title: Management of Obstructive Sleep Apnea in Commercial Motor Vehicle Operators: Recommendations of the AASM Sleep and Transportation Safety Awareness Task Force.
abstract: The American Academy of Sleep Medicine Sleep and Transportation Safety Awareness Task Force responded to the Federal Motor Carrier Safety Administration and Federal Railroad Administration Advance Notice of Proposed Rulemaking and request for public comments regarding the evaluation of safety-sensitive personnel for moderate-to-severe obstructive sleep apnea (OSA). The following document represents this response. The most salient points provided in our comments are that (1) moderate-to-severe OSA is common among commercial motor vehicle operators (CMVOs) and contributes to an increased risk of crashes; (2) objective screening methods are available and preferred for identifying at-risk drivers, with the most commonly used indicator being body mass index; (3) treatment in the form of continuous positive airway pressure (CPAP) is effective and reduces crashes; (4) CPAP is economically viable; (5) guidelines are available to assist medical examiners in determining whether CMVOs with moderate-to-severe OSA should continue to work without restrictions, with conditional certification, or be disqualified from operating commercial motor vehicles.
authors.affiliation: Division of Sleep Medicine, Perelman School of Medicine, University of Pennsylvania, Philadelphia, Pennsylvania.|Corporal Michael Crescenz VA Medical Center, Philadelphia, Pennsylvania.
authors.forename: Indira
authors.initials: I
authors.lastname: Gurubhagavatula
authors.affiliation: Department of Psychiatry, Stanford University, Palo Alto, California.
authors.forename: Shannon
authors.initials: S
authors.lastname: Sullivan
authors.affiliation: Penn State Sleep Research and Treatment Center, Hummelstown, Pennsylvania.
authors.forename: Amy
authors.initials: A
authors.lastname: Meoli
authors.affiliation: Johns Hopkins School of Medicine, Baltimore, Maryland.
authors.forename: Susheel
authors.initials: S
authors.lastname: Patil
authors.affiliation: Oregon Institute of Occupational Health Sciences, Oregon Health and Science University, Portland, Oregon.
authors.forename: Ryan
authors.initials: R
authors.lastname: Olson
authors.affiliation: Concentra, Inc., Grand Rapids, Michigan.
authors.forename: Michael
authors.initials: M
authors.lastname: Berneking
authors.affiliation: University of Washington Medicine Sleep Disorders Center and Department of Neurology, University of Washington, Seattle, Washington.
authors.forename: Nathaniel F
authors.initials: NF
authors.lastname: Watson
mesh_terms: D000063:Accidents, Traffic / Q000517:prevention & control*; D026683:Advisory Committees; D001334:Automobile Driving; D001364:Awareness; D006801:Humans; D012307:Risk Factors; D012449:Safety; D020181:Sleep Apnea, Obstructive / Q000175:diagnosis* / Q000628:therapy*; D056508:Sleep Medicine Specialty; D012955:Societies, Medical; D014481:United States
keywords: OSA; motor vehicle operators; obstructive sleep apnea; oral appliance therapy; transportation safety