Obstructive sleep apnea is not a problem to be taken lightly, especially within the trucking industry.
According to the Sleep Disorder Network at the Lung Disease Center of Central Pennsylvania in Altoona, more than 18 million Americans suffer from the disorder, and according to the Federal Motor Carrier Safety Administration, 28 percent of those who hold commercial drivers licenses suffer from some form of sleep apnea.
Sleep apnea for the general population is about 5 percent, said Dr. Mehrdad Ghaffari, medical director of Altoona Regional's Institute for Sleep Medicine.
Mirror photo illustration by Patrick Waksmunski
(Mirror photo by Gary M. Baranec)
Dr. Tim Lucas holds a CPAP device which provides airway pressure while a patient sleeps.
Truck drivers can be prime candidates for sleep apnea, which is caused by a blockage of air flow in the back of the throat. The main symptoms are tiredness and sleepiness, and some people have loud disruptive snoring, which causes them to actually stop breathing at night, said Dr. Timothy Lucas, medical director of the Sleep Disorder Network.
People who have high blood pressure are at risk, as are those who are overweight, Lucas said.
"Sleep apnea is up to six times higher in drivers because they are middle-age males leading a sedentary life, and they gain weight. Obesity is one of the biggest reasons. They are like the perfect storm for sleep apnea," Ghaffari said.
Currently, there are no regulations requiring trucking companies to test their drivers for sleep apnea.
Federal guidelines instruct medical examiners that if they are aware a commercial driver has been diagnosed with obstructive sleep apnea and the driver is not undergoing treatment for the condition, the examiner should not issue the driver a medical certificate, said Duane DeBruyne, FMCSA spokesman.
If a doctor determines the driver has a condition that could impair his or her ability to drive, the doctor files an initial medical report with PennDOT, which investigates and seeks additional information from the driver and his or her medical provider.
Based on the information, and using the regulations in Chapter 83 of the Pennsylvania Code, PennDOT could decide to recall the driver's license, restrict it or take no action, said Jan McKnight, PennDOT's community relations director for safety administration.
In 2012, the FMCSA announced plans to issue regulatory guidance concerning truck and bus drivers who exhibit certain risk factors for obstructive sleep apnea. The proposed guidance would be based upon recommendations issued jointly by the Agency's Medical Review Board and Motor Carrier Safety Advisory Committee. FMCSA is currently reviewing the recommendations of the two groups.
Sleep apnea is a significant problem, and a truck driver with sleep apnea could be dangerous.
"It is a significant issue because of the fact they are operating an up to 80,000-pound vehicle. It is risk to the public if they would fall asleep at the wheel," said Dr. George Fouse, a Department of Transportation medical examiner and medical director of HealthForce, the occupational medicine program of Altoona Regional Health System.
"They need to be in decent health to operate that machinery, and that means they have to be alert and awake," said Dr. Timothy Lucas of the Sleep Disorder Network. "If the drivers are tired they are not as productive. There is risk involved. If they wreck a vehicle, they may take a hit from their insurance companies. In a broader sense, it is a public safety issue."
Treatment for sleep apnea has been available in the Altoona area for many years.
"The beauty of sleep medicine is most of the problems we find are fixable problems," Ghaffari said. "If you are a truck driver and have sleep apnea, you shouldn't drive until we fix the problem. There is no excuse to have sleep apnea and be driving. It can be fixed."
The Sleep Disorder Network recently developed a plan specifically for the trucking industry to address obstructive sleep apnea.
"It is a program geared toward truck drivers and their companies to help them meet the need for sleep testing and evaluate drivers who are at risk for sleep apnea," said Sherri Stayer, Sleep Disorder Network practice manager.
The "ZZZ Program" consists of five elements that can be customized to fit a company and its drivers needs. They include education, diagnostic testing, therapy and treatment, monitoring, and compliance and account management.
The Sleep Disorder Network is ready in case testing becomes mandatory.
"We are trying to be proactive with companies that employ truck drivers. We are going directly to companies to make sure they and their drivers are aware of the services we offer," Lucas said.
The Sleep Disorder Network has tested and treated drivers from CLI Transport and Ward Transport and Logistics, Lucas said.
"Our drivers go through a physical, and if it comes out they may have obstructive sleep apnea, they can choose where they want to go whether it be that clinic or somewhere else. We are not directing people to go there, that is between their medical professional and the driver," said John Tippery, director of safety for CLI Transport LP, the dedicated petroleum carrier for Sheetz Inc.
Tippery said he has met with the Sleep Disorder Network to learn about the program.
"Their facility is first grade, the accommodations and the staff. They have done their homework as far as the customers they are trying to serve, the truck driver," Tippery said. "Their staff is pleasant, and it is very comfortable, they do a lot of good to work with and support the drivers."
Ward Transport & Logistics Corp., Altoona, owned and operated by the Ward family for more than 80 years, has seen heightened awareness being placed on sleep apnea by the Department of Transportation in recent years, said Dave Crean, vice president of operations.
Crean said that driver and public safety are of the utmost importance at Ward.
"When identified as an issue, a delay in a driver receiving their physical card pending a sleep study result may be viewed as an inconvenience by some in the transportation industry, but at Ward, we take this very seriously, as the consequences of not appropriately treating sleep apnea could be life threatening," he said.
"Sleep apnea is not just a matter of falling asleep, you are endangering yourself and society. It is a health issue and also increases the chances of having a heart attack and stroke. Studies also have shown it can increase the chances of getting cancer," he said
Mirror Staff Writer Walt Frank is at 946-7467.