Test Would Curb Drivers Asleep at the Wheel

Mandatory Obstructive Sleep Apnea (OSA) tests for commercial truck drivers could reduce the risk of truck crashes that kill and injure thousands a year, according to a recent study by Harvard researchers.

OSA causes excessive daytime sleepiness and irregular nighttime breathing. Because of its role in increasing drowsiness, the disorder—which is expected to affect approximately 2.4 to 3.9 million licensed commercial drivers in the United States, according to a Harvard press release—can increase the risk of vehicular accident.

The OSA study, published in the Journal of Occupational and Environmental Medicine, recommends steps to address the problem.

The medical review board of the Federal Motor Carrier Safety Administration has suggested that they make sleep apnea screening mandatory for regular truck drivers, said Stephen N. Kales, the study’s senior author and an assistant professor at Harvard Medical School.

Because commercial truck drivers must be medically certified at least every two years, OSA tests could be conducted as part of those routine examinations, Kales said.

Currently, compliance with receiving treatment for OSA is low, he said.

“Drivers have an obvious motivation to keep their jobs, especially in this economy,” said Kales. “They are not going to admit when they have a serious condition.”

“The Administration needs to make sure that if drivers have the condition, they don’t go down the street to another doctor who does not check for sleep apnea,” Kales added.

The study examined 456 commercial drivers over a 15-month period. Of the 20 who were both confirmed with OSA and participated in a sleep study, only one complied with treatment. suggesting that OSA-stricken truck drivers tend to avoid taking measures to treat their illnesses.

“It is very easy for people with medical conditions to get these [truck driving certification] cards, even though this has serious implications,” he said.

Sleep apnea has been linked to obesity, which can encourage fat deposits to collect around the throat, making the airway more susceptible to collapse, said Atul Malhotra, the medical director of the Brigham and Women’s Hospital Sleep Disorders Program.

Future studies will examine the effects of both sleep apnea and obesity in different professions.

“We are looking at the implications of obesity and sleep apnea in fire fighting,” said Kales.

In addition to testing for OSA, most doctors agree that “education about symptoms of sleep apnea and the risks of driving while tired are very important,” said Malhotra.

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