Sleep Apnea Driving Controversy in New FMCSA Regulations

by Jana Ritter - Published: 9/24/2013

Earlier this week, lawmakers introduced a bill that would require the Federal Motor Carrier Safety Administration to go through the formal rule-making process if they want to establish guidelines geared toward sleep apnea among commercial drivers. But Sleep Apnea Surgicure is urging such drivers not to wait until the process is finished to seek help.

In a bid to respond to the fatigued driving situation sleep apnea can create, the Federal Motor Carrier Safety Administration has long been attempting to put through regulatory guidance focused on mandating at-risk truckers to be tested and treated for obstructive sleep apnea (OSA). Now, two members of the House have introduced a bill that could potentially lengthen the time it takes for the FMCSA recommendations to go through. These lawmakers, and the trucking industry as a whole, are concerned that only offering guidance (as opposed to a formal rule with the imprimatur of law) would leave fleets susceptible to liability.

What the new bill seeks to ensure, as described by an Occupational Health & Safety article from September 14 called "Trucking Groups Back Sleep Apnea Testing," is that actual regulations would take the place of guidance related to sleep apnea testing. To do that, the FMCSA would have to go through the formal rule-making process, which allows the administration to garner the input of industry officials and requires a cost-benefit analysis to be carried out before any rules could be set (this has been deemed essential by the trucking industry, which estimates a cost of $1 billion for the testing).

The physicians at Sleep Apnea Surgicure understand the prevalence of Obstructive Sleep Apnea among all drivers and thus worry about this proposed bill's potential to delay measures designed to identify and correct the condition. Stephen D. Ochs, M.D., chief medical director of Sleep Apnea Surgicure, hopes this doesn't mean at-risk commercial drivers will delay medical screening for an accurate diagnosis and proper treatment.

"We respect the desire in the trucking industry and among lawmakers to ensure that protective measures related to Obstructive Sleep Apnea take into account the full breadth of the issue," said Dr. Ochs. "At the same time, it's my fervent wish that commercial drivers struggling to get a good night's sleep don't put off screening just because the law doesn't yet compel diagnosis and treatment. There are many options out there for those who suffer from OSA, and they need to be explored by those in at-risk demographics."

For some, the proper therapy will hinge on the use of something called Continuous Positive Airway Pressure, or CPAP. Much of what the FMCSA's pending guidance is thought to be focused on this type of initial medical therapy. The FMCSA panel also discussed the efficacy of a maxillo-mandibular advancement (MMA) procedure in appropriate selected individuals. Some commercial drivers, like many others diagnosed with OSA, simply can't tolerate nightly CPAP because of the unique time demands and circumstances of their job.

No matter what the eventual outcome is in terms of sleep apnea testing requirements for commercial drivers, it's imperative that commercial vehicle operators understand the role they play when it comes to identifying and correcting the condition. There are important issues in play here potentially impacting both public highway safety and the personal health of drivers.