From Our Alliance: ASAA

ASAA Hosts Inaugural Sleep Apnea And Trucking Conference

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The amount of misinformation and misunderstanding that circulates about obstructive sleep apnea and the commercial truck driver led the American Sleep Apnea Association to host The Sleep Apnea and Trucking Conference for the first time.

This important meeting, held in May in Baltimore, brought together experts from the various stakeholders to come to common understandings about the condition, the regulations, and what can be done to diagnose and treat OSA.

At an opening reception, invited speakers Christopher Hart, vice chair of the National Transportation Safety Board, and Anne Ferro, the recently appointed administrator of the Federal Motor Carrier Safety Administration (FMCSA), spoke eloquently about the need to address OSA. They discussed the condition's prevalence and the consequences of not treating it from a safety and driver wellness perspective.

For the next day, conference planners included basic information to provide a foundation for the sold-out meeting. Maggie Gunnells, director of medical programs with FMCSA, started off with an overview of the current regulation. Her presentation was followed with talks about ongoing and planned research by the government with regard to sleep apnea and trucking.

The balance of the morning focused on the medical and legal perspective. Lawrence Epstein, MD, a sleep physician, gave a sleep apnea 101 talk.

Natalie Hartenbaum, MPH, MD, an occupational medicine physician, spoke about the challenges facing the doctor responsible for certifying the commercial driver with sleep apnea.

The unfinalized FMCSA rule makes it difficult for examining physicians to know what they should do, and the examiners face great pressure to certify drivers.

Clay Porter, Esq., an Atlana attorney who specializes in defending trucking companies in bodily injury cases, provided valuable insight about the legal liability associated with sleep apnea and commercial drivers.

Prior to the beginning of the afternoon sessions, Bob Stanton, one of the coordinators of the Truckers for a Cause A.W.A.K.E. support group, spoke about a driver who was fired for testing positive for OSA. He also discussed the employment discrimination that exists against drivers who admit they have OSA.

The afternoon talks offered attendees a brief introduction to five companies specializing in diagnosis, treatment, and monitoring of sleep apnea in commercial drivers. Organizers chose these companies because they feature an innovative approach to delivering services to the driver at risk of sleep apnea.

The final set of speakers gave the trucking industry perspective. Don Osterberg of Schneider National and Debra Plumlee from J.B. Hunt each discussed the importance of establishing programs within their organizations and the challenges they face in implementing them.

SOURCES OF CONFUSION

    The Federal Motor Carrier Safety Administration has not finalized the rule governing when drivers need to be screened for sleep apnea. As a result, some Department of Transportation qualified medical examiners use the old rules, and some use the "unfinalized" rule.

    Another source of confusion concerns the options for diagnosis. Some see a lab-based polysomnography as the only option when other lower-cost alternatives exist.

Besides the FMCSA rule issues, most continuous positive airway pressure devices are not made for use in a truck sleeper. Heated humidification is required for many devices, which can be problematic when the truck is parked in an anti-idling area.

Our goal was to bring together representatives from the sleep community, trucking industry, occupational medicine, and regulatory agencies for the first-ever conference to specifically discuss the diagnosis, treatment, and monitoring of sleep apnea in commercial vehicle operators.

A related goal was to create common understanding among these stakeholders about the condition in the hopes of clearing up some misconceptions that exist.

We successfully brought together a diverse audience to learn from each other. Time will tell if we promoted greater understanding.

Ed Grandi is the executive director of the ASAA.

This Sleep Tracks column is produced in conjunction with the American Sleep Apnea Association. The ASAA can help you help your  patients. For more info, visit www.sleepapnea.org. The conference program/resource toolkit distributed to attendees,which includes a copy of the ASAA educational DVD, will be available through www.satc2010.org.


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