Fit for the Road

Misty Bell | April 01, 2011

When it comes to Department of Transportation health qualifications for the job, sleep apnea has become something of a buzzphrase, but it also remains a gray area in many ways. Because of this, some drivers fear a sleep apnea diagnosis could amount to a CDL death sentence.

But is that really true? Below are a few commonly held misconceptions about sleep apnea.

The fuss over sleep apnea is just a money grab by the sleep medicine industry.

Sleep apnea is a very real disorder, and Dr. Barbara Phillips, former Medical Review Board member and current professor in the Division of Pulmonary, Critical Care and Sleep Medicine, University of Kentucky College of Medicine, says common risk factors include “obesity, male gender, increasing age, heavy snoring, big necks and hypertension, among other things.” Many of these indicators are common for truckers.

“If a driver (or that drivers bed partner) thinks he or she has sleep apnea, it is in the best interest of that driver to seek out a sleep center that is known for evaluating patients promptly, following up with patients and addressing problems quickly (rather than referring the patient back to a primary MD, if any) and not doing unnecessary (generally more than one [test]) testing,” Phillips says. Some sleep laboratories may focus on expansive treatments rather than patients’ wellbeing, but the majority are reputable facilities.

Phillips noted that all opinions expressed were her own and not on behalf of any institute or agency.

Sleep apnea can be “cured” through CPAP alternatives.

According to American Sleep Association Executive Director Ed Grandi, the only potential way to “cure” sleep apnea is through weight loss — if it’s caused by being overweight — or through a surgery that puts a hole in the base of the patient’s throat, called a tracheotomy.

Tracheotomy is not an option for all sleep apnea patients and brings its own set of difficulties, including care for the surgery wound — not a good option for truckers.

Grandi says drivers should be “very careful” when looking at treatment options other than ones approved by the FDA, largely because there’s no scientific proof these will work. “I know that for men and women in the trucking industry, the margins aren’t very big, and they’re worried that they may have a problem and that they need to deal with the problem,” Grandi says. Even CPAP is only a way of managing the problem, not a cure. Still, Grandi says, why not go for the treatment option you can use while you sleep?

“To me, it seems like a no-brainer,” he says.

The new CSA program says you lose your CDL if you are overweight, a factor in some sleep apnea cases.

This is simply not true. The Federal Motor Carrier Safety Administration has printed and distributed fliers for drivers that clearly state “CSA does not restrict who can be a CMV driver based on body mass index (BMI), weight or neck size.”

Many drivers fear that neck size or BMI could also be used to determine who is required to be tested for sleep apnea in the future, but this is currently not the case.

You can get fired for having sleep apnea.

In general, if your company has more than 15 employees, it cannot fire you simply for having sleep apnea because sleep apnea is considered a disability under the Americans with Disabilities Act.

Peter Berg, Project Coordinator of Technical Assistance DBTAC Great Lakes ADA Center, says a disability is defined under the ADA as “a physical or mental [limitation] that substantially impairs a life activity. Sleep is considered a life activity.”

The issue of sleep apnea and trucking comes down to whether someone is qualified to perform a job “with or without reasonable accommodation,” Berg says.

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