Truckers and Sleep Apnea
OSA, Microsleeps, Commercial Accidents and Truck Driver Sleep Apnea Law
We’ve all had our moments when we’ve gotten sleepy at the wheel and needed to pull over. Sometimes it just takes a small break and some coffee; other times a short nap is called for. We might even have to stop for the night.
But when you drive a big rig for a living, the consequences of falling asleep at the wheel can be deadly for many around you on the road. “Microsleeps” and other fatigue problems that stem from obstructive sleep apnea (OSA) are a troubling and not uncommon problem. A full 13 percent of large truck crashes arise from fatigue or falling asleep, according to the Large Truck Crash Causation Study done by the Federal Motor Carrier Safety Administration (FMCSA). Some studies peg the percentage much higher. The National Transport Insurance (NTI) numbers support the conclusion that fatigue combined with speeding is implicated in 42 percent of heavy vehicle wrecks. The June 2014 crash on the New Jersey Turnpike that killed comedian James McNair and grievously injured comedian Tracy Morgan, along with several other passengers, is an example of this lethal combination. The truck driver that ran into their limo van had gone over 28 hours without sleep and was doing 65 mph in a 45 mph zone.
What Are Microsleeps and OSA?
With obstructive sleep apnea, a breathing disorder, certain muscles relax during sleep that cause a reduction in, or even a complete cutoff of, airflow to the lungs. The sleeper cannot breathe adequately because the tissues at the back of the throat collapse when the muscles relax. The sleeper then awakens suddenly. With OSA, this can happen dozens of times a night, resulting in poor sleep and significant chronic fatigue.
A microsleep is when you fall asleep for up to 30 seconds because you are so tired. You are truly asleep for those few seconds and don’t sense any external stimuli. Microsleeps are usually associated with OSA and its resulting sleep deprivation.
How Common Are OSA and Microsleeps?
FMCSA estimates that more than one-fourth of all commercial drivers suffer from obstructive sleep apnea:
- About 17 percent of those with mild OSA
- About 5 percent of those with moderate OSA
- About 4 percent of those with severe OSA.
In those who have OSA, the problem of microsleeps is common. Even OSA drivers who get enough sleep in terms of numbers of hours do not get the quality of sleep they require. In one study, sleep-deprived drivers were found to have large numbers of microsleep episodes while using a driving simulator. No napping was allowed during the study. At 1 AM, an average of 40 microsleeps during a 40-minute interval was detected, with an average length of 5 seconds. By 7 AM, the number of microsleeps had risen to 140, with an average episode length of 8 seconds. The number of “crashes” while driving the simulator rose as well. It’s clear that untreated OSA and the resulting microsleeps multiply the risk of crashes.
What Causes OSA, and How Is It Treated?
OSA can arise from a number of factors and happens more often in men than in women. The more factors you have from this list, the greater the likelihood of OSA:
- Excessive weight
- High blood pressure
- Others in your family have OSA.
Doctors usually prescribe a continuous positive airway pressure (CPAP) machine for those with OSA. The machine is used whenever the OSA sufferer is trying to sleep, wearing a mask that delivers the air flow needed to keep the airway unobstructed. However, the diagnosis process (which requires an overnight sleep study) and the treatment are expensive, especially if health insurance does not cover them. Drivers, on average, had out-of-pocket costs of about $1,220 in one study.
Despite the cost, treatment is essential to safety. Truck drivers who are not treated for their OSA have a much greater rate of crashes—five times more than the drivers who do not have OSA. These findings strongly suggest that commercial drivers should undergo screening for OSA and be required to take treatment if they want to continue driving trucks.
Is Anything Being Done?
On March 8, 2016, the FMCSA and the Federal Railroad Administration (FRA) joined forces and made public “an advance notice of proposed rule-making.” This phrase means that facts will be gathered for 90 days about OSA and its effects on truck drivers and some railroad employees. Once the period for fact-gathering and comments is closed, the FMCSA and FRA will decide what to do. It’s possible they will announce a new rule that will involve mandatory testing and treatment for obstructive sleep apnea. It would seem logical to require OSA testing (and treatment if needed) as part of the usual process for gaining a commercial driver’s license. The numbers point to a significant savings of lives should that process come into being.
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