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

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==Background==
==Background==
Obstructive sleep apnea (OSA) is associated with an increased risk of motor vehicle crash<sup>[1-3]</sup>, and effective treatment with continuous positive airway pressure (CPAP) reduces that risk<sup>[4]</sup>. 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<sup>[5]</sup>. 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<sup>[6-8]</sup>.
Obstructive sleep apnea (OSA) is associated with an increased risk of motor vehicle crash<sup>[1-3]</sup>, and effective treatment with continuous positive airway pressure (CPAP) reduces that risk<sup>[4]</sup>. Although evaluation of the risk for crash in commercial motor vehicle drivers with OSA has not been extensively evaluated<sup>[2]</sup>. 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<sup>[5]</sup>. 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<sup>[6-8]</sup>.
 
The Federal Motor Carrier Safety Administration (FMCSA) of the Department of
Transportation’s (DOT) primary mission is to reduce crashes, injuries and fatalities involving
large trucks and buses. The process by which regulations and guidelines are developed is welldescribed.9
As part of this process, the FMCSA commissioned an evidence review and convened
a Medical Expert Panel, which made recommendations about identification and management
of OSA in commercial drivers. 10 Among the recommendations of the Medical Expert Panel were
that certain individuals should be required to undergo evaluation to confirm the diagnosis of
and to stratify the severity of OSA, including those categorized as high risk for OSA according to
the Berlin Questionnaire; 11 those with a Body Mass Index (BMI) ! 33 kg/m2
; or those judged to
be at risk for OSA based on a clinical evaluation. After further review of the evidence and of the
Medical Expert Panel’s recommendations, the Medical Review Board of the FMCSA
recommended adopting the Medical Expert Panel’s report and recommendations in toto, with
the exception that individuals with a BMI > 30 kg/m2
(rather than 33 kg/m2
) should undergo
evaluation for OSA.12


== Methods ==
== Methods ==
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