Experts insist on sleep screenings for truck drivers

Photo by Laura Williams

Photo by Laura Williams

ALBANY -- In recent years, some officials have recommended sleep disorder screenings for truck drivers to make the nation's highways safer.

Given the nature of what they do, commercial drivers are a unique case.

"The uniqueness with truck drivers is that they are driving big

machinery down the highway," said Dr. Chris Mann, who practices sleep medicine in Albany. "Currently, to get a commercial license you have to pass a physical exam, but there is nothing about sleep apnea."

While recommendations have been made regarding truckers, no guidelines have been implemented yet. Part of the reason may be that there are still some issues to sort out, Mann said.

"Everyone's trying to figure out how they (the screenings) are going to be paid for," he said. "It's a huge cost. There are recommendations, but no guidelines have been implemented."

In the meantime, the Federal Motor Carrier Safety Administration has been trying to set up a medical team similar to what the Federal Aviation Administration has in place. However, where they are in pulling the pieces together is anybody's guess.

"I think they are moving forward with it, but I can't figure out in my research where we are with that," Mann said.

Most experts would compare the effects of a sleepy driver to that of a driver operating a vehicle under the influence of drugs or alcohol.

"That (effect has) been proven," said American Trucking Associations Workplace and Fleet Safety Director Christie Cullinan.

The biggest issue in regards to sleep problems for truckers, as well as the general population, is insufficient sleep, Mann said. The result of insufficient sleep is drowsiness, an effect that has proven to be very dangerous when combined with driving.

"As far as sleep disorders go in all people, (the biggest problem) is insufficient sleep," he said. "People drive sleepy. They are trying to work when their bodies are telling them they need to sleep."

Generally, those most at risk for developing sleep apnea are males or those with a body mass index over 30. The condition is characterized by an individual's airway being blocked while sleeping, typically resulting in frequent breathing interruptions lasting from 10 seconds to more than a minute at a time, loud snoring and non-restorative sleep.

The treatment is known as continuous positive airway pressure, or CPAP, which is an airmask that is worn every night in order to keep the

airway open.

"Sleep apnea is a very treatable problem," Mann said. "If you have sleep apnea and are not being treated, you'll have all sorts of medical problems."

Individuals with sleep apnea are more likely to have high blood pressure, heart problems, stroke and depression, contributing to annual health care costs twice as much as those that don't have the condition.

"Sleep apnea does predispose you to a number of conditions," Cullinan said.

Research on the topic indicates that sleep disorders among truck drivers occur at roughly the same frequency as the general population.

Even so, Cullinan said there are certain risk factors for sleep apnea officials see in truck drivers.

"A number of our truck drivers are overweight," she said. "About 28 percent of commercial motor vehicle drivers are at risk for sleep apnea."

Roughly 3 percent of truck crashes are related to a medical condition, Cullinan added.

Experts say that the average expense of an accident involving a trucker is $200,000 with injuries, and $3.7 million with fatalities.

"You want the highways to be as safe as they can possibly be," Mann said. "It would be nice if we can get all sleepy truckers off the highway."

Experts also say what might be feeding the problem is that some truckers, in order to maintain financial security, are opting not to report sleepiness.

"Truckers are good, hard-working folks," Mann said. "Truckers want to be safe, but they want to keep their job. It's natural to protect employment."

Roughly 24 percent of the country's population is thought to have some degree of sleep apnea, although some experts say the actual number could be much higher.

"A lot of folks with sleep apnea don't realize they have it," Mann said.

Males are more prone to significant sleep apnea and daytime sleepiness, with females catching up to them when they reach menopause, Mann said.

In order to help combat the problem, some trucking companies are already conducting screenings for their drivers, some of whom are either turning potential employees away or giving them a shorter route for the first few months of service.

"A lot of companies are acknowledging the problem," Cullinan said.

In order to do their part to help combat the problem, the ATA is co-sponsoring the first national conference on sleep apnea and commercial motor vehicle drivers. The event is set to take place during the middle part of next year in Baltimore, with the overall goal of getting to the bottom of a few misconceptions as well as getting ahead of the curve, officials with ATA say.

"There are a lot of unanswered questions," Cullinan said. "There are a lot of issues out there. There are a lot of misconceptions and tough questions nobody has gotten an answer for. We want to get ahead of the curve for whenever the (Department of Transportation) standards come down.

"There are solutions to the problem out there, it's just a matter of making it cost-effective."

The conference, hosted by the American Sleep Apnea Association, will feature presentations and panel discussions that focus on providing a common understanding of sleep apnea diagnosis and treatment, clarifying current and proposed regulations, establishing an ongoing forum of experts to generate guidance for improvements and providing trucking management with the resources to improve employee health and safety.