CDME Module 4: Respiratory-Federal Motor Carrier Safety Administration. Bulletin to Medical Examiners and Training Organizations Regarding Obstructive Sleep Apnea

Federal Motor Carrier Safety Administration. Bulletin to Medical Examiners and Training Organizations Regarding Obstructive Sleep Apnea

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Pdf Summary

The FMCSA has issued a bulletin reminding healthcare professionals about the physical qualifications standard and advisory criteria for drivers with obstructive sleep apnea (OSA). The bulletin highlights that OSA is considered a respiratory dysfunction that can interfere with a driver's ability to operate a commercial motor vehicle safely. OSA is a disorder characterized by breathing cessation during sleep, leading to excessive daytime sleepiness and the potential for crashes. OSA can impact cognitive abilities such as vigilance, reaction time, and attention span, and can also lead to mood swings. In 2000, the FMCSA issued advisory criteria recommending that drivers with respiratory dysfunctions likely to interfere with safe operation should be referred to specialists for evaluation and therapy. The criteria also consider OSA a respiratory dysfunction interfering with oxygen exchange. Medical examiners are urged to use their clinical judgment and expertise to determine if a driver exhibits risk factors for OSA and to request further evaluation or information as needed. The primary safety goal is to identify drivers with moderate to severe OSA to ensure they are managing their condition. However, FMCSA regulations and advisory criteria do not provide specific guidelines for OSA screening, diagnosis, or treatment. Medical examiners should consider common symptoms and risk factors for OSA, and diagnosis methods include polysomnography. Treatment options can range from weight loss to Continuous Positive Airway Pressure (CPAP) therapy. The FMCSA emphasizes that medical examiners should make qualification decisions based on their clinical observations and findings, and should explain the basis for their decisions to drivers who may receive a medical certificate with a shorter duration or be denied a certificate.

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January 20, 2015

Keywords

FMCSA

bulletin

obstructive sleep apnea

respiratory dysfunction

drivers

commercial motor vehicle

cognitive abilities

medical examiners

polysomnography

CPAP therapy