Sleep apnea is a type of sleeping disorder that that is characterized by pauses in breathing, or shallow and infrequent breathing while sleeping. The pause in breathing is called an apnea, and can last from ten seconds, to several minutes. It can occur between 5 to 30 times, or even more than an hour.
A person with sleep apnea is not usually aware of having difficulty breathing, even if he or she is awake. Sleep apnea is then recognized by others who have seen the individual during episodes, or is suspected because of its effects on the individual’s body (known as sequelae). These symptoms of sleep apnea can go on for several years, or even decades, without being identified. The person who suffers from it may develop fatigue and daytime sleepiness, due to the significant levels of sleep disturbance.
The most common category of sleep disordered breathing is OBS, or Obstructive Sleep Apnea. This happens when the muscle tone of the body relaxes while sleeping, and at the level of the throat the human airway is composed of collapsible walls of soft tissue. This can block breathing during sleep.
Truck drivers with sleep disorders are becoming more common because of their demanding schedules and other types of conditions. Sleep apneas, plus other types of disorders such as restless leg syndrome and insomnia, are battled by drivers all over the country. If untreated, these can have a negative impact on the driver’s health. Drivers that suffer from sleeping disorders are at a bigger risk of getting into an accident while driving, because of fatigue.
A lot of trucking accidents are caused by sleeping disorders. These can be dangerous to the driver, and to everyone around them. Early diagnosis can prevent other types of illnesses and help ensure that these drivers will reach their destination and come home safely every single time.
On October 15, US president Barack Obama signed into law legislation to ensure any federal standards governing screening, testing or treatment of individuals that operate commercial motor vehicles for sleep disorders would be a rulemaking instead of guidance, which was always the case.
This bill passed the House 405-0 and the Senate on undisputed consent.
Even though these sleep disorders have defined a wide range of medical problems, this bill clearly identifies sleep apnea as a type of sleeping disorder.
According to ATA President and CEO Bill Graves, the two most serious issues facing the trucking industry are fatigue, and driver health. Even though it is important to address these issues, it is even more necessary for the federal government to make use of the regulatory process – With its emphasis on cost-benefit analyses and science-based results.
The Las Vegas-approved ATA policy reads that any effort to address sleeping disorders, such as OSA (Obstructive Sleep Apnea) should be done through rulemaking, and not through the publication of regulatory guidance. Also, those rules should focus on conditions that have a substantially elevated crash risk, based on analysis and sound data. There should also be cost-beneficial and promote effective treatments that lessen the impact to vehicle drivers.
President Obama signed the sleep disorder legislation the previous month, along with a rulemaking on a National Registry of Certified Medical Examiners to take effect on May 21, 2014. Commercial driver health and fitness just moved up from the backburner of the government, to the front.
The president signed legislation, stating that if the FMCSA (Federal Motor Carrier Safety Administration) takes on tackling issues about sleeping disorders/sleep apnea, they should do it as a part of a rulemaking, and not a type of guidance. Many see this as a fuzzy rulemaking without the necessary steps, checks, and balances of a rule.
The signing of the legislation was quite anti-climactic. Ever since following the bill’s introduction, the FMCSA has announced that it would bring a rulemaking on the testing and diagnosis of sleeping disorders, rather than a guidance.
The National Registry of Certified Medical Examiners, as well as the NRCME II rules addresses a bigger issue, and “changes how medical examinations on the DOT should be done.”, according to one article written for a state truck lobbying group.
The rules of the NCRME allow any medical professional licensed in their state of practice to perform a DOT physical exam. This includes Mds; Doctors of holistic medicine or osteopathy, physicians’ assistants, advanced care nurse practitioners, and chiropractors to give DOT physical examinations.
The NCRME is a FMCSA program. It requires all medical examiners who want to perform physical examinations for interstate Commercial Motor Vehicle (CMV) drivers to be trained and proficient in FMCSA’s physical qualification standards. These medical examiners who have completed the training and successfully passed the exam are then included in an online directory on the National Registry’s official website.
The National Registry’s goal is to promote as well as preserve the highest level of professional standards, training, and care among medical examiners. So the National Registry requires that all of their medical examiners performing CMV driver examinations are certified and trained.
Healthcare professionals are qualified to apply to become a certified medical examiner if their field of practice allows them to perform medical examinations, as defined by the state where they practice.
The National Registry’s Objectives:
To ensure that medical examiners fully understand the medical standards in the Federal Motor Carrier Safety Regulations and related guidance, and how they apply to CMV drivers.
Maintain competency of medical examiners through training, certification, testing, and recertification. Promote confidence in the quality of medical examinations of CMV drivers.
To ensure that the list of certified medical examiners is accessed easily.
The FMCSA is, and will continue to take part in all aspects of the National Registry program development and implementation, maintaining an oversight role. This implementation of the National Registry program demonstrates the commitment of the Department of Transportation and the Federal Motor Carrier Safety Administration for making America’s highways a lot safer.