Truck drivers account for 16-20% of all crashes, which, in turn, has caused a number of injuries and fatalities, and risked public safety.
This warning comes from Uma Victor, MBBS, a research analyst from the Toronto Rehabilitation Institute (TRI), who is currently working on a study about sleep apnea in long haul driving. “Sleep apnea is a cause of concern for the drivers, for the industry, for the public,” She explains “When a driver does not get a proper sleep, they may not have the cognitive ability to drive safely.”
According to StatsCanada, insufficient sleep is associated with a range of adverse health outcomes, including obesity, Type 2 diabetes, cardiovascular disease, injuries, depression, irritability, and reduced well-being. It is increasingly common that people are not getting the sleep they need – especially those out on the road.
Truckers are more at risk to acquire sleep apnea, especially the most prominent form, obstructive sleep apnea (OSA) – and they may not even know it. 85% of Canadians continue to go undiagnosed.
So, what is OSA?
“OSA is the collapse of the upper air way,” says Uma, “which can happen for 10 to 90 seconds, 5 to 100 times per hour while an individual is asleep. This can result in a partial or complete stop of breathing.”
A TRI blog post titled Sleep Science and Sleep Apnea – It’s Not Just About Feeling Tired states: “Once the brain realizes that the individual is no longer breathing, it rouses them from sleep, resulting in sleep that is continuously disrupted throughout the night. As a result, most people with sleep apnea experience excessive levels of sleepiness while they are awake.”
Sleepiness is not the only symptom, however. Warning signs of sleep apnea include choking and gasping; having morning headaches; feeling tired or unrested, and having bouts of sleepiness throughout the day; having high blood pressure; and snoring.
“Sleep apnea could happen to any individual,” Uma says, “Truck drivers, in particular, because they work up to 14 hours per day, sit for long periods of time, and have less of a chance at a healthy lifestyle.”
She adds, “Truckers may often have periods of interrupted sleep, in areas of high noise pollution where they do not have a chance to rest – especially if they sleep around truck stops or take sleep breaks while another driver takes the wheel.” It can be exacerbated by alcohol or medication.
“The issue of safety is particularly relevant in commercial drivers, who show a higher prevalence of OSA (between 28% and 78%) compared with the general population and are more exposed to risk of driving accidents because of their high mileage per year compared with non-commercial drivers,” writes Maria Bonsignore in her paper, Sleep Apnea And Its Role In Transportation Safety.
That means sleep apnea doesn’t impact only a driver’s life, it impacts every person in every vehicle they pass on the road.
Yet, there is good news: sleep apnea, when detected, is treatable. The standard treatment for OSA is the use of a continuous positive airway pressure (CPAP) machine during sleep. This prevents the airway from collapsing while a driver sleeps. Other helpful techniques to fight sleep apnea include weight loss, oral appliances, or changing of sleeping positions (side sleeping, instead of back).
According to the blog post by TRI, “Sleep apnea is typically diagnosed using a combination of the person’s symptoms and the results of an overnight stay in a sleep lab, where breathing, blood oxygen levels, heart rate, and movement during sleep are recorded. Individuals are required to spend a night of sleep away from home, and it often takes several months before an appointment can take place. As a result, about 85% of sleep apnea cases in Canada go undiagnosed.”
TRI has been working to make detection and screening more accessible, especially to long-haul drivers. Currently, TRI is conducting a new detection test with drivers.
“We are testing long haul drivers 18 years or older who have not been tested for sleep apnea and are not using a CPAP machine,” Uma says “They must also have been a driver for two [or more] years, so their history can be reviewed for any patterns of note. This data is important to the study because it may show if the driver’s sleep apnea has any relation to his or her driving history. We also want to see if the screening tools fleets use to detect sleep apnea are successful.”
Through its research, TRI has developed the BresoDx®, a cordless mask equipped with a microphone to record breathing sounds and an accelerometer that records sleeping position.
“The applicant gets a mask to take home, and to sleep with for one night,” Uma says “This records the breathing patterns for eight hours. After the data from this in analyzed by the researchers, the driver’s sleep index is emailed to the driver and is completely confidential. There are also benefits and compensation for participants in the study. They are also able to take care of a potential health risk, preventing what they may not have even considered.”
TRI says the results from BresoDx® are 96% compatible with those from a sleep lab, and they claim the Health Canada-approved device is just as effective at detecting sleep apnea as an overnight stay in a sleep lab.
“Diagnosis will benefit the driver’s personal health and safety,” Uma states, “preventing oxygen-deprivation issues, including high blood pressure, which results in other diseases and conditions.”
“There is an increase in crash rates, seen in drivers not treated for sleep apnea from 2 to 10%,” says Uma “Sleep apnea may also cause employees to take more sick days and have less productivity.”
For fleets, this provides a chance to improve the health of their drivers, the safety of the roads, and the liability risk sleep apnea brings to a fleet.
