The medical community’s fascination with obstructive sleep apnea may be fairly new, but the condition isn’t. According to a paper titled “The Truth about Obstructive Sleep Apnea” released earlier this month by the Owner-Operator Independent Drivers Association Foundation, the crash statistics don’t support the sudden need for increased regulations.
“Proponents of obstructive sleep apnea screening fail to recognize that sleep apnea is not a new disorder, but a condition that has affected millions of people over several decades … Yet there has not been the carnage and devastation on our roadways that the Federal Motor Carrier Safety Administration would have us believe is inevitable without stricter mandatory obstructive sleep apnea screening regulations,” the OOIDA Foundation wrote.
Last year, the FMCSA and Federal Railroad Administration issued an advanced notice of public rulemaking regarding a possible sleep apnea screening regulation. In August 2016, the FMCSA’s Medical Review Board recommended stricter guidelines for when a driver should be tested for obstructive sleep apnea.
However, OOIDA contends that the data doesn’t back up the need for a costly mandate.
“FMCSA’s own studies, in particular, have found that there is ‘no association between sleep apnea, as measured by the apnea/hypopnea index, and commercial motor vehicle crashes,’” OOIDA wrote.
In addition, OOIDA cited the FMCSA’s Sleep Apnea Crash Risk Study from 2004 that said patients with sleep apnea had no greater probability of having a crash than patients without sleep apnea, either before or after their diagnosis. Drivers with sleep apnea were also not found to be at an increased risk for multiple crashes, nor were crash rates impacted by the prevalence of apnea, according to the study.
Furthermore, the OOIDA Foundation’s survey of owner-operator members indicates that the small sampling of owner-operators who are actually receiving treatment for obstructive sleep apnea have been involved in fewer crashes than the national average.
“While FMCSA’s own data and research demonstrates that there is no causal link between sleep apnea and commercial motor vehicle accidents, it is frequently stated that between 7 and 20 percent of all large truck crashes are due to drowsy and fatigued driving, which in turn is supposedly linked to obstructive sleep apnea,” the OOIDA Foundation wrote. “According to the OOIDA Foundation’s own research, however, those owner-operators who are currently receiving treatment for obstructive sleep apnea have a crash rate of 0.36 crashes per million vehicle miles traveled, which is four times better than the national average of 1.47.”
The OOIDA Foundation added that the average owner-operator with sleep apnea has more than 2 million miles of accident-free driving.
Based on the Medical Review Board’s recommendations, all truck drivers with a body mass index of 40 or above would be required to be screened for sleep apnea. The recommendation also suggested that the BMI be reduced to 33 for drivers with certain “risk factors.” Interestingly, being a 42-year-old man with a neck size of 17 inches would qualify as three “risk factors.”
The OOIDA Foundation said a sleep apnea screening mandate such as this could cost the trucking industry billions of dollars.
“If a conservative 26 percent of all truck drivers had a body mass index of 33, along with three other factors recommended by the Medical Review Board, requiring them to undergo a sleep study, it would cost the trucking industry between $624 million and $7.3 billion just for obstructive sleep apnea testing,” the OOIDA Foundation wrote.
Low-end estimates for a sleep test are about $624, while high-end estimates are $7,300, the Foundation said. Treatment could cost an individual anywhere from $116 to $1,500 on the low end and $440 to $5,500 on the high end.
“The potential cost of treatment would be between $116 million to $1.5 billion and $440 million to $5.5 billion,” the OOIDA Foundation wrote. “Thus, the total potential cost to the industry, not including costs for travel, time off work and maintenance, is approximately $740 million to $2.07 billion or $7.7 billion to $12.8 billion.”
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