WCInsights has written about the sleep (or better yet, lack of sleep) problem in the trucking industry. What if drivers were seemingly getting their recommended hours of sleep, but it wasn’t the quality sleep they need to rest and recharge so they can stay alert on their routes? Obstructive Sleep Apnea (OSA) is a common condition among drivers and may be leading to a higher chance of crashes.

In a study out of the University of Minnesota, researchers found that drivers who had OSA and were not being treated for it were up to five times more likely to be involved in a crash that could have been prevented. Drivers who did not have sleep apnea or drivers who had it and adhered with positive airway pressure treatments were much less likely to have a crash. For every 100,000 miles driven they had a 0.014/100,000 miles chance versus a 0.070/100,000 miles chance for those who were not treating the condition. Drivers who have the condition and only partly adhere to treatments had a 0.021/100,000 miles driven chance of a crash, which is closer to the group that does not treat their condition at all. The AAA Foundations estimates that over 300,000 crashes a year can be tied to drowsy driving.

Screening for OSA is not mandatory for commercial truck drivers even though they have medical fitness tests twice a year to make sure they are fit to drive. Researchers think that there should be routine screening for OSA, and then subsequent monitoring and treatment programs for drivers who do have it. In a study published in Industrial Health, it is estimated that of the 14 million commercial drivers in this country, 17-28 percent have OSA. While a person with OSA sleeps, their breathing becomes obstructed during the night and they can wake up and have their sleep disturbed several times throughout the night. This leads them to have an impaired night of sleep and can cause them to be sleepier during the day and have psychomotor deficits and slower reactions. Those are symptoms that do not bode well for people who are driving all day and expected to be alert.

Having a BMI that qualifies that patient as obese is the biggest risk factor in developing OSA. Just under half of the country’s commercial truck drivers are classified as obese. Being older and being male are also two risk factors associated with OSA.

Researchers have found that relying on workers to self-report possible OSA is not always the best route to try and diagnose or curb the problem, as drivers are scared to report for fear of losing their job or license to drive. That’s why they say it is important for doctors to use sleep related questionnaires that may not ask outright if a patient feels they have OSA, but will ask them about their sleepiness levels during the day or if they thought they were likely to fall asleep in a given scenario. This, in addition to physical exams for blood pressure and BMI, and questions about heavy snoring or other co-morbidities. Researchers have found that using these strategies does a better job at uncovering the true diagnosis rates of OSA among drivers than self-reporting.

The Federal Motor Carrier Safety Administration and the Federal Railroad Administration recently announced they are considering required testing and subsequent treatment for sleep apnea for bus drivers, railroad workers and truckers. Pilots already undergo these tests. They will be seeking public input on topics of screening, evaluation and treatment for these transportation workers.