OBSTRUCTIVE SLEEP APNEA INFORMATION FOR COMMERCIAL DRIVERS

As a new or re-certifying driver, you may have questions why our certified medical examiners have changed their approach to the condition you may know as “sleep apnea”. Based on medical studies, the medical leadership of US HealthWorks made a decision to have our examiners follow a consistent protocol if this condition is suspected during your medical examination as a commercial driver, whether you cross state lines or drive within them. Hopefully, this will answer most of the questions you may have about this change.

OUR CONCERN FOR YOUR HEALTH

Sleep apnea is a condition that causes you to stop breathing while you sleep. This may happen as many as fifty or sixty times a night. When it does, your blood oxygen drops to very low levels and to your sleeping brain it’s as if you were suddenly drowning. The brain responds by making you gasp for breath and breath rapidly until your oxygen level is back to normal. You don’t usually wake up when this happens, however these episodes prevent you from getting the quality rest you need to function the next day. You find yourself tired and you likely have trouble staying awake especially during times of boredom or routine activity. You may actually fall asleep during the day. While this may be safe if you’re on the sofa at home reading, it clearly isn’t when you’re driving an eighteen wheeler or a school bus. Accident studies show sleep apnea to be a significant cause of many fatal and career ending crashes. Also, if you have undiagnosed or untreated sleep apnea, you are at a much higher risk for a sudden heart attack or stroke. That snoring your partner may complain about is a sign you may have sleep apnea. While your medical examiner is responsible for determining if you can safely drive a commercial vehicle, he or she is also concerned about your health and may be the only clinician you see every year. Because it is such a serious condition, our examiners must consider the possibility you may have undiagnosed sleep apnea. In addition to the medical history you complete on the standard DOT form, our examiners are now using two additional tools to identify possible risks for sleep apnea. These are the Body Mass Index (BMI) and the Obstructive Sleep Apnea Evaluation Worksheet.

Because of the long hours, lack of exercise and limited food choices, your job  makes it easier for you to become overweight. Being overweight not only increases the chance of you developing high blood pressure, heart disease and diabetes, but at a certain level, you also may develop sleep apnea. We use the Body Mass Index (BM!) to determine in which category your current weight puts you. Once you reach a BM! of 25 you are considered overweight. Should your number increase to 30, you are officially obese. Medical studies have shown that 70% of persons with a BM! of 35 or ‘ more have sleep apnea. When the weather man says there’s a 70% chance of rain, you take an umbrella. When our examiners find your  BM!  is at this  level, they  will  assume  you  have sleep apnea until proven otherwise.

WHAT TO EXPECT IF YOUR BMI IS 35 OR MORE DURING YOUR EXAMINATION

If your  BM/ is  35  or greater, you will  be  required to complete  the  Obstructive  Sleep   Apnea Evaluation Worksheet To evaluate your risks for sleep apnea and have testing for sleep apnea. You-should arrange this through your private physician’s office.  You will receive a 90-day temporary medical certificate while we await the outcome of the testing;

    • On your next visit, you must bring the results of your sleep studies for the examiner to review.
    • If the study does not show signs of sleep apnea, your medical card will be updated to expire two years from the date of your first exam unless another condition is present that requires a shorter duration of certification ( i.e. high blood pressure or diabetes)
    • If your study does show you have sleep apnea, we expect that your physician will have ordered you a CPAP machine or other device. You need to start using your device immediately and at least thirty (30) days before returning for your follow-up exam, and show that your have used the machine at least four (4) hours a day 70% the time. Because we cannot download data from your machine at our centers, you need to bring your examiner a print out from the machine’s data chip that shows how often and long you have used your device. If the print out shows you have controlled your sleep apnea, you will receive an updated medical card that will expire one year from the date of your original exam.
    • When you re-certify in the future, you will need to bring a print out of the each time for the examiner to review.

WHAT TO EXPECT IF YOUR BMI IS BETWEEN 25 AND 35 DURING YOUR EXAMINATION

    • If your BM/ is 25 through 34, you will be required to complete the Obstructive Sleep Apnea Evaluation Worksheet to evaluate your risks for OSA. Depending on your answers and what your medical examiner finds, you may be required to have testing for sleep apnea. If so, you will be given a 90-day temporary medical certificate while you arrange sleep testing with your private physician. Thereafter, you will be asked to follow the protocol outlined above for drivers with BMl’s of 35 or more.

WHAT WILL DISQUALIFY YOU?

    • If you have had a vehicular crash related to falling asleep while driving, you will be disqualified from driving until you either undergo evaluation for sleep apnea as outlined above or return to using your device as instructed.

The important thing to take away from this is that untreated obstructive sleep apnea affects your health and the safety of yourself and others. Having this condition and doing nothing about it puts your life at risk. Having a crash that injures or kills others on the road is nothing you would wish to live with if you survived. Missing the chance to be diagnosed puts you at risk for medical problems that by themselves

are unwelcome let alone being expensive, time    consuming to care for and which lower the quality of I your  life.  If  you  or your  employer  needs  more information on this  matter, please contact the center where your examinations are done and ask to speak with the Medical Director.   Drive safely and stay healthy.