Researchers urge mandatory screenings for sleep apnea in truck drivers

A new study published in the latest issue of the Journal of Occupational and Environmental Medicine links obesity to obstructive sleep apnea (OSA) in truck drivers and urges policymakers to consider mandating OSA screenings to reduce the risk of deadly crashes.
“It is well-known that obesity, a leading risk factor for obstructive sleep apnea, is on the rise in the United States,” said Dr. Philip Parks, medical director of Lifespan’s employee health and occupational services and the study’s lead author. “Truck drivers with sleep apnea have up to a sevenfold increased risk of being involved in a motor vehicle crash.”
OSA is a syndrome characterized by sleep-disordered breathing, leading to excessive daytime sleepiness, sleep attacks, psychomotor deficits, and disrupted nighttime sleep. An estimated 2.4 to 3.9 million licensed commercial drivers in the United States have OSA, which not only increases the risk of accidents, but is also linked to heightened risk of high blood pressure, diabetes mellitus and heart disease.
Parks worked with researchers at the Cambridge Health Alliance to examine 456 commercial drivers from more than 50 companies over a 15-month period. Seventy-eight (17 percent) met the screening criteria for suspected OSA; they were older and more obese, and had a higher average blood pressure.
More troubling, the study found, of the 53 drivers who were referred for sleep studies, 33 did not comply with the referral and were lost to follow-up. The remaining 20 were all confirmed to have OSA, but after diagnosis, only one of these 20 drivers with confirmed OSA complied with treatment recommendations.
“Although it is not surprising, it is concerning that we found that drivers with sleep apnea frequently minimize or underreport symptoms such as snoring and daytime sleepiness,” Parks said. “In our study, the majority of truck drivers did not follow through on physician recommendations for sleep studies and sleep apnea treatment. As a result, it is possible that many of the 14 million truck drivers on American road have undiagnosed or untreated sleep apnea.”
The Federal Motor Carrier Safety Administration is currently deliberating recommendations to require sleep apnea screening for all obese drivers based on body mass index (BMI). The agency requires medical certification of licensed commercial drivers at least every two years, and the study suggests that OSA screening should be mandated.
Lifespan is Rhode Island’s largest health care system. Formed in 1994, it includes Rhode Island Hospital and its Hasbro Children’s Hospital; The Miriam Hospital; Bradley Hospital and Newport Hospital. It is the state’s largest private employer, with more than 11,000 employees, and is affiliated with The Warren Alpert Medical School of Brown University. For more information, go to www.lifespan.org.