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Sleep Apnea- A Smoke Screen for Many Truck Driver Fatigue Issues

May
18,
2010
11

by Allen Smith

Driver Fatigue and Sleep Apnea

Driver Fatigue is no stranger to the trucking industry. The FMCSA has performed studies in the past in order to better understand what causes driver fatigue and how to reduce it by correcting the major contributing sources.

Back in 1996, a 7 year study, The Commercial Motor Vehicle Driver Fatigue and Alertness Study (DFAS), was published by the FMCSA evaluating driver fatigue. At the time, Hours of Service was under review and many contributors to driver fatigue were considered.  The cost of this study was 4.45 million dollars. This is the Introductions written by the FMSCA concerning this study.

The Driver Fatigue and Alertness Study (DFAS) was the largest and most comprehensive over-the-road study ever conducted on driver fatigue and alertness in North America. It provides extensive information on the alertness, driving performance, and physiological and subjective states of commercial motor vehicle (CMV) drivers as they perform real-life, revenue-generating trips. This Executive Summary overviews the objectives, methods, principal findings, and safety implications of this landmark 7-year study.”

During this comprehensive study this is what was concluded in regards to the concerns of Sleep Apnea:

“Although this study was not designed to determine a population prevalence, analysis of subject sleep revealed that two of the 80 drivers (2.5%) had clinically-diagnosable apnea, a sleep disorder characterized by breathing cessations. The driving performance of these two individuals was not statistically different from that of other comparable drivers in the study.”

The Study concludes with:

ASSESSMENT OF RESULTS FOR FATIGUE MANAGEMENT:

There is no quick fix and no single solution to the fatigue problem. Sleep is the principal countermeasure to fatigue…. Partnerships among government, industry, drivers, safety groups, the scientific community, and shippers are needed for effective solutions to the commercial motor vehicle driver fatigue problem.”

On May 12, 2010, during the Sleep Apnea & Trucking Conference in Baltimore,  co-sponsored by the FMCSA and the ATA,  Anne Ferro, administrator of the Federal Motor Carrier Safety Administration, stated that fatigue-related crashes need to be reduced in the trucking industry.

In an article by Misty Bell of eTrucker , Mary Gunnels, director of the Federal Motor Carrier Safety Administration Medical Programs made the statement  “We know that fatigue is a problem,” she said, “and we know that sleep apnea is a major contributor to fatigue.”

Do we really know that sleep apnea is the major contributor?  Where is the data?

In that same article, Martin R. Walker, chief, FMCSA Research Division, pointed to the prevalence of sleep apnea in commercial truck drivers, noting that a study published in 2002 found that almost a third of CMV drivers have mild to severe obstructive sleep apnea. This study, along with a later study, found that older age and higher body mass index are two factors commonly linked with sleep apnea.

30% of drivers have mild to severe sleep apnea? How could that be? The 7 year study performed by the FMCSA didn’t come close to those figures?

I decided to look at the research, and this is what I came up with:

It appears that these figures and statements made during the Sleep Apnea & Trucking Conference of May 12, 2010 were possibly based on this study.  At least this is the only study I could find actual data on.

TECH BRIEF: Sleep Apnea Crash Risk Study

The study was conducted by the University of Pennsylvania  Sleep Apnea Study. The research was conducted during 1996 to1998. Sleep apnea is a condition in which a narrowing or closure of the upper airway during sleep causes repeated sleep disturbances, and possible complete awakenings, leading to poor sleep quality and excessive daytime sleepiness. This study was completed to assess the risks of commercial motor vehicle (CMV) crashes due to the presence of sleep apnea among truck drivers.

Basically, this study involved 1391 drivers. The drivers were asked a series of questions, including their height and weight, sleep patterns, medical history, snoring, etc. This was used as a screening process to determine which drivers were most likely to have sleep apnea.  Out of the 1391 drivers, 406 were selected as a result of their questionnaire, to proceed with the overnight laboratory study in order to determine how many of them were accurately predicted to have sleep apnea.

The results were as follows:

64% or  260 of the  406 flagged for most likely to have sleep apnea had no sleep apnea.
21.2%
or 86 of the 406 flagged for most likely to have sleep apnea  had mild sleep apnea.
7.9% or32 of the 406 flagged for most likely to have sleep apnea  had moderated sleep apnea.
6.9%
or 28 of the 406 flagged for most likely to have sleep apnea  had severe sleep apnea.

Now, the above percentages and figures are for the 406 flagged drivers.  When you perform the calculations based on the group study of ALL 1391 Drivers, here are the results ( the calculation required to accurately represent and  determine % of ALL drivers):

2.0% or 28 of total 1391 drivers had severe sleep apnea  ( matches the 1st study by FMCSA- DFAS)
2.3% or 32 of total 1391 drivers had moderate sleep apnea
6.2% or 86 of total 1391  drivers had mild sleep apnea.

This would mean that only 4.3%  of drivers have moderate to severe sleep apnea. If you include mild sleep apnea, the % jumps to 10.5%

The following  statement in the report however is the most revealing of all:

“The results of the study 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. Another meaningful study finding showed that the prevalence of sleep apnea depends on the average duration of sleep over consecutive nights at home.  Short sleep duration, six hours or less per night, results in an increase in the prevalence of sleep apnea.”

Here’s that last statement again which has not been mentioned by the authorities and experts as a major source of sleep apnea,” Short sleep duration, six hours or less per night, results in an increase in the prevalence of sleep apnea.”

When you consider that the average OTR truck driver gets 5.2 hours sleep/night, then you have to wonder if it is the trucking industry lifestyle, behavior, and rules  which are major causes for driver fatigue and also for creating/inducing “driver  sleep apnea.”

The original hypothesis tested was the following: “A driver diagnosed with sleep apnea is more likely to be involved in a motor vehicle crash than a driver with no history or symptoms of sleep apnea, after controlling for differences in the other predictor variables included in the model.

Finally, the study concluded to say, No association was found between sleep apnea presence or severity and multiple crashes. This suggests that the commercial drivers in this study who were diagnosed with sleep apnea were not at increased risk for having more than one crash over the 14 year period prior to and following diagnosis…. Furthermore, there was no evidence from the data used in this study to suggest that crash risk is impacted before and after drivers are diagnosed with sleep apnea.”

There are many reasons for Driver Fatigue, and despite what many would like you to believe, lack of available sleep is the major cause.  Sleep Apnea appears to represent a much smaller percentage than what is being stated.  The data strongly suggests this.

Although sleep apnea is a real condition, it represents a much smaller percent of the driver population than the FMCSA and the ATA are suggesting.  To screen a driver by height and weight (BMI), and neck size ( 17 or greater) is not only discriminatory, but is ludicrous.  To force drivers to pay for the testing based on such information is simply wrong and unjust.  A serious look at other reasons for driver fatigue should be investigated.

  • Lack of adequate truck parking.
  • Dispatchers pushing drivers to driver when they say they are either ill or tired.
  • Shippers and receivers holding drivers up at the docks for hours, cutting into their rest time.
  • Dispatch waking drivers up via qualcomm etc., to ask questions, failing to respect and abide by the HOS regulations.
  • Retaliation tactics from carrier if the drivers states he or she is too fatigued to drive

On the other side of that coin, if you do believe you may have sleep apnea, then you should by all means be tested and start the treatment.

The FMCSA needs to create laws, ensuring that drivers are not sleep deprived rather that associate driver fatigue on the hype of sleep apnea.  It appears this is just a way to take the attention off of the real and valid reasons that drivers are fatigued, thus relieving the responsibility from carriers, shippers, and receivers who are all a part of depriving drivers from the rest they need. It’s also a way to deviate attention from the present HOS rules which need to be modified in order to aid in better and more rest for drivers.

Creating a sleep apnea testing program will be a BIG money maker for many as well as one more excuse to eliminate “undesirable” drivers from the industry.

© 2010 – 2011, Allen Smith. All rights reserved.

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By: Allen Smith

Allen Smith is a 37 year veteran who started at an early age in a household goods family moving business. He began driving straight trucks in 1977 and moved to the big rigs in 1982. His experience within the industry includes; owner operator, company driver, operations manager, and owner of a long distance HHG moving business, taking many of the long haul moves himself when needed. Allen Smith, a truck driver advocate who is driven by the desire to help others succeed within an industry where injustice, unrewarded sacrifice, and lack of respect and recognition exists. Allen and his wife Donna are hosts of Truth About Trucking ”Live” on Blog Talk Radio. Other websites include AskTheTrucker, TruckingSocialMedia, NorthAmericanTruckingALerts, TruthAboutTrucking, and many Social Media websites. In 2011 Allen and Donna hosted the first Truck Driver Social Media Convention, designed to create unity and solutions for the trucking industry. This is now being extended through the North American Trucking Alerts network as those within the industry join forces for the betterment of the industry. Allen strongly supports other industry advocates who are also stepping up to the plate to help those who share honesty, guidance and direction. He believes that all those involved in trucking need to be accountable for their part within the industry, including drivers, carriers, brokers, shippers, receivers, etc… The list of supporters and likeminded people grow daily, networking together and sharing thoughts and ideas for the betterment of trucking. He has coined the popular phrase "Raising the standards of the trucking industry"

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11 Responses to Sleep Apnea- A Smoke Screen for Many Truck Driver Fatigue Issues. - Post a Comment

  1. […] “Sleep Apnea-A smoke Screen for Truck Driver Fatigue Issue” […]

  2. Linda

    Finally! Somebody critiques the study! I’ve been screaming about this for three years! The ‘study’ doesn’t say what they’re reporting it does . . .those selected for the study were heavily weighted toward those whose questionnaires showed possible sleep apnea-about 2-to-1. The first time FMCSA looked at the study, they said it showed NOTHING! This is the same recycled study! Second, sleep testing is designed to elicit instances of sleep apnea that wouldn’t necessarily be there if not for the way they test.Any certified testing outfit will confirm this IF you ask the right questions! Third, there are reasons for a positive sleep test that have nothing much to do with the driver’s physical condition . . .like long-term irregular sleep schedules, interrupted sleep, poor sleep environment . .all part of the job. If you fall asleep too quickly, according to testing criteria, when placed in a dim room with nothing to do, then you have ‘sleep apnea’ – bullpuckey; you’re just a typical truck driver who suffers from having to sleep when you get a chance!

    The main sleep testing/ CPAP mills are advertising this to carriers as a way to cut their health and liability costs. The original carrier who teamed with this CPAP purveyor bounced out some ridiculously-high numbers of accident reduction and health care costs . . .no one has seen the actual test results, just their claims. I’d guess they’re as twisted as the U of P studies.It says a great deal that the ‘RN’ who ran this first carrier program and came up with all these ‘findings’ is now second in command at this CPAP purveyor.

    Finally – and I think you’re getting to that point in some of your posts, Allen -these carriers wanted to get rid of older, higher-paid drivers. Their testing criteria (using age as part of the criteria) forced a great many drivers out because they simply couldn’t deal with all the crap they got. CSA 2010 will do the same thing, as experienced drivers will have higher scoring than new drivers-for a while. They’re already talking about needing new trainees. Do they want foreign drivers? YES! But, they’d prefer not to have to deal with employment problems and liability at all. Watch for opening the border to Mexican carriers, and relaxation of cabotage laws! All the big carriers will become ‘logistics’ companies and broker their freight to the Mexican carrier, thus escaping liability and raking in profits based on lower-cost drivers. The big financial people have been saying for some time that the most profitable transportation companies were those who had no rolling stock . . . .you can see it coming down the tracks. And, yes, it IS a train! Bye-bye, American truck driver. The deck is stacked against you!

  3. Eskimoe Joe

    My father used to say “Figures don’t lie but liars can figure”. No doubt the bottom line will be that the sleep apnea companies are giving boatloads of money to whatever congress people are behind this scam. Not to mention the significant increase in the value of these companies stock if this program is implemented. Congress wrote a law years ago exempting themselves from being prosecuted for insider trading violations.
    That’s how these politicians are able to develop 7 figure net worth on $150K incomes. It makes me sick to my stomach. How about just a little bit of integrity for a change????

  4. Gerda Harder

    They cannot differentiate responsible drivers from irresponsible drivers. What happend from Simplicity. If they would take al reckless irresponsible drivers of the road, then they do not need to do all this **** and get the $150K incomes. Yes how about integrity? That is the right word. I’m in disbelieved and sick to my stomach too.

  5. Gerda Harder

    Fight American drivers, don’t give-up; If Mexican crriers will come to the Unided States, we will face another dilema with safety, plus lost of freight. I tell you because I know, trust me, fight back.

  6. […] On May 18th we wrote a blog post to explain the data and results conducted by the FMCSA regarding a study on Sleep Apnea; “Sleep Apnea- A Smoke Screen for Many Truck Driver Fatigue Issues” […]

  7. […] On May 18th we wrote a blog post to explain the data and results conducted by the FMCSA regarding a study on Sleep Apnea; “Sleep Apnea- A Smoke Screen for Many Truck Driver Fatigue Issues” […]

  8. andre duclos

    Did any see the dates of these studies? Many are 15-20 years old. The average truck driver gets more sleep then 5.2 hours per night. The current hours of service are good enough, and a very small portion of drivers have sleep apnea and they know it. Many drivers have their machines right next to them at night and function just like everyone else. I find this funny that their testing results say “The results of the study showed that the prevalence rates of sleep apnea among commercial truck drivers are similar to sleep apnea rates found in other general populations.” Now if that is not a slam dunk on their testing scam, I dont know what else there is to say.

  9. […] “Sleep Apnea-A smoke Screen for Many Truck Driver Fatigue Issues” […]

  10. Roy Ijams

    http://mobile.the-scientist.com/article/27316/harvard-prof-falsified-sleep-data . another story. By: Martha Garcia | Published: April 15th, 2013 Nearly two dozen universities failed to properly warn parents that a national oxygen study may put their premature infants at risk, federal officials say. According to a letter (PDF) issued by the Department of Health and Human Services (DHHS) to the University of Alabama at Birmingham, the lead institution in the study, research institutions involved in the study did not offer informed consent to the parents of the premature infants. The study involved 1,300 premature infants between 24 to 27 weeks of gestation. Researchers evaluated the results of increased or decreased oxygen through a continuous positive airway pressure (CPAP) treatment to determine the levels of oxygen saturation and neurological effects on premature infants. According to the letter, the institutions involved were aware of the potential adverse affects the treatment may have on the infants, including blindness and even death. The DHHS Office of Human Research Protection says the institutions had sufficient evidence to know such treatment may cause serious consequences, but never properly informed parents participating in the study about the potential risks. The office considers the failing a violation of regulatory requirements for informed consent. The study took place between 2004 and 2009 and 130 infants of 654 in the low oxygen level group died, while 91 of 509 infants in the high oxygen group developed a serious eye problem, which can result in blindness. The study, published in the New England Journal of Medicine in 2010, was financed by the National Institutes of Health and involved 23 high profile Universities, such as Stanford, Duke and Yale. The consent form only mentioned risks involving abrasion of the infants skin, and claimed there was a potential benefit of decreased need for eye surgery if the infant was assigned to a certain oxygen level group. DHHS officials say the consent form should have highlighted that the risks of the trial were not the same as the risks of receiving standard care, so parents could make a more informed decision. I’v found billions in fraud connected to sleep studies. I sleep walked out of a semi 6/8/2012. My wife was driving and granddaughter was in passinger seat. Was put on cpap Feb 2012. When I called I told sleep folks I didn’t feel better. Was told I’d get used to it. 10/1/12 I had a seizure. Have had 6 known seizures sence then. Trying to get on disabilty. Have over 2 million safe driving miles with Prime Inc. Was not brought in for more sleep testing till after sleep walking with cpap. I know of other sleep walking cases. And have found you can become cpap dependent. 02 toxicity in lungs which can cause cysts that can go undetected. Pulse ox senser on finger doesn’t give good reading because hemoglobin in blood tries to protect body. It said researchers new that effect would be hard to prove. Can’t find Doc willing to go against sleep folks. I have more.

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