Truckers and medication

Our Hurt Trucker blog series on a trucker’s health continues this week with a discussion of sleep apnea, which has received a lot of publicity in the trucking industry in recent years.

Sleep apnea is a condition in which a narrowing or closure of the upper airway during sleep causes repeated sleep disturbances, leading to poor sleep quality and excessive daytime sleepiness. This constant sleepiness can have a negative impact on a truck driver’s quality of life. It can make the truck driver sluggish and increase stress and the risk of other health issues such as obesity and high blood pressure.

This fatigue can lead to very serious truck accident injuries once the driver gets behind the wheel. The fatigue associated with sleep apnea is thought by some researchers to be a significant contributing factor in as many as one out of every seven tractor trailer crashes. However, it is important to note that the studies of the relationship between sleep apnea and trucking accidents have been mixed. The Department of Transportation recently sponsored a study that found no compelling statistical evidence that sleep apnea increases crash risk among commercial drivers. Even if sleep apnea does not increase a truckers likelihood of a highway accident, the condition can have a serious negative impact on the quality of a truckers life and as such should be taken seriously and treated.

Sleep apnea is closely associated with being overweight. Truck drivers are particularly susceptible to being overweight because of the nature of their job. Trucking requires a driver to sit for eight hours or more each day with limited opportunities for exercise. As a result, as many as 40 percent of truck drivers are classified as significantly overweight. Body weight is hardly a problem limited to the trucking industry. Nearly a third of all Americans are clinically obese.

Truckers, Sleep Apnea and the DOTTruck drivers receive medical exams every couple years, but it has never been required that they be tested for sleep apnea as part of the exam. That could change. The Medical Review Board of the FMCSA has recommended that CDL holders with a body mass index (BMI) of 30 or higher be tested for sleep apnea. A BMI of 30 or greater – 220 pounds for a 6-foot-tall person – puts people at risk for developing obesity-related medical conditions such as sleep apnea.

No sleep apnea testing requirement currently exists. However, the Federal Motor Carrier Safety Administration (FMCSA) Criteria for Medical Evaluations currently provides that truckers shall not have an “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.” If the Medical Examiner detects a respiratory dysfunction such as sleep apnea “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.”

As these regulations indicate, diagnosing and treating sleep apnea has become a hot topic in the trucking industry. The FMCSA is engaged in ongoing talks focused on combating trucker health issues like sleep apnea. Last year a Sleep Apnea & Trucking Conference was organized by the American Sleep Apnea Association. This conference brought together trucking, regulatory, medical, insurance, legal and policy experts to provide information about sleep apnea diagnoses, and treatments.

For mild cases of sleep apnea, doctors often recommend lifestyle changes, such as losing weight or quitting smoking. If these steps do not work, or if your apnea is moderate to severe, other treatments are available. Certain devices can help open up a blocked airway. In the most severe cases, surgery may be necessary.

The most common treatment for moderate sleep apnea is Continuous Positive Airway Pressure (CPAP). The CPAP is a machine that delivers air pressure through a mask placed over your nose while you sleep. This pressure is just enough to keep your upper airway passages open, preventing apnea and snoring. A Bilevel Positive Airway Pressure (BPAP) is another device that automatically adjusts the pressure while you sleep and is sometimes used to treat sleep apnea.

Another option is sleeping with an oral appliance designed to keep your throat open. CPAP is generally thought to be more effective than oral appliances, but oral appliances are easier for some people to use. Most are designed to open your throat by bringing your jaw forward, which sometimes relieves snoring and mild sleep apnea.

Surgery is sometimes a treatment option for serious sleep apnea. The surgery procedure removes excess tissue from your nose or throat that may be vibrating and causing you to snore, or that may be blocking your upper air passages and causing sleep apnea.

If you think you may have sleep apnea, contact your doctor today. Curing your sleep apnea will improve the quality of your life and reduce your risk for other serious health problems.