Archive for December, 2011

Truck Driver Sleep Apnea

Saturday, December 31st, 2011

truck driver sleep apneaLarge truck accidents are serious because of the size, weight and speed of these   commercial vehicles. The Federal Motor Carrier Administration’s (FCMSA) Large Truck Crash Study revealed that 50% of accidents result in fatal or incapacitating injuries. The truck driver was judged to be at fault in 87% of these accidents, and in 7% the driver admitted to having fallen asleep while driving.

Truck accidents result in over 5,200 deaths annually and more than 125,000 injuries. Truck driver sleep apnea is a common disorder among drivers, with a prevalence believed to be between 17% to 28%. Given that there are roughly 14 million commercial drivers license holders in the U.S., somewhere between 2.4 and 3.9 million of these drivers are expected to be affected by truck driver sleep apnea.

Medical research demonstrates that drivers with undiagnosed OSA have an increased risk (2 to 7 times) for falling asleep at the wheel and increases the possibility of an individual developing important health issues such as hypertension, stroke, ischemic heart disease, and mood disorders. Studies suggest that commercial motor vehicle operators have a higher prevalence of OSA than even the general population.

The chance of having truck driver sleep apnea depended on two key elements — age and degree of obesity — with prevalence increasing with both. Population projections by FMCSA indicate the amount of older drivers will increase by 50% over the next 20 years.

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Fleet Vehicle Safety

Monday, December 26th, 2011

fleet vehicle safetyManaging risk is one of the most important functions of fleet vehicle safety. Risk can be safety, security or efficiency related. Fleet managers must be vigilant about risks on a day-to-day basis. However, fleet vehicle safety concerns pose the greatest range of risks.

According to a new study on highway deaths, the number of drivers involved in fatal accidents from distracted driving rose 42 percent from 2005 to 2008. The National Highway Traffic Safety Administration (NHTSA) found that more than 5,000 people died in 2008 in crashes involving a distracted or inattentive driver. Driver distraction is increasing because drivers are multitasking while driving.

Fleet operators have traditionally accepted a 20% annual accident rate in their industry. Some experts though, such as Eric Strom, maintenance and safety product manager for GE Capital Solutions Fleet Services believe a manufacturing analogy is appropriate and say that any fleet-related accident should be viewed as a “defect.”

What other industry would view a 20% or more defect rate as acceptable? What’s even more concerning is that these “defects” — fleet accidents — are often preventable since they are almost always the result of driver negligence and inattention.

Many companies offer products that combat inattentive driving, working to modify driver behavior through various means. These products are generally GPS-based vehicle tracking and monitoring systems that allow managers to set speed limits and map out safety zones beyond which drivers should not venture. Technologies such as these can help decrease dangerous incidents, maintain fleet vehicle safety, limit company liability and even lower insurance costs.

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Obstructive Sleep Apnea

Tuesday, December 20th, 2011

obstructive sleep apneaA typical person spends one-third of their lifetime sleeping. Various types of sleep-related health problems can sometimes lower the quality of sleep people get on any given night. Even though snoring is regarded as the most prevalent reason for insomnia,  there are other types of sleep issues that are far more dangerous.

Either of two reasons can be responsible for snoring —  obstructive sleep apnea and another condition scientists refer to as primary snoring.

Obstructive sleep apnea manifests itself in noisy, increased loud breathing, disrupted by air blockages along with repeated gasping for air. Additional signs and symptoms consist of extreme drowsiness during the day and difficulty concentrating.

Primary snoring, on the other hand, is extremely common and is not related to apnea. Primary snoring could be an early indicator for individuals that may ultimately have obstructive sleep apnea. This kind of development has been known to be more probable in individuals age 35-40 as well as those that put on excess weight.

While primary snoring can be an irritation for a spouse or significant other, there are no immediate health concerns for the sleeper. However, there are some significant medical consequences to be aware of with regard to both primary snoring as well as obstructive sleep apnea. During an episode, the apnea sufferer simply cannot get air into his lungs. In more severe cases, the airway is temporarily closed. Either situation repeatedly awakens the sufferer. Consequently, people that have sleep apnea experience excessive day time drowsiness.

A certified sleep specialist can fully diagnose whatever sleep abnormalities a person is experiencing. They can then prescribe a treatment plan. The benefit will be more restful sleep, better concentration during the day, and a more enjoyable life.

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FMCSA Sleep Clinic

Sunday, December 11th, 2011

FMCSA sleep clinicSleep apnea is a big health problem among commercial truck drivers, but many have trouble scheduling the overnight sleep study in a FMCSA sleep clinic that is required for an accurate diagnosis. Sleep Pointe mobile sleep labs, equipped by Covidien, are now available to meet truckers anywhere on the road.

The Mobile Sleep Solution Centers — 53-foot trailers with private bedrooms and bathrooms and fully functional control rooms for sleep technicians, hauled by International trucks — were unveiled June 19 at the Boulder, Colo., campus of healthcare-products giant Covidien as part of the company’s Sleep Wellness program. This convenient type of FMCSA sleep clinic will make having a required overnight sleep study performed a whole lot easier for drivers always on the road.

Covidien is a maker of the continuous positive air pressure machines that are widely prescribed to control obstructive sleep apnea. By gently blowing air into the sleeper’s nose through a face mask, CPAP machines keep the airways open and permit uninterrupted sleep. Sleep Pointe is a sister company, aimed at the transportation industry, of Somnograph, a maker of diagnostic sleep labs for hospitals, doctors’ offices and employers.

Designed in part to promote Covidien’s equipment and Sleep Pointe’s services to trucking fleets, the mobile FMCSA sleep clinic is located on major trucking routes throughout the United States.

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FMCSA Sleep Apnea Testing

Thursday, December 8th, 2011

FMCSA sleep apnea testingThe Federal Motor Carrier Safety Administration’s (FMCSA) Office of Research and Technology conducted a study whose primary goal was to ensure that commercial drivers are physically qualified, trained to perform safely, and mentally alert.

From 1996 to 1998, the University of Pennsylvania Center for Sleep and Respiratory Neurobiology collected data for a study on the prevalence and consequences of obstructive sleep apnea (OSA) among commercial vehicle drivers, and involved the FMCSA sleep apnea testing of 406 subjects.

The subjects were chosen after UPenn sent a multi-variable apnea prediction questionnaire to a random sample of 4,826 commercial driver’s license (CDL) holders residing in Pennsylvania. From the 1,391 responses that were returned, 406 drivers were selected to participate in the overnight FMCSA sleep apnea testing done in a laboratory. The overall findings from this study revealed that 28 (6.9 percent) of the 406 participants were diagnosed with severe sleep apnea, 32 (7.9 percent) had moderate sleep apnea, 86 (21.2 percent) had mild sleep apnea, and 260 (64 percent) had none.

The results of the FMCSA sleep apnea testing showed that the prevalence rates of sleep apnea among commercial truck drivers are similar to sleep apnea rates found in other general populations. The study also revealed that the prevalence of sleep apnea depends on the relationship between two major factors – age and degree of obesity as measured by body mass index (BMI) – with the prevalence of sleep apnea increasing with increasing age and BMI.

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FMCSA Sleep Apnea Standards

Monday, December 5th, 2011

FMCSA sleep apnea standards“Sleep apnea is an important cause of fatigue,” Mary Gunnels, head of FMCSA’s Office of Medical Programs, said at the Sleep Apnea & Trucking Conference recently. “It is an important problem that has to be addressed. We know this is a public health issue.” Based on these findings, new FMCSA sleep apnea standards are currently being developed. The one-day conference was sponsored by American Trucking Associations, FMCSA and the American Sleep Apnea Association.

Sleep apnea is a condition that affects an estimated 28% of truckers. Gunnels told carriers, doctors and government officials in attendance to expect “more emphasis” on apnea as the agency formulates new FMCSA sleep apnea standards that medical examiners can use to perform physical examinations on commercial drivers.

Drivers who are fatigued from sleep apnea and other causes are involved in at least twice as many accidents as those who are not, according to recent studies. The new FMCSA sleep apnea standards will be able to separate those with sleep apnea from the general population of truck drivers on our roads.

It’s currently required that truckers undergo testing every two years or more frequently, if necessary, because of health conditions. The exam does not specifically disqualify drivers diagnosed with sleep apnea as it does if a driver’s vision does not meet the required standards.

It is the determination of the examiner whether a driver with sleep apnea should be prevented from driving. FMCSA now considers the condition as one of several severe cardiopulmonary conditions that can sideline a driver.

Fatigue has been specified as the cause of at least 15% of fatal single-truck crashes, in which drivers typically run off the road and hit a fixed object such as a tree. FMCSA has said crashes occur most often between 1 a.m. and 7 a.m. on rural roads.

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FMCSA Sleep Apnea Questions

Friday, December 2nd, 2011

FMCSA sleep apnea questionsAccording to the fmcsa.dot.gov website these are some of the most frequently asked FMCSA sleep apnea questions. If you have additional FMCSA sleep apnea questions you might be able to find answers on the FMCSA website.

Is Sleep Apnea disqualifying?

Drivers should be disqualified until the diagnosis of sleep apnea has been ruled out or has been treated successfully. As a condition of continuing qualification, it is recommended that a CMV driver agree to continue uninterrupted therapy such as CPAP, etc. / monitoring and undergo objective testing as required.

A driver with a diagnosis of (probable) sleep apnea or a driver who has Excessive Daytime Somnolence(EDS) should be temporarily disqualified until the condition is either ruled out by objective testing or successfully treated.

Narcolepsy and sleep apnea account for about 70% of EDS. EDS lasting from a few days to a few weeks should not limit a driver’s ability in the long run. However, persistent or chronic sleep disorders causing EDS can be a significant risk to the driver and the public. The examiner should consider general certification criteria at the initial and follow-up examinations:

Severity and frequency of EDS
Presence or absence of warning of attacks
Possibility of sleep during driving
Degree of symptomatic relief with treatment
Compliance with treatment.

Can a driver who has a condition that causes excessive daytime sleepiness be certified?

Narcolepsy and sleep apnea account for about 70% of EDS. EDS lasting from a few days to a few weeks should not limit a driver’s ability in the long run. However, persistent or chronic sleep disorders causing EDS can be a significant risk to the driver and the public. While most of these diseases are usually disqualifying, The examiner should consider these general certification criteria at the initial and follow-up examinations:

Underlying condition causing the EDS.
Severity of and frequency of EDS
Presence or absence of warning of attacks
Possibility of sleep during driving
Degree of symptomatic relief with treatment
Compliance with treatment

After the initial evaluation, the examiner can decide if additional testing is required. Generally, drivers with excessive EDS need further evaluation to determine the cause and certification.

Can CMV drivers be qualified while being prescribed Provigil (Modafinil)?

Provigil (Modafinil) is a medication used to treat excessive sleepiness caused by certain sleep disorders. These sleep disorders are narcolepsy, obstructive sleep apnea/hypopnea syndrome and shift work sleep disorders. Provigil has several concerning side effects such as chest pain, dizziness, difficulty breathing, heart palpitations, irregular and/or fast heartbeat, increased blood pressure, tremors or shaking movements, anxiety, nervousness, rapidly changing mood, problems with memory, blurred vision or other vision changes to name a few. Many drugs interact with Provigil which include over-the-counter medications, prescription medications, nutritional supplements, herbal products, alcohol containing beverages and caffeine. The use of Provigil needs careful supervision. Provigil may affect concentration, function or may hide signs that an individual is tired. It is recommended that until an individual knows how Provigil affects him/her, they may not drive, use machinery or do any activity that requires mental alertness.

Drivers being prescribed Provigil should not be qualified until they have been monitored closely for at least 6 weeks while taking Provigil. The treating physician and the Medical Examiner should agree that the Provigil is effective in preventing daytime somnolence and document that no untoward side effects are present. Commercial motor vehicle drivers taking Provigil should be re-certified annually.

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