Understand sleep apnea before the regulations arrive

by Evelyn Cartmill

Roadside inspectors have traditionally been limited to examining the lines of a logbook when trying to measure the threat of driver fatigue, but a recent push in the US could see truckers screened for one sleep-depriving condition before they are even recruited for the job.

If supporters of the plan are successful, tests for sleep apnea could be linked to the driver recruiting and dispatching process as closely as tests for the presence of illegal drugs. And Canadian fleets might want to wake up and take notice before the rules actually become a reality.

The US Federal Motor Carrier Safety Administration believes that about one in four commercial drivers would fail such tests and require treatment before being allowed to take a seat behind the wheel.

The regulators are also considering whether to introduce such screening programs during preemployment testing, after a crash and before drivers are cleared to return to work.

That would certainly play a role in any future recruiting efforts.

The condition appears to deserve some added attention in the name of highway safety as well. Researchers at Stanford University discovered in 1994 that drivers who had sleep apnea were seven times more likely to be involved in a crash. That is obviously a cause of concern.

The general label of “sleep apnea” actually includes three different conditions. Obstructive Sleep Apnea (OSA), which is caused when the upper airway is blocked by relaxed soft tissue, accounts for about 85% of the cases. Another 1% of those with the condition have Central Sleep Apnea, which is caused by a problem in the respiratory centre of the brain. The remaining cases involve Complex Sleep Apnea, which includes a combination of both conditions.

A sleeping driver who has any one of these conditions will regularly stop breathing for anywhere from 10 to 120 seconds, wake up, gasp for air, and then fall back into a fitful sleep.

The hope of a restful, restorative period of rest becomes little more than a dream.

The end results are drivers who can feel irritable, depressed and wake up with headaches. They are tired all the time, less alert at the wheel, and struggle to remember things.

Every one of those factors will affect performance on the job.

The problem can also have a lasting impact on a driver’s health. In addition to identifying the higher crash rates, studies have indicated that those with sleep apnea are more likely to suffer from high blood pressure, diabetes, heart attacks and strokes.

But fleets can use this information to improve their safety records and driver health alike. When Schneider National began to study the issue between 2004 and 2006, it identified 339 drivers with Obstructive Sleep Apnea. The fleet’s screening process helped it to reduce preventable crashes by 30%. The cost of the crashes which did occur dropped 48%, while health care costs were cut in half. Driver retention also increased 60%. Maybe it was a sign that rested drivers are happier drivers.

Sleep clinics may have the final say on any diagnoses, but there are ways to spot drivers who are more at risk of sleep apnea, giving fleets an opportunity to recommend a closer look by qualified medical professionals. Factors such as obesity, age, smoking, drinking and the use of sedatives will all play a role in the condition.

Carriers can also turn to their insurance providers -and resources such as Markel’s STS advisors -to identify the signs of sleep apnea, find out how to arrange for screening and treatment, and learn ways to integrate this knowledge into an overall fatigue management program.

Of course, there are still plenty of questions to be addressed as regulators discuss the potential of any testing program.

There are a limited number of testing facilities that can identify cases of sleep apnea, which could lead to long waits for tests and treatment alike.

Besides that, there is the question of who will pay for the treatment, and whether Canadian regulators will follow the lead of their counterparts in the US or develop rules of their own.

Will the two systems mesh? Who knows?

But in the time leading up to any specific mandates, proactive fleets can still use an awareness of sleep apnea to improve safety records and protect the drivers who are on the road today.

Safety managers must dream about benefits like that before any day on the job.

-This month’s expert is Evelyn Cartmill, STS senior advisor, CHRP, CRM. Evelyn has served the trucking industry for over 15 years in the areas of Human Resources, Safety and Compliance. Markel Safety and Training Services, a division of Markel Insurance Company of Canada, offers specialized courses, seminars and consulting to fleet owners, safety managers, trainers and drivers. Markel is the country’s largest trucking insurer providing more than 50 years of continuous service to the transportation industry. Send your questions, feedback and comments about this column to info@markel.ca.To read about more industry hot topics, visit Markel’s website at www.markel.caand click on the Articles & Essays section.

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