Trucker Fatigue and the Need for Sleep Apnea Testing

By Aaron Corley, D.C., 941-539-3412

Recent incidents highlight the dangers of trucker fatigue, particularly when linked to undiagnosed obstructive sleep apnea (OSA). On July 4, 2025, a tragic accident in Texas saw a truck driver fall asleep at the wheel, resulting in a collision that killed six people, drawing scrutiny to the trucking company involved. This follows reports of two major accidents on I-20 within days, both attributed to truck drivers dozing off, fueling public demand for industry reform. These incidents underscore why screening for sleep apnea is critical for commercial motor vehicle (CMV) drivers.

OSA, a condition where breathing stops repeatedly during sleep, affects an estimated 24 million Americans, with 90% undiagnosed. Among truck drivers, prevalence ranges from 28% to 78%, with studies showing 40% having at least mild OSA (apnea-hypopnea index ≥5). Untreated OSA causes daytime sleepiness, increasing crash risk by two to eight times, with sleep-related accidents having a higher lethality rate (11.4% vs. 5.6%). A 2013 Metro-North train crash, where an engineer with undiagnosed severe OSA fell asleep, injuring over 100, exemplifies the stakes. The National Highway Traffic Safety Administration reports over 1,200 deaths annually from crashes involving drivers falling asleep.

The Federal Motor Carrier Safety Administration (FMCSA) lacks mandatory OSA screening, relying on certified medical examiners (CMEs) to identify at-risk drivers during DOT physicals based on symptoms like loud snoring or daytime fatigue. However, drivers often under-report symptoms, and no specific regulations guide screening or treatment. A 2016 proposal to mandate testing was withdrawn in 2017, despite National Transportation Safety Board (NTSB) warnings, citing costs and industry pushback. Critics argue this leaves millions at risk, as seen in posts on X expressing frustration over lax safety measures.

Screening is vital because treatment, like CPAP therapy, can reduce crash risk to levels comparable to non-OSA drivers within two years. Risk factors like obesity (BMI >30) and neck size, common among truckers, increase OSA likelihood, making proactive testing essential. Climate change may exacerbate OSA, with studies projecting a 45% rise in cases by 2100 due to higher temperatures worsening sleep quality.

Mandatory OSA testing could prevent tragedies, save lives, and reduce healthcare costs. Drivers should consult CMEs and consider sleep studies if at risk. For guidance, contact Aaron Corley, D.C., at 941-539-3412, and verify FMCSA rules at fmcsa.dot.gov.

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