Home > All Mercertown Blog Posts, Safety > SLEEP APNEA, PART II

SLEEP APNEA, PART II

I was on vacation last week when Jason posted the comments on sleep apnea, but I wanted to share a couple of more things as it relates to Mercer. As Jason mentioned, obstructive sleep apnea (OSA) is on the Fed’s radar screen and is something plaintiff attorneys try to latch onto as well. OSA means that breathing during sleep is interrupted, generally multiple times over the course of a sleep session. That means that a full measure of rest is not realized and the person tends to be fatigued after the period of rest. The implications for over the road truck drivers are cause for concern.

There is a correlation between body weight and OBS. The body mass index (BMI) is the measurement used to determine body fat in relation to height. One can google BMI and access a number of BMI calculators. Punch in your weight and your height and your BMI is automatically calculated. Generally, a BMI under 30 is desirable. Higher numbers signal different categories of obesity and are cause for concern. Our experience here shows those with higher BMI’s also tend to suffer from such things as hypertension, heart disease, diabetes, lower back injuries and hernias in far greater numbers than those with lower BMI’s. They are also more likely to have OSA.

The Feds are looking at 35 as a trigger for mandantory sleep studies for OSA. That may or may not be where things end up. I have been looking at driver BMI’s here for the past year or so. At this point, a 40 BMI trips my trigger. If a new driver has a BMI of 40 or better, he is required to have annual physicals and is restricted to “van only” operation. I will not clear a driver with a BMI of 50 or above. Period.

I look at every existing driver’s new physical. A BMI of 40 or above will earn him or her a one year physical regardless of what the doctor puts down. Generally,  with a BMI in that neighborhood, I see other issues anyway such as heart disease,  hypertension, diabetes or some combination of those three. I don’t generally require drivers to get a sleep study done, but I have, twice, when it looked like they had obvious fatigue issues. If a driver has been diagnosed with OSA, he is required to have his breathing (CPAP) machine on the truck and inspected each year by my truck inspectors in Louisville.

My advice to everyone who may be on the wrong side of the BMI issue is to use this time while the Feds are debating it to get a handle on your health. Generally, if your waist size (around the biggest part of your stomach, not your hips) is more than one-half your height, in inches, you have this problem, and it will get worse without immediate and continued lifestyle change. Lose weight and get some type of daily exercise, for at least thirty minutes. If you smoke, stop, now, today, ahora mismo. Aside from the cancer risk, smoking exponentially compounds all the other health issues previously mentioned. Basically, you are shooting for a BMI under 30.

Another thought and I’ll quit for today: Most if not all of the Mercer drivers who have suffered heart attacks in the past four or five years have had BMI’s over 35. The threat to your health is real, the sleep apnea is only one tip of the iceberg. Take care of yourself.

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  1. John Wieczorek
    July 14, 2009 at 7:07 am

    Hi Len, thanks for the info from what I see out here and looking at the measurements of my body where are they going to get the drivers from for these trucks. What about the workers in the other industries.

  2. Len Dunman
    July 14, 2009 at 8:44 am

    Good question, John, you skinny little thing! You folks have it rough, healthwise. You constantly criss-cross time zones and climates, eat and sleep on generally erratic schedules, and for the most part are stuck with the crap they serve at many (but not all) truckstops. Exercise on the road is a difficult proposition.

    I think if the Feds put something like this into effect, you’ll see it carry over into railroads and inland marine as well. The airline folks already have a pretty involved physical and most of those companies have their own BMI standards.

    Where the drivers will come from is anyone’s guess. I will tell you that the Feds don’t care about that. They care about preventing fatigued drivers from driving and there is a bunch of scientific evidence out there connecting high BMI’s with OSA and fatigue in general.

    From my perspective, I’m doing the same thing with high BMI’s that I am with mechanical engines: Keeping the ones we’ve got but not leasing any more on. Although the recession is masking a lot of what’s going on, the world of trucking is changing rapidly and will be considerably different in another year or two. This is just one piece.

    Oh, by the way, John, I suggest you get a hula hoop and work on your form in truckstop parking lots! Be careful today.

    • July 15, 2009 at 6:50 am

      Uh oh , I think Im a mechanical engine , or I just look that way because im a short block ? (lol)

  3. Big John Kelsey
    July 18, 2009 at 11:08 pm

    Hi Uncle Lenny, Yes it’s your not-so-favorite pest with a question, and on topic for a change.

    Actually it’s in two parts but if you have already had a sleep study say 4-5 years ago and it showed positive for OSA, will you be required a second study under proposed new rulings?

    A driver, for other medical reasons, considered and obtained certain surgical procedures that remedied the obstruction, took a 2nd sleep study which showed him “in bounds”. Would this driver still be on the “hit list” (no negatives intended) if his BMI was still above the maximum norm?

    This is all hypothetical of course, because a lean, mean, stealth machine like me wouldn’t have such issues.

    • Len Dunman
      July 28, 2009 at 10:45 am

      Good questions, Big John. The answer to each is ” I don’t know.” We don’t know what the time frames for the tests will be. I suspect if you showed OSA 4-5 years ago and nothing has changed you would still be under treatment so no second study would be required. On the second, regardless of the “in bounds”, I suspect the BMI is ultimately going to dictate that. I just don’t see any doctor signing a driver off as ok if his or her BMI is above whatever threshold they set for OSA. The liability exposure on the doctor would be enormous. Just conjecture at this point.

  4. John Bewley
    July 25, 2009 at 4:57 pm

    Len what are they going to do about people who dont exactly fit the average scale of the BMI index?

    That index assumes that a persons frame, build etc is typical. Well what are they gonna do if its not?

    My BMI is 49.5 which according to everything im reading is borderline for basically being told i cant be a driver anymore if all these regulations go thru, but my frame is way bigger than average.

    Do you think there will be recourse for those of us who dont fit thier perfect little scale? I would like to believe they wouldnt put regulations into effect that would disqualify someone based solely on the derivative of height versus weight. There are many many more aspects to a persons build to determine if they are fit or unfit to do a job.

  5. Len Dunman
    July 28, 2009 at 10:56 am

    Excellent question, John, and I’ve heard this a lot at the various conferences and seminars I’ve attended on the subject. Other things will go into this, as well. I probably over-simplified it in the piece I wrote. Drivers with large frames or who are extremely muscular will consistantly be on the wrong side of the BMI calculation. In that regard, there are three other basic considerations that come into play. First and foremost is waist size. The measurement around the widest part of your stomach should be less than half your height. Second, neck size comes into play. I’ve heard several measurements on this from 17 1/2 to 18 ” max. Third, of course, is blood pressure. Generally, folks who have high BMI’s due to large frame or muscular build do not have the hypertension issue that is generally found in a high BMI without those factors. I think some combination of these factors will be the recourse for BMI’s such as yours. Hope this helps.

  6. Mike
    April 16, 2010 at 8:33 am

    RE: sleep apnea

    I was diagnosed with sleep apnea & currently use a cpap machine. Should I still be concerned about losing my job? My bmi is too high also.

    Thanks

    • Jason Schaftlein
      April 16, 2010 at 9:47 am

      As long as you have a cpap machine in the truck you will be fine.

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