Troy and Connor discuss sleep apnea in trucking — what it is, how it affects drivers, and some of the current laws surrounding this aspect of commercial driving. We’ll read some listener comments on the matter and talk about some potential solutions to this health issue. Stay tuned for an interview from John Drury also known as, The Dancing Trucker later in the month!
Big Rig Banter – Episode 17 Transcript – Sleep Apnea in Trucking
Connor: Hello, and welcome to the 17th episode of Big Rig Banter, a show about all things commercial driving and transportation related. I’m your co-host, Connor Smith.
Troy: And I’m your co-host Troy Diffenderfer.
Connor: And today’s date is July 5th, 2018 and we’re so happy to be releasing this episode today. We’re gonna be talking about sleep apnea and the current laws surrounding this topic, an issue for drivers. So buckle up, and get ready for a great and informative show.
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Connor: Alright, so welcome to the show. Troy, how are you doing today?
Troy: I’m doing good! I’m ready to get right into things. We’re gonna do things a little different.
Connor: That’s right, yeah. We’re trying to streamline the show, make it a little more efficient, get right down to the topics, so expect that from us as we move forward and evolve here. But, sleep apnea: what is it, how does it relate to trucking, and why are we talking about it today?
Troy: Well, why don’t we get started and tell our listeners what sleep apnea is? I’m sure they’ve heard it. Many of you truckers deal with it every day but for those who are unfamiliar with it, it’s basically when the upper airway becomes blocked repeatedly during sleep, reducing or completely stopping airflow. This is known as obstructive sleep apnea. If the brain does not send the signals needed to breathe, the condition may be called central sleep apnea, and it’s a serious issue that can eventually lead to a variety of other health issues, and it’s something that many truckers suffer from and deal with every single day.
Connor: Right, and so this is basically something that, in terms of driving commercially, if you don’t get good sleep because of your sleep apnea, it can be a huge issue for your wellbeing and the amount of safety that you can maintain on the road, is that right?
Troy: Yeah, for sure. It’s definitely a huge factor. Sleep apnea causes some major sleep issues, and many truckers don’t even know it. Many of you will often wake up feeling very tired, even though you think you got a full night’s rest when in reality, your body was waking itself up simply because you weren’t breathing, which is definitely scary.
Connor: Kinda freaky, yeah.
Troy: Yeah, it can lead to a bunch of major health concerns, but Connor, why don’t you talk about some of the causes of sleep apnea? There’s definitely a wide range of causes of the issue.
Connor: Right, so there are a lot of different causes of sleep apnea. Some of the main causes, of course, include lifestyle choices, one of the main factors is your neck diameter, so if you are overweight and you have more material, let’s say, in the neck region, it compresses your airways when you sleep, depending on the position that you choose when you’re resting…that kind of thing. And so, that’s one of the main and most obvious causes of sleep apnea. Otherwise, most of them are out of your control, in other words. Other factors can include large tonsils, your genetic makeup, any conditions that you’re predisposed to, and also premature birth can cause your airways and your development to be hindered in that area, such that your airway may not function as properly as it could. And so, like you mentioned, a lot of other health conditions can arise from having sleep apnea, such as heart or liver failure. You know, when you’re not breathing at night, it puts a lot of stress on your other organs to try to maintain your vitals, so over many years, if you have sleep apnea you can eventually develop other, more serious conditions. So, some of the main symptoms you want to look out for or you’ll be tested for in order to tell if you have sleep apnea include reduced or absent breathing, known as apnea events, frequent, loud snoring, gasping for air during sleep, excessive daytime sleepiness and fatigue like you mentioned, Troy, and decreases in attention, vigilance, concentration, motor skills, and verbal memory, as well as dry mouth or headaches when walking. So obviously, those last things are gonna be serious issues when it comes to operating a motor vehicle and a semi truck.
Troy: Yeah, and what’s scary about this is a lot of these symptoms you technically can’t see yourself. Obviously, you can’t see yourself sleeping so you might not realize that you’re snoring loudly or that you’re gasping for air during sleep, or that you have this reduced or absent breathing, so these symptoms like the daytime sleepiness and fatigue and the concentration and motor skills or the headaches are the main ones that you really need to keep an eye on cause many truckers will just assume that they’re not getting enough sleep, that they’re being worn out, but it actually could be a different problem. It could be sleep apnea, and that’s a serious thing that all truckers should consider.
Connor: Right, and so, when it comes to a lot of the laws and regulations surrounding sleep apnea, I think that’s what a lot of truckers have issues with, especially independent drivers who, you know, usually resist regulations and overarching sorts of things making laws about their own lifestyles whenever possible, which is completely understandable. So, we’re going to dive into a blog that is on our website, AllTruckJobs.com written by our associate, Lenay Ruhl, who you’ll meet at GATS, by the way. We’ll be there, side note, but her blog is talking about all the common questions that people raise regarding trucking and sleep apnea.
Troy: Yeah, and it’s interesting. Lenay wrote this a few months ago, but I actually called the DOT recently and was unable to get any clarity or feedback from them regarding these sleep apnea laws. If you go to the FMCSA website or the Department of Transportation’s website, these sleep apnea laws are very confusing, and they’re pretty vague regarding trucking and sleep apnea and, as we’ll talk about shortly, truckers have a lot of questions and there’s not really any clear answer for them, but we’re gonna try our best to clarify and tell you what you need to know. Connor, talk more about that blog that Lenay wrote.
Connor: Right! So, for starters, there is no new law on DOT physical sleep apnea for truck drivers, even though there’s been a lot of confusion around that. As it stands today, the U.S. Department of Transportation, or DOT, does not require sleep apnea testing for drivers necessarily. However, the DOT does require that truck drivers get a medical examination, which you’re all aware of, in order to hold a CDL license. The medical examiner is the one who decides if the driver needs sleep apnea testing or not. The DOT says that it’s up to your medical examiner whether or not your medical condition will interfere with your driving, however if you are diagnosed with moderate to severe sleep apnea, you’re considered unsafe to drive and will lose your CDL unless you’re treated for that sleep apnea and deemed safe to drive again by your medical examiner. So essentially, whoever examines you during your CDL physical will determine your sleep apnea status and, therefore, your ability to safely drive. And that seems pretty straightforward, so why is there all this confusion around it still?
Troy: Actually, Connor, the confusion stems from the fact that government officials can’t make up their minds. Last year, the DOT planned to pass a new law for truckers regarding sleep apnea, and it would require them to undergo sleep apnea testing. They consulted medical examiners and carrier employees, and a lot of drivers hoped this new law would finally give the industry more direction. However, the law never passed because President Donald Trump, after being elected, reduced regulations across the industry, and the government officials eventually scrapped the proposal. This change of plans triggered a debate across the trucking industry and also added to the confusion because many truckers don’t know if there’s a specific law regarding sleep apnea or if it’s up to the carrier’s discretion. Nobody knows what they’re actually supposed to do about sleep apnea, and we’re gonna read a few of these blog comments and really show just how confusing it can be and why many truckers are having trouble dissecting the sleep apnea issue.
Connor: So, from our blog’s comment section here, we have a lot of feedback on this lack of law, you know? Like you said, we’re going to read some of our comments here. This comes from Patrick. He says, “Although I tested positive for sleep apnea, I feel that the way the test was administered, gave a false positive. It took 8 months for me to get used to the mask and achieve compliance. Only 5 times in the last year have I woken up after 8 hours still wearing the mask. Most nights I only manage to keep the mask on for 3 hours. Using the machine has ruined my sleep and now I’m more irritable than ever before. I can’t be the only driver to contemplate saying ‘screw it’ and leaving the industry that I’ve spent more than 18 years in.” So, that’s a huge statement right there, and I think he summed up a lot of different thoughts and concerns that drivers have, especially with the whole issue of compliance, the ability to even sleep well with these things. It seems like, in a way, the lack of regulation or lack of guidance on this is causing way more issues than drivers even have with sleep apnea as a medical condition.
Troy: Yeah, he’s certainly not the only one. Many drivers are putting their CPAP machines to the wayside and trying to find a different routine to help with their sleep apnea. Ron, on our blog, said, “I have sleep apnea. Diagnosed. Got a CPAP. Cannot sleep with it. I spend $4,000 on testing, machine, and another $3200 talking to a specialist to tune my machine. That is 15% of my pay. I cannot sleep with the machine on, as 6 out of 10 drivers have told me they also cannot. Now I do what they do. Watch TV with it on to hit my minimum, then go to bed without it. I am in an incredible cardiovascular shape. I do kickboxing and jujitsu 4 nights a week and run marathons on the weekend. After 20 years of driving without CPAP I never once felt I was going to fall asleep. After 4 months with machine waking me every 15 minutes. I almost feel asleep a handful of times. It does not work for all. A specialist now wants me to try another type of CPAP. I’m not sure who this law helps.” So we can really see that there are drivers out there who are trying to find alternatives and, unfortunately, if a law does go through, no matter what your alternative is you might still be forced to use this CPAP, regardless of whether you think you need to use it or not.
Connor: And with those types of prices too and not having the full support of the industry in helping finance these devices, it’s just sort of like coming out of everyone’s pockets and not really providing any real solutions. At the same time, it is a serious medical issue, so you have that side of things where it’s, you know, either drivers aren’t getting enough sleep because they have sleep apnea so they have to buy these expensive devices, or they get diagnosed with it after having no real idea of what sleep apnea is or even realizing they had it at all, and then actually their sleep is ruined because they’re trying to adapt to this new way of getting rest.
Troy: Yeah, it seems like there’s another side that are really pushing for these devices and really do see a medical benefit. David K. who’s a dentist, said, “I make oral appliances for people with sleep apnea, I respectfully disagree and think truck drivers should be tested. The test is very easy and is done at home in your own bed. However,” he says, “A positive diagnosis should not mean a trucker can’t work. It just means treatment is needed,” which is definitely a fair point to make. It should definitely be addressed like any other medical issue, obviously. If you have insomnia, that should be treated. If you have a mental health issue, that should be treated. Anything that could possibly impair your ability to drive definitely should be addressed. Should it necessarily mean that you cannot drive anymore? We probably can’t make that call, but it’s definitely something to think about. Connor, what else are our truckers talking about on that blog? We’ve got a ton of comments. It definitely stirred up a heated debate, and it was very interesting to hear all of your opinions out there.
Connor: Another thing is, you know, a lot of truckers who are overweight feel that this is personally kind of targeting them because of the fact that, you know, if you have a certain body mass index you’re almost, in a way, guaranteed to have sleep apnea, or medical professionals will very, very likely say that you have this condition, regardless of how thorough their testing is. I’m not saying that any medical professionals are out to just make diagnoses willy-nilly, but people who have struggled with weight issues have a much higher prevalence of this condition, and so it’s definitely frustrating for them because it’s like, they’re trying all they can do. I mean, maybe weight loss has been difficult for them all their life, and now there’s this other layer added to it that’s just sort of like, an extra frustration, extra money that they don’t need to spend. You know, I think just probably working toward a better solution for all types of truckers but, for instance, Clarence W. says, “It is a money grab for states and it’s biased if you’re a big person naturally, because you’re deemed to have a sleep disorder. That’s B.S. because it puts your livelihood at risk, especially if you’re working to take care of your family.” He says, “I’ve been driving seven years, never been in an accident, and weigh 300 pounds all my life, and now all of a sudden you say I have sleep apnea because my BMI exceeded the limit.” So, again, that perspective I’m sure is very common, and it’s sort of an unnecessary frustration for a lot of people, but we do have to just keep stressing the importance of how detrimental this condition can be to your health. On that same note, you can go back and check out past episodes on mental and physical health for truckers, it’s the Mind and Body Roadmap, so there will be a link to that in the show notes, or just scroll down if you’re on iTunes, Stitcher, or Google Play, wherever you’re listening. Even on YouTube, check the related videos. But there’s lots of ways to stay fit and counteract some of the negative health effects of sleep apnea if you’re on the road.
Troy: Yeah Connor, and I want to close out these blog comments. We had another reader, Paul N., made some really good points which I think is a good note to end on. He says, “I feel, unless you have an accident history due to lack of sleep, no one should determine your need for testing. I do, however, feel that driving schools should emphasize sleep management practices. As a driver of 24 years, I know when to rest and when I can drive. That, of course, comes with experience.” I think those are all great points to make. I think it’s always gonna be an issue, and it’s definitely something that you need to manage yourself, regardless of what kind of sleep issue you have. Hopefully, we’ll see come clearer laws in the future, and we really want to know what you guys think. As always, leave a comment below on the YouTube page or reach out to us via Facebook or Twitter.
Connor: Or just leave a comment on this blog and join the discussion with everybody else who’s talking here. Alright, so now we’re gonna take a little bit about some of the treatments for sleep apnea because you’ve heard us mention some of the things that people have already purchased or are using currently. So, we just thought we’d give a brief rundown of what those are. To start, you have your oral and dental appliances, which are essentially kind of just like mouth guards that position your mouth such that your airway can remain opened while you sleep. It kind of helps your nasal air passage prop itself open in a certain way.
Troy: Yeah, these mouth guards will actually often compress your tongue down. Many people have trouble breathing simply because they have a large tongue. Or it will readjust your jawline. It will position your jaw in a way that will open the airway better.
Connor: And this is usually an alternative to the CPAP machine, which is actually a mask that regulates your airflow. Its basically a mask that can regulate your airflow. It’s hooked up to another machine with this tube that connects to your face. Looks pretty alien, to be honest. The thing has to strap onto your face, around your head, just to stay positioned correctly, and so that interferes with a lot of people’s comfort during sleep. While it is probably the more technologically sound and efficient way to monitor your sleep apnea, it just simply doesn’t work for people who have grown up all their lives sleeping normally, for lack of a better term. So, that’s essentially what you’re getting with the CPAP machine. Otherwise, you can get surgery for sleep apnea, which another one of our blog comments noted it can be upwards of $30,000 just for the surgery if you’re paying out of pocket. So, that’s a considerable investment to make that medical improvement for yourself but in some cases, it could be necessary if you have one of the more severe types of sleep apnea. What they’re going to be doing, in that case, is basically eliminating any extra tissue in your throat that collapses and blocks your airway during sleep. So, you know, keep in mind that some of these surgeries may be minimally invasive, others can be considerably more complex, and so before you undergo surgery, you’ll need some medical consultations and that sort of thing. Otherwise, the success rate for that’s pretty high. A lot of the times it’ll improve your snoring and eliminate your need to use a sleep apnea machine, so it’s all about what length you want to take to better your health in this area. Otherwise, you know, some other treatments for sleep apnea include weight management programs, because a lot of the time, people who are overweight have a higher body mass index which causes their throats to have more material and restrict their breathing in that way. So, that’s another option if that’s within your ability to do. Otherwise, there’s positional therapy, which essentially just you wear this sort of device around your waist or back which positions your body in a consistent way throughout the night so that you’re not fighting against your own posture just to get a good night’s sleep, so that’s another option. Otherwise, of course, you want to quit smoking, that’s a huge factor in your ability to breathe in general, but especially at night. So, quit smoking. No alcohol as well because that can cause brief bouts of waking up and muscle movement throughout the night…things you don’t really want. And you know, if you’re driving, you don’t want to be hung over the next day anyway. I’m sure you truckers out there know that drinking a couple beers on the road isn’t necessarily in your best interest most of the time. Yeah, so those are some of the main ways that you’re going to be treating sleep apnea and, of course, if you do have this condition, always be sure to consult a doctor. Don’t really take things into your own hands just by scouring the Internet, mostly like what we’ve done. Always seek professional opinion and consultation.
Troy: Yeah, and listeners, we wish that we could provide some more concrete laws or information, but the fact is, they just aren’t out there. We will, of course, always keep you informed if these laws change, but we do want to cover topics like these that are very polarizing in the industry and have a lot of truckers talking. Again, we thank you guys for listening. We are excited to announce a new kind of mini-episode that will be debuting monthly. Connor, why don’t you tell the listeners some more about that?
Connor: Right, so we’ve been doing it for the past couple episodes, but now we’re gonna be taking our industry spotlight and kind of breaking that out into a smaller, monthly episode. So, halfway through the month, because we normally release these main episodes the first Wednesday of every month, we’ll have another industry spotlight in a slightly related or unrelated topic coming out midway through the month. This month we’ve got John Drury, the Dancing Trucker, with us, and he’s gonna tell you guys all about his journey as the Dancing Trucker, what he’s working on now, and just some really inspirational stuff about getting out there and getting healthy and following your dreams, you know? So, be sure to tune into that. That’s what we’ve got on the radar, as well as our upcoming appearance at GATS, the Great American Trucking Show, so anybody who is gonna be in the Dallas area August 23-25, be sure to come check us out at booth 2822. We have a lot of great prizes to give away, we just have some nice swag, some cool Big Rig Banter merch, and AllTruckJobs stuff.
Troy: Yeah, and we’re going to have the Long Haul Lounge where you guys can kick your feet up, maybe do an interview, maybe be on the next episode of the podcast, so that’s always cool. We love to talk to our listeners, so make sure to stop by. And again, as always, drop us a review on iTunes or leave a comment on YouTube. We love the feedback. We want to get as much exposure as we can, and that help comes from you listeners and we really appreciate that.
Connor: Absolutely. If you’re a fan of the show, always be sure to subscribe as well on YouTube and iTunes. That’ll help you get all the latest episodes, especially because we’re gonna be posting more throughout each month, so they’ll be sent right to your device, right to your feet instantly.
Troy: That’s right! And, Connor, why don’t you tell us what our next episode is going to be on?
Connor: That’s right, and so the next episode is gonna be focusing all about the Uberization of trucking, as we see more companies kind of moving into the shipping and logistics space, such as Amazon, Uber, and companies like Tesla with their automated trucks. We’ll explore how the model for shipping is going to be changing in the future, perhaps the very near future, so stay tuned for that episode. But again, we thank you all for listening. I’m your co-host, Connor Smith.
Troy: And I’m your co-host, Troy Diffenderfer.
Connor: And this has been Big Rig Banter.
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