Evidence Report

Evidence Report:
Obstructive Sleep Apnea and Commercial Motor Vehicle Driver Safety (Comprehensive Review)

Download the Report (PDF, 6MB)

Expert Panel Recommendations:
Obstructive Sleep Apnea and Commercial Motor Vehicle Driver Safety)

Download the Report (PDF, 550KB)

A published paper by Schneider National reveals its sleep-apnea screening and treatment program has generated a return on investment in the form of savings on medical costs, accident reduction, reduced turnover and increased productivity.

Schneider National report drew the following conclusions:
  1. Among 348 drivers diagnosed with sleep disordered breathing (SDB) and who were treated, medical costs accrued were slashed in half per month.
  2. There was a 73% reduction in preventable driving accidents among a group of 225 SDB-diagnosed drivers treated with continuous positive airway pressure (CPAP) devices.
  3. The driver retention rate of CPAP-treated individuals was 2.29 times greater when compared to that of the total company driver population in 2004.
Wendy Sullivan, Schneider’s occupational health manager, said that Schneider had long been investigating ways to cost-effectively diagnose and treat sleep apnea. In the past three years, the truckload giant has “recognized a trend in those medical records that sleep apnea had a lot to do with fatigue and hypertension, heart disease and diabetes.”

“With 15,000 drivers, we’re scaling this effort and learning as we go,” Sullivan said. “With this sort of return on investment we decided that we’re going to pay for the cost of this study and CPAP.”

The Schneider white paper was made available to Fleet Owner shortly after the American College of Chest Physicians, American College of Occupational and Environmental Medicine and the National Sleep Foundation offered a joint recommendation on how FMCSA should update its standards so that DOT medical examiners could more effectively screen for sleep apnea.

Sullivan acknowledged that the funding of Schneider’s sleep apnea screening and treatment program was largely thanks to the size of the company. However, she fully supports the joint recommendation.

“I’m presuming there’s health insurance for small carriers,” Sullivan noted. “If you’re going to have this sort of return on investment then [treating sleep apnea is] always viable. I realize there’s soft versus hard savings but if you could retain your drivers through aging rather than workers comp, it’s viable.”

Mark Berger, founder of Precision Pulmonary Diagnostics, a sleep apnea solutions provider for the trucking industry, has worked with Schneider to “vertically integrate” its screening and treatment program and also conducted the research behind the white paper.

“There’s no driver out-of-pocket cost—[Schneider] promotes it because they benefit from it,” Berger toldFleetOwner. “It is an uphill battle for this industry to change the perception of sleep apnea by drivers that being diagnosed means being out of work.”

Indeed, that’s one of the major reasons why drivers avoid receiving a diagnosis of sleep apnea.

The joint recommendation to DOT stated:
“Under current FMCSA guidelines, CMV operators who are being treated for sleep apnea can return to work a minimum of one month after initiation of treatment. The task force’s recommendations include reducing return-to-work time to two weeks after treatment initiation in certain situations. Reevaluation after four weeks to ensure compliance with therapy and improvement in symptoms is also recommended.”

“It’s been a ‘don’t ask, don’t tell’ situation for drivers,” Dana Voine, senior vp of occupational health for ResMed, a manufacturer of CPAP respiratory devices, told FleetOwner. “It’s completely ridiculous; it’s causing people not to get screened or treated.”

A FMCSA spokesperson said in an emailed statement:
“We anticipate that the recommendations released by the joint task force will be considered when the Medical Review Board reviews sleep apnea and related medical issues, as it pertains to commercial driver health and safety. The prevalence of sleep apnea was a key component in establishing this subject area as a priority for the newly formed Board.”

To comment on this article, write to Terrence Nguyen, attnguyen@fleetowner.com