Pilots, Drivers and Sleep Apnea
I-95, Route 66, runways at O’Hare…what is common to all three? Safety concerns with the looming possibility that pilots and drivers are drowsy flying or driving due to undiagnosed and untreated obstructive sleep apnea (OSA). People who suffer from OSA experience poor concentration, sleepiness (daytime, or if shift-working, nighttime) and memory loss due to the obstruction of their airway when they sleep.
Required Sleep Apnea Testing
It has been a hot topic in the news with much debate. Should sleep apnea testing be a mandatory requirement for pilots, and commercial and truck drivers? With a high prevalence of OSA in pilots and drivers, the Federal Aviation Administration (FAA) and Federal Motor Carrier Safety Administration (FMCSA) have been contemplating the implementation of regulations that would enforce sleep apnea testing. It makes sense from a safety perspective, that is to say, making the air a safer place to fly and making our roads and byways safer for all drivers. Unfortunately, both organizations have faced push-back and opposition from employers, pilots and drivers associations. These groups raised concerns that sleep apnea testing would be expensive and then if diagnosed with OSA, the worry that jobs would be lost.
Despite the opposition, the FAA made the decision to move forward with mandatory screening and testing for OSA. They decided to require pilots to be screened to determine their body mass index (BMI). If they have a BMI of 40 or more, pilots would then need to be evaluated for OSA and treated if they were diagnosed.
For years, the FMSA required truckers to pass a medical evaluation every two years and warned of the dangers of sleep apnea. Yet no specific sleep apnea testing was required unless the driver reported symptoms of the disorder. The FMSA proposed the following screening and testing guidelines:
- Drivers with a BMI of greater than 35 would be evaluated for OSA using an objective test.
- During the evaluation and treatment process, the driver could be given a 60-day conditional certification.
- If a driver is diagnosed with OSA, he or she would need to verify appropriate treatment in order to maintain certification with evidence of appropriate treatment (if any) and effective compliance and if the examiner determines that the condition does not affect the driver’s ability to safely operate a motor vehicle.
Currently, the government is limiting what the FAA and FMSA can require. In December 2013, the House of Representatives passed legislation that would require the FAA to go through the rulemaking process before implementing policy changes related to sleep disorders. And President Barack Obama signed legislation mandating that any new requirements pertaining to driver sleep disorders and OSA be subject to rulemaking as opposed to “guidance.”
Why are These Groups Susceptible to OSA?
One of the roles of the FMSA is to collect data about motor vehicle safety and at the same time improve regulations. In a study entitled “A Study of Prevalence of Sleep Apnea among Commercial Drivers,” this organization reported that 17.6 percent of commercial drivers had mild sleep apnea, 5.8 percent had moderate sleep apnea and 4.7 percent had severe sleep apnea. In addition, the group discovered that an OSA diagnosis had a strong connection to both age and degree of obesity. Almost all tracking performance tests discovered a relationship between poor level of driving and severity of OSA. Another finding in this study was that 35 percent of truck drivers terminated sleep early in order to get back on the road, leading to significantly shorter time sleeping with an accompanying negative effect on driving performance. In a separate study FMCSA reported that commercial drivers are involved in 4,000 fatal crashes a year, and 13 percent of these crashes result from symptoms of fatigue or other physical issues.
If you are a pilot, or a commercial or truck driver and get drowsy or fall asleep at the controls or wheel, you might be suffering from sleep apnea. Contact one of our medical concierges today at 1-855-863-4537 or schedule a free consultation to learn how we can help you drive safely.