Sleep Apnea Tied to Body Mass Index

A recent meeting of the Federal Motor Carrier Safety Administration with various medical groups was the site of a new proposal that would connect the body mass index of people who hold truck driving jobs with sleep apnea screening.

Because of recent research and studies that relate body mass index and sleep apnea, the following guidance has been recommended. This guidance is intended to be a short-term way to make the roadways safer for all trucking companies and non-commercial drivers until sleep disorders are officially included into the FMCSA's trucking regulations. A first draft of the official regulations may be available as soon as February 2012.

Criteria for Disqualification

It is also recommended that drivers who meet any of the following criteria will be automatically disqualified from trucking until their condition has been thoroughly evaluated and is being treated.

These criteria include:

  • Reporting excessive sleepiness during the daylight hours
  • Not complying with a treatment plan after being diagnosed with apnea.
  • Being involved in an accident that was caused by sleepiness or falling asleep
  • Awaiting evaluation after undergoing apnea correction surgery
  • Displaying Apnea-Hypopnea Index scores of no less than twenty

With support from the Motor Carrier Safery Advisory Committee from the FMCSA and Medical Review Board, medical examiners would be refer any commercial motor vehicle driver who has a BMI of 35 or more to be evaluated for obstructive sleep apnea.

Comments from Various Agencies

These guidances for trucking companies have come about because of comments made by members of various agencies. Larry Minor, from the FMCSA has stated that the guidance that is being proposed will be available for the public to comment. Members of the Owner-Operator Independent Drivers Association are questioning the necessity for these guidances. Todd Spencer, executive vice president of the OOIDA asked if sleep apnea is such a big problem, why America's highways don't look like a war zone.

The director of the Division of Sleep Medicine at Harvard Medical argued that highways are a war zone. He quoted statistics to show that about twenty percent of all crashes in the United States are caused by or related to sleepy drivers. The statistics he quoted covered all U.S. drivers, not just commercial truck drivers.
He stated that the FMCSA has been hearing recommendations about this growing problem for years and has not moved forward in the past.

A sleep specialist from Chicago named Andrew Mouton presented his view on sleep apnea and screening requirements. He believes that the current regulations regarding respiratory regulation for people who hold truck driving jobs provide a good foundation for detecting and regulating drivers with sleep disorders, and only a few words need to be changed to require every doctors to give individuals with suspected sleep apnea certain diagnostic tests. He emphasized that each apnea case is individual and variable.

Several of the people who presented information at the meetings believed that information presented by other agencies may be inaccurate or misleading. They believe that public comment will be very important in the stages going forward and that it should be carefully evaluated before a final draft of the recommendations become part of the FMSCA's regulations.

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