FMCSA Medical Board to Review Comments on Sleep Apnea Pre-Rule

August 9, 2016

By David Cullen

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With the extended comment period on the impact a sleep-apnea rule might have on CMV drivers closed for several weeks, the Federal Motor Carrier Safety Administration has announced its Medical Review Board will meet on August 22 and 23 in a public session to make recommendations on comments submitted regarding its Advance Notice of Proposed Rulemaking “on safety-sensitive rail and commercial motor vehicle drivers with moderate to severe Obstructive Sleep Apnea.”

That APRN— also known as a “pre rule”—was issued jointly with the Federal Railroad Administration back in March. At that time, the agencies described the pre rule as “the first step” in considering whether to propose specific requirements around OSA.”

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

Since March, almost 600 comments were filed in the APRN’s docket and three “listening sessions” were held at several locations across the country to further elicit public comments on moving forward with such a rulemaking.

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 its August 9 Federal Register notice of the upcoming meeting, FMCSA said that the MRB will also review its previously issued report on OSA from 2012 to determine whether the report should be updated based on any changes to medical standards and practice or on any pre-rule comments placed in the docket or received at the listening sessions.

The MRB is composed of five medical experts who each serve 2-year terms. The board is charged with establishing, reviewing and revising “medical standards for operators of commercial motor vehicles that will ensure that the physical condition of operators of commercial motor vehicles is adequate to enable them to operate the vehicles safely.”

The MRB will meet on Monday and Tuesday, August 22-23, 2016, from 9 a.m. to 4:30 p.m. EDT, at the FMCSA National Training Center, 1310 N. Courthouse Road, Arlington, Vir., 6th floor. Copies of the task statement and a meeting agenda will be made available online in advance.

Oral comments from the public will be heard during the meeting, subject to the discretion of the chairman, FMCSA noted. Members of the public may also submit written comments on the topics to be considered during the meeting. Those are due by Wednesday, August 17, and should be directed to the Federal Docket Management System Docket Number FMCSA-2008-0362 and FMCSA-2015-0419 for the MRB using any of the following methods: 

  • Federal eRulemaking Portal. Go to and follow the instructions for submitting comments
  • Fax. 202-493-2251 
  • Mail. Docket Management Facility; U.S. Department of Transportation, 1200 New Jersey Avenue SE., West Building, Room W12-140, Washington, DC 20590
  • Hand Delivery. U.S. Department of Transportation, 1200 New Jersey Avenue SE., Room W12-140, Washington, DC, between 9 a.m. and 5 p.m., Monday through Friday, except Federal holidays

Related: How Not to Lose Sleep Over Apnea


  1. 1. George Meredith MD [ August 10, 2016 @ 06:54AM ]

    On Improving Obstructive Sleep Apnea Surgery

    Remembering that just 54 percent, of the really advanced adult obstructive sleep apnea (OSA) cases, will be able to use the CPAP, long term (5years).

    Remembering that, because of their otolaryngologist has not done a comprehensive literature review on non surgical rapid (RME) maxillary expansion, as well as non surgical semi rapid maxillary expansion (SME) for those patients under age 30. And remembering that because their otolaryngologist was not trained nor sought training on how to effectively trim the inferior turbinates (PRIT) .

    And remembering that these same surgeons have not studied and nor performed the unilateral adult tonsillectomy (done under a combination of local and general anesthesia) in order to reduce postoperative morbidity (discomfort). (and then only in those adult cases in which the tonsils are truly massive).

    In truth, simply by keeping the soft palate trim conservative, and by doing a trim of the intranasal sidewall structures (PRIT), why the success rate for OSA surgery can be raised from 25% up to around 85%.....and the postoperative morbidity can be greatly reduced by avoiding the adult tonsillectomy (or in cases of marked tonsillar hypertrophy, doing a unilateral tonsillectomy) and by conservatively modifying extensive palatal surgery….why with these simple modifications, surgery for OSA can save millions of patients the long term misery of decades of CPAP use.
    To learn more about this, log on to the Amazon/Kindle eBook “On Improving Obstructive Sleep Apnea Surgery” by George Meredith MD. First 50 pages are free!

    The Unilateral Adult Tonsillectomy

    George Meredith MD
    Virginia Beach, VA

  2. 2. CJ [ August 12, 2016 @ 04:34AM ]

    I drive truck and I have seen more 4 wheelers going to sleep if a law is made for truckers then ALL drivers need the same we all drive on the same roads. #2 Make it a law that ALL who make this law and give the test MUST DO THE SAME sounds like most of the new laws the jerks are asleep them selves. just another way to screw with the truckers. I DO THINK OF SAFTEY FIRST...... But $ 1200 for a sleep test SCREW THEM

  3. 3. Steve Baumgras [ August 12, 2016 @ 05:43AM ]

    Aeroflow healthcare cost $500 for sleep test an they monitor your cpap use if u need one. They file all your 90 day compliance reports for u with your carrier. Great people to work with an yes i use a cpap

  4. 4. Groo [ August 12, 2016 @ 08:01AM ]

    I started using a CPAP several years back. I never noticed and increased effectiveness in my sleep when I started and never notice a decrease when I occasionally don't use it. It only helps those around me sleep. If you drive while tired and cause a wreck, does it matter why you are tired? IF YOU ARE TIRED PULL OVER!!!

  5. 5. Keith [ August 12, 2016 @ 08:30AM ]

    It's doesn't matter what goes on at a listening session because the fmcsa is deaf when it comes to regulations. Past hos listening sessions is a perfect example. To much government and no common sense!

  6. 6. Glenn D. Meyer [ August 12, 2016 @ 12:34PM ]

    If we could go back to the old hours of service rules were when we were tired we pulled over and slept for four hours and then drove 4 hours not to exceed a given number in 24 hrs. Give us control back instead of fitting us into a pigeon hole and the sleep problem is solved,We are now driving to get the max 11hrs. drive time regardless how we feel!

  7. 7. John [ August 13, 2016 @ 03:35AM ]

    I personally, in my 21yr career thus far, have been hit from behind by drivers who fell asleep (3) times!!! And yet, it's us professional drivers who are being scrutinized 24/7/365 about driving drowsy, for whatever the reason. Legislation after legislation gets passed with thunderous applause for every law that the desk drivers can get signed. All in the name of protecting John and Mary Q. Public/4 wheeler from the truck drivers.'s a novel idea. Start passing legislation that will protect us, from THEM!!!!

  8. 8. Michael Galorath [ August 13, 2016 @ 07:26AM ]

    Very interesting comments here. Dose any one read what the people have to say here? Politicians are following the what has been said to them and by a few doctors or agencies! Where does any person burning the candle at both ends effect the safety on our highways? Where does a diet and like me MSG will prevent me from getting any sleep for at least 10 hours. Beside increasing my Blood pressure. All the studies and laws and HOS laws will not protect the public if one does not chose or able to get any sleep. Sleep apnea is just a small percent of the drivers falling asleep. Where does bordum fit in here? We have managed (for those old enough) to have made a vehicle so comfortable it's like driving your reclining couch sitting in front of you picture window at home with all the creather comforts of home at your finger tips. This is the same for trucks and cars. We have drivers who are fatigued and then we put up no parking signs and limit where they can pull over to rest. I ask this questions to the doctors and the rocket scientists who are putting together the recommendations to our useless politicians. How many accident in both cars and trucks are caused by Sleep apnea? How many are just the lack of sleep? how many are by distracted drivers etc. What time of day are a majority of these so called Sleep apnea accidents? Because of the laws you will not find anyone to give an officer an honest answer as to what (if it was fatigue) that caused the accident. Jail time for those who are truthful. Tired driving is jail time for a CDL driver.

  9. 9. Randi Hoagland [ August 17, 2016 @ 07:12PM ]

    The whole driving tired issue has taken control away from the driver. Who is better to say how tired a driver is than the driver themselves? By pushing to get every mile out of the given 11 hours drive time within 14 hours of when you start makes us drive even when we should stop for a break. I personally would like the option to pull over when I feel I need to and not have to worry about the 14 consecutive hour clock running out. It should be up to us not someone that drives a desk to decide when to drive and for how long within a specified amount of daily drive time. We would be both safer and more productive as a result.
    I am also on a CPAP machine and feel no difference between sleeping with or without the device. I agree that it is more for those around us then for those useing them. To have a machine just because we snore.


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