The Medical Review Board of the Federal Motor Carrier Safety Administration (FMCSA) outlined its official recommendations to the agency on screening and disqualification criteria for truck drivers who are suspected of having moderate to severe obstructive sleep apnea.
The board’s preliminary recommendations, which have not yet been approved by the board, encourage the FMCSA to require a trucker to be screened for sleep apnea if:
1. Has a body mass index greater than 40, or
2. Has a body mass index greater than 33 and meets three of the following:
· Older than 42
· Postmenopausal female
· Type 2 diabetes
· High blood pressure
· History of stroke, coronary artery disease, or arrhythmias
· Small or recessed jaw
· Loud snoring
· Witnessed pauses in breathing
· Small airway
· Neck size over 17 inches (male) or 15.5 inches (female)
· Untreated hypothyroidism
The board also recommends that FMCSA allow truckers with a sleep apnea diagnosis to continue to drive if they are being “treated effectively,” which is defined as “the resolution of moderated to severs OSA to mild or better, as determined by a certified sleep specialist.”
These recommendations are not yet final, however, as the board did not vote to approve them. Also the recommendations are just that — recommendations. FMCSA has no legal requirement to adopt any of the recommendations, but will likely lean on them when developing a sleep apnea rule.
Other Recommendations made included the following:
1. A driver found to be at risk for sleep apnea based on BMI should be certified for 90 days pending a sleep study.
2. If a driver already has a negative or mild diagnosis, a new sleep study should be ordered if any additional risk factors appear or if the driver has a 10 percent increase in weight. If age is the only added risk factor, then there should be a three-year wait since the last sleep study.
3. To diagnose drivers, an in-lab test is preferred but at-home testing is acceptable if the results cannot be falsified.
4. For treatment, a positive airway pressure (PAP) machine is preferred but oral devices and surgeries are options. A driver using a PAP machine can be certified for one year if they use the machine for at least 30 days (fewer if being recertified), at least 4 hours per night and on 70 percent of nights.
For more information, stay tuned for Part 2 of this series.
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