Screening for Obstructive Sleep Apnea During Commercial Driver Medical Examinations

Objective: To evaluate consensus criteria for screening commercial drivers for obstructive sleep apnea (OSA). Methods: Consecutive drivers underwent OSA screening using Joint Task Force consensus criteria at commercial driver medical examinations. Outcomes included: clinical yield of screening; and drivers’ compliance with polysomnography (PSG) referrals and OSA treatment. Results: Among 456 drivers, 53 (12%) were referred for PSG, and 20/20 were confirmed to have OSA, supporting a high positive predictive value. The other 33 drivers referred for PSG were lost to follow-up but demonstrated no significant differences from those with confirmed OSA. After diagnosis, only one of 20 drivers with confirmed OSA demonstrated treatment compliance. Conclusions: Drivers identified by the consensus criteria have a high likelihood of OSA. Drivers’ poor compliance with PSGs and OSA treatment support federally mandated screening of commercial drivers.

[1]  N J Douglas,et al.  Under reporting of sleepiness and driving impairment in patients with sleep apnoea/hypopnoea syndrome , 1997, Journal of sleep research.

[2]  E. Bixler,et al.  Severe obstructive sleep apnea--I: Onset, clinical course, and characteristics. , 1985, Journal of chronic diseases.

[3]  Yaron Dagan,et al.  Body Mass Index (BMI) as a First-Line Screening Criterion for Detection of Excessive Daytime Sleepiness Among Professional Drivers , 2006, Traffic injury prevention.

[4]  R. Stafford,et al.  Principles and Practice of Sleep Medicine , 2001 .

[5]  T. Weaver Outcome measurement in sleep medicine practice and research. Part 1: assessment of symptoms, subjective and objective daytime sleepiness, health-related quality of life and functional status. , 2001, Sleep medicine reviews.

[6]  E. Lugaresi,et al.  Hypersomnia with periodic apneas , 1978 .

[7]  Gary L Moffitt,et al.  Sleep Apnea and Commercial Motor Vehicle Operators:: Statement From the Joint Task Force of the American College of Chest Physicians, American College of Occupational and Environmental Medicine, and the National Sleep Foundation , 2006, Chest.

[8]  D. Pauleit,et al.  Body fat distribution, serum leptin, and cardiovascular risk factors in men with obstructive sleep apnea. , 2002, Chest.

[9]  Meir Kryger,et al.  Reducing motor-vehicle collisions, costs, and fatalities by treating obstructive sleep apnea syndrome. , 2004, Sleep.

[10]  L J Findley,et al.  Serious motor vehicle crashes: the cost of untreated sleep apnoea , 2001, Thorax.

[11]  A. Pack,et al.  Estimated cost of crashes in commercial drivers supports screening and treatment of obstructive sleep apnea. , 2008, Accident; analysis and prevention.

[12]  M. Johns,et al.  A new method for measuring daytime sleepiness: the Epworth sleepiness scale. , 1991, Sleep.

[13]  Anup V. Desai,et al.  Sleepiness, sleep-disordered breathing, and accident risk factors in commercial vehicle drivers. , 2004, American journal of respiratory and critical care medicine.

[14]  D. Levy,et al.  Prediction of coronary heart disease using risk factor categories. , 1998, Circulation.

[15]  P. Philip Sleepiness of occupational drivers. , 2005, Industrial health.

[16]  R. Chervin Epworth sleepiness scale? , 2003, Sleep medicine.

[17]  C. George,et al.  Sleep · 5: Driving and automobile crashes in patients with obstructive sleep apnoea/hypopnoea syndrome , 2004, Thorax.

[18]  Greg Maislin,et al.  Occupational screening for obstructive sleep apnea in commercial drivers. , 2004, American journal of respiratory and critical care medicine.

[19]  W. Flemons,et al.  Obstructive Sleep Apnea , 2002 .

[20]  W C Dement,et al.  The sleep apnea syndromes. , 1976, Annual review of medicine.

[21]  W. Flemons Clinical practice. Obstructive sleep apnea. , 2002, The New England journal of medicine.

[22]  Daniel W. Jones,et al.  The Seventh Report of the Joint National Committee on Prevention, Detection, Evaluation, and Treatment of High Blood Pressure: the JNC 7 report. , 2003, JAMA.

[23]  A. Alvarez A Study of Prevalence of Sleep Apnea Among Commercial Truck Drivers , 2003 .

[24]  F. Louzada,et al.  High Risk for Obstructive Sleep Apnea in Truck Drivers Estimated by the Berlin Questionnaire: Prevalence and Associated Factors , 2004, Chronobiology international.

[25]  R. Chervin,et al.  Comparison of the results of the Epworth Sleepiness Scale and the Multiple Sleep Latency Test. , 1997, Journal of psychosomatic research.

[26]  Kurt T. Hegmann,et al.  Consensus Criteria for Screening Commercial Drivers for Obstructive Sleep Apnea: Evidence of Efficacy , 2008, Journal of occupational and environmental medicine.

[27]  N. Collop,et al.  Paying attention to at-risk commercial vehicle operators. , 2006, Chest.

[28]  Daniel W. Jones,et al.  The Seventh Report of the Joint National Committee on Prevention, Detection, Evaluation, and Treatment of High Blood Pressure: the JNC 7 report. , 2003, JAMA.

[29]  H. Gastaut,et al.  Polygraphic study of the episodic diurnal and nocturnal (hypnic and respiratory) manifestations of the Pickwick syndrome. , 1966, Brain research.

[30]  A. Kales,et al.  Severe obstructive sleep apnea--II: Associated psychopathology and psychosocial consequences. , 1985, Journal of chronic diseases.

[31]  A. Pack,et al.  How much do crashes related to obstructive sleep apnea cost? , 2004, Sleep.

[32]  Obesity in Adults,et al.  Identification, Evaluation, and Treatment of Overweight and Obesity , 2021, Obesity Prevention and Treatment.

[33]  G. Coccagna,et al.  [The disorder of sleep and respiration in the Pickwick syndrome]. , 1968, Sistema nervoso.

[34]  V. Somers,et al.  Obesity and obstructive sleep apnea. , 2003, Endocrinology and metabolism clinics of North America.

[35]  Ruth N. Kingshott,et al.  The Role of Sleep-Disordered Breathing, Daytime Sleepiness, and Impaired Performance in Motor Vehicle Crashes—A Case Control Study , 2004, Sleep and Breathing.

[36]  D. Hillman,et al.  The economic cost of sleep disorders. , 2006, Sleep.

[37]  J. Fleetham,et al.  Risk and severity of motor vehicle crashes in patients with obstructive sleep apnoea/hypopnoea , 2008, Thorax.