Transportation Workers and Sleep Disorders - It's Time for Companies to Wake Up

Vehicle Accidents
Drowsy Driving

Anyone who drives a vehicle while fatigued, drowsy or asleep is a hazard to those sharing the road. The situation gets even more dangerous when the person is driving a commercial truck, which could weigh 80,000 pounds, travelling at highway speeds. Commercial truck drivers and their employers have an obligation to be safe on the roads, and they need to take steps to put that obligation into motion.

Drowsy driving is a major problem in the United States, according to the federal Centers for Disease Control and Prevention. This normally occurs after a driver has not gotten enough sleep, he or she suffers from an untreated sleep disorder like sleep apnea, or due to using medications or drinking alcohol. Just feeling sleepy makes you dangerous behind the wheel. Drowsy driving is risky:

  • It limits your ability to pay attention to the road.
  • Drowsy driving slows your reaction time if you need to brake or steer suddenly.
  • Your ability to make safe decisions is impaired.

It has been estimated that more than 70 million Americans have some type of sleep disorder, with about 18 million of them suffering from sleep apnea. In a survey of drivers 18 years old or older, one in 25 admitted to falling asleep while driving during the prior 30 days. The National Highway Traffic Safety Administration estimates that drowsy driving caused about 72,000 accidents in 2013, resulting in 44,000 injuries and 800 deaths. That number is too low, according some studies; the number of fatalities due to drowsy drivers may be as high as 6,000 per year.

Sleep apnea is one of the sleep disorders affecting commercial drivers. Obstructive sleep apnea causes the upper airway to become blocked repeatedly during sleep, reducing or completely stopping airflow into the lungs, according to the National Institute for Health. Central sleep apnea occurs when the brain doesn’t send the signals needed to breathe. Sleep apnea can be caused by obesity, large tonsils, endocrine disorders, neuromuscular disorders, heart or kidney failure, certain genetic syndromes and premature birth.

Because sleep is repeatedly disturbed, a person with sleep apnea doesn’t get the quality of quantity of sleep needed and can be drowsy or fall asleep during the day. Devices such as continuous positive air pressure (CPAP) machines can provide better air flow during sleep, and lifestyle changes can treat sleep apnea.

Nearly a third (28%) of commercial truck drivers have some degree of sleep apnea, according to a study conducted by the University of Pennsylvania sponsored by the Federal Motor Carrier Safety Administration (FMCSA) and the American Transportation Research Institute of the American Trucking Associations. There were about 3.5 million truck drivers employed in 2015, according to the American Trucking Association, so at the time there could have been about 980,000 of these drivers with some form of sleep apnea, treated or untreated, on the nation’s roads.

If the condition is untreated, a commercial driver is five times more likely to be involved in an accident as those who are being treated for it, according to a 2016 study by researchers at Virginia Tech University. Researchers estimated that for every thousand truck drivers diagnosed with sleep apnea who refused treatment, there would be about 70 preventable, serious accidents, compared to 14 such accidents by drivers with the condition but who receive treatment.

Given how serious the situation is, you might think the federal government would do something about potentially hundreds of thousands of truck drivers with untreated sleep apnea travelling across the nation, but you’d be mistaken. Last year the FMCSA withdrew a proposed regulation that would have required truck drivers to be tested for sleep apnea. Testing is being left to trucking companies to make sure their drivers are safe.

The FMCSA requires those with commercial driver’s licenses to undergo a physical exam every two years. The physician needs to sign a medical certificate to confirm the driver is healthy enough to safely operate a commercial motor vehicle.

Federal regulations require commercial truck drivers to be physically qualified to drive a commercial motor vehicle. There is a long list of medical conditions which can prevent a commercial driver from passing a medical exam -- but sleep apnea, treated or not, isn’t included. Part of the regulations covering medical exams states the driver must have “…no…nervous…or functional disease…likely to interfere with his/her ability to drive a commercial motor vehicle safely…”

The disqualifying level of sleep apnea, according to the FMCSA, is moderate to severe, because it interferes with safe driving. A motor carrier may not require or allow a driver to operate a commercial motor vehicle if the driver has sleep apnea serious enough to affect his or her ability to safely operate the vehicle.

Of the 3.5 million truck drivers in the country, an one in nine are independent and self-employed, a majority of whom are owner operators (they own the trucks they drive). These hundreds of thousands of self-employed drivers are being relied upon to truthfully disclose during their medical exams information, including sleep problems like sleep apnea, which may keep them off the road, end their income and essentially close their business. It’s unlikely that all drivers would risk their ability to support themselves and their families by being totally upfront and honest during these exams.

If a motor carrier believes a driver may have sleep apnea, a sleep study would be used. It’s a test that electronically transmits and records specific physical activities while the person sleeps. The recordings become data that a qualified sleep specialist analyzes to figure out whether the person has a sleep disorder like sleep apnea.

A commercial truck driver with untreated sleep apnea is like a ticking time bomb waiting to go off. We need to trust these drivers and their employers to do the right thing, but all too often rules are bent, problems aren’t disclosed and drowsy truck drivers cause accidents that injure and kill others sharing the road. If the federal government or the industry fails to deal with this problem, truck accident victims and their attorneys are left to hold drivers and their employers accountable. Lives will be lost, and the solution is far more expensive and arduous than preventing the problem in the first place.

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