Trucking: Caution-Sleep apnea may cause restless nights for shippers
May 24, 2010
Shippers, logisticians and their motor carrier partners, who often worry about various problems that can occur at any time for shipments in their supply chains, now have another worry that could keep them awake at nights.
Their latest concern could be that the driver of the truck hauling their shipment might be impaired by a little-known condition known as obstructive sleep apnea, which is increasingly being called a public health problem.
Obstructive sleep apnea (OSA) is a condition in which individuals obstruct their own air passages, causing interruptions in breathing during sleep. It is said to affect as many as 20 million Americans. About 80 percent of people with sleep apnea don’t know they have it.
A recent Federal Motor Carrier Safety Administration-commissioned study on the prevalence of sleep apnea in commercial drivers found that 17.6 percent had mild OSA, 5.8 percent had moderate OSA and 4.7 percent had severe OSA. The actual numbers could be higher; a study of Australian truck drivers showed as many as 60 percent could have sleep apnea.
A person suffering OSA can experience a lack of proper sleep and, as a result, their risk of being involved in a life-threatening accident, such as a motor vehicle crash, is increased. The lack of sleep also causes impairment in judgment and reaction time. The condition affects more men than women, is most common in people over 40 and is especially common in people who are overweight—characteristics common to the nation’s 7 million truck drivers.
Don Osterberg, senior vice president of safety for Schneider National, the nation’s second-largest truckload carrier, has estimated that drivers with untreated sleep apnea might have crash rates as much as six to seven times higher than typical drivers.
Schneider National recently tracked 339 of its drivers with sleep apnea, before and after treatment, and found that following treatment, preventable crashes were reduced by 30 percent, median cost of crashes reduced by 48 percent, health care costs were lowered by 50 percent, resulting in health care savings on average of $539 per driver per month.
Recently, the National Transportation Safety Board, after investigating an truck accident in Tennessee involving a 358-pound male truck driver whose truck crossed the median on Interstate 40 and killed a state trooper, found that the driver was being treated for sleep apnea.
The NTSB concluded the probable cause of the accident was the driver’s incapacitation, owing to the failure of the medical certification process to detect and remove a medically unfit driver from service.
The NTSB recently concluded that the relative risk of accident involvement for individuals with sleep apnea is “clearly elevated” and “quite clearly associated” with the untreated disease. Its recommendations included recommending the FMCSA implement a program to identify truck drivers with sleep apnea and increased education of the affliction for drivers,
As such, some 200 companies were represented as the trucking industry and FMCSA held a two-day sleep apnea and trucking conference last month in Baltimore co-sponsored by the American Trucking Associations and the FMCSA. The objective was to achieve a common understanding of sleep apnea to pave the way for progress on what was uniformly called a critical health and safety issue.
Fatigue is estimated to be involved in 15 percent of single-vehicle fatal truck accidents, with sleep apnea an important factor in those crashes.
Treatments can include surgery and a mask that utilizes continuous positive airway pressure (CPAP) that works by gently blowing pressurized air through the airway at a pressure high enough to keep the throat open. But those devices can be difficult to use in the sleeper berth of a truck, where heat and humidity and power supply issues can affect the device’s effectiveness.
The problem seems to build on itself. Experts at the conference said sleep deprivation seems to increase the occurrence of sleep apnea.
Dr. William K. Sieber, a research health scientist with the National Institute for Occupational Health and Safety said his agency is currently conducting a study of long-haul drivers to determine a screening tool for prediction of apnea. That would be based on frequency of loud snoring, breathing cessation, “snorting” and gasping.
Dr. Lawrence Epstein, a sleep expert from the Harvard Medical School, said sleep apnea is common, dangerous, easily recognized and treatable.
“You can find it—if you ask for it,” Epstein said.
Sleep experts agreed the best way for truckers to manage this disease is the “4A” approach—awareness, assessment, adjustment and adherence. The FMCSA is expected to issue new guidance on sleep apnea later this year.
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