Three organizations are making recommendations for
changes to the screening and management of sleep apnea for commercial motor
The recommendations – which were published jointly
by the American College of Chest Physicians, the American College of
Medicine, and the National Sleep Foundation as a supplement to the September
issue of theJournal of Occupational and Environmental Medicine – include a revisedscreening and evaluation process, modified
criteria for returning to work after treatment and recommendations for how
truckers could recertify.
“Sleepiness and inattention contribute to a
significant number of CMV crashes each year and (sleep apnea)has been shown to significantly increase a
driver’s risk of driving drowsy. Yet, current CMV screeningand treatment procedures … are ambiguous,” said Nancy Collop, a spokeswoman for the American Collegeof Chest Physicians, in a press release.
Federal Motor Carrier Safety
Administration guidelines for the diagnosis and treatment of sleep apnea are
based on a 1991 report sponsored by the Federal Highway Administration.
Current FMCSA guidance for
certification cites that drivers must have “no established medical history or
clinical diagnosis of respiratory dysfunction likely to interfere with the
ability to control and drive a commercial motor vehicle.”
According to a National
Sleep Foundation press release, the recommendations:
an updated definition of sleep apnea;
a screening process that bases driver certification on the severity of the
sleep apnea; and
expanding the screening process to include a more extensive medical and
physical history, flagging such risk factors as body mass index, neck
circumference and family history.
Although the task force
recommends more thorough screening, their recommendations suggest a shorter
Under current FMCSA
guidelines, commercial vehicle operators who are being treated for sleep apnea
can return to work a minimum of one month after initiation of treatment. The
task force’s recommendations include reducing return-to-work time to two weeks
after the start of treatment in many situations. Reevaluation after four weeks
to ensure compliance with therapy and improvement in symptoms is also
A study sponsored by FMCSA
and the American Trucking Association estimated that nearly one in three
commercial truck drivers suffers from mild to severe sleep apnea.