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Proposed sleep apnea rule canceled


WASHINGTON, D.C. — The Donald Trump Administration has withdrawn a proposed regulation that would clear up the confusion on how truck drivers should be diagnosed and treated for obstructive sleep apnea (OSA).

The withdrawal was announced in early August by the U.S. Department of Transportation’s Federal Motor Carrier Safety Administration and the Federal Railroad Administration.

The proposal would have screened truck drivers and train operators for the disorder that has been linked to nodding off behind the wheel.

And while some in the trucking industry generally oppose excess regulations in the trucking space, surprisingly, few were against this proposal and many were actually hoping for the rule to go through.

According to the U.S. Department of Health, sleep apnea is a disorder that causes one to stop breathing during sleep. These pauses in breath can last from a few seconds to a few minutes. As a result, the body moves from a state of deep sleep to light sleep as normal breathing resumes. This movement to a lighter sleep, which is often accompanied by snorting or choking sounds, makes sleep apnea sufferers more tired during the day, as they don’t get quality rest each night. Typical treatment for the condition is the use of a continuous positive airway pressure (CPAP) machine at night, which provides the user with continuous air pressure while sleeping.

More alarming, a recent study by the American Transportation Research Institute of the American Trucking Associations found that close to a third (28%) of commercial truck drivers have some form of sleep apnea.

As it stands in the U.S., everything will remain unchanged for now, since the proposal has been withdrawn. But even though nothing is changing, according to Steven Garrish the senior vice-president of safety and regulatory compliance at SleepSafe Drivers, an organization that helps to streamline and shorten the process of diagnosing and treating sleep apnea in the transportation industry, the withdrawal is causing even more confusion in the trucking industry.

“What we’re finding so far on this side of the border is that fleet managers and drivers are getting confused with the headlines about the proposal withdrawal,” he said. “We’ve actually had some of our driver patients call us and say, ‘I read the news, so does this mean that I don’t have to wear the CPAP machine anymore?’ And we have to tell them no, that the treatment still has to be used and that’s not what the proposal withdrawal means.”

Garrish, who spent more than two decades in the industry as a trucking executive, said that without a clear rule about sleep apnea screening, the process is like the “wild, wild west.”

“Without a clear rule, we have found that medical professionals are all over the board,” he said. “Some will send anyone and everyone for testing and others will send none because they don’t even know the signs and symptoms of OSA. There’s so much inconsistency across the board so we felt that a rule in this particular case was a good one. It really would have brought some order to what is generally an unchecked area in terms of driver fatigue.”

In fact, Garrish believes that even though sleep apnea is a major risk, it will be and is being eclipsed by the electronic logging device (ELD) debate in the U.S.

“It’s unfortunate most fleets don’t know a lot about the rule and the impact this will cause,” he said. “Fleets down here have just been focused on ELDs instead of fatigue, so this rule has really been on the back burner. Now, things will just keep going the way they are and it’ll keep fleets on the sidelines. The end result of this rule not passing will be a continued delay and expense for the drivers, and a continued risk on the roadways.”

The only thing that will change that risk of future crashes caused by fatigue would be a “well put together regulation that would level the playing field for everyone,” Garrish said.

And until then, he believes the industry will suffer.

Brandon Leininger, the director of risk management at American Central Transport, a family-run trucking company based in Kansas City, Mo., agreed with Garrish saying he too was disappointed at the rule withdrawal.

“Even though it’s business as usual for now, it would have been nice to have this in black and white,” he said. “I think the industry needs a regulation on this so that it’s standard across the country. Driver health is a huge thing. Certainly, I would like to know if I have a driver who is prone to falling asleep at the wheel, with the potential to injure or kill him or herself and others on the roadways.”

In late August, SleepSafe Drivers sent a letter to the Transportation Secretary’s office explaining its support for a rule to be put in place.

“When it comes to identification and treatment for OSA, the current guidelines and recommendations are insufficient and leave room for interpretation and misinformation. A clear rule, will help commercial drivers, rail operators and others in safety sensitive roles, feel more rested, less fatigued, healthier and ultimately safer behind the controls of their equipment,” said Garrish in a release. “Financially, we’ve seen the companies we serve actually save money in their costs associated with liability, health care, and turnover.”

When Truck News went to press, the secretary’s office had not responded.

Currently there is no rule in Canada for how to screen drivers, either. Commercial drivers in Canada require doctors to refer them for a sleep study if they suspect they may suffer from the disorder.

And in Canada, researchers at the Toronto Rehabilitation Institute believe the proposal’s withdrawal isn’t the worst thing to happen. According to Dr. Douglas Bradley, the director of the sleep research laboratory at Toronto Rehab, the link between sleep apnea and risky driving doesn’t have much research and data to back it up.

“The proposal to screen drivers with a certain body mass index was not really based on much information about the actual risk that sleep apnea poses to drivers in terms of accidents,” he said. “So, putting this on hold is not necessarily a bad thing because it does allow researchers like us here at Toronto Rehab to test drivers and see if their sleep apnea really does relate to their accident records.”

Currently, the institute is conducting a massive study with 1,000 long-haul truck drivers in Ontario to see if there is a correlation between sleep apnea and poor accident records.

Researchers will be testing drivers for sleep apnea and then comparing results to their driving records and insurance claims.

“The research will help us see whether the presence of sleep apnea is associated with higher accident rates or higher insurance payouts,” Dr. Bradley said. “That will provide solid evidence on if we should be screening or not and if so, who? If the evidence shows a relationship, then by all means we should be screening to increase road safety and reduce cost of accidents and injuries and death. But if the relationship doesn’t occur, then we can spare a lot of people the trouble of not having to treat them if they don’t need it.”

The institute says the study is still ongoing and results won’t be known for the next few years. You can learn more about the study at www.tritruckingstudy.com.

 


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