CDME Module 4: Respiratory (2025)-NTSB Recommendation Letter. Obstructive Sleep Apnea and Commercial Drivers

NTSB Recommendation Letter. Obstructive Sleep Apnea and Commercial Drivers

Pdf Summary

The National Transportation Safety Board (NTSB) issued a safety recommendation on October 20, 2009, addressing the Federal Motor Carrier Safety Administration (FMCSA) regarding obstructive sleep apnea (OSA) among commercial drivers. The NTSB has investigated accidents across different transportation modes, noting that operators with sleep disorders, such as OSA, contribute to accidents. OSA, characterized by airway obstruction during sleep leading to hypoxia, loud snoring, and poor sleep quality, can cause daytime sleepiness and impaired cognitive and motor functions. Commercial drivers with untreated OSA face higher accident risks, with studies indicating a six-fold increase in traffic accident risk.<br /><br />The letter cites several specific accidents involving drivers with OSA, affecting road, aviation, rail, and maritime operations. In some cases, drivers failed to report their conditions during medical certification processes. Medical evidence indicates that OSA also increases the risk of serious health conditions such as stroke, heart disease, and diabetes.<br /><br />Current FMCSA guidance mandates drivers with suspected or diagnosed OSA to be disqualified until the condition is ruled out or treated. Despite this, the FMCSA lacks specific guidelines to identify those at risk for OSA. Recommendations have been made to the FMCSA and other transportation agencies to increase screening and treatment of drivers with OSA. <br /><br />The NTSB urges FMCSA to implement a program to identify high-risk drivers, requiring them to demonstrate through medical certification that they have been evaluated and treated for OSA if necessary. Further, the NTSB calls for developing and distributing guidance for the early detection and treatment of OSA, ensuring affected drivers continue to receive medical certification when treated effectively.

Keywords

NTSB

FMCSA

obstructive sleep apnea

commercial drivers

safety recommendation

traffic accidents

medical certification

health risks

screening

treatment