Sleep Apnea and Professional Drivers
Approximately 18 million Americans suffer from sleep apnea, experiencing sleep disruptions and chronic daytime sleepiness. Many go to a doctor, schedule a sleep study and return to work the same day. Those with truck driving jobs, however, are typically told they can’t return to work until they complete a sleep study and show they’ve used CPAP equipment for a while. The entire process can entail months with no income.
The fear of an income gap causes many employees at trucking companies to avoid seeking treatment. "Anybody with a CDL knows you're never supposed to tell the medical doctor that you snore. If you have sleep apnea, you're a liability to the company," said Peggy Fender, 52, a concrete truck operator from Tightwad, Mo.
Fender, who has kept up her commercial driver’s license for 22 years, became concerned four years ago when she started snoring and waking up with headaches. At her physical exam, the questionnaire asked if she snored. Fender checked “yes,” and that’s when the trouble started.
“The doctor flat-out told me I couldn’t go back to work,” Fender said. Her doctor wouldn’t give her the medical card she needed to drive. Fender was left with no income as the trucking company deliberated for two months. Finally, the company directed her get a sleep study at Bothwell Regional Health Center in Sedalia, Mo. Insurance wouldn’t cover it, driving Fender deeper into the hole financially. Doctors at the sleep center diagnosed her with sleep apnea and prescribed a CPAP machine. Before she could return to work, however, her employer required her to use the CPAP for a month and show them the digital card that records how often she used the machine and other sleep statistics. After she proved compliance and got a doctor’s authorization, the company finally let her drive. She and her husband, who had been out of work himself after surgery, were without pay for three months.
Fender understands the dangers of driving without adequate rest because of sleep apnea. She also supports regulations that the federal government has enacted to ensure truck drivers get treatment for sleep apnea before getting behind the wheel. A 2002 government-sponsored study shows that as many as 28 percent of commercial truckers have some level of sleep apnea. Because of the risks, employees of trucking companies must undergo physicals and sleep screenings every other year. Drivers with sleep apnea must have physicals every year and submit evidence that they’ve complied with their CPAP treatment.
Many commercial driver medical examiners (CDMEs) require drivers to submit to a Maintenance of Wakefulness Test before they can renew their CDL for truck driving jobs. This test is conducted in four 40-minute trials, all on the same day. The applicant is seated in an empty, darkened room with no stimuli. If the driver goes into any stage of sleep for 30 seconds or more, he or she fails the test.
A few drivers retire from trucking rather than face the double-whammy of income loss and costly tests. Ernie Williams, now 63, is one of them. After he began waking up gasping for air, he sought treatment. Then, when his insurance wouldn’t cover the expensive sleep study, he decided his only option was retirement.
Some trucking companies are responding to the dilemma with solutions of their own. Prime, Inc., constructed its own sleep lab to screen drivers and conduct sleep studies. Sleep Pointe of Wichita, Kan., staffs the company’s six-room sleep lab. Don Lacy, Prime’s safety director, says that having the in-house sleep lab cuts costs and ensures drivers comply with treatment, a win-win solution for everyone.