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Obstructive Sleep Apnea and Commercial Motor Vehicle Drivers: What Do We Do Now?

Obstructive sleep apnea (OSA) is prevalent in commercial motor vehicle drivers and the potential for increased accidents and its public health impact are particularly worrisome.

On March 8, 2016, the U.S. Department of Transportation's (DOT) Federal Motor Carrier Safety Administration (FMCSA) and Federal Railroad Administration (FRA) in an advance notice of proposed rulemaking, announced that the agencies were seeking public input on the impact of screening, evaluating, and treating rail workers and commercial motor vehicle (CMV) drivers for OSA.  The National Transportation Safety Board recommended that DOT take action to address OSA screening and treatment for transportation workers.

On Aug 4, 2017, FMCSA withdrew the decision for rulemaking and announced: "OSA remains an on-going concern for the Agencies and the motor carrier and railroad industries because it can cause unintended sleep episodes and resulting deficits in attention, concentration, situational awareness, and memory, thus reducing the capacity to safely respond to hazards when performing safety sensitive duties. The Agencies received valuable information in response to a series of public listening sessions in May 2016. The Agencies believe that current safety programs and FRA's rulemaking addressing fatigue risk management, are the appropriate avenues to address OSA."

FMCSA further went on to say it will consider an update to its January 2015 "Bulletin to Medical Examiners and Training Organizations RegardingObstructive Sleep Apnea" regarding the physical qualifications standard and related advisory criteria concerning respiratory dysfunction, specifically how the standard applies to drivers who may have OSA, using the Medical Review Board August 2016 recommendations.

In this podcast, Dr. Shirin Shafazand chats with Dr. Allan Pack, Professor of Medicine, Chief of the Division of Sleep Medicine and Director of the Center for Sleep and Circadian Neurobiology at the Perelman School of Medicine, University of Pennsylvania, regarding the prevalence of OSA in commercial drivers, the current screening and treatment recommendations, and suggestions for physicians who are taking care of drivers at risk for OSA.



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