U.S. DOT Seeks Input on Screening and Treating Obstructive Sleep Apnea

The U.S. Department of Transportation’s (DOT) Federal Motor Carrier Safety Administration (FMCSA) and Federal Railroad Administration (FRA) announced that the agencies are seeking public input during the next 90 days on the impacts of screening, evaluating and treating rail workers and commercial motor vehicle (CMV) drivers for obstructive sleep apnea (OSA). The National Transportation Safety Board recommended that DOT take action to address OSA screening and treatment for transportation workers.

The joint Advance Notice of Proposed Rulemaking (ANPRM) is the first step as both agencies consider whether to propose requirements specifically on OSA. FRA and FMCSA will host three public listening sessions to gather input on OSA in Washington, D.C., Chicago, and Los Angeles. 

“It is imperative for everyone’s safety that commercial motor vehicle drivers and train operators be fully focused and immediately responsive at all times,” said U.S. Transportation Secretary Anthony Foxx. “DOT strongly encourages comment from the public on how to best respond to this national health and transportation safety issue.”

It is estimated that 22 million men and women could be suffering from undiagnosed OSA, a respiratory disorder characterized by a reduction or cessation of breathing during sleep. Undiagnosed or inadequately treated moderate to severe OSA can cause unintended sleep episodes and deficits in attention, concentration, situational awareness, memory, and the capacity to safely respond to hazards when performing safety sensitive service. For individuals with OSA, eight hours of sleep can be less refreshing than four hours of ordinary, uninterrupted sleep, according to a study by the American Academy of Sleep Medicine. The size and scope of the potential problem means that OSA presents a critical safety issue for all modes and operations in the transportation industry.

“The sooner patients with OSA are diagnosed and treated, the sooner our rail network will be safer,” FRA Administrator Sarah E. Feinberg said. “Over the next 90 days, we look forward to hearing views from stakeholders about the prevalence of obstructive sleep apnea, their views on diagnosis and treatment, and potential economic impacts.” 

“The collection and analysis of sound data on the impact of OSA must be our immediate first step,” said FMCSA Acting Administrator Scott Darling. “We call upon the public to help us better understand the prevalence of OSA among commercial truck and bus drivers, as well as the safety and economic impacts on the truck and bus industries.”

FRA is also currently working on a rule that will require certain railroads to establish fatigue management plans. In 2012, FRA partnered with the Division of Sleep Medicine at Harvard Medical School, WFBH Education Foundation and the John A. Volpe National Transportation Systems Center to sponsor the Railroaders’ Guide to Healthy Sleep website. The site provides educational information to railroaders and their families about sleep disorders and information to improve sleep quality.

For any CMV drivers who are detected to have a respiratory dysfunction, such as OSA, FMCSA currently recommends that medical examiners refer them for further evaluation and therapy. In January 2015, FMCSA issued a bulletin to remind healthcare professionals on the agency’s National Registry of Certified Medical Examiners of the current physical qualifications standard and advisory criteria concerning the respiratory system, specifically how the requirements apply to drivers that may have obstructive sleep apnea.