Truckers Drive Their Own Assessment for Obstructive Sleep Apnea: A Collaborative Approach to Online Self-Assessment for Obstructive Sleep Apnea

B. Smith and B. Phillips, "Truckers Drive Their Own Assessment for Obstructive Sleep Apnea: A Collaborative Approach to Online Self-Assessment for Obstructive Sleep Apnea", Journal of Clinical Sleep Medicine, vol. 7, no. 3, pp. 241-245, 2011.

Abstract

Background. Commercial motor vehicle drivers are at an increased risk for Obstructive Sleep Apnea (OSA). The Federal Motor Carrier Safety Administration (FMCSA) Medical Review Board has recommended that commercial motor vehicle drivers undergo testing for OSA if they have a positive Berlin Questionnaire or a BMI > 30 kg/m2. We developed an online screening tool based on the Berlin Questionnaire for anonymous use by commercial drivers to assess their risk of OSA prior to their required FMCSA physicals.

Methods. We based the survey on the Berlin Sleep Questionnaire. The survey was hosted on the Truckers for a Cause Chapter of Alert Well and Keeping Energetic of the American Sleep Apnea Association (TFAC-AWAKE) organization website, and was promoted through the TFAC’s XM radio, word of mouth and trucking industry press contacts.

Results. 595 individuals completed the survey. Of these, 55.9% were positive on the Berlin, 78.3% had either hypertension or obesity, 69.6% were obese, 47.6% had a BMI > 33 kg/m2, and 20.5% reported falling asleep at stoplights.

Conclusions. Some commercial drivers willingly assess their OSA risk anonymously online, and a majority of those who do so are obese, have positive Berlin screening questionnaires, and would be required to undergo polysomnography if recommendations made to the FMCSA regulation. In contrast to reported behavior during actual Commercial Driver Medical Examinations physicals, some commercial drivers will report OSA symptoms if it is “safe” to do so. Sleep health professionals need expedient, non-punitive methods to keep commercial motor vehicle drivers healthy and driving and to raise drivers’ awareness of the dangers of drowsy driving and unhealthy lifestyles.

Background

Obstructive sleep apnea (OSA) is associated with an increased risk of motor vehicle crash^[1-3], and effective treatment with continuous positive airway pressure (CPAP) reduces that risk^[4]. Although evaluation of the risk for crash in commercial motor vehicle drivers with OSA has not been extensively evaluated,2 it is likely that OSA increases the crash risk for those drivers as well. Commercial motor vehicle crashes carry an increased risk because of the size of the vehicles, the number of passengers, and the types of cargo that they may carry. Indeed, the fatality rate per 100 million vehicle miles travelled was higher for large trucks than for all vehicles in 2005^[5]. Further, commercial motor vehicle drivers appear to be at increased risk for OSA, with some estimates as high as one in four commercial drivers having OSA^[6-8].