Apnea screening helps in the fatigue fight

by Dave Nawton

The trucking industry spends plenty of time tracking the hours that drivers work.

Every line recorded in a logbook is carefully scrutinized to ensure no one is sitting behind the wheel for too long. Many fleets have gone so far as to install electronic on-board recorders (EOBRs) to track the activities.

In the true fight against fatigue, however, the quality of off-duty time is just as important as the allowable hours of work.

It’s why there has been growing interest in exams to screen drivers for obstructive sleep apnea (OSA), to ensure that people who have the condition get enough rest.

It’s surprising some of these drivers get any sleep at all. Breathing can be interrupted hundreds of times a night, for anywhere from 10 to 120 seconds.

Sufferers wake up gasping for air and collapse. When it’s time for a day to begin, they feel irritated or depressed. Short-term memory can suffer, too.

As someone with sleep apnea, I know the challenges first hand. I spent years feeling tired all the time, but was quick to dismiss comments about my snoring.

Only after my wife mentioned that I stopped breathing in the middle of the night did I go for testing.

And even when the issue was diagnosed I ignored it, largely because my benefits package didn’t cover the costs for a continuous positive airway pressure (CPAP) machine to control breathing while I slept.

The tipping point came when I was hired by a company with a better benefits package – and my wife threatened to banish me to the spare room if I didn’t get help.

The machine made a difference within days. I felt 18 again, with tons of energy.

The fleet that employed me updated its overall driver orientation programs to include information on sleep apnea and managing fatigue.

At first, drivers quietly came forward to ask about details “for a friend.”

Then our employer began covering the cost of private tests at sleep clinics, with benefits paying for treatments.

Even though we never asked about results, respecting personal privacy, many drivers came forward to rave about the difference they experienced.

Employees known to be perpetually grumpy suddenly began coming to work in a better state of mind.

Our driver relations manager assembled related information and mailed it to home addresses, so family members would learn about the condition and treatments that could make a difference.

That was a wake-up call for many households.

Not every fleet is large enough to support a comprehensive program like this, but everyone can tap into free online sources of information.

A good place to start is www.nbins.com/sleepapnea.

And the fleets that introduce voluntary programs today will be in a much better position to meet any mandatory screening requirements in the future.

Anyone who questions whether mandatory tests are on the horizon needs to look no further than the US National Highway Traffic Safety Administration.

It is currently led by renowned fatigue management expert Mark Rosekind.

The regulator has already released plenty of data to make the case for such screening, estimating that more than 28% of truck drivers could have sleep apnea.

The National Institute of Occupational Safety and Health (NIOSH) studied 1,760 long-haul drivers and found 15% with some signs of sleep apnea, and 59% showing some sort of respiratory disturbance.

A look around any truck stop could show why the numbers are so high. The people at greatest risk are middle-aged, overweight men with a neck size above 17 inches, or women with a neck size above 15.5 inches.

Every one of them could be screened with a simple questionnaire about sleeping habits, and potentially a home sleeping test or polysomnogram (PSG).

The treatments for those who need help can vary. Some will need to be fitted with CPAP masks, which deliver a steady supply of air to keep airways open. In other cases, the driver may need to wear compression stockings, lose a bit of weight, or avoid alcohol and sleeping pills. But the end result is better rest.

Schneider National discovered the difference screening can make. It identified 339 drivers with sleep apnea between 2004 and 2006, and credits the program for helping to reduce preventable crashes by 30%. Driver retention also increased, suggesting that rested drivers are also happier drivers.

As part of a comprehensive fatigue management program, it can represent an important step toward ensuring that drivers are always alert and ready for duty.


This month’s expert is Dave Nawton, risk services specialist. Dave has served the transportation industry for 20 years as a driver trainer, HR specialist, safety manager, and in loss control and risk management. Northbridge Insurance is a leading Canadian commercial insurer and has been serving the trucking industry for more than 60 years.

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