Could Sleep Apnea Testing be Enforced by FMCSA?

Last week the FMCSA erroneously published a public notice asking for comments on it’s proposed guidelines for sleep apnea testing for truck drivers. Later the same day, the agency recalled the notice saying it was published in ‘clerical error’. “FMCSA is withdrawing its proposed regulatory guidance for obstructive sleep apnea and request for comment as published in today’s Federal Register,” an agency email stated late Friday afternoon (April 20).

The agency is still in the process of carefully reviewing the recommendations submitted by the Motor Carrier Safety Advisory Committee and Medical Review Board and anticipates requesting public comment on the recommendations later this year.

Here are some key points listed in last week’s publication regarding Sleep Apnea guidelines which may be an indicator of what’s to come later this year:

•Drivers with a BMI of 35 or greater to be certified for 60 days pending sleep study and treatment, followed by a 90-day certification if they’re compliant during first 60 days, followed by a one-year certification.

•Clinicians may cite any combination of possible factors to require or recommend sleep labs. For example, drivers who are male and postmenopausal females with a BMI of 28 or greater, who have experienced a single-vehicle crash or have a 17-inch neck (male) or 15.5-inch neck (female) should be prepared to prove they don’t have sleep apnea. Other factors include being 42 or older, family history, and having a small jaw or airway.

•Commercial drivers diagnosed with apnea may not be unconditionally certified medically to receive their CDL, and must instead use a CPAP at least four hours a day for 70 percent of days.

Any driver who reports excessive sleepiness during the major wake period, or experiences a crash associated with falling asleep, or has been found to be non-compliant in using a CPAP should be disqualified or immediately denied certification. OOIDA Executive Vice President Todd Spencer, who serves on the advisory committee known as MCSAC, has spoken out against the recommendations on behalf of members during numerous meetings on the topic.

“While there is plenty to indicate some commercial truck drivers have sleep apnea, we find virtually nothing to indicate that that is a factor in increased likelihood of crashes,” Spencer said following the most recent MCSAC meeting.

MCSAC’s next meeting is scheduled for May 21-23 in the Washington, DC, area.

Given the wide variety of treatments available and the costs associated with the testing to diagnose sleep apnea, OOIDA is skeptical of the real motivation behind the recommendations. “It’s kind of an issue that’s looking for a place where it can receive gobs of money is certainly what it looks like to me,” Spencer said.

The OOIDA Foundation researched cost of sleep labs and calculated that 49 percent of the 3.5 million commercial truck drivers have a BMI of 30 or greater. If that number of drivers is required to undergo sleep lab exams, such a rule would cost truckers $5.25 billion.

“That is a tremendous economic price for our industry to have to absorb,” Spencer said. “Of course, in this instance we’re primarily talking about individual drivers paying this.”

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