No one disputes that driver fatigue can be extremely dangerous but are the new recommendations for sleep apnea testing going a step too far?
People who suffer from sleep apnea are continually fighting sleepiness all day, including while they’re working or driving. In the most common form of the condition obstructive sleep apnea (OSA), the airway is blocked by the tongue pressing against the soft palate and uvula making them fall against the back of the throat. This causes sufferers to stop breathing through the sleep cycle, with breathing being affected potentially hundreds of times during the night. Sufferers often snore or make choking or gasping sounds when they are sleeping. This somewhat “sleepless” sleep results in an ongoing fatigue while doing something that doesn’t require considerable activity…like driving.
The industry has been aware of this problem and certainly recommends that drivers that exhibit signs of sleep apnea go for testing and treatment, according to Federal Motor Carrier Safety Administration (FMCSA) guidelines. But this year, an expert panel has recommended the following changes to those guidelines, and they are quite far reaching. These changes apply to a driver who (1) has a body mass index (BMI) greater than or equal to 40, or (2) has a BMI greater than or equal to 33 and meets at least three of the following criteria:
• Is 42 years of age or older
• Is male
• Is a post-menopausal female
• has diabetes
• has high blood pressure
• has a neck size greater than 17 inches (male) or 15.5 inches (female)
• has a history of heart disease
• snores loudly
• has had witnessed apneas
• has a small airway to the lungs
• has untreated hypothyroidism
• has micrognathia (undersized jaw) or retrognathia ( a kind of overbite)
The big issue is that drivers who are 42 are older need to meet only one of these additional criteria and they will automatically be required to be screened for sleep apnea. These guidelines are only suggestions at this point and have not yet been set in place, but the outcry is there and, when one considers the reasons for it, it’s understandable.
The cost for a driver to be tested for sleep apnea can range from $1,800 at the low to $3,000 at the high. Insurance may not pay for it and some drivers are required to pay the fees themselves rather than have the company pay. Plus, drivers need to take two to three weeks off of work to complete the tests. This is another hit to drivers, especially owner operators who already face economic challenges. Then, if treatment is needed, CPAP devices can be costly.
And there are additional problems with these new proposed changes. A recent article in Overdrive Magazine details their survey of over 3,000 drivers. When asked about their BMI, 34% had no idea what theirs was, while 17% said that they had a BMI at 40 or higher. However, the question does remain whether or not, with today’s more limited criteria, correct decisions are made. A full one-third of the publication’s readers experienced false positive or false negative results. So some additional criteria are needed. It’s just questionable, with all of the added regulations that today’s drivers face, whether these new recommendations are just going too far.