Screening for Obstructive Sleep Apnea During Commercial Driver Medical Examinations

• Published in: Journal of occupational and environmental medicine Vol. 51; no. 3; pp. 275 - 282
• Main Authors: Parks, Philip D., Durand, Gerardo, Tsismenakis, Antonios J., Vela-Bueno, Antonio, Kales, Stefanos N.
• Format: Journal Article
• Language: English
• Published: Hagerstown, MD Lippincott Williams & Wilkins 01-03-2009; The American College of Occupational and Environmental Medicine; Lippincott Williams & Wilkins Ovid Technologies
• Subjects: Adolescent; Adult; Aged; Airway management; Anthropometry; Automobile drivers; Biological and medical sciences; Body Mass Index; Consensus; FAST TRACK ARTICLE; Female; Humans; Male; Mass Screening - methods; Mass Screening - standards; Medical sciences; Middle Aged; Occupational health; Occupational Medicine; Physical Examination; Physical examinations; Pneumology; Respiratory system : syndromes and miscellaneous diseases; Retrospective Studies; Sleep apnea; Sleep Apnea, Obstructive - diagnosis; Sleep Apnea, Obstructive - epidemiology; Transportation; United States - epidemiology; Young Adult; United States; North America; America; Vehicle driver; Human; Nervous system diseases; Sleep apnea syndrome; Respiratory disease; Traffic safety; Traffic accident; Road safety; Medical screening; Detection; Occupational exposure; Occupational medicine
• ISSN: 1076-2752; 1536-5948
• DOI: 10.1097/jom.0b013e31819eaaa4

Objective: To evaluate consensus criteria for screening commercial drivers for obstructive sleep apnea (OSA). Methods: Consecutive drivers underwent OSA screening using Joint Task Force consensus criteria at commercial driver medical examinations. Outcomes included: clinical yield of screening; and drivers ' compliance with polysomnography (PSG) referrals and OSA treatment. Results: Among 456 drivers, 53 (12%) were referred for PSG, and 20/20 were confirmed to have OSA, supporting a high positive predictive value. The other 33 drivers referred for PSG were lost to follow-up but demonstrated no significant differences from those with confirmed OSA. After diagnosis, only one of 20 drivers with confirmed OSA demonstrated treatment compliance. Conclusions: Drivers identified by the consensus criteria have a high likelihood of OSA. Drivers' poor compliance with PSGs and OSA reatment support federally mandated screening of commercial drivers.