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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 The primary findings of this report are that 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 (PSG) if suggested guidelines become regulation. Those who reported classic OSA symptoms (snoring, sleepiness) were more likely to report drowsy driving. Contrary to our hypothesis, however, objective data (BMI, hypertension history) did not predict sleepy driving better than did subjective data (sleepiness, snoring).
-To our knowledge, this report is the first to result from an anonymous screening tool for obstructive sleep apnea in commercial drivers. Nearly 600 individuals took the anonymous screen within a few months. In return, they received fairly specific information about whether or not they would be likely to be referred for polysomnography at their next Commercial Driver Medical Examination, should recommendations currently being considered by the FMCSA become policy. Although this project was initially conceived as a service to commercial drivers, it enabled us to gain some insight into demographics and symptoms in this group. As we hypothesized, those who reported symptoms of sleep apnea (snoring, witnessed apneas) were more likely to report drowsy driving. We were surprised to discover that symptoms such as sleepiness and snoring were correlated with drowsy driving more robustly than did objective data in this anonymous, online survey. Previous reports<sup>[14, 15]</sup> have indicated that objective findings (e.g, BMI, blood pressure) were more predictive of sleep apnea in commercial drivers than subjective symptoms. Indeed, in a prospective study of 440 commercial drivers, Parks et al found that every driver who was subsequently found to have OSA by polysomnography had denied related symptoms on his Commercial Driver Medical Examination<sup>[14]</sup>, and Talmage et al actually found that the Epworth Sleepiness Scale correlated inversely with Apnea plus Hypopnea Index (AHI) as determined by polysomnography in trucker who were undergoing required DOT physicals<sup>15<sup>. Possibly, drivers understand that reporting symptoms of sleep apnea on their DOT evaluations will result in potentially lengthy and expensive disruptions in work, and thus avoid reporting them on their commercial driver’s license certifying exam. However, they can and did report these symptoms on this anonymous web-based screening tool. This result suggests that commercials drivers are sincerely interested in knowing whether they might have sleep apnea.
+To our knowledge, this report is the first to result from an anonymous screening tool for obstructive sleep apnea in commercial drivers. Nearly 600 individuals took the anonymous screen within a few months. In return, they received fairly specific information about whether or not they would be likely to be referred for polysomnography at their next Commercial Driver Medical Examination, should recommendations currently being considered by the FMCSA become policy. Although this project was initially conceived as a service to commercial drivers, it enabled us to gain some insight into demographics and symptoms in this group. As we hypothesized, those who reported symptoms of sleep apnea (snoring, witnessed apneas) were more likely to report drowsy driving. We were surprised to discover that symptoms such as sleepiness and snoring were correlated with drowsy driving more robustly than did objective data in this anonymous, online survey. Previous reports<sup>[14, 15]</sup> have indicated that objective findings (e.g, BMI, blood pressure) were more predictive of sleep apnea in commercial drivers than subjective symptoms. Indeed, in a prospective study of 440 commercial drivers, Parks et al found that every driver who was subsequently found to have OSA by polysomnography had denied related symptoms on his Commercial Driver Medical Examination<sup>[14]</sup>, and Talmage et al actually found that the Epworth Sleepiness Scale correlated inversely with Apnea plus Hypopnea Index (AHI) as determined by polysomnography in trucker who were undergoing required DOT physicals<sup>15</sup>. Possibly, drivers understand that reporting symptoms of sleep apnea on their DOT evaluations will result in potentially lengthy and expensive disruptions in work, and thus avoid reporting them on their commercial driver’s license certifying exam. However, they can and did report these symptoms on this anonymous web-based screening tool. This result suggests that commercials drivers are sincerely interested in knowing whether they might have sleep apnea.
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