Archive for the ‘FMCSA sleep apnea questions’ Category

Sleep Apnea.. Did you know?

Wednesday, November 21st, 2012

Snoring. Fatigue. Long pauses in breathing. These are just a couple of symptoms and warning signs of sleep apnea. Similar to seeing smoke alerting you of a fire, daytime sleepiness or gasping for air during your sleep can alert you to sleep apnea and should be mentioned to your doctor. If left untreated it could lead to diabetes, heart failure or stroke. Possible treatments of sleep apnea include therapies, surgeries and even an implant that shocks you every time the airways in your lungs close. Each of these possible treatments does include a list of pros and cons.

Therapies for sleep apnea include CPAP (Continuous Positive Airway Pressure) or BiPAP (Bilevel Positive Airway Pressure) machines designed to continuously deliver various pressure of air into the nose or mouth in order to keep the airway passages open for the free flow of air into your lungs. The pro to this treatment is not having to get surgery. If going under the knife doesn’t please you, then wearing a mask over your nose or mouth during slumber is your best bet. However, the con to this treatment is wearing the mask at night. Many PAP users feel the masks can be quite obtrusive and uncomfortable during slumber. If you’re a stomach sleeper then you would certainly need to adjust your sleeping habit in order to wear a PAP mask. Another con, of course, would have to be constantly replacing your PAP supplies every 3 to 6 months. Bacteria build-up and deterioration is common when using these machines on a daily basis. Make sure you have insurance that will cover durable medical equipment.

If wearing a mask on a nightly basis doesn’t necessarily tickle your fancy, you might want a more permanent treatment to your restless night’s sleep. The most commonly performed surgeries to combat sleep apnea include nasal surgery (correction of nasal problems such as a deviated septum), Uvulopalatopharyngoplasty – UPPP (surgically removing the soft tissue in the back of your throat and palate in order to increase the width of the airway at the opening of the throat) and Mandibular maxillar advancement surgery (constructive surgery to improve a birth defect in your face or throat that may contribute to sleep apnea). The pro to this treatment is that it is permanent. The con would be having to go under the knife which might scare a lot of OSA sufferers.

In some cases especially with only mild cases, weight loss or cutting cigarettes and alcohol out of your diet can improve your night’s slumber. Therapies and surgeries are suggested by your doctor only in moderate or severe cases. If either of these does not sound pleasing to you, you can always look into shock treatment like a Wisconsin man did earlier this year. Dan Gutzman, husband and father of two in Milwaukee, tried a CPAP and could not get used to it. He thought surgery was far too drastic. His doctor explained the shock treatment to him as a nerve stimulator that sends an electric shock wave to his lungs and tongue when his airway is blocked and snoring occurs. If you’d rather not sleep with probes in your mouth and lungs and think an electric shock is just scary, keep to a CPAP therapy treatment.

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.