Driver Sleep Apnea - Truckers' Trucking Forum

Cybergal · **^ Top** #1 02.05.2006

Quote:

Driver Sleep Apnea: a Hidden Crisis

By Henry Goldberg, M.D.
with Mark Berger, M.D.

Sleep apnea syndrome is a serious and sometimes fatal condition that is far more common than generally known. Because its symptoms include drowsiness, sleep apnea is of particular concern for an industry that relies on wide-awake truck drivers.

A sleep apnea study conducted with drivers employed by a major carrier is about to be published by Mark Berger, M.D., who contributed to this essay and whose specialty is this syndrome. The study looked at the incidence and costs related to sleep apnea among commercial drivers.

Sleep apnea syndrome affects at least 5% of the adult population in the United States and its incidence is significantly higher in commercial drivers. It is estimated that 25% to 30% of that population has the disease.

Sleep apnea is caused by complete, or near-complete, obstruction of the upper airway by redundant tissue and/or relaxed musculature just above the vocal cords. Its exact cause is unknown, but it is more common in overweight individuals. These obstructions to an individual’s air flow during sleep can cause snoring, gasping breaths, abrupt awakening, daytime sleepiness and, most troubling, can cause the person to stop breathing.

Upper airway obstructions can occur scores of times per hour of sleep and each obstruction can last from many seconds to more than one minute in duration. These events produce frequent disruptions of the normal sleep cycle and quality of sleep, as well as profound drops in blood oxygen levels. People with untreated sleep-disordered breathing are excessively sleepy and are at risk for accidents, elevated blood pressure, heart disease, stroke and other adverse health conditions — and in severe cases, death.

Recently, 2,342 respondents to a questionnaire distributed
to a random sample of 3,268 Australian commercial vehicle drivers revealed that more than half (59.6%) had sleep-disordered breathing and 15.8% had obstructive sleep apnea syndrome. Twenty-four percent of drivers had excessive sleepiness. One major risk factor for sleep apnea is being of the male gender; a second is an increased body mass index, which indicates overweight.

Various studies have found that drivers with sleep apnea have two to seven times the accident rate of drivers without sleep apnea.

Large truck crashes are expensive. Beyond the immeasurable costs of loss of life and permanent injury, the average cost per large truck crash involving a fatality in 1999 was $3.54 million. The average cost for a crash with injury was $217,005.

Moreover, fatigue-related accidents are beginning to be treated more seriously in courts of law. For example, in early 2001, a Florida judge sentenced a trucker to 15 years in prison for falling asleep at the wheel and killing three people.

At the federal level, Annette Sandberg, head of the Federal Motor Carrier Safety Administration, stated at a recent conference on truck and bus safety that her agency plans to focus future regulations on driver health.

An ongoing study of a large U.S. longhaul truckload carrier already has produced startling, but not unexpected results. Working with Dr. Berger’s firm, the carrier has now implemented a program to rapidly identify and treat truckers with clinically significant sleep apnea.

Treatment is usually with a machine that delivers a constant flow of air through the nose. This produces continuous positive airway pressure — or CPAP — eliminating upper airway obstructions while the driver is asleep. Participating drivers are allowed to continue driving so long as they comply with the CPAP therapy.

Results of this ongoing program recently were presented at the 2005 International Symposium on Truck and Bus Safety and Security, in Alexandria, Va. Significant findings included:

• Of 348 drivers with sleep apnea, CPAP intervention resulted in a 47.8% (p<.0001) reduction per member, per month in health-care spending.

• There was a 73% reduction in preventable driving accidents in a subgroup of 225 full-time CPAP-treated drivers.

• The driver retention rate in CPAP-treated individuals was 2.29 times greater than the 2004 global corporate driver retention rate.

It is obvious that sleep apnea and related disorders contribute significantly to health-care and liability costs in the commercial trucking industry. Beyond the already cited and easily recognized losses from major motor vehicle accidents, other costs are incurred daily, but generally not recognized. Untreated sleep apnea is intimately linked with:

• Heart disease.
• High blood pressure and stroke.
• Obesity.
• Diabetes.
• Chronic pain syndrome.
• Reduced life expectancy.

Recent medical studies have shown an increased risk of cardiovascular complications and death in patients with at least moderate or severe sleep-disordered breathing. However, many people with sleep apnea and high blood pressure enjoy a substantial reduction in their blood pressure once their sleep apnea is treated.

Other studies show a close link between sleep deprivation, appetite, obesity and the development of diabetes.

The programs already under way to identify and treat sleep apnea will save lives and millions of dollars in liability costs. Commercial carriers embracing these issues should be commended for their efforts to reduce the risk of large-truck accidents without a federal mandate. These forward-thinking companies already are enjoying lower employee health-care costs and fewer accidents for drivers treated for sleep apnea and will receive further financial rewards through lower liability premiums.

Moreover, in a time when most carriers are keenly aware that good drivers are in short supply, they may find drivers are anxious to work for a company considerate of their
well-being.

Henry Goldberg, M.D., is president of RAIR Technologies, Boca Raton, Fla. Mark Berger, M.D., is president of Precision Pulmonary Diagnostics, Houston.

© 2006 American Trucking Associations, Inc., TTNews.com

Redneck · **^ Top** #2 04.18.2006

I have sleep apnea, and I have had the surgery to correct it. I also have the CPAP machine. I don't use it to much after the surgery but I do still have it.
The thing is akward to wear I hate mine, makes me very uncomfortable to sleep.
Now before I had the surgery I loved the machine I had not had more than a couple hours sleep in years before my sleep study was done. During the first 30 min of my study I had 30 episodes of sleep apnea. Then you had to have 180 episodes in 8 hours to qualify for the machine.

The technician immediantly came in and woke me up and put the machine on me. I never moved the rest of the night. I forget what the pressure was set on before my surgery, but I remember the home health guy saying his machine would not go any higher.

The DR said I was the 3rd worse case she had ever seen.

I can remember having my wife ride with me on a local job to keep me awake, by squirting water in my face.

The reason I went and got checked was. I left for work one foggy morning I was running up a 2 lane hiway in a International tractor pulling a 48' dump trailor. I must have fell asleep but I awoke to the flashing of school bus lights. I jammed the brakes and slid completely passed the stopped bus. Thankfully the kids were truck smart (there dad owned some trucks) and when they saw me sliding they ran away from the road.

I drove to the first place I could turn around and drove straight to the place I parked and got in my car and went home, then to the DR and had my DR to take me off from driving.

6 months later I came back to work, and have ever since. That all happened in 1997.

DRIVERS if you have any of the symptoms described elswhere get to a DR and get checked out. It does work!

deiseldog · **^ Top** #3 05.28.2006

Good info! Thanks Cybergal and 168.

DeiselDog

SWANGS · **^ Top** #4 01.20.2007

Will Be Any Problems With Getting A Otr Job?
I Have Been Using My Machine For 5 Mo. What Differance In Sleep Its Great.

Thanks Jeff

overburden · **^ Top** #5 01.20.2007

The easiest way to do it is to tell the company before you go to orientation to find their policy. Some may want documentation from your doctor to confirm you are using the machine well.

Roehl requires you to have a battery backup for the machine, and confirmation from your doctor that you are using the machine well. From what i understand Schneider is very aware of sleep apnea and will make reasonable accommodations for them.

Anybody that snores probably has some sleep apnea.

Jokers_Wild · **^ Top** #6 01.21.2007

Quote:

Originally Posted by SWANGS

Will Be Any Problems With Getting A Otr Job?
I Have Been Using My Machine For 5 Mo. What Differance In Sleep Its Great.

Thanks Jeff

Ya know the amazing thig is there are companies that will hire you But as of now Schneider is the only one I know of that will take a questionair and if the questions conclude you may be a canidate they will send you to Houston on your 10 hr break and do a sleep study and get you the machene if you indeed have sleep apthea I was shocked when I complained of being tired all the time and the sent me to Houston and I am an Owner Operator.

Rev. Paul R.
Schneider Owner Operator
Amateur Radio Operator AG9R

rdubill · **^ Top** #7 03.15.2007

Quote:

Originally Posted by Jokers_Wild

Ya know the amazing thig is there are companies that will hire you But as of now Schneider is the only one I know of that will take a questionair and if the questions conclude you may be a canidate they will send you to Houston on your 10 hr break and do a sleep study and get you the machene if you indeed have sleep apthea I was shocked when I complained of being tired all the time and the sent me to Houston and I am an Owner Operator.

Rev. Paul Ragsdale
Schneider Owner Operator
Amateur Radio Operator AG9R

To all - I've searched on sleep apnea throughout the forum and have learned a lot...

My pressure has recently been very high even while on medication, many night awakenings, and at times complete exhaustion during the day - to the point where I've actually went home to sleep.

I am completing my CDL training but now having 2nd thoughts about trucking with the way I feel so often...

Do these CPAP devices really work - I need to start getting some quality sleep or I won't be working at all!!!

Is there a site to visit with all treatments listed?

Thanks so much to any and all who can offer suggestions/encouragement...

pjw044 · **^ Top** #8 03.15.2007

Have your Doc set up a sleep test.The test will tell how bad your Apnea is.
And yes a CPAP really does work. Had mine for 2 years now.Ins paid for the machine (800 bucks ) and a new mask every 6 months.

dadspeer · **^ Top** #9 12.24.2007

I recently worked for Schneider National, with Sleep apnea. Their response from the maintanience office is that connecting a converter for sleep apnea does not take precedence, "it takes three days, hooking up a converter does not take precenance over truck repairs." This means you are waiting in the yard not making any miles. Yes Schneider encourages testing but does not provide reasonable accomadations for a driver with sleep apnea. It took me over two weeks to get in complaince with my using the C-Pap which works wonders on my sleep when I am able to use.
now Schneider won't rehire me because I made a stink over my being in complaince with my C-pap usage.

pjw044 · **^ Top** #10 12.24.2007

My cpap plugged right in to 12 volt socket...

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