DOT proposal requires test

Monday, June 30, 2008

WASHINGTON--The U.S. Department of Transportation (DOT) has proposed new regulations that would require truck drivers at risk for sleep apnea to get tested and treated in order to obtain their licenses.

The move is aimed at reducing the number of truck crashes caused by driver fatigue, said Rex Patty, a nurse practitioner at Stormont-Vail WorkCare, a regional healthcare facility in Topeka, Kan.

The Federal Motor Carrier Safety Administration estimates that of the approximately 141,000 large truck crashes that occurred during a 33-month study period, 18,000 or 13% were related to driver fatigue.

Not all driver fatigue is the result of sleep apnea, but about 28% of truckers may be at risk, compared to around 10% in the general population, said Patty.

Drivers with certain risk factors for OSA would be evaluated by a DOT provider and, if necessary, referred to their private physician for a sleep study.

“They estimate that 45% to 50% of (at-risk) drivers will need additional evaluation,” said Patty. “And I would say that for 70% of those patients, the treatment would be CPAP.”

Drivers diagnosed with OSA would need at least a week of treatment before they could get back behind the wheel. They would need to meet a minimum compliance of four hours or more each night, 70% of the time, with periodic re-evaluations to maintain their license.

Trucking companies and independent drivers aren’t embracing the proposed rules.

“Who is going to pay for it is a big question,” said Patty. “The average cost of a CPAP is $800 to $1,000. The sleep study can be around $2,300. That’s a lot out-of-pocket.”

Cost concerns go beyond initial diagnosis and treatment.

“If they are not compliant, they are disqualified to drive,” said Patty. “The trucking company can have a driver they depend on that can’t drive. And at this point, nobody knows how they get requalified. We have to determine what that means.”

It could be six months to a year before the proposal is finalized.