Breathe easier: Sleep apnea screening can help protect truck drivers at risk

Obstructive Sleep Apnea (OSA) can be the stuff of nightmares. The breath-depriving medical condition robs drivers of a restful slumber. At worst, it leads them to fall asleep behind the wheel.

Maybe there should be little surprise that the U.S. National Highway Traffic Safety Administration (NHTSA) has been asked to explore the costs and benefits of mandatory sleep apnea screening, testing and treatment. Mark Rosekind, a known sleep expert, has also been named the administration’s leader.

Several research studies have clearly suggested that apnea is a challenge in the trucking industry. The National Institute of Occupational Safety and Health (NIOSH) recently looked at 1,670 long-haul drivers and found that 15% showed some signs of sleep apnea, while 59% recorded some type of respiratory disturbance. An earlier U.S. Federal Motor Carrier Safety Administration study suggested that almost one in every three truck drivers suffers from apnea.

Still wondering why a fleet should be concerned? When testing reaction times, Stanford University discovered that drivers who are tired because of disrupted sleep perform as poorly as those who are drinking. On three separate measures, apnea patients scored as badly or worse than test subjects who were legally drunk. Meanwhile, Schneider National was able to reduce preventable crashes by 30% after identifying and helping 339 drivers who had OSA.

Truck drivers clearly fall into the demographic group at the highest risk. Men are more likely to have the condition, and 97% of Canada’s truck drivers are male. Apnea is also more common among people who are obese. NIOSH found 70% of its studied truck drivers to be obese, compared to 31% of other workers. Seventeen percent of those behind the wheel were even morbidly obese.

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The risks increase among anyone over 40, with a neck size larger than 17 inches, a small upper airway and large overbite. The warning signs can range from loud snoring to excessive sleepiness despite enough time in a bunk, as well as headaches and problems concentrating. Left untreated, the issue can also contribute to heart problems. At the very least, it can affect productivity or lead to the fatigue that contributes to workplace injuries.

In most cases, apnea comes in the form of OSA, caused when relaxed soft tissue blocks an upper airway, although other cases involve the brain’s respiratory centre. The end result is that the drivers who have it will stop breathing for 10 to 120 seconds at a time, wake up gasping for air, and then falling back into a fitful sleep.

The good news is that apnea can be quickly diagnosed and treated.

A popular test known as the Berlin Questionnaire can help drivers tell if they are at risk. In addition to measuring weight and age, the checklist looks for those who snore, how loud that snoring can be (is it louder than talking?), how often it happens, and whether it bothers other people. It also asks if anyone has noticed that they stop breathing during sleep, how often they feel tired, and whether they ever fell asleep at the wheel. The emerging score can identify whether someone might want to seek a related medical opinion.

Screening programs can require drivers to sleep in a lab overnight, using a polysomnogram (PSG), or take a Home Sleeping Test which tracks breathing patterns. While a limited number of clinics offer this service, appointments will undoubtedly be easier to schedule before any regulated program is introduced.

Some of the most common treatments include Continuous Positive Airway Pressure (CPAP) machines that keep a driver’s airway from closing by feeding air through a mask. The portable systems can be used inside sleepers equipped with a sufficient power inverter.

The options are not limited to the equipment alone. Other treatments include using compression stockings, losing weight, or avoiding things like alcohol and sleeping pills.

Of course, a proper fatigue management program reaches well beyond these pre-screening efforts. Fleets can help to keep every driver alert through training programs and dispatching efforts alike. People who know about a change to their work schedule 24 hours ahead of time will always have a better chance to get the sleep they need. And drivers who are informed about departure times as well as delivery deadlines are also less likely to jump behind the wheel for an overnight drive after a full day of family activities.

When all the available steps are combined, everyone will have the chance to sleep a little better.