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establish sleep apnea programs. Fortunately, science has produced


a very effective diagnostic and treatment process. Drivers are tested for the condition in a sleep lab or by using a home-based device about the size of an iPhone. Those who test positive are prescribed continuous positive airway pressure (CPAP) machines in which a mask imparts air pressure on the airway to keep it open during sleep. Other versions exist, such as automated positive airway pressure (APAP) machines that adjust the therapy by analyzing the wearer’s previous breaths to determine if sleep apnea is occurring. SleepSafe Drivers and Sleep Access


have set up testing and treatment programs with sleep physicians across the country. They say they can test drivers overnight and provide treatment services at lower costs than if trucking companies establish their own programs. After 25 years of working with


the trucking industry as an insurance underwriter, marketing officer and consultant, Rich Bren knows how debilitating sleep apnea can be. Bren, now vice president of strategic sales for Contractor Management Services, an ATA-member company that helps trucking companies work with independent contractors, often suspected sleep deprivation was a contributing factor in many accidents, even when it wasn’t listed as a cause. For example, why else would a driver have a rollover accident in wide-open territory out on remote Arizona highways? And it wasn’t just truck drivers who were affected – dispatchers and forklift operators also had problems. Meanwhile, Bren was having his own


trouble sleeping. He could manage only about four hours a night and would awaken with headaches because of the oxygen deprivation. He stayed awake thanks to a lot of caffeine and started being treated for high blood pressure. “I was, quality of life-wise, killing myself and didn’t know it,” he said. Bren strongly suspected he had sleep


apnea, which existed in his family, but tests were inconclusive, so he continued to suffer from sleep deprivation until about 2005, when he finally was diagnosed and treated with a CPAP machine. “My wife, first night I had that machine, thought I had died because I laid there just resting finally,” he said.


Arizona Trucking Association 2012 Yearbook “WE SEE AN OPPORTUNITY TO IMPROVE FLEET


SAFETY, IMPROVE DRIVER HEALTH AND WELLNESS, SO WE’RE NOT GOING TO WAIT FOR A REGULATOR OR A LEGISLATOR TO TELL US.“


—DON OSTERBERG


SENIOR VICE PRESIDENT OF SAFETY, SECURITY AND DRIVER TRAINING SCHNEIDER NATIONAL


As a result of his own experience, Bren


became involved in the American Sleep Apnea Association. He is now a member of the board of directors and served on the executive committee in 2011. For more information, go to www.sleepapnea.org. The Federal Motor Carrier Safety


Administration (FMCSA) requires drivers to be medically certified that they do not suffer from a respiratory dysfunction, including sleep apnea that could interfere with safe driving. But guidelines for certifiers are lacking, and states can have their own regulations. According to Don Osterberg, senior vice president of safety, security and driver training for Schneider National, that “regulatory vacuum” allows unqualified medical professionals – doctors, nurse practitioners, even chiropractors – to OK a driver who shouldn’t be behind the wheel. It also encourages drivers to “doctor hop” until they can find a supportive certifier. The FMCSA for several years has


considered revamping its rules. The National Traffic Safety Board has recommended that it screen drivers for sleep apnea and develop programs to identify the disorder. The FMCSA’s own Medical Review Board, which is comprised of medical professionals, submitted a comprehensive set of recommendations in January 2008, but nothing came of them. The Medical Review Board and the FMSCA’s Motor Carrier Safety Administration Council, which involves industry insiders, jointly provided recommendations to the FMSCA early in 2012.


Those recommendations said that a driver diagnosed with sleep apnea should


not be certified unless the condition is mild to moderate, unless the driver “does not admit to experiencing excess sleepiness during the major wake period,” or unless the driver is being treated. Drivers with the diagnosis should be recertified annually if they are complying with treatment recommendations. Drivers who admit to experiencing heavy sleepiness while driving, who experience a crash while falling asleep, or who don’t comply with treatment recommendations should be disqualified or denied certification. The recommendations temporarily


were published in the Federal Register, which contains federal rules and proposed rules, on April 20, with public comments requested by May 21. However, the agency pulled the recommendations within hours of posting them, explaining that the posting was a clerical error and it was still evaluating its position. According to an FMCSA spokesperson, the recommendations are being reviewed, and the agency expects to issue a Federal Register notice later in 2012 requesting public comment. Schneider National has not waited


for new guidelines. It began a fatigue management program in the mid-1990s and then did a causal factor analysis in 2003 of its high severity crashes. After studying the previous four years, the company determined that fatigue was underreported, either because drivers were hiding the fact or because they didn’t realize they were impaired. “If it was 3 a.m. and we had a single vehicle crash where the driver ran off the road, whether the driver acknowledged


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