WASHINGTON -- Mandating obstructive sleep apnea (OSA) screenings for truck drivers could reduce the risk of fatigue-related truck crashes, according to a new study which confirms OSA is linked to obesity.

"Truck drivers with sleep apnea are much more likely to fall asleep at the wheel, and the condition is increasingly common as Americans become more obese," said the study's senior author, Stefanos N. Kales, MD, MPH, medical director of Employee and Industrial Medicine at Cambridge Health Alliance.

"Additionally, we found that drivers who suffer from obstructive sleep apnea frequently underreport symptoms and diagnoses and often do not follow through with sleep study referrals and sleep apnea treatment."

OSA is a syndrome characterized by sleep-disordered breathing, resulting in excessive daytime sleepiness, sleep attacks, psychomotor deficits, and disrupted nighttime sleep. Common among truck drivers it could increase the risk of a vehicular accident by two- to seven-fold.

Approximately 2.4 - 3.9 million licensed commercial drivers in the U.S. are expected to have OSA. In addition to being unrecognized or unreported by drivers, OSA often remains undiagnosed by many primary care clinicians despite the fact that OSA increases the risks of hypertension, diabetes mellitus, and heart disease.

Over the 15-month study period, 456 commercial drivers were examined from over 50 different employers. Seventy-eight (17%) met the screening criteria for suspect OSA. These drivers were older and more obese, and had a higher average blood pressure, the study found.

The study, published this week by the Journal of Occupational and Environmental Medicine, has significant policy ramifications, as the Federal Motor Carrier Safety Administration is currently deliberating recommendations to require sleep apnea screening for all obese drivers based on body mass index or "BMI" (BMI is calculated based on height and weight).

"OSA screenings of truck drivers will be ineffective unless they are federally mandated or required by employers," said Dr. Kales.
The study's authors also support the prohibition of "doctor shopping."

Dr. Kales added, "Such action would prohibit drivers diagnosed with a serious disorder that might limit driving or require treatment to seek out more lenient or less rigorous medical examiners.