Drivers: Your input is critical

By Mark Schremmer, staff writer

A federal proposal by the Federal Motor Carrier Safety Administration and Federal Railroad Administration could lead to commercial drivers and railroad workers being required to undergo evaluation and treatment for sleep apnea.

The two agencies opened a 90-day comment period about the subject on March 10. The FMCSA and FRA remain in the discovery phase of the rulemaking process and are requesting data and information concerning the impact of moderate-to-severe obstructive sleep apnea on the safety of highway and rail transportation.

While the current federal proposal doesn't impose any new regulations regarding sleep apnea, the agencies suggest future regulatory action may be necessary.

"Based on the potential severity of obstructive sleep apnea-related transportation incidents and accidents and the varied, non-regulatory OSA-related actions taken by the department's operating administrations to date, the agencies are considering taking regulatory action to ensure consistency in addressing the safety issue presented by transportation workers with safety sensitive duties who are at risk for OSA," the agencies said in the advanced notice of proposed rulemaking.

Comments can be based on the 20 questions provided in the notice.

Examples of the questions include:

  • Is there information available for estimating the future consequences resulting from individuals with sleep apnea occupying safety sensitive transportation positions in the absence of new restrictions?
  • What alternative forms and degrees of restriction could FMCSA and FRA place on the performance of safety-sensitive duties by transportation workers with moderate-to-severe sleep apnea, and how effective would these restrictions be in improving transportation safety?
  • What costs would be imposed on transportation workers with safety sensitive duties by requiring screening, evaluation and treatment of sleep apnea?
  • When and how frequently should transportation workers with safety sensitive duties be screened for sleep apnea? What methods of diagnosing sleep apnea are appropriate and why?
  • Should medical examiners impose restrictions on a transportation worker with safety-sensitive duties who self-reports experiencing excessive sleepiness while performing safety-sensitive duties?

According to research on sleep apnea published by FMCSA and authored by Dr. Allan Pack of the University of Pennsylvania, "there is no statistical evidence in these data to suggest that the presence of sleep apnea significantly increases the likelihood or the risk of motor vehicle crashes."

In addition, the percentage of large truck crashes related to drowsiness, being asleep at the wheel and/or fatigue has been consistently low. According to Large Truck and Bus Crash Facts 2013, only 1.5 percent of all fatal crashes were linked to drivers being asleep or fatigued.

One trucker who plans to have his voice heard is OOIDA Life Member Tim Begle.

The Indiana truck driver with more than 35 years of experience says he was misdiagnosed with a severe case of sleep apnea and ordered to undergo CPAP treatment several years ago. The treatments were ordered even though Begle never complained of problems sleeping or drowsiness while driving.

According to Begle, the misdiagnosis and unnecessary treatment left him exhausted. Begle turned to soda to keep him awake while he was driving and sleeping pills in order to get a few hours rest at night. The combination led to excessive weight gain and depression.

"I couldn't sleep with the machine," Begle said. "They told me that the machine was working fine, so I would have to get used to it. I told them that I couldn't sleep like that. They said that I had to use it. And if I didn't, they would call the state of Indiana and have my CDL pulled."

"I couldn't live like that. It was playing with my mind."

After some research, Begle learned that he had mild sleep apnea, which didn't require a CPAP.

Begle said he believes the diagnosis was largely based on money.

"They got their money for the sleep study," Begle said. "They got their money for the supplies. They got their money for the CPAP."

He said the charges totaled $5,000, which included $1,000 of out of pocket expenses.

"What really irritates me is that a lot of these clinics weren't truthful," Begle said. "They want to sell these sleep studies and want to sell these machines. Everyone was so untruthful in this situation. That's what makes me so mad.

"I told them that I had no sleeping issues. I had no problems staying awake. I had no signs of having sleep apnea."

Many truck drivers have told OOIDA that their medical examiners have ordered sleep tests based on a driver's weight, body-mass index, neck size, overbite, snoring and other criteria.

"It's pretty clear that while various physical characteristics may be more common among people who have apnea, that's not always conclusive," OOIDA Executive Vice President Todd Spencer said. "Some big people have it. Some big people don't. Some small people have it, and others don't. But I also don't want to get lost in this whole merry-go-round that there's a connection. We've yet to see any legitimate data that people with sleep apnea, even untreated sleep apnea, crash more. There are lots of other things that can cause you to not get the most restorative sleep. It could be noise in the neighborhood. It could be all kinds of things." LL