Sleep Apnea: What Every Trucking Company Needs to Know
Sleep apnea has shown to be a prevalent and recurring diagnosis in the fleet trucking industry. By definition, sleep apnea is a temporary cessation of breathing while you are asleep. It can occur over 100 times each hour in some severe cases. It is a disorder that is treatable, however it also worsens with age and weight gain. If sleep apnea remains untreated, it can lead to serious health conditions such as high blood pressure, anxiety, stroke, heart disease, diabetes, depression, respiratory disorders, and heartburn. Untreated sleep apnea also makes the driver at 2 to 7 times more likely to get into a motor vehicle accident. In addition, drivers who remain untreated for sleep apnea tend to revert to less effective habits to stay awake and alert, including smoking cigarettes and drinking caffeine; these habits just perpetuate the unhealthy and detrimental lifestyles of these drivers. On the other hand, sleep apnea that is treated results in reduced healthcare costs for both the driver and the employer. Treated sleep apnea allows the drivers to increase their productivity immensely and go through their work day with an alert and active mind. As a fleet owner, becoming proactive and investing in a program to advise all of your drivers to get tested and/or treated for sleep apnea can be a very constructive decision, yielding higher retention of your drivers, loads being delivered on time since treated drivers will no longer have to pull over to nap during the workday, and self-assurance that your drivers are not adding danger to the roads.
Increasing Standards for Sleepy Truck Drivers
In the recent months, the Federal Motor Carrier Safety Administration (FMCSA) has proposed stricter standards for commercial driver sleep apnea. These proposals recommend medical examiners to thoroughly evaluate and rule out sleep apnea as a condition for these drivers. The recommendations have been presented from the medical community, an advisory panel from the trucking industry, and various advocacy interests including labor and safety.
Specifically, it was recommended that any driver with the body mass index of 35 or greater should be evaluated for sleep apnea by the medical examiner. The regulation of 35 was determined to be a decisive indicator of sleep apnea. Those who have a higher body mass index, have a stronger likelihood of being diagnosed with sleep apnea. Although it is a request at the moment, the FMCSA and panels believe that in the near future, this screening process will be mandated for all drivers.
Once tested and compliant in undergoing treatment, the driver will be qualified to drive again. By taking these drivers off the road temporarily, the risk of a driver falling asleep or having decreased job performance due to fatigue will be lessened, thus making the roads safer for all drivers. Driving while fatigued due to sleep apnea can result in a driver having a slower reaction time and having larger lapses of attention. Charles Czeisler, a professor of sleep medicine at Harvard Medical School, stated that “The crash risk for a person with sleep apnea is 242% greater than a person without the disorder.”
Private Trucking Fleet Safety
Starting a sleep program in a private fleet may put your company far ahead of other companies in the transportation industry with regards to the to the FMSCA guidelines about sleep apnea. Implementing an OSA program can help fleet companies and the public combat the number of accidents that were caused by fatigue associated with a sleep apnea. A key driving factor of an OSA program is the reduced healthcare costs and may help in driver recruitment and retention. Up to 28% of commercial drivers have some level of sleep apnea. The largest contributing factor of sleep apnea is having a body mass index (BMI) of 35 or greater. DOT examiners are looking for the following risk indicators as well: High Blood Pressure, Neck Size – 17 inches (male), Neck Size – 16 inches (female), and Tobacco and Alcohol Use
The Federal Motor Carrier Safety Administration (FMCSA) continues to review the following guideline – The medical examiner may, but is not required to, accept the recommendations. Section 390.3(d) of the FMCSRs allows employers to have more stringent medical requirements.
Respiratory Dysfunction 391.41(b)(5)
A person is physically qualified to drive a commercial motor vehicle if that person:
Has no established medical history or clinical diagnosis of a respiratory dysfunction likely to interfere with the ability to control and drive a commercial motor vehicle safely.
Since a driver must be alert at all times, any change in his or her mental state is in direct conflict with highway safety. Even the slightest impairment in respiratory function under emergency conditions (when greater oxygen supply is necessary for performance) may be detrimental to safe driving.
There are many conditions that interfere with oxygen exchange and may result in incapacitation, including emphysema, chronic asthma, carcinoma, tuberculosis, chronic bronchitis and sleep apnea. If the medical examiner detects a respiratory dysfunction, that in any way is likely to interfere with the driver’s ability to safely control and drive a commercial motor vehicle, the driver must be referred to a specialist for further evaluation and therapy.
Lawyers are using this type of information against truck drivers who have an untreated sleep disorder and are involved accidents that have resulted in a fatality. It’s documented that there have been lawsuits that resulted with multi-million dollar settlements against the trucking companies that employed the truck driver with the untreated sleep disorder. Implementing an OSA program can reduce your exposure to litigation and improve your existing fleet safety program. AllTrans Fleet Services offers state-of-the-art remote testing and treatment technology to the transportation industry with the convenience of full program implementation and support, DOT compliance reporting with little if any down time.
Liability in the Trucking Industry has a Major Contributor – Sleep Disorders
The trucking industry has a major contributor when it comes to health care and liability costs, its sleep disorders. There are well documented and easy to spot losses that are incurred daily but not recognized. Sleep disorders that go untreated are linked to heart disease, obesity, high blood pressure, diabetes and many other medical conditions. We are trying to be proactive before the disease catches the patient.
AllTrans Fleet Services Program provides a Turnkey Obstructive Sleep Apnea (OSA) Program that offers state-of-the-art remote testing and treatment technology to the transportation industry with the convenience of full program implementation and support, superior compliance reporting with little if any down time. The program is easy to follow and affordable for commercial truck drivers and keeps them on the road. Many Fleet managers are meeting the sleep apnea problem head on and reaping the rewards of lowering health-care costs and reducing the amount of accidents for their drivers. Treating sleep apnea will continue to lower costs in the long run by lowering liability premiums.
Keep Your Health Care Costs Down
For employers in every industry, health care costs are continuing to grow with no signs of stopping in the recent future. It is nearly impossible to find a decent coverage policy at a low cost to the company. One particular instance causing health care costs to increase is accidents. Accidents, although affect every industry to an extent, is extremely evident particularly in the trucking industry.
If a driver is fatigued due to undiagnosed or untreated sleep apnea, the risk for them to get into an accident is increased. A fatigued driver has a decreased ability to remain alert and concentrate, affecting their safety while on the road as well as safety of other drivers. Sleep apnea almost guarantees a driver to have an inadequate amount of sleep causing them to be fatigued during the work day.
Not only do they increase accident risk, untreated sleep apnea in truck drivers increases risk of other health issues. This included heart attack, strokes, high blood pressure, diabetes, immune problems, and more that are at a higher risk of occurring with the presence of untreated sleep apnea. Adding these conditions to the list would increase the company’s cost in health care immensely. Diagnosing and treating sleep apnea will, in the long run, decrease a company’s potential increase in health care due to the additional costs. Costs for health care associated with sleep apnea can be reduced by up to 50% for each driver who is diagnosed and treated with sleep apnea.
AllTrans Fleet works to screen, test, prescribe, and treat all drivers in your fleet. By monitoring the treatment of each diagnosed driver, we ensure that the treatment is successfully allowing your drivers to improve their lifestyles, while simultaneously preventing your health care costs from increasing.
The National Transportation Safety Board (NTSB) says that a Fatal Bus Crash Underscores the Need for Fatigue Management Programs.
The National Transportation Safety Board has urged the Federal Motor Carrier Safety Administration to be more aggressive in monitoring fatigue management programs due to a fatal bus crash in last year.
On May 31, 2011 at 4:55am an incident occurred because the driver fell asleep, the Board found. A Sky Express bus that was headed northbound on I-95 in Virginia flipped over after it drifted across the roadway and struck a cable barrier. Unfortunately, four passengers were killed and fourteen others were seriously injured.
After the investigation was completed, the Board found that the bus driver had been suffering from sleep loss, poor sleep quality and interruption of his heart rhythm.
“Sky Express’s failure to exercise even minimal oversight of its drivers’ rest and sleep activities enabled the drivers to drive while dangerously fatigued,” the Board said.
The Board would like for the FMSCA to implement a program to monitor and improve the safety management programs to address fatigue. This is a direct follow up on a previous recommendation that all carriers have a fatigue management program.
The Board also wants new-entrant safety audits to include a review of a structured safety management process so the new carriers will know how to identify safety risks and maintain a safety assurance program.
Sky Express passed the Federal Motor Carrier Safety Administration new entrant safety assurance audit despite safety shortcomings in its operation, which indicates the new entrant audit process is not always keeping unsafe carriers from entering the motor carrier industry,” the Board said.
Fatigue Management Program for North American
The Board has urged the agency to incorporate fatigue management strategies, in addition to the hours of service rules for bus drivers who work at night.
The Board has also recommended a joint FMCSA-Transport Canada project to develop a fatigue management program.
The North American Fatigue Management Program, as it is called, aims to provide carriers with a manual that would have a best-practices reference for implementing a fatigue management program in their operations.
Rebecca Brewster, president and COO of the American Transportation Research Institute stated that It has been in the works for several years and now is nearing completion. The American Trucking Associations is on the project’s steering committee.
Brewster said the project expects to launch a website by November that will provide program materials at no charge. Training and materials for drivers, dispatchers, and management, have been developed and tested by carriers in the U.S. and Canada.
Ways to address the condition that adds to Fatigue
In the transportation industry, many risk managers and commercial drivers have to deal with the problem of sleep apnea, a condition that is directly related to daytime drowsiness, as they look for ideas to improve road safety. According to the Federal Motor Carrier Safety Administration (FMSCA) estimates that up to 26% of licensed commercial drivers have some level of sleep apnea. Per a FMSCA study, 17% of commercial drivers have mild sleep apnea, 5% have moderate, and 4% have severe prevalence of sleep apnea.
It has been shown in several studies that sleep apnea can directly impact driving performance by increasing fatigue therefore the direct relation of increasing the risk of crashes. The trucking industry is well aware of the awareness and prevalence of sleep apnea among drivers, however there are ways that the condition can be diagnosed, treated, and monitored.
Obstructive Sleep Apnea (OSA) is when the airway in the back of the throat is constricted due to the muscular relaxation when sleeping thus causing interruptions of a person breathing lasting several seconds at a time. Loud snoring is followed as the person gasps for air and resulting in a night of no restful sleep. Individuals considered at risk for sleep apnea are those with a body mass index of 35 or greater and a neck size of 17 inches or more for men and 16 inches for women. Many medical experts have stated that these types of individuals quite often suffer from other medical conditions such as diabetes and heart problems related to obesity.
Researchers say that there are a countless number of people that are not aware that they even have sleep apnea. Sleep apnea quite often contributes to daytime sleepiness, which impacts reflexes and motor skills. Even if the vast numbers of commercial drivers have some type of sleep apnea, many drivers are not willing to talk about it or admit that they may have the medical condition. There needs to be a way to educate the drivers about sleepiness and the dangers it can cause.
Currently the Federal Motor Carrier Safety Administration (FMSCA) has given guidelines on sleep apnea to the DOT Examiners for medical examination report on commercial driver’s physicals. It states the following for Respiratory Dysfunction 391.41(b)(5): A person is physically qualified to drive a commercial motor vehicle if that person:
Has no established medical history or clinical diagnosis of a respiratory dysfunction likely to interfere with the ability to control and drive a commercial motor vehicle safely.
Since a driver must be alert at all times, any change in his or her mental state is in direct conflict with highway safety. Even the slightest impairment in respiratory function under emergency conditions (when greater oxygen supply is necessary for performance) may be detrimental to safe driving.
There are many conditions that interfere with oxygen exchange and may result in incapacitation, including emphysema, chronic asthma, carcinoma, tuberculosis, chronic bronchitis and sleep apnea. If the medical examiner detects a respiratory dysfunction, that in any way is likely to interfere with the driver’s ability to safely control and drive a commercial motor vehicle, the driver must be referred to a specialist for further evaluation and therapy.
The guidelines are currently under review but are not yet regulation. Many DOT examiners and trucking companies are taking the guidelines seriously and have implemented screening policies. The National Registry for Medical Examiners will be keying in on sleep apnea and only physicians that are in National Registry for Medical Examiners will be allowed to conduct DOT exams.
Maintain Trucker Safety in Several Ways
One of the top priorities in the transportation industry is trucker safety due to the heavy amount of risk in the job. Truck drivers know that it is important to make safety the top priority in the job. Here are six (6) tips to help commercial driver’s maintain trucker safety.
1. Truck drivers need to keep up to date with the new safety regulations and pending truck driving laws. This can easily be accomplished online and your fleet manager or employer is directly responsible for circulating safety regulations/developments to you as soon as they receive information from the Federal Motor Carrier Safety Administration (FMCSA).
2. One of the main essentials for safe driving is the maintenance of your vehicle. Following and adhering to a scheduled maintenance program ensures that your truck is in good condition.
3. Defensive driving needs to be practiced on a daily basis by all truckers. Many of the automobile drivers lack the skills to maneuver around or behind trucks that can lead to potentially hazardous and unfortunately fatal mistakes.
4. Staying alert is not only the key to trucker safety, it’s required. All truckers need to be aware of when they need to take a break. Know and find trusted rest areas and truck stops that are along your route. Take steps to stay alert and know your limitations. Make the best use of rest breaks to relax and refresh yourself for your entire shift.
5. If your responsibility involves unloading your cargo when you reach your final destination, be sure to use proper lifting techniques. Being on the road for hours on end can put a strain on the muscles in your back. Don’t exert yourself and put your health at risk that would involve an injury.
6. The responsibility to ensure that they are in good physical condition falls on the truck driver themselves. Management of fatigue is important to trucker safety. Make sure that you always have had enough sleep to stay alert.
Sleep Apnea: What Every Trucking Company Needs to Know
Sleep apnea has shown to be a prevalent and recurring diagnosis in the fleet trucking industry. By definition, sleep apnea is a temporary cessation of breathing while you are asleep. It can occur over 100 times each hour in some severe cases. It is a disorder that is treatable, however it also worsens with age and weight gain. If sleep apnea remains untreated, it can lead to serious health conditions such as high blood pressure, anxiety, stroke, heart disease, diabetes, depression, respiratory disorders, and heartburn. Untreated sleep apnea also makes the driver at 2 to 7 times more likely to get into a motor vehicle accident. In addition, drivers who remain untreated for sleep apnea tend to revert to less effective habits to stay awake and alert, including smoking cigarettes and drinking caffeine; these habits just perpetuate the unhealthy and detrimental lifestyles of these drivers. On the other hand, sleep apnea that is treated results in reduced healthcare costs for both the driver and the employer. Treated sleep apnea allows the drivers to increase their productivity immensely and go through their work day with an alert and active mind. As a fleet owner, becoming proactive and investing in a program to advise all of your drivers to get tested and/or treated for sleep apnea can be a very constructive decision, yielding higher retention of your drivers, loads being delivered on time since treated drivers will no longer have to pull over to nap during the workday, and self-assurance that your drivers are not adding danger to the roads.
