TORONTO, Ont. –Imagine if 24% of your drivers were suddenly placed out-of-service due to health issues. That’s a frightening scenario that could play out if the US Federal Motor Carrier Safety Administration (FMCSA) proceeds with proposed legislation that will require all commercial drivers operating in the US to undergo screening for sleep apnea and seek treatment within as little as 30 days.

The proposed regulation, still very much in flux, would require all commercial drivers to take a test to determine if they suffer from the common sleep disorder, which is characterized by abnormal pauses of breathing during sleep. Sleep apnea symptoms include loud snoring, restless sleep and daytime drowsiness.

Barry Kurtzer, chief medical review officer with DriverCheck, said carriers that operate in the US should prepare for the prospect of 24% of their drivers failing the first round of tests, consisting of an adjusted neck circumference measurement, body mass index reading and questionnaire. Based on the body mass index component alone, the FMCSA predicts as many as 24% of commercial drivers will fail the first test and require a full-blown medical test at a sleep centre. Worse yet, drivers may have to take the medical test (known as a polysomnogram) as many as three times to get an accurate diagnosis since it’s difficult to sleep while hooked up to machines.

As the regulation is currently proposed, drivers will have just 30 days to take part in the polysomnogram before having their ticket pulled by the DoT. This raises some important issues, especially in Canada where sleep centres are few and far between and wait times would almost certainly be longer than 30 days when the floodgates open.

“The problem we’re going to have is getting people in for the test if we’re looking at a 24% fail rate…our resources here in Canada are lean,” Kurtzer said during a panel discussion on the topic at the recent Ontario Trucking Association convention. “If 24% of your drivers have to go through this, what’s it going to do to your company?”

Drivers who are diagnosed with sleep apnea will require treatment, which usually comes in the form of a CPAP (Continuous Positive Airway Pressure) machine that drivers must use while sleeping. It prevents the soft tissue structures in the throat from collapsing and choking off airways during sleep. Surgery is also an option.

Kurtzer said when the FMCSA finalizes its regulation (a proposed rulemaking could be published by the end of the year), Canadian carriers will need to implement a screening and treatment program in much the same way they test US-bound drivers for drugs and alcohol.

“It’s similar to drug and alcohol testing programs, so you’ve already been through this and it will be easy to parallel that model,” said Kurtzer.

Joel Schechter, partner with Watson Bennett Attorneys at Law, warned that once a law is passed, carriers that allow drivers with sleep apnea to operate vehicles without undergoing treatment will be at an enormous liability risk in the US. They may even be subjected to punitive damages, with decisions that can run into the tens of millions of dollars, he warned.

While the prospect of screening and treating drivers with sleep apnea may seem daunting, the FMCSA can hardly be faulted for addressing the issue. It’s estimated that one in 15 Americans are affected by the disorder, meaning there are 20 million US sufferers and 17 million of them remain untreated. That costs the US system as much as US$22 billion per year, Kurtzer pointed out.

Doing some rudimentary math and dividing that by 10 would suggest there are two million Canadians suffering from sleep apnea, 1.7 million of whom are untreated. The FMCSA has also found that driver sleepiness is prevalent in as many as 20% of commercial vehicle accidents. Brian Taylor, president of Liberty Linehaul, said fleets should be proactive about addressing the problem. “I think morally, we have an obligation to keep our drivers safe,” he said.

Mark Seymour, president of Kriska Holdings, revealed that he himself was affected by sleep apnea. He sought help and is amazed at how much better he feels since beginning treatment.

“It’s a very personal experience for me, because it took me a long time to deal with it,” Seymour said. “I knew I had a problem but it took me years to get checked out.”

Seymour learned he was waking up as many as 40 times per hour while sleeping, and “you never get caught up, it builds upon itself and you never really restore your body.”

Seymour said his quality of life has improved since treating the condition. “You never know how much better you can feel until you feel it,” he said. “It changed my life, I feel better, I feel healthier. Let’s embrace it; it’s a problem you should not avoid treating.”

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‘The problem we’re going to have is getting people in for the test if we’re looking at a 24% fail rate.’

Barry Kurtzer, DriverCheck