How Sleep Apnea Impacts Your Drivers
Posted 6/29/2017 by UHBlog
Americans are becoming a nation of sleepy heads, which can have deadly consequences on the roads. The National Sleep Foundation says that about 100,000 crashes each year are caused by fatigued drivers. If your business relies on commercial truck drivers, the impact on your workplace can be tremendous.
One of the leading causes of excessive daytime sleepiness is obstructive sleep apnea (OSA), says occupational medicine specialist Paul Miotto, MD. OSA occurs when your breathing starts and stops during sleep. It’s a serious health risk, affecting up to 18 million Americans, including children.
According to Dr. Miotto, drivers who suffer from sleep apnea may be impacted in one or more of the following ways at work:
- Attention deficit
- Problems with memory, headache and concentration
- Trouble focusing their eyes
- Falling asleep while driving
“Untreated sleep apnea will make drivers’ reaction times slower,” he says. “It’s going to diminish their ability to brake and safely maneuver the vehicle. Anything that affects safety or reduces their ability to respond to a safety hazard has the potential to cause an accident.”
Besides the harm it does to the people involved and your company’s reputation, the average cost of all large truck crashes is about $91,000 per crash, according to the Federal Motor Carrier Safety Administration (FMCSA). If an injury or fatality occurs, the costs can be between $200,000 and $3.6 million, respectively.
The seriousness of sleep apnea and other sleep disorders is one of the reasons the Department of Transportation (DOT) physical examination screens for sleep apnea. Dr. Miotto, who is a certified medical examiner on FMCSA’s National Registry and tests drivers to ensure they can safely operate a commercial vehicle, says there are certain health conditions and characteristics that could indicate a driver may have untreated sleep apnea, such as:
- Body mass index (BMI) greater than 35
- Gender - Men are more likely than women to be at risk
- Neck size of 17 inches or larger
- Older age
- Family history
- Having small airways or some physical abnormality in the nose, throat or other parts of the upper airway
- Allergies or other conditions that cause congestion
- Enlarged tonsils, which are more often seen in children
- Lifestyle choices such as smoking and alcohol usage
- Medical conditions such as diabetes, high blood pressure and/or heart disease
If the certified medical examiner suspects the person has untreated sleep apnea, he or she will be required to go for a sleep study test, called a polysomnography (PSG), which uses the Apnea–Hypopnea Index (AHI) to rate the severity of sleep apnea. AHI is only one of the factors that is measured to rate the severity of sleep apnea and is the FMSCA’s measurement tool of choice, Dr. Miotto says.
“If we suspect untreated sleep apnea, the medical examiner can decide to give the driver a temporary card that lasts anywhere from 30 to 90 days while we wait for the results,” Dr. Miotto says. “If the driver has sleep apnea, they’ll need to take steps to get it under control using a continuous positive airway pressure therapy (CPAP) machine. We’ll want a month or more of data showing compliance with CPAP usage for at least four hours per night for 70 percent of the nights and an improvement in the AHI. At that time, we can recertify the driver for up to one year.”
To learn more about University Hospitals’ occupational health and safety services, connect with University Hospitals Employer Solutions for more information.
Paul Miotto, MD, is an occupational medicine specialist and Medical Director for University Hospitals Occupational Health at University Hospitals Elyria Medical Center Occupational Medicine. You can request an appointment with Dr. Miotto or any other doctor online.