Wednesday, March 21, 2018

Trying to get clear picture of possible sleep apnea regs like blind men describing elephant

Tuesday, August 31, 2010

There will be medical guidelines coming some time in the near future dealing with sleep apnea. (The Trucker file photo)
There will be medical guidelines coming some time in the near future dealing with sleep apnea. (The Trucker file photo)

Sometimes it seems that trying to understand what the federal government is doing in relation to driver health, specifically sleep apnea,  is a little like the blind men who were examining the elephant.

One, who was feeling the animal’s trunk, said an elephant is like a snake. One, who had hold of the tail, said the elephant was like a stick. A third man, who was feeling of one of the elephant’s legs, said the animal clearly was like a tree trunk.

What I can say is there will be medical guidelines coming some time in the near future dealing with sleep apnea. Exactly what they will entail, no one seems to know, or can say, for sure.

However, we know what they will NOT be. We think.

Dr. Maggie Gunnels, director, Office of Medical Programs, FMCSA, said in July that there will be a respiratory requirement “update” and sleep apnea will be an element of that.

“We are intending to propose an update to the respiratory regulations of which sleep disorders are an element,” she said. “Right now a medical examiner can screen for sleep apnea and require testing.”

She added, however, that “We haven’t proposed anything formally yet. Sleep apnea is contained with the current (and the future) respiratory regulation.”

When asked if FMCSA was going to set a weight limit for truckers and regulate neck size and body mass index (BMI) Gunnels said “the answer is no. These are factors that are indicators evaluated during the [medical] exam, but it’s unrealistic to set guidelines on symptoms like that.”

However, during a segment of the Evan Lockridge show on Sirius XM satellite radio Aug. 3, she said there’s no BMI mandated by FMCSA but that if a doctor considered a trucker to be at-risk for sleep apnea “he would look at that [BMI].”

I’m feeling the confusion start to set in.

We asked driver Bob Stanton, co-coordinator of the Truckers For a Cause chapter of A.W.A.K.E. to enlighten us, since he has sleep apnea and has tried to learn everything he can about it.

Stanton said some of the confusion over sleep apnea standards has to do with the fact that in trucking, drivers are used to having clear-cut rules. He used out-of-service criteria as an example. “If your brake pads are anything less than a quarter-inch thick, you’re out of service.”

Medical questions, he said, “are not so clear cut. They have large gray areas. The lack of clarity and specific criteria on medical issues in the DOT medical exams both in guidance and practice may be where the confusion among drivers is coming from.”

Christie Cullinan, director of workplace and fleet safety for the American Trucking Associations, said once FMCSA does come out with some guidance related to sleep apnea “some of the hearsay will probably calm down.”

She said right now, whether a driver is tested and treated for sleep apnea is up to the individual medical examiner and right now how they determine whether a driver has sleep apnea “is all over the place.”

At least, guidelines would give some consistency as far as screening, she said.

Dorothy Cox of The Trucker staff can be reached to comment on this article at

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