Advisory groups agree on guidelines for apnea regulations

By Mark Schremmer, staff writer

In a more direct path toward regulating drivers with sleep apnea, the Motor Carrier Safety Advisory Committee and Medical Review Board voted to approve guidelines for obstructive sleep apnea screening during a joint meeting in late October.

The guidelines could serve as a framework for future regulation on drivers with obstructive sleep apnea, depending on what FMCSA does with the recommendation.

The two groups voted 16-4 to approve the guidelines that were originally recommended by the Medical Review Board in August. Few changes to the original guidelines were made.

"There were few changes," OOIDA Federal Affairs Manager Jay Grimes said. "None of it was anything that really benefited drivers."

Among the board’s recommendations was a set of guidelines for when a truck driver should be required to have a sleep test. The board suggested mandatory screening for any truck driver with a body mass index of 40 or above, with admitted fatigue or sleeping during wakeful periods, or for any drivers who have been involved in a sleep-related motor vehicle accident.

Based on the review board’s recommendations, screening could also be mandatory for drivers who possess a BMI of at least 33 and have at least three of the following factors:

  • Untreated hypertension
  • Type 2 diabetes
  • Loud snoring
  • Witness apneas
  • Small airway/Mallampati score
  • A neck size of 17 inches or more for males and 15.5 or more for females
  • Age 42 or older
  • Male or post-menopausal female
  • Untreated hypothyroidism
  • Stoke, coronary or artery disease
  • Micrognathia or retrognathia

OOIDA, which was represented by Executive Vice President Todd Spencer on the advisory committee, has argued that physical attributes like gender, age and neck size would essentially reduce the required BMI to 33 for the majority of drivers.

Increasing the contributing factors from three to four was taken to a vote but was defeated 15-7. Previous guidelines called for anyone with a BMI of 35 or more to be tested.

The Federal Motor Carrier Safety Administration will have to make the decision whether to incorporate the recommended guidelines into the medical certification regulations. But before moving forward with a full apnea regulation, the FMCSA would have to determine the cost-benefit analysis and the overall impact on the drivers.

"OMB is going to have a lot to figure out and determine what impact these guidelines would have on the driver population and whether it would actually increase safety or not," Grimes said.

FMCSA isn’t expected to make any decisions on obstructive sleep apnea regulation until the next administration.

(Editor’s note: The recommendations and procedures outlined in the above article are not related to OOIDA’s legal challenge on Page 22.)