A major threat to OTR (over-the-road) truck drivers—obstructive sleep apnea—is getting more attention from larger carriers, according to a recent article in Transport Dive.1 Drivers can be hesitant to complain about sleep problems or seek help from physicians over fear of losing their medical cards.*1,3 Combined with some skepticism about the sleep disorders in general and wariness of treatment cost, sleep apnea can often go undiagnosed in drivers.1
One trucking company steps forward
That may be about to change, thanks to initiatives from trucking carriers like Schneider.1 The company’s website states, “Schneider provides sleep apnea screening and treatment for all of its drivers in an effort to promote a healthier, happier lifestyle and prevent accidents caused by daytime drowsiness.”2
Many positives from corporate focus on sleep apnea in drivers
Tom DiSalvi, Schneider vice president of safety and loss prevention, outlined in the Transport Drive article how the company reduced delays in screening and found a supplier for CPAP machines.1 Three big positives from this corporate focus on the health and safety of its drivers are: Schneider made the process cost-free to insured drivers, the result is a health cost savings to the company of $441 per month per driver, and drivers with apnea were retained at a 30% improvement rate.1
Many other trucking companies “on board”
A number of other companies have sleep apnea and “fatigue management” (as the industry often calls it) programs—including Marten, Maverick, Old Dominion, Saia, and Southeastern Freight, according to Mary Convey of SleepSafe Drivers, who was interviewed for the article.1
Undiagnosed sleep apnea in the driver population
Sleep apnea is known to be underdiagnosed in the general population but is believed to be much more so among long-haul truckers.1 A study by the Virginia Tech Transportation Institute (VTTI) found that as many as 47% of drivers are at risk for sleep apnea because of weight (BMI) or neck size.1 In the general population, diagnosis of sleep apnea is believed to be between 6 and 17%. Among truck drivers, it’s about 33%, according to the VTTI.1
Existing medical conditions can be made worse
As dangerous as undiagnosed sleep apnea can be to the general population, in the driver population it may be worse; potentially causing memory problems, headaches, daytime fatigue, and difficulty focusing on the road, according to the American Sleep Apnea Association.1 Sleep apnea also contributes to comorbid conditions like weight gain or obesity, high blood pressure, and heart issues that many OTR drivers are documented to have, as well as Type 2 diabetes.4
Physicians offer telemedicine, disposable diagnostic machines, and hope
In addition to trucking companies, physicians are changing how they approach screening and diagnosis of sleep apnea by using more remote and disposable options.1 The use of home sleep apnea tests (HSATs) or holding virtual visits are trends that continue to grow.5 For example, Dr. Jordan Stern, a New York-based physician, said he conducts his test through telemedicine and his sleep tests can be done at home.1 Stern said his office mails the patient a disposable home sleep apnea test that can be self-administered while the patient sleeps, according to the article.1 Dr. Stern reassures his reluctant patients that he is “going to get you fixed.”1 This is a testament to the way home sleep apnea tests (and disposal devices) like the WatchPAT® ONE provide critically needed relief to those who are unable or unavailable to do an in-lab study, which is often the case for OTR drivers. With a career that keeps them on the road for the majority of the time, telemedicine and home sleep tests can offer screening, diagnosis, and a faster path to treatment—all without truckers having to miss out on work that is 100% travel-based.
Help from Washington?
With more serious focus on sleep apnea from the trucking companies and medical community, help may also be on the way from the federal government. The Federal Motor Carrier Safety Administration (FMCSA), an agency of the Department of Transportation, is working “to develop guidelines and materials that enable motor carriers to implement a comprehensive Fatigue Management Program (FMP) and means of delivering a FMP to motor carriers throughout North America.”3
Heading in the right direction
It began with awareness, but now there is a movement toward better, easier diagnosis and treatment of sleep apnea among truck drivers. That diagnosis and treatment is more affordable and comes with the support of employers and physicians. A healthier, more alert OTR driving population should mean safer roads as well, which is better for everyone.
References:
1. Jim Simpson, Sleep apnea: a slow killer lurks among OTR truck drivers. Transport Dive. https://www.transportdive.com/news/OTR-truck-drivers-sleep-apnea-schneider-safety/594568/ February 25, 2021. Access date 4/3/2021.
2. Driver Experience Fact Sheet. Schneider. Schneider.com. https://schneider.com/resources/whitepaper/driver-experience-fact-sheet Access date 4/3/2021.
3. North American Fatigue Management Program. FMCSA. Fmcsa.dot.gov. https://www.fmcsa.dot.gov/research-and-analysis/research/north-american-fatigue-management-program Access date: 4/3/2021.
4. Maria R. Bonsignore, Pierpaolo Baiamonte, Oreste Marrone. Obstructive sleep apnea and comorbidities: a dangerous liaison. https://mrmjournal.org/mrm/article/view/10
Multidisciplinary Respiratory Medicine journal 14, Article number 8, 2019. Access date: 4/6/2021.
5. How to maintain momentum on telehealth after COVID-19 crisis ends. American Medical Association. https://www.ama-assn.org/practice-management/digital/how-maintain-momentum-telehealth-after-covid-19-crisis-ends. Andis Robeznieks. June 30, 2020. Access date: 4/6/2021.
This material is subject to a disclaimer available here.
*A US DOT medical card is a document usually carried in a commercial driver’s possession that states that the driver has had a physical examination by a registered and qualified medical doctor and is medically certified and physically qualified to operate a commercial motor vehicle.
The FMCSA website: “A person with a medical history or clinical diagnosis of any condition likely to interfere with their ability to drive safely cannot be medically qualified to operate a commercial motor vehicle (CMV) in interstate commerce. However, once successfully treated, a driver may regain their “medically-qualified-to-drive” status. It is important to note that most cases of sleep apnea can be treated successfully.” [emphasis added]