Carriers Must Treat Drivers’ Sleep Apnea, Fatigue, Schneider’s Safety Chief Warns

This story appears in the Oct. 12 print edition of Transport Topics.

LAS VEGAS — The safety chief of the nation’s largest truckload fleet said trucking can no longer afford to ignore sleep apnea and fatigue, a disorder that is significantly under-diagnosed and “grossly underreported” in accidents.

Don Osterberg, Schneider National Inc.’s senior vice president of safety and driver training, said not testing drivers and requiring treatment is threatening highway safety and leaving fleets exposed to both civil liability and higher health-care costs.

“We need to deal with the ugliness of this issue. We no longer can pretend we don’t have an issue,” Osterberg said here during a presentation at American Trucking Associations’ Management Conference & Exhibition.

Though Osterberg said trucking already is taking many steps to make the nation’s highways safer, he bluntly explained why more steps — such as tackling sleep apnea — need to be taken.

“We need to be careful what we celebrate,” he said. “Fourteen people will be killed in truck-involved crashes today. And 14 will die tomorrow. That is too many. We need to strive for that to be zero, although it may never be fully attainable.”

Angela Cash, a partner at law firm Scopelitis, Garvin, Light, Hanson & Feary, said a fleet’s claim that it was not aware a driver involved in a crash had the disorder probably would not be a sufficient defense.

With the growing amount of scientific and industry research, “it’s more difficult for you to say ‘I didn’t appreciate we had a problem’ and get away with it,” Cash said. “The jury is likely to say, ‘You should have known.’ ”

Osterberg said a four-year study of Schneider’s most serious crashes found 36% involved fatigue, but that among all highway crashes, fatigue often ap-pears in a police report only if a driver admits to falling asleep.

He also said studies indicate up to 28% of the truck driving population has some level of the sleep disorder, characterized by daytime sleepiness, loud snoring and fatigue. However, only about 15% of that pool has been diagnosed.

Cash, who spoke on the panel with Osterberg, said there have not been many cases yet involving apnea. But statements from these reports showing that fatigued drivers are seven times more likely to be in a crash, and perform as poorly as individuals who are legally drunk, are an extremely persuasive argument against carriers.

Rose McMurray, acting administrator for the Federal Motor Carrier Safety Administration, told ATA’s board that the agency was actively reviewing recommendations from its medical board, “which includes sleep disorders and sleep apnea.”

Cash predicted that FMCSA would issue a rule requiring testing of truck drivers with a body mass index of at least 30 — the level where the threat of apnea and other health issues is greatest — within the next two years. Osterberg noted 18% of Schneider’s drivers who have tested positive for the disorder have a BMI under 30, so he urged full testing of all drivers.

In the conference exhibit hall, several companies offered initial screenings for attendees and displayed Continuous Positive Airway Pressure masks — worn while sleeping — for treatment of apnea.

They also said companies can easily electronically monitor drivers’ compliance with their treatment while on the road. 

The first step of the apnea test generally is a pre-screen questionnaire that usually can be completed online. Osterberg said this is predictive 82% of the time.

Next, a driver would visit a clinic for a more in-depth evaluation, including spending a night to be monitored.

Osterberg said Schneider monitors drivers in real-time for the first 30 days. By the end of that month, drivers generally see benefits and take it upon themselves to continue treatment, so Schneider then reviews data every 90 days.

Exhibitors estimated the cost from pre-screen through treatment is $2,500 per driver, excluding lost earnings.

Despite the costs, Osterberg told Transport Topics he is convinced sleep apnea is “on the very short list of things that provide a quick return on investment.”

Schneider’s initial study of 339 drivers found a 30% drop in preventable crashes, a 48% dip in the cost of crashes and a $539 monthly savings per driver in the 12 months after being diagnosed.

To his surprise, Osterberg said there was a 60% jump in driver retention, which he now attributes to drivers “generally appreciating our concern for their well-being.”

An expanded study in 2006 found similar results, but its most recent review of data found only a 12% drop in crashes. However, there was a 63% drop on the median cost of a crash.

Osterberg acknowledged the current treatment needs to be refined. A battery powered device that can last through the night needs to be developed, so truckers can sleep without idling or electrification. He also said compliance monitoring data needs to be integrated into the critical events reporting of in-cab communication devices.

Senior Reporter Sean McNally contributed to this story.