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Require Medical Fitness – Screen for and Treat Obstructive Sleep Apnea - Highway
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 Require Medical Fitness – Screen for and Treat Obstructive Sleep Apnea - Highway

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What is the problem?

Undiagnosed and untreated obstructive sleep apnea (OSA)—and the fatigue that results from it— continues to be deadly on our highways. Commercial drivers must be medically fit to operate their vehicles safely, yet many suffer from OSA.

OSA is a treatable chronic disease in which patients experience episodes of airway obstruction while sleeping, resulting in fragmented sleep and subsequent daytime sleepiness and fatigue. Because many commercial drivers are older, obese males, they tend to have higher incidences of OSA than the general population. OSA often goes undiagnosed in the transportation environment, which increases the risk that drivers will suffer from fatigue and perform their duties in an unsafe manner.

Too many commercial drivers with inadequately treated OSA operate on our roadways due to a lack of strong federal regulations addressing screening, diagnosing, and ensuring adequate OSA treatment; inadequate Federal Motor Carrier Safety Administration (FMCSA) guidance for certified medical examiners; and weak company policies and procedures regarding driver health.

What can be done?

Commercial drivers operating on our roadways are generally conscientious and well-trained; however, some employers and federal regulators don’t pay enough attention to their drivers’ health and well-being. Many commercial drivers are at risk of developing OSA, which puts the public at risk for a crash. Highway personnel in safety-sensitive positions need to be screened for OSA and treated if necessary. When treated, OSA is not a medically disqualifying condition for transportation operators in safety-sensitive positions.

To address the problem of medical fitness, the following actions should be taken:


  • Develop a formal sleep apnea program that includes screening, diagnosis, treatment, and follow-up for commercial drivers.

Regulatory Agencies (FMCSA)

  • Provide drivers and certified medical examiners easy access to more specific, clearer guidance on OSA.

Commercial Drivers

  • Work with qualified health care providers to ensure they are evaluated and adequately treated for OSA.

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