There is no proof that sleep apnea increases the risk of crashes, and a rule requiring testing would be an unnecessary burden to truck drivers, a representative of the Owner-Operator Independent Drivers Association said during a public listening session on Tuesday, May 17, in Chicago.
The second of three listening sessions was held in response to the Federal Motor Carrier Safety Administration and Federal Railroad Administration’s advance notice of proposed rulemaking. The notice was published on March 10 to receive feedback about any potential obstructive sleep apnea regulations.
Johanne Couture, an OOIDA senior member from Ontario, Canada, questioned the link between having sleep apnea and crashes.
“The bigger point to this proposal is the direct relationship between sleep disorders and crash causation,” Couture said. “Is there really a direct relationship between the two? There are so many different factors to be considered in crash data. Driver experience, weather, time of day, equipment condition, road conditions, signage, driver state of mind, and many others.”
“A point of contention I have is with the insistence of monitoring usage of obstructive sleep apnea treatment,” Couture said. “American CPAP and oral appliance manufacturers have included a usage monitoring chip in their products. Why? If the patient is aware of the benefits of treatment for the condition, the patient realizes it's in their best health interest to use it. I compare this to the use of my glasses. If I don’t wear them, I don’t see the road signs and traffic conditions so well, but no one monitors how much I use my glasses. There’s a noted condition on my license that says I need to be wearing them while driving, period.
Andrew King, a research analyst for OOIDA, also addressed the panel on Tuesday and pointed to two studies regarding crash risk and sleep apnea.
A study released in March by University of Minnesota Morris professor Stephen Burks claimed that truck drivers with untreated sleep apnea are much more likely to crash, but King cited a paragraph in the study that was contradictory to those claims.
“However, if the No Adherence drivers – those who weren’t compliant – have a higher crash risk than their controls, it is not possible to conclude that this difference was caused by the effect of untreated obstructive sleep apnea,” King read to the panel.
King also referenced an FMCSA study that found no association between sleep apnea and increased crash risk.
Without causation, King said there is no justification for creating such a large financial burden on the trucking industry and its drivers.
King said studies and equipment can cost thousands of dollars. He also said the time off the road could cost an owner-operator $3,500 a week and $15,000 a month.
“According to an OOIDA member survey, 29 percent of members have no medical insurance and for those who do, 72 percent of medical policies do not cover the sleep apnea expense,” King said. “This would be a huge financial burden to the industry. Why are we doing something if we don’t have causation?”
Couture also said she doesn’t think there should be such a negative stigma surrounding sleep apnea.
“There is a stigma with this condition, which should not be there. It should be as simple as getting your eyesight checked, which is a decision between patient and physician,” Couture said.
Dr. Steve Burton told the panel the cost of sleep studies has become much more cost-efficient in recent years and that insurance covers the cost.
However, OOIDA Director of Regulatory Affairs Scott Grenerth submitted an email, saying that is often not the case.
“We have members who have incurred out of pocket costs of $2,000, $6,000, $10,000 and $12,000 for testing and CPAP equipment combined,” Grenerth wrote. “It is extremely rare that an insurance company covers the cost of any testing required by a Certified Medical Examiner, especially when a CME is telling the driver that they will only accept a test from a very specific sleep lab and that they will require a very specific CPAP device. There absolutely are vendors who provide testing and equipment at a much lower cost, but drivers who are not allowed to seek a second opinion are stuck with using only one CME who holds their ability to earn a living in their hands.”
The third and final public listening session on sleep apnea is scheduled for Wednesday, May 25, in Los Angeles. The 90-day comment period ends June 8.
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