Monday, April 02, 2012

Required Sleep Disorder Tests for Truck Drivers

I applaud the effort to increase driver safety.
While convenient, these devices are not 100% sensitive. They can have artifact. And in some the results may not be valid given the person's medical history and exam. 
Sleep apnea is best treated with a face-to-face with a physician. This is a high risk population that needs close follow up with a specialist.
Success with CPAP is best at devoted sleep center. Many people are still very sleepy even after CPAP has started. 
Are we selling CPAP's or improving road safety?
Eyes Open.

Required Sleep Disorder Tests for Truck Drivers
Truck drivers should be required to undergo medical tests for sleep disorders before getting a licence, experts say, after a study that has revealed a high number with sleep apnea.
The study, published on Sunday in the Journal of Sleep, surveyed 517 long-haul drivers of B-doubles, semi-trailers and road trains in NSW and Western Australia.
It found 41 per cent had undiagnosed obstructive sleep apnoea (OSA), a condition in which the airways close, causing people to stop breathing during sleep.
OSA can increase drivers' risk of crashing by two to seven-fold, the study said.
Currently, truck drivers are required only to fill out a questionnaire about their sleep patterns in order to pass a medical to obtain their heavy vehicle licence.
However, researchers found that only 12 per cent of truck drivers reported struggling with tiredness using this questionnaire, called the Epworth Sleepiness Scale(ESS).
The OSA sufferers in the study were diagnosed using a take-home monitoring device, which has been proven to identify sleep apnea accurately.
The report's authors concluded that the questionnaires alone were not sufficient to assess drivers' crash risk.
Prof Mark Stevenson, the director of Melbourne's Monash University Accident Research Centre, said the current licensing requirements would not identify those with sleep disorders.
"We know there is an elevated risk of crashing in drivers with untreated OSA, therefore it is important that truck drivers - behind the wheels of the largest vehicles on the road network, at times with combustible freight - should be tested with a diagnostic tool that does not rely on self reporting."
Industry body the Australian Trucking Association fully reported the study's conclusions.
Communications manager Bill McKinley said the association in 2009 recommended diagnostic testing for truck drivers to the National Transport Commission, which develops licensing guidelines.
However he said the recommendation was ignored in the most recent guidelines, in place since March 1.
"The ATA fully agrees that there should be a diagnostic tool for sleep apnea included in the medical standards for truck drivers," Mr McKinley told AAP.
The National Transport Commission declined to comment.
The study also found that 50 per cent of truck drivers surveyed were overweight and 49.5 per cent were smokers.
Eighteen per cent had hypertension but only 13 per cent took medication for the condition.
Truck drivers worked an average of 65.4 hours a week, 40 per cent reported trouble sleeping in the past month and 17 struggled with tiredness at least twice a week.
The study, the largest of its kind, involved the universities of Sydney, NSW, Queensland, Monash University Accident Research Centre, The George Institute for Global Health, and Curtin University.
Read more here

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