WASHINGTON — Advisors to the Federal Motor Carrier Safety Administration (FMCSA) recommended that the agency toughen up its approach to sleep apnea.

Specifically, they want the FMCSA to tell medical examiners that driver's with a body mass index (BMI) of 35 or more must be evaluated for sleep apnea.

The two advisory panels, the Motor Carrier Safety Advisory Committee and the Medical Review Board, have formed a joint subcommittee in order to produce recommendations for an eventual rule that could set standards for sleep apnea screening, evaluation and treatment.

But for right now, if the agency adopts the recommendations, it would lead to guidance to examiners rather than a rule.

That guidance would include conditions for immediate disqualification of a driver, like falling asleep at the wheel or having fatigued-related crashes. It would also allow the driver to get a 60-day conditional card during evaluation and treatment for the condition.

"Our goal is to very quickly get something done," said David Parker, chairman of the safety committee.

Parker said the subcommittee will meet in January, then report to the two committees in February and come up with a joint recommendation to the agency by March.

The selection of a body mass index of 35 as a trigger for screening arose from research that shows BMI, a measurement of body fat based on height and weight, is a primary indicator that a person may have sleep apnea. The higher the BMI, the greater the risk of sleep apnea.

"We need a prescriptive number to make it easy for the examiner," said Benjamin Hoffman, chairman of the Medical Review Board. He said it is almost impossible to controvert the evidence that a BMI of 35 is a reliable indicator of sleep apnea.

The crash risk for a person with sleep apnea is 242 percent greater than a person without the disorder, said Charles Czeisler, professor of sleep medicine at Harvard Medical School.

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