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Obstructive Sleep Apnea Recommendations and Controversies


Controversies Loom over 2016 Obstructive Sleep Apnea Recommendations





3/8/2016:   After recommendations from the National Transportation and Safety Board the FMCSA and FRA jointly published an Advanced Notice of Proposed Rulemaking on Obstructive Sleep Apnea.  The purpose was to collect data and information concerning the prevalence of moderate to severe obstructive sleep apnea (OSA)  in highway and rail workers and it’s impact on safety.

8/22/2016-8/23/2016:  The FMCSA Medical Review Board (MRB) met to review more than 600 comments that were submitted from medical professionals and organizations, labor, industry and safety organization as well as reviewing it’s own previously published 2012 Report on OSA in  preparation for the recommendations that the MRB would be making to the Motor Carrier Safety Advisory Committee (MCSAC).  Preliminary recommendations made were referral for diagnostic studies for OSA in drivers with a BMI greater than or equal to 40 or a BMI of 33-39 who meet 3 of 11 risk factors.

10/24/2016-10/25/2016:   The MRB and the Motor Carrier Safety Advisory Committee (MCSAC) agreed on recommendations.  It is up to the FMCSA at a later meeting to decide whether or not to adopt any of the recommendations made to it by the MRB and MCSAC.   If adopted, drivers with BMI equal to or greater than 40 OR with BMI 33-39 and 3 of 11 risk factors can receive conditional certifications and undergo testing.  If they are found to have OSA, they would need to undergo treatment.

Summary of Recommendations  (Obstructive Sleep Apnea)

Any driver with a Body Mass Index (BMI) of 40 or more will require testing.

For those with a BMI of 33-39 the MRB recommended that they have at least 3 of 11 risk factors listed below to require testing.

  • Male or post menaupausal women
  • Age 42 or older
  • Loud snoring
  • Witnessed apnea
  • Mallampati Class 3 or 4
  • Neck size greater than 17 in men or 15.5 in women
  • Micrognathia or retrognathia
  • Hypertension
  • History of stroke, coronary artery disease (CAD) or arrythmia
  • Type 2 diabetes
  • Hypothyroidism


Related Articles –Truckers with high BMI would be forced into apnea screening under FMCSA committee recommendations, drivers respond

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By: Randolph Rosarion

Dr. Randolph Rosarion MD is the DOT Medical Adviser for North American Trucking Alerts. Dr. Randolph Rosarion is a certified medical examiner listed in the US DOT FMCSA National Registry of Certified Medical Examiners and received his medical degree from Stony Brook University School of Medicine. His medical practice, USDOT Medical Examiner is located in College Point, Queens, New York and specializes in Physical Medicine/Rehabilitation and Occupational Medicine. As a recognized leader in the field, he received the Best of Queens Award 2013 for Department of Transportation Commercial Driver License Medical Examinations. Board Certified physician in Physical Medicine & Rehabilitation (PM&R) Board Certified American Board of Pain Medicine Certified National Registry of Certified Medical Examiners (NRCME) Certified Medical Review Officer (MRO)

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