Issue link: https://read.dmtmag.com/i/53821
Advances for sleep apnea treatment The most common successful treatments for obstructive sleep apnea are breathing devices. The sleeper wears a mask hooked to a machine that pushes air into the lungs — either a CPAP (continuous positive airway pressure) or APAP (auto-titrated airway pressure) machine. For patients with mild to moderate apnea, dental devices can help by moving the lower jaw forward. A new treatment involving a tiny surgical implant under the skin is being tested at Tampa General Hospital's Sleep Disorder Center, says Dr. William McDowell, who heads the center. He notes that, generally, costs for diagnosing sleep apnea in-lab and monitoring devices for treating the condition are decreasing. Weight loss, the least expensive treatment, has also been shown to help, he says. McDowell and Duke Naipohn, CEO of sleep apnea treatment provider SleepPointe, based in Wichita, Kan., urge drivers to be tested and treated if diagnosed with the potentially dangerous disorder. "We're going to have drivers who will have to deal with this. It's hit the radar, and it's not going away," Naipohn says. SleepPointe is one of several sleep providers that have helped carriers develop fatigue management programs in the last several years. Prime Inc. and Schneider National started programs years ago. J.B. Hunt, Swift Transportation Corp., Crete Carrier Corp., H.O. Wolding and Ryder System Inc. are among fleets that have recently partnered with sleep labs to treat drivers. Trucker Bob Stanton, who heads the A.W.A.K.E. network of the American Sleep Apnea Association, at awake. truckersforacause.com, tells drivers to take the time to see a doctor: "If you think you've got sleep apnea, get tested. If you've been diagnosed with it, you need to be treated before you drive again." Visit understandingsleep.org for details on screening and treatment. Sleep apnea signs Some trucking advocates say no hard evidence shows sleep apnea causes crashes, but others point to crashes caused by fatigue, a major symptom of sleep apnea. In 2010, 3,675 fatalities involved trucks, including Class 8 rigs and smaller, according to the U.S. Department of Transportation. An estimated 500 of those deaths involved a fatigued trucker, FMCSA head Anne Ferro says. Charles Czeisler, chief of Harvard Medical School's sleep medicine division, says 20 percent of all highway crashes are related to fatigue. He served on the Medical Review Board panel that developed proposed sleep apnea guidelines in 2008. He says drivers with a BMI of 30 or higher – not 35 or higher – should be screened for the disorder. Czeisler is weary of FMCSA's decades of indecision on a rule that would regulate the disorder and the screening for it, though he notes that the National Registry will be "a key in making the roads safer." Experts familiar with driver health regulation say one of the surest ways for truckers to stay on the road is to take responsibility for their health. Regarding sleep apnea, "The no-cost solution is weight loss," says Ben Hoffman, Medical Review Board chair. "Changing lifestyle is the solution." Anne-Marie Puricelli, a veteran CDL medical examiner and trainer with Concentra Medical Center, in Maryland Heights, Mo., agrees. Truckers "need to focus on improving their health in terms of losing These symptoms and related conditions often indicate sleep apnea: • Excessive, loud snoring or snorting • Interrupted sleep • Obesity (a body mass index of more than 30) • Large neck (17 inches for men, 15.5 inches for women) • Short sleep periods • Daytime drowsiness • Frequent nighttime urination • Soft throat tissue • Hypertension • Reduced libido • Cigarette smoking weight, exercising and getting conditions tested," she says. "Right now there is a big focus on improving the health of the drivers who have sleep apnea, and they might as well do it themselves before they're told they have to do it." Truckers who've sought sleep apnea treatment have found that CPAP machines produce quick results. "Most of them come back to us and thank us for treating them," she says. One of the smartest changes for smokers is to stop smoking. Its associated health care costs are high and it exacerbates sleep apnea, as well as other conditions, says Bob Rose of J.J. Keller & Associates. "Owner- operators concentrate on their business, but they also have to concentrate on their health. Their return on the investment will prove itself." 28 OVERDRIVE FEBRUARY 2012 The apnea hurdle