Is the FMCSA Sleep Apnea Rule Good or Bad for the Trucking Industry?

LDL Voice

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Sleep Apnea has become a serious problem for drivers on the road—at least that’s what some government officials say. But do the pros of enforcing mandatory screenings outweigh the potential cons? 

What is Sleep Apnea?

Obstructive Sleep Apnea, or OSA, is a respiratory disorder that causes breathing disruptions during sleep, occurring up to 400 times per night. In addition to chronic illnesses, the condition leads to drowsiness and inattentiveness during waking hours—a problem for some commercial truck drivers, who are far more likely than non-professional drivers to stay on the road when tired (Fox News). Because a fatigued driver may experience a 50 percent decrease in decision-making capabilities and a 75 percent reduction in concentration, this creates a significant crash risk for drivers, fleet owners, and the public at large (BiS).

Drowsy driving has long been a concern among commercial truck drivers, 28 percent of whom may suffer from OSA (Fox News). In fact, a substantial number of fatal road and rail disasters have been attributed to OSA, influencing recent Federal Motor Carrier Safety Administration (FMCSA) and Federal Railroad Administration (FRA) recommendations to examine the issue closely, and potentially update screening rules for drivers and rail workers (Fleet Owner).  

While most agree that OSA is problematic, the possibility for new regulation has prompted drivers and fleet owners to weigh both the pros and cons of mandatory screening and treatment:

The Pros

  • Safer Roads. According to sleep experts, drivers treated for OSA have 73 percent fewer preventable accidents (Fox News). 
  • Alert, Healthy Drivers. In addition to being more alert on the road, diagnosed and treated drivers report more sleep, lower blood pressure, reduced risk for heart disease and diabetes, and generally feeling better upon waking (BiS).  
  • Existing Standards. Airline pilots are routinely screened for sleep apnea, making the statistics available and processes repeatable. Some argue that screening commercial truck and rail operators makes even better sense because, unlike pilots who can rely on autopilot, truck drivers must stay aware at all times (Safety+Health).  
  • Treatable Nature of OSA. An OSA diagnosis doesn’t mean a truck driver has to leave his or her job.  Once treatment has begun, drivers may resume normal responsibilities within a month.

The Cons

  • Worsening Driver Shortage. Implementing mandatory OSA screenings may cause some drivers to leave the industry. Doing so at a time when recruitment is already difficult causes an obvious disincentive for fleet operators. Further, employee turnover can cost fleets as much as $9000 per driver in terms of training and hiring efforts (BiS).     
  • Expensive Diagnosis and Treatment. Estimates for OSA screening and treatment can run between $2500 and $4000, a sum not covered by many insurance policies. A positive diagnosis can also result in time off work—up to 30 days in some cases—until a doctor certifies that it’s safe to get behind a wheel (Fox News).     
  • False Positives and Over-Treatment. Current requirements for self-reporting OSA has limitations, including under-reporting and reporter bias. However, critics say prescribing a broad screening approach will encourage false positive results as well as treatment for diagnoses that don’t really need it. Tested subjects across the transportation industry recognize that doctors and medical equipment manufacturers have a financial interest in diagnosing and treating the condition, which simply shifts the bias instead of correcting it (Overdrive).        

In the end, safety and long-term health may outweigh what some perceive to be over-regulation. Data shows that the average cost of an undiagnosed driver in terms of productivity, legal exposure from crashes, and other factors tops $6300, while a diagnosed driver costs about 60 percent less (Fox News).  

Carriers may justify support for mandatory screening through simple cost-benefit analysis, yet understanding the numbers and logic doesn’t make the decision easy, particularly for drivers and small owner-operators. The real issue is far more complex. How can drivers and small owner-operators combat OSA, investing in safety and health, without burdensome costs and requirements?

Commercial truck drivers, what do you think? Post your comments below.

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