New Sleep Apnea Rules Could Curb Collisions

The FMCSA’s Motor Carrier Safety Advisory Committee and Medical Review Board again met last week in Washington, D. C. and issued new guidelines which — in enacted — might prevent a few 18 wheeler drivers who suffer from sleep apnea from driving.

The panel of doctors found that “Untreated sleep apnea causes excessive daytime sleepiness, which impairs judgment, causes attention deficits, slows reaction times, and decreases alertness … and greatly increases a driver’s risk for being involved in a fatigue-related motor vehicle crash.”

Really?

All drivers with a BMI over 35 might have to be tested to determine whether they suffer from sleep apnea. Or might not have to. It would be up to the examiner. And the final recommendations won’t be ready until March, and it is not clear if they will ever be adopted. This process has been going on for 30 years.

A BMI of 35 would include a 5 foot 9 inch male who weighs 237 pounds. One half of commercial truck drivers have a BMI over 30.

The crash risk for a person with sleep apnea is 242 percent greater than a person without the disorder, said Charles Czeisler, professor of sleep medicine at Harvard Medical School.

I have handled several cases involving drivers who we believe had fallen asleep driving tractor trailers, although that has been notoriously hard to prove in the past. I just settled one where a commercial trucker, whose BMI was 36, rear ended my client’s vehicle on Interstate 35, seriously hurting her and other drivers. And in another I-35 case, a severely overweight, older driver drove onto the shoulder and crashed into a parked rig that my client was underneath as he was about to have it towed away, killing him.

AC — need link to Walters case
The FMCSA reports that 1/3 of truck drivers suffer from this condition and the trucking industry recognizes that a driver with a BMI over 30 probably has it.

The Facts About Sleep Apnea and Commercial Drivers (from the FMCSA):Commercial drivers are at an increased risk of having sleep apnea. According to a Federal Motor Carrier Safety Administration study, almost one-third of commercial drivers have some degree of sleep apnea.

Untreated sleep apnea causes excessive daytime sleepiness, which impairs judgment, causes attention deficits, slows reaction times, and decreases alertness.
Untreated sleep apnea greatly increases a driver’s risk for being involved in a fatigue-related motor vehicle crash.

Sleep apnea is a highly treatable disorder. Drivers who are treated should be able to do their job as safely as those who do not have sleep apnea.

Risk Factors for Sleep Apnea Sleep apnea occurs in all age groups and both sexes, but there are a number of factors that may put you at higher risk:

A family history of sleep apnea Having a small upper airway Being overweight Having a recessed chin, small jaw, or a large overbite A large neck size (17 inches or greater for men, 16 inches or greater for women)
Smoking and alcohol use Being age 40 or older Ethnicity
Symptoms of Sleep Apnea

Loud snoring Morning headaches and nausea Gasping or choking while sleeping Loss of sex drive/impotence Excessive daytime sleepiness Irritability and/or feelings of depression Disturbed sleep Concentration and memory problems Frequent nighttime urination

Diagnosing Sleep Apnea

In order to diagnose sleep apnea, your doctor will probably send you to a sleep disorders center for testing. You may be asked to spend a night or two at the center, where experts will monitor your sleep. A sleep study test (polysomnography) will determine if you have sleep apnea and how severe it is. If you are diagnosed with sleep apnea, you may benefit from both lifestyle changes and specific medical treatment.

Lifestyle Changes

Lose weight — Overweight persons can help treat their sleep apnea with even moderate weight loss. For instance, a 200-pound man can lose 20 pounds and greatly reduce the number of breathing pauses.

Avoid alcohol and sleeping pills — Both alcohol and sleeping pills slow down breathing and make sleep apnea symptoms worse.

Sleep on your side or stomach — Some people suffer from sleep apnea only when lying on their backs. Try using pillows to avoid sleeping on your back.

Quit smoking — Cigarette smoking increases both the risk and the severity of sleep apnea, by causing swelling and excess mucus in the airways and by damaging the lungs.
Medical Treatment

Continuous positive airway pressure (CPAP) — This is a highly effective form of treatment. CPAP treatment involves wearing a mask over the nose during sleep while gentle air pressure from a blower prevents the throat from collapsing during sleep. A CPAP device is portable, so you can take it on the road.

Oral appliances — Some sleep apnea patients are helped by devices that open the airway by bringing the lower jaw or tongue forward.

Surgery — Some patients may choose surgery for their sleep apnea. Although several procedures are used to increase the size of the airway, none of them are completely successful in all patients or without risks. More than one procedure may need to be tried before the patient realizes any benefits.

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