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Truck drivers who fail to adhere to treatment for obstructive sleep apnea (OSA) are five times more likely to be involved in serious, preventable crashes, according to a new study led by researchers at the University of Minnesota Morris (UMM). The project, sponsored in part by the Roadway Safety Institute (RSI), is the largest study of sleep apnea and crash risk among commercial motor vehicle drivers to date.

According to the American Academy of Sleep Medicine, OSA affects at least 25 million adults in the United States. A frequent warning sign is excessive daytime sleepiness, which can manifest as drowsy driving.

“This study emphasizes that untreated obstructive sleep apnea is a pervasive threat to transportation safety,” says American Academy of Sleep Medicine President Dr. Nathaniel Watson. “It is critical for transportation companies to implement comprehensive sleep apnea screening and treatment programs to ensure that truck drivers stay awake at the wheel.”

Image of Stephen Burks

Stephen Burks

As part of the study, researchers compared more than 1,600 truck drivers with OSA to an equal number of drivers screened as unlikely to have OSA. Drivers with the disease were given a mask with an air pump worn while sleeping to keep the airway open (an auto-adjusting positive airway pressure machine), and its use was electronically monitored. The rates of preventable serious truck crashes per 100,000 miles driven were compared across the study groups.

“To put our findings in context, if we look at 1,000 truck drivers each working for a year, the drivers with obstructive sleep apnea who refuse mandated treatment would have 70 preventable serious truck crashes, compared to 14 crashes experienced by both a control group and by drivers with sleep apnea who adhered to treatment,” says Stephen Burks, lead author of the study and professor of economics and management at UMM.

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Burks organizes the UMM’s Truckers & Turnover Project (T&T), assisted by Jon Anderson, professor of statistics, and Rebecca Haider, research coordinator. T&T researchers performed the statistical analysis of the study data, acquired from Schneider National—the first major motor carrier to institute an internal OSA program—and its sleep apnea services provider, Precision Pulmonary Diagnostics.

“I expect our sleep apnea findings will be carefully considered in the rulemaking process on sleep apnea standards for truck drivers and train operators just launched on March 8, 2016, by the U.S. Department of Transportation,” Anderson says.

According to Burks, the study’s findings stress the importance of adding OSA screening standards to the medical exam that commercial truck drivers take every two years.

T&T is a multi-year UMM research effort also involving faculty co-investigators at other institutions both in the United States and internationally. Funding for T&T was provided by Schneider National, RSI, and UMM. Additional funding for this research analysis was provided by the MacArthur Foundation, the Sloan Foundation, Harvard Catalyst/Harvard Clinical and Translational Science Center of Harvard University, and the National Surface Transportation Safety Center for Excellence.

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