Screening Drivers
Fleets that test for sleep disorders find 'neat things' happen.
When Jet Express, Inc. started screening its 275 drivers for sleep apnea in 1998, "Some drivers were scared about possibly losing their jobs. We had to do a lot of reassuring that we as a company were here to help," says Jeffrey Davis, vice president, safety and human resources for the Dayton, Ohio carrier.
"It was important that we explain, face to face, what we, as a company, wanted to do," he says.
He had read an NTSB report projecting 40% to 80% of truckers suffer from apnea, and he decided to find out "...what percent of our drivers were affected."
Davis had followed work done during the comment period for revision of hours of service, and concluded, "The proposed regulations are based on the fact that an individual has the ability to sleep when they are supposed to. If they are unable to get the sleep they need, it doesn't matter what kind of regulations there are. We would still have fatigued drivers. If they can't sleep, you have to enable them to do so, so they can comply with the hours of service."
Working with the University of Kentucky Biostatistics Unit, Davis commissioned a written screening test to identify drivers with sleep apnea characteristics.
A questionnaire looks at a driver's sleeping habits through the eyes of his/her sleep partner.
Using results from the completed questionnaires, drivers are ranked according to their risk for OSA. Those with the highest risk are given a take-home testing unit. "The driver simply hooks up and goes to sleep. It's all very simple," Davis says.
Those test results are sent to a certified sleep doctor who then makes the diagnosis on the presence of apnea. Drivers in the high risk category are sent to local sleep labs for an in-depth sleep study and treated with a properly calibrated Continuous Positive Airway Pressure (CPAP) machine.
Davis has also brought in a sleep expert, Dr. Martin Scharf, Tri-State Sleep Disorders, Cincinnati, Ohio, to speak to drivers, using safety meetings as the forum to educate them about OSA.
Everyone in Jet Express management went through screening; one of the owners was diagnosed and is on CPAP now. "His brother continues to thank me," Davis says.
All costs associated with the sleep studies are picked up by Jet Express.
"Some drivers never go to sleep without [the CPAP]. Others use it, start feeling better, and then stop using it," Davis notes.
"I have seen neat things happening," he says, referring to changes he has observed in drivers who underwent treatment. These include personality changes, more enthusiasm, more energy to get the job done, less stressed, more patience on the road.
"In theory you have a much safer driver because he isn't going into micro sleeps if he suffers from OSA," says Davis.
Today all new hires complete the apnea screening questionnaires as a matter of course.
Davis feels confident that "...we are doing something important. We have built an awareness within the company and helped raise our drivers to a new level of health and safety."
He has also participated in presentations on OSA screening at TCA and ATA safety conferences.
SOUTHERN STYLE
When getting up to speed on sleep apnea in a fleet, it helps to have someone on the inside who is already familiar with the issue. At Suttles Truck Leasing, Inc., in Demopolis, Ala., that guy is Bob Bonich, vice president, human resources.
He went through diagnosis and treatment for OSA more than 20 years ago, and he knows the difference a good night's sleep can make.
"My brother took a video of me sleeping. I showed it to my doctor. He said, 'You've got a bad problem.' I learned I had never really experienced deep sleep."
Bonich met HealthScreenings' Stuart Lowenthal at a National Tank Truck Carrier meeting where Lowenthal was giving a presentation on OSA.
The two hit it off. Together they have shared the podium before trucking groups, making joint presentations about sleep apnea. Bonich even demonstrated what a CPAP machine is and how it works, using his own machine, in one of the talks.
"Would you rather have a guy fall asleep at the wheel or someone who went for treatment, uses his machine, gets the proper rest, and feels good about himself?" he asks audiences of safety directors like himself.
Lowenthal helped Bonich develop screening procedures for Suttles drivers.
Telltale measures for spotting drivers with OSA are "...overweight, like I was, with a large neck size, and snoring," says Bonich.
Screening begins at quarterly safety meetings. Here, Bonich explains OSA and tells his drivers about his own experiences before and after treatment.
"I tell them what happened to me and describe the symptoms. Having been there myself, I know the results drivers will have after they get treated."
Drivers complete questionnaires which are sent to Lowenthal who forwards them to the University of Kentucky for evaluation by computer.
Drivers whose quiz results indicate the possibility of OSA are given a take-home device to sleep with. It monitors the driver's breathing and snoring. If those results confirm a strong possibility for OSA, the driver is sent to a sleep clinic.
"Drivers who get on the CPAP experience the same rewards that I received. It's a plus for safety."
Currently the fleet has several drivers and one terminal manager using a CPAP machine. The company is self-insured. Costs associated with screening and treatment are picked up by its insurance carrier, less the deductibles. "We absorb most of the costs," Bonich said.
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