DOT medical renewal. And I checked yes to the box DO YOU SNORE? It does not pay to be honest. Because I was instantly referred to a sleep study, which cost me 4 days of income off work, $1200 for the study, which then required I purchase a Cpap machine for $980, a $400 inverter to run the machine, 3 more days lost wages in two follow up appointments, one with the sleep dr, and the other with my DOT dr and DMV. If I did not pay up front these costs I would have lost my job. Needless to say, I am not a man of many means. Just a single dad raising three kids who have no mother. We are now going without heat. No christmas tree or presents. And have $40 toward food until January 10th.

  15. 15. Rebecca Burleson [ December 29, 2015 @ 12:44PM ]

    There are now fee CPAP, BIPAP or Auto Devices,mask and Tubing.
    Sleep apnea.org

  16. 16. Rebecca Burleson [ December 29, 2015 @ 12:49PM ]

    https://m.facebook.com/story.php?story_fbid=10153328480930642&id=8932715641&ref=m_notif&notif_t=feed_comment

    Free CPAP information

  17. 17. Tish [ December 30, 2015 @ 11:00AM ]

    I've managed this type of compliance for over 6 years with excellent success. If anyone is struggling or has questions feel free to reach out to me. www.papcompliance.com

  18. 18. michael mahoney [ June 06, 2016 @ 10:00AM ]

    me and my brother both have sleep apnea and he drives trucks. I actually owe my diagnosis to him. He was required by the department of transportation to get a sleep study done because of his loud snoring, and low and behold....he has sleep apnea. I always snored loud as well and we have the same body shape so i decided to get tested as well. Turns out i did have <a href="www.apneapros.com">sleep apnea</a> just like my brother. Now its been about 7 months and i feel much better than i have in the past 6+ years. I was about 90% compliant withn the first two weeks.

 

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