by Donna Smith

On May 18th we wrote a blog post to explain the data and results conducted by the FMCSA regarding a study on Sleep Apnea;
“Sleep Apnea- A Smoke Screen for Many Truck Driver Fatigue Issues”

In that article we discussed how Truck Driver Fatigue was being used almost synonymously with the condition called sleep apnea. We showed how the data of the study was not truly representative of the results that were being spread around the various media sites.
We also discussed in that article and a follow up article what the real major reasons for truck driver fatigue were caused by.

On May 19th we had a Blog Talk Radio Show, “Truck Driver Fatigue and the Sleep Apnea Deception,” discussing  these finding and results, and discussed the many reasons and major causes of truck driver fatigue…and it was not sleep apnea as so many would have you believe.  We did however on the show demonstrate that sleep apnea is a real and serious condition which should be treated, just not the major cause of driver fatigue which seems to be the latest and greatest “  alarm for a new mandate driver screening.”

During the show that evening, less than halfway through the show, a caller called in, defending the statistics and study conducted by the FMCSA.  The call was from Bob Stanton, a  speaker from the recent Sleep Apnea and Trucking Conference 2010 which was held just a few days prior to our Blog Talk Radio Show. Mr Stanton said that there were newer studies performed by the FMCSA, including ones still in process, that indeed did correlate with the FMCSA’s figure of 30% of truck drivers have sleep apnea.  He also stated that the study and data we used was a different study. Basically, the call was to rattle or intimidate us, not to mention an attempt to discredit our research and information.  Fortunately, we had done extensive research and felt confident to discuss the topic, and rightly so.

After the show I wrote Mr Stanton and requested that he email me links to the information regarding the new studies on sleep apnea which would support the 30% of drivers have sleep apnea figure which is being so loosely stated as concrete fact.

I did receive an email back. The first paragraph was an apology for the way he spoke on the radio show, commending our research on the topic. He went on to state that it’s not the % that matters, but rather the correlation between untreated sleep apnea and the increased risk of crashes  by CMV drivers.  Well, if it’s not the % that matters, why is everyone who is supporting mandatory screening using % to have law passed….give me a break!!

"To me the real issue is not what % of drivers
may have sleep apnea.
 
The real issue is ... Is there a clear coorelation beteween
untreated sleep apnea and an increased risk of crash in
CMV operators in studies done in the US."

Mr Stanton also sent me a few attachments and an article ,which included a bibliography which may support further findings and possibly add to our research.  He also sent the pdf which was utilized to support the “30% of drivers have sleep apnea rage”,  FMCSA driver 28% more likely to have OSA.pdf ( Again, notice who’s making a big deal over the %?)

After carefully reviewing everything, I could not find data which correlated CMV crashes and drivers with sleep apnea.
Also, the PDF of the new study FMCSA driver 28% more likely to have OSA.pdf, which was suppose to support that high % driver with sleep apnea figure, was actually based on the original pool of 1391 drivers study within a 50 mile radius, and did not equal the exaggerated 28% figure of both the  FMCSA and ATA ( according to my math anyway) but rather indicated  the following:
9.8% drivers had mild sleep apnea ( not 17.6%), 3.2% had moderate sleep apnea ( not 5.8%). and 2.7% had severe sleep apnea ( not4.7%)

So rather than 28% having sleep apnea as suggested ,the number is reduced to 15.7%, with the majority of those figures displaying  mild sleep apnea.

You may wonder why these %’s are so different?
Simple. It appears that when the calculation were made, the total # of drivers was not included  in the calculations when deriving the %’s, but rather just the drivers which had been screened through the questionnaire.  This is apparent by reading the part that says,” based on the results of several tests”
Remember, only the drivers that were screened to possibly have sleep apnea were tested in the study ( not the entire 1391 drivers), therefore the % concluded are not a true representation of the entire pool of random drivers. ( You really can make numbers say anything you want!)

These kinds of  calculations were explained in detail on our Blog Talk Radio Show and also in the first article

FMCSA Finding from ” A study of Prevalence of Sleep Apnea Among Commercial Truck Drivers”

“A major goal of the study was to determine the prevalence of sleep apnea in
commercial truck drivers, based on the results of several tests conducted on
a random sample of commercial driver’s license (CDL) holders living within
a 50-mile radius of the University of Pennsylvania.
The results of the study revealed that 17.6 percent of CDL holders had
mild sleep apnea, 5.8 percent had moderate sleep apnea,
and 4.7 percent had severe sleep apnea.”

I believe by modifying the questionnaire which was given to the  1391 drivers who responded for the study, a higher number of positively screened applicants through the questionnaire were tested this time ( 406 screened positive the first time and 778 the second. ) This appears to be the major modification in repeating the study , not an entire new random pool of drivers  which the caller suggested  : ( unless by a huge coincidence, the same exact number of 1391 drivers responded to the study? I doubt that seriously)

I will say this, I do agree that it would be important to see a correlation between sleep apnea and truck crashes. So far I have not seen data to support this. If anyone has a study to prove otherwise, please reply to this post with the link to the study.

Finally, let’s not lose sight of the purpose of these posts.  We are NOT saying that sleep apnea isn’t a serious condition that one should not be treated for. We are saying that truck driver fatigue is a serious problem that can not be solely blamed just on sleep apnea.  As long as we’re all on the same page with safety and truck driver fatigue, let’s investigate everything involved in driver fatigue that can be attributed and possibly cause danger to all of our safety.

Driver lifestyle, sleep patterns, hours of continuous driving, lack of quality sleep, interruptions of sleep from qualcomm, shippers and receivers not keeping appointment time, drivers forced to drive when tired or out of hours ( gotta get that hot load delivered), and the nature of the profession all play major roles.
If a mandate is to be made to screen drivers for sleep apnea, then each driver should also be required to fill out a truck driver fatigue questionnaire asking :

• Have you ever been forced to drive by your company when you were either out of hours or too tired? If so, how often, which company?
  
• Have you been forced to stay awake and missed your sleep  because your appointment time was late by shipper or receiver? If so, how often, which company?
• Were you ever woken from sleep by the qualcomm  to ask a question that could have waited? If so, how often? Which company?
• Are you satisfied with the way the present HOS are set up?
  

Perhaps a study and investigation  to the above questions should be conducted in order to correlate fatal crashes by CMV drivers as a result of  sleep deprivation caused by trucking companies, shippers, receivers and HOS rules that are not in the best interest for the lifestyle or circumstances that exist for the  professional truck driver.  These causes of truck driver fatigue are equally as serious as sleep apnea. They all force drivers to drive with inadequate or  lack of quality sleep and should all be addressed in equal proportion to one another.

© 2010, AskTheTrucker. All rights reserved.

: DOT, FMCSA, sleep apnea, sleep deprivation, truck driver fatigue, truck drivers, trucking

Related posts

• Truck Driver Fatigue and the Sleep Apnea Deception (7)
• Sleep Apnea- A Smoke Screen for Many Truck Driver Fatigue Issues (7)
• Sleep Apnea Testing Coming Soon for Truck Drivers (11)
• Will Sleep Apnea Test be New Regulation for Trucking? (25)
• Truckers United: A True Brotherhood (2)

Truck Driver Fatigue

Truck driver fatigue is always being taunted as a major problem.  The NTSB, the FMCSA and the American Trucking Association are all behind the implementation of a new bill that will require truck drivers to undergo testing for a medical condition known as sleep apnea.

Media reports are stating that about 30% of all truck drivers have sleep apnea.  Furthermore, it has been reported that the condition affects between 6% to 12% of the adult male population.

Truth About Trucking “LIVE” talk radio discussed the real truth behind truck driver fatigue and the sleep apnea deception on Wednesday, May 19th, 2010.

We had the reports . . . we had the data . . . we had the numbers.

“Sleep Apnea-A smoke Screen for Many Truck Driver Fatigue Issues”

When one study did not provide the data that they were looking for, then they conducted more studies until the data met their agenda.

Sleep apnea is a serious medical condition that needs to be treated and the truck driver population needs to be made aware, but the real problem of truck driver fatigue lies with the lifestyle of the professional trucker and how the motor carriers contribute to this problem.  (See our previous post: Motor Carriers Responsible for Truck Driver Fatigue).

Continually pushing the issue of sleep apnea as the major cause of driver fatigue is taking the focus off of the real problem : pushing drivers to their limit, disturbing drivers while they are trying to sleep, forced dispatch and so-forth. Sleep apnea needs to be taken seriously and those who have it should take steps in its treatment.  But saying that 30% of truck drivers have this condition is just not the case, when independent studies have shown a regular percentile of around four percent.

Furthermore, if the studies conducted do not present the figures that you were hoping for, performing more studies until you reach the wanted figures only minimize the findings.

Listen to the show and you decide . . .

© 2010, AskTheTrucker. All rights reserved.

: ata, deception, fatigue, FMCSA, NTSB, sleep apnea, truck driver, truck driver fatigue, trucking

Related posts

• Sleep Apnea- A Smoke Screen for Many Truck Driver Fatigue Issues (7)
• Sleep Apnea Mandate – Does the Data Really Indicate 28% of Truckers have Sleep Apnea? (5)
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• Motor Carriers Responsible for Truck Driver Fatigue (3)
• How Safe is the HOS 14 Hour Rule for Truckers? (3)

by Allen Smith

Driver Fatigue and Sleep Apnea

Driver Fatigue is no stranger to the trucking industry. The FMCSA has performed studies in the past in order to better understand what causes driver fatigue and how to reduce it by correcting the major contributing sources.

Back in 1996, a 7 year study, The Commercial Motor Vehicle Driver Fatigue and Alertness Study (DFAS), was published by the FMCSA evaluating driver fatigue. At the time, Hours of Service was under review and many contributors to driver fatigue were considered.  The cost of this study was 4.45 million dollars. This is the Introductions written by the FMSCA concerning this study.

“The Driver Fatigue and Alertness Study (DFAS) was the largest and most comprehensive over-the-road study ever conducted on driver fatigue and alertness in North America. It provides extensive information on the alertness, driving performance, and physiological and subjective states of commercial motor vehicle (CMV) drivers as they perform real-life, revenue-generating trips. This Executive Summary overviews the objectives, methods, principal findings, and safety implications of this landmark 7-year study.”

During this comprehensive study this is what was concluded in regards to the concerns of Sleep Apnea:

“Although this study was not designed to determine a population prevalence, analysis of subject sleep revealed that two of the 80 drivers (2.5%) had clinically-diagnosable apnea, a sleep disorder characterized by breathing cessations. The driving performance of these two individuals was not statistically different from that of other comparable drivers in the study.”

The Study concludes with:

ASSESSMENT OF RESULTS FOR FATIGUE MANAGEMENT:

“There is no quick fix and no single solution to the fatigue problem. Sleep is the principal countermeasure to fatigue…. Partnerships among government, industry, drivers, safety groups, the scientific community, and shippers are needed for effective solutions to the commercial motor vehicle driver fatigue problem.”

On May 12, 2010, during the Sleep Apnea & Trucking Conference in Baltimore,  co-sponsored by the FMCSA and the ATA,  Anne Ferro, administrator of the Federal Motor Carrier Safety Administration, stated that fatigue-related crashes need to be reduced in the trucking industry.

In an article by Misty Bell of eTrucker , Mary Gunnels, director of the Federal Motor Carrier Safety Administration Medical Programs made the statement  “We know that fatigue is a problem,” she said, “and we know that sleep apnea is a major contributor to fatigue.”

Do we really know that sleep apnea is the major contributor?  Where is the data?

In that same article, Martin R. Walker, chief, FMCSA Research Division, pointed to the prevalence of sleep apnea in commercial truck drivers, noting that a study published in 2002 found that almost a third of CMV drivers have mild to severe obstructive sleep apnea. This study, along with a later study, found that older age and higher body mass index are two factors commonly linked with sleep apnea.

30% of drivers have mild to severe sleep apnea? How could that be? The 7 year study performed by the FMCSA didn’t come close to those figures?

I decided to look at the research, and this is what I came up with:

It appears that these figures and statements made during the Sleep Apnea & Trucking Conference of May 12, 2010 were possibly based on this study.  At least this is the only study I could find actual data on.

TECH BRIEF: Sleep Apnea Crash Risk Study

The study was conducted by the University of Pennsylvania  Sleep Apnea Study. The research was conducted during 1996 to1998. Sleep apnea is a condition in which a narrowing or closure of the upper airway during sleep causes repeated sleep disturbances, and possible complete awakenings, leading to poor sleep quality and excessive daytime sleepiness. This study was completed to assess the risks of commercial motor vehicle (CMV) crashes due to the presence of sleep apnea among truck drivers.

Basically, this study involved 1391 drivers. The drivers were asked a series of questions, including their height and weight, sleep patterns, medical history, snoring, etc. This was used as a screening process to determine which drivers were most likely to have sleep apnea.  Out of the 1391 drivers, 406 were selected as a result of their questionnaire, to proceed with the overnight laboratory study in order to determine how many of them were accurately predicted to have sleep apnea.

The results were as follows:

64% or  260 of the  406 flagged for most likely to have sleep apnea had no sleep apnea.
21.2% or 86 of the 406 flagged for most likely to have sleep apnea  had mild sleep apnea.
7.9% or32 of the 406 flagged for most likely to have sleep apnea  had moderated sleep apnea.
6.9% or 28 of the 406 flagged for most likely to have sleep apnea  had severe sleep apnea.

Now, the above percentages and figures are for the 406 flagged drivers.  When you perform the calculations based on the group study of ALL 1391 Drivers, here are the results ( the calculation required to accurately represent and  determine % of ALL drivers):

2.0% or 28 of total 1391 drivers had severe sleep apnea  ( matches the 1^st study by FMCSA- DFAS)
2.3% or 32 of total 1391 drivers had moderate sleep apnea
6.2% or 86 of total 1391  drivers had mild sleep apnea.

This would mean that only 4.3%  of drivers have moderate to severe sleep apnea. If you include mild sleep apnea, the % jumps to 10.5%

The following  statement in the report however is the most revealing of all:

“The results of the study showed that the prevalence rates of sleep apnea among commercial truck drivers are similar to sleep apnea rates found in other general populations.”  The study also revealed that the prevalence of sleep apnea depends on the relationship between two major factors – age and degree of obesity as measured by body mass index (BMI) – with the prevalence of sleep apnea increasing with increasing age and BMI. Another meaningful study finding showed that the prevalence of sleep apnea depends on the average duration of sleep over consecutive nights at home.  Short sleep duration, six hours or less per night, results in an increase in the prevalence of sleep apnea.”

Here’s that last statement again which has not been mentioned by the authorities and experts as a major source of sleep apnea,” Short sleep duration, six hours or less per night, results in an increase in the prevalence of sleep apnea.”

When you consider that the average OTR truck driver gets 5.2 hours sleep/night, then you have to wonder if it is the trucking industry lifestyle, behavior, and rules  which are major causes for driver fatigue and also for creating/inducing “driver  sleep apnea.”

The original hypothesis tested was the following: “A driver diagnosed with sleep apnea is more likely to be involved in a motor vehicle crash than a driver with no history or symptoms of sleep apnea, after controlling for differences in the other predictor variables included in the model.“

• The data gained in this study did not support this hypothesis
  

Finally, the study concluded to say, “No association was found between sleep apnea presence or severity and multiple crashes. This suggests that the commercial drivers in this study who were diagnosed with sleep apnea were not at increased risk for having more than one crash over the 14 year period prior to and following diagnosis…. Furthermore, there was no evidence from the data used in this study to suggest that crash risk is impacted before and after drivers are diagnosed with sleep apnea.”

There are many reasons for Driver Fatigue, and despite what many would like you to believe, lack of available sleep is the major cause.  Sleep Apnea appears to represent a much smaller percentage than what is being stated.  The data strongly suggests this.

Although sleep apnea is a real condition, it represents a much smaller percent of the driver population than the FMCSA and the ATA are suggesting.  To screen a driver by height and weight (BMI), and neck size ( 17 or greater) is not only discriminatory, but is ludicrous.  To force drivers to pay for the testing based on such information is simply wrong and unjust.  A serious look at other reasons for driver fatigue should be investigated.

On the other side of that coin, if you do believe you may have sleep apnea, then you should by all means be tested and start the treatment.

The FMCSA needs to create laws, ensuring that drivers are not sleep deprived rather that associate driver fatigue on the hype of sleep apnea.  It appears this is just a way to take the attention off of the real and valid reasons that drivers are fatigued, thus relieving the responsibility from carriers, shippers, and receivers who are all a part of depriving drivers from the rest they need. It’s also a way to deviate attention from the present HOS rules which need to be modified in order to aid in better and more rest for drivers.

Creating a sleep apnea testing program will be a BIG money maker for many as well as one more excuse to eliminate “undesirable” drivers from the industry.

© 2010, AskTheTrucker. All rights reserved.

: ata, BMI testing, DOT, FMCSA, hours of service, sleep apnea, truck driver fatigue

Related posts

• Truck Driver Fatigue and the Sleep Apnea Deception (7)
• Sleep Apnea Mandate – Does the Data Really Indicate 28% of Truckers have Sleep Apnea? (5)
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By Allen Smith

Allen Smith

In a meeting yesterday, May 12th, 2010, the FMCSA began discussions on the concerns of fatigue on truck drivers.  Citing that fatigue is a major problem among truckers, it was also noted that the medical condition, sleep apnea, is a major contributor to fatigue.  The FMCSA and the National Sleep Foundation have initiated an awareness campaign called “Get on the Road to Better Health: Recognizing the Dangers of Sleep Apnea.”

While the final plans for sleep apnea testing for truck drivers play out, present discussion is pointing to the possibilities of having drivers tested for the condition, who have a body mass index of 30 or higher.  The FMCSA is wanting testing done when a driver’s BMI is at least 30, while the Sleep Apnea Medical Expert Panel is recommending testing at the 33 level.  Although a date for the new requirements have not been announced, it is noted that there are still much needed discussion on how to handle various aspects of the proposed initiative. One aspect being who exactly will be responsible for paying for the testing : the trucking company or the truck driver?   Don Osterberg, Senior V. P. of safety for Schneider National points out that the total cost for sleep apnea testing will run around $3500, with about $2,000 for the sleep study and $1,500 for the equipment.

As per our previous post from July 14th, 2009 on the future of sleep apnea testing for truckers, talks are in the works again for truckers to face another regulation in relationship to trucking safety.  As a concerned driver, you can check your  BMI to see where you would stand in this issue.

Although the roll-out date is still in question, R. Clay Porter, a partner at Dennis, Corry, Porter & Smith, LLP, pointed out that while sleep apnea has not yet become a major player in the realm of truck litigation, he also said that  it is “going to be part of this legal landscape sooner rather than later.”

© 2010, AskTheTrucker. All rights reserved.

: driver fatigue, FMCSA, sleep apnea, testing, truck drivers, trucking

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By: Allen Smith

There may be a new regulation coming for the trucking industry.  If so, this new requirement could effect as many as 3.9 million licensed commercial truck drivers, according to a recent study by the Cambridge Health Alliance.

Sleep apnea is a sleep disorder characterized by pauses in breathing during sleep. Each episode, called an apnea, lasts long enough so that one or more breaths are missed, and such episodes occur repeatedly throughout sleep.  Clinically significant levels of sleep apnea are defined as five or more episodes per hour of any type of apnea.  There are three distinct forms of sleep apnea:  central, obstructive and complex ( a combination of central and obstructive).  Regardless of type, the individual with sleep apnea is rarely aware of having difficulty breathing, even upon awakening.   Sleep apnea is diagnosed with an overnight sleep test called a polysomnogram, or a Sleep Study.  This “Sleep Study” may be the laying foundation for the new trucking regulation.

Truckers with severe sleep apnea or who sleep less than five hours a night are more likely to experience sleepiness and impaired ability while driving, one study concluded.  Furthermore, studies have shown that obesity is the most significant risk factor for obstructive sleep apnea.   Over 60% of adult Americans  are categorized as being overweight.  Each year obesity causes at least three hundred thousand deaths in the United States.  The statistics are even worse for truckers.

Studies show that approximately 73% of drivers are overweight and more than 50% are obese.   Because of these statistics, another aspect for the possible new regulation will be a required BMI test for truck drivers.  BMI ( Body Mass Index) is a measure of body fat based on height and weight that applies to both adult men and women.  It is calculated by four different categories:

1. BMI of 18.5 or less = Underweight
2. 18.5 – 24.9 = Normal Weight
3. 25 – 29.9 = Overweight
4. 30 or greater = Obesity

As an example, an adult male who is 5′ 10″ tall and weighs 220 pounds, would calculate out with a BMI reading of 31.6, thus being regarded as obese.  An adult woman who is 5′ 8″ tall and weighs 150 pounds, would calculate out at 22.8 BMI, being regarded as normal weight.   You can calculate your BMI to see where you would fit in, if this was already a regulation for truckers.

Being discussed on the grounds of safety, sleep apnea testing, along with BMI calculations, is becoming more of a possibility as a new trucking regulation.  Even though this condition is completely treatable and reversible, I have heard from one source that one trucking company has said that they expect to lose 20% of their current drivers if this does become a regulation.   We have learned that many trucking companies are in a silent “panic mode” right now, and plan to either ask new driver applicants to take the sleep test, as well as considering current drivers in their employment to have the testing performed also.

Other factors which may be considered before someone could become a professional truck driver are:

• High blood pressure testing
• Their pattern of sleep
• Neck size
• Age

Their is a lot of underground talking going on about the problem of sleep apnea and obesity.   Don’t be surprised if this new testing soon becomes a new regulation for the trucking industry and our nation’s truck drivers.

UPDATE: Read our updated post from May 13th, 2010 -Sleep apnea testing coming soon for truck drivers.

© 2009 – 2010, AskTheTrucker. All rights reserved.

: apnea, BMI, body mass index, obesity, regulation, sleep apnea, sleep test, testing, truck drivers, Truckers, trucking, trucking companies, trucking regulation

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