Assessing clinical fitness to-drive symposium, all slides
Grandi Carolina Sleep Society 2011
1. Truckers & Sleep Apnea Presented to Carolina Sleep Society May 20, 2011 Edward Grandi, Exec. Director American Sleep Apnea Association
2. Conflict of Interest Disclosures Speaker: Edward Grandi 1. I do not have any potential conflicts of interest to disclose, OR 2. I wish to disclose the following potential conflicts of interest: X 3. The material presented in this lecture has no relationship with any of these potential conflicts, OR 4. This talk presents material that is related to one or more of these potential conflicts, and the following objective references are provided as support for this lecture: 1. 2. 3. Type of Potential Conflict Details of Potential Conflict Grant/Research Support Consultant Speakers’ Bureaus Financial support Other
3. ASAA is dedicated to reducing, injury, disability and death from sleep apnea and to enhancing the well-being of those affected by this common disorder.
7. 12 – 28% of commercial truck drivers have OSA OSA increase the risk of vehicular accident 2- to 7-fold OSA patients are three to five times more likely to be involved in crashes that result in personal injuries.
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10. Something has to be done Implement a program to identify commercial drivers at high risk for OSA and require that those drivers provide evidence through the medical certification process of having been appropriately evaluated and, if treatment is needed, effectively treated for that disorder before being granted unrestricted medical certification. - NTSB Recommendation (H-09-15) NTSB Chair Debra Hersman
26. Is Sleep Apnea disqualifying? Drivers should be disqualified until the diagnosis of sleep apnea has been ruled out or has been treated successfully. As a condition of continuing qualification, it is recommended that a CMV driver agree to continue uninterrupted therapy such as CPAP, etc. / monitoring and undergo objective testing as required. A driver with a diagnosis of (probable) sleep apnea or a driver who has Excessive Daytime Somnolence(EDS) should be temporarily disqualified until the condition is either ruled out by objective testing or successfully treated. Narcolepsy and sleep apnea account for about 70% of EDS. EDS lasting from a few days to a few weeks should not limit a driver’s ability in the long run. However, persistent or chronic sleep disorders causing EDS can be a significant risk to the driver and the public. The examiner should consider general certification criteria at the initial and follow-up examinations: Severity and frequency of EDS Presence or absence of warning of attacks Possibility of sleep during driving Degree of symptomatic relief with treatment Compliance with treatment.
