Getting enough rest is one of the most important ways to stay safe on the road, and for professional truck drivers, good, restful sleep is vital.

For some, however, restful sleep never comes thanks to sleep apnea, a silent disorder that can cause those who suffer from it to wake up hundreds of times a night because breathing problems prevent them from taking in enough oxygen, which signals the brain to wake up and fix the problem. It can happen hundreds of times a night.

Most people with sleep apnea have no idea they wake up so often during the night since the moments are so brief, but here’s the thing. When you’re constantly waking up all night long, it doesn’t matter how much sleep you get—you’re still going to wake up tired. Because many people with sleep apnea don’t even remember waking up, they may go years without knowing that they have sleep apnea. They may blame their fatigue on something else, like stress or long hours at work, and just write it off.

It usually takes a loved one to point out a snoring problem – one of the key symptoms of obstructive sleep apnea, the most common kind of sleep apnea – before sufferers realize they have a problem.

Obstructive sleep apnea (OSA) happens when the muscles in your throat relax so much during sleep that you can’t breathe properly. When OSA occurs, the brain is alerted that something’s wrong, and you wake up. Usually, this mental wake-up call is so short that you don’t even remember it, but as we’ve said, it doesn’t just happen once, but numerous times while you sleep.

A lack of quality sleep is extremely serious, however, because without restful sleep – the REM kind where you get the most solid rest – you are not only at risk of a myriad of health problems, but it can also leave you feeling so fatigued that it’s difficult to effectively do you job.

For some jobs, tiredness is annoying and can reduce productivity, but it isn’t dangerous. The same isn’t true for commercial truck drivers, who operate heavy machinery every day. To protect themselves and the public, commercial truck drivers are required to be fully engaged and alert on the job – and the sleep deprivation caused by sleep apnea can lead to serious cognitive impairment. On the road, this can have deadly consequences.

DOT exams screen for sleep apnea

Because of this, Department of Transportation (DOT) examinations include screenings for sleep apnea. During a DOT physical exam, medical examiners will ask a driver if they have respiratory or sleep disorders that could impact their ability to handle a commercial vehicle. They’ll also look for sleep apnea risk factors, including:

• Weight. Overweight people are more likely to experience sleep apnea because fat deposits surrounding the upper airway can obstruct breathing.
• Neck circumference. A thicker neck often means narrower airways. Men with a neck circumference of more than 17 inches and women with a neck circumference that’s larger than 16 inches are considered to be at higher risk of sleep apnea.
• Smoking. Studies have shown that people who smoke are at higher risk of obstructive sleep apnea. In fact, one study published by the National Library of Medicine found that smokers were more than two times likelier to have obstructive sleep apnea than non-smokers and former smokers.
• Family history. If you have a family member with sleep apnea, you’re more likely to have it, too.
• Sex and age. Men are more likely to have obstructive sleep apnea than women. As we age, our risk of sleep apnea also increases.

Concentra performs apnea evaluations

For truck drivers, finding quality health care while on the road can be a challenge.

One particular company, however, was founded with workers such as truck drivers in mind.

Concentra is on the front lines of ensuring the safety of drivers, and the public by providing:

• Department of Transportation (DOT) physical exams for COVID-19 asymptomatic professional drivers and certification for all commercial driver’s license (CDL) holders
• Breath alcohol testing (BAT) and urine drug screening (UDS) collections for controlled substance testing, which is required under Federal Motor Carrier Safety Administration regulations for pre-employment testing, post-accident testing, reasonable suspicion, return to duty, or follow-up testing.
• Physical and occupational therapy.
• General health and wellness.

The Addison, Texas-based health care company Concentra Inc. is a national health care company that operates more than 520 urgent care centers in 44 states, so there is usually a facility close by if you need one while on a job but away from home. The company has more than 1,000 affiliated physicians and more than 1,000 physical therapists, all of whom focus on keeping drivers on the road.

Apnea is one health problem the health care provider takes seriously.

In order to determine whether or not a driver may have sleep apnea, Concentra medical examiners conduct a sleep apnea evaluation including a questionnaire, which records the driver’s medical conditions, determines level of sleepiness, and measures body mass index (BMI), neck circumference, and airway anatomy (called a Mallampati Score, which is also used to determine the ease of intubation.)

Depending on the driver’s answers and risk factors, the medical examiner may recommend a sleep study to find out if the driver has obstructive sleep apnea or not. If they do, they’ll refer the driver for a sleep evaluation.  There are several options available such as an in-home sleep test or an in-lab test.

How does a sleep study happen?

At-home sleep apnea testing is an easy, cost-effective way to determine if you have sleep apnea.

A home sleep apnea test is a very simplified breathing monitor that tracks your breathing, oxygen levels, and breathing effort while you sleep. It does not fully capture what is monitored with an overnight sleep study, which give a more thorough assessment of sleep issues. Overnight studies are attended by a sleep technologist and capture many more signals, including brainwaves for sleep, muscle tone, and leg movements. For individuals with certain heart, breathing, or neuromuscular problems, an overnight sleep study at a sleep center may be a better option.

FACTS ABOUT AN AT-HOME SLEEP STUDY

• It monitors breathing, not the sleep itself.  The sleep study test won’t analyze how long you’re in light or deep sleep, instead it will measure pauses in and absence of breathing, how much effort it takes to breathe and whether your breathing is shallow.
• A sleep study needs to be prescribed.  It is not an over-the-counter test.  Your primary care physician or a physician at a sleep clinic can write the order for the at-home sleep apnea test.
• It uses sensors to detect breathing patterns. The sensors include a small probe over your finger that measures oxygen levels. You’ll insert another mask with tubes into your nostrils and secure it around your ears, similar to an oxygen mask. Other sensors are placed on your abdomen and chest to measure their rise and fall as you breathe.
• Most at-home sleep tests are used just for one or two nights. It’s convenient because it’s at home, and it’s also less expensive than a sleep study in a clinic, and can be typically be covered by your health insurance.
• It’s convenient. With an at-home study, you’ll be in the comfort of your own home, which could offer a more accurate reading of how you actually sleep, as you are more relaxed.
• After the test, your results will be reviewed by a sleep technologist and sent to your physician.
• If it is determined that you have sleep apnea, then your physician will discuss possible solutions, including a CPAP machine, which will require a consultation as well as a fitting for the right type of mask.

What does a Concentra DOT physical cover?

If you visit a Concentra Clinic for a DOT exam – required for all employees in safety-sensitive positions – it will be performed by a medical examiner listed on the National Registry of Certified Medical Examiners. The exam is necessary in order to rule out any DOT disqualifying medical conditions.

The exam is thorough and assesses:

• General appearance 
• Visual acuity 
• Hearing and/or any evidence of ear disease
• Throat conditions that might compromise breathing or swallowing
• Heart irregularities or disease 
• Blood pressure 
• Lungs
• Abdominal weakness, tenderness, or enlargement
• Urinalysis to assess protein, blood, and sugar levels
• Spine and musculoskeletal exam
• Upper and lower extremity exam to identify any impairment or loss of function in legs, feet, toes, arms, hands, or fingers
• Neurological exam to assess mental awareness and function of the brain and nervous system
• Sleep apnea

Finding a Concentra Clinic for apnea, more

If you are on the road and in need of a Concentra Clinic:

In 2019, Concentra performed approximately one million DOT exams and about half that many pre-placement exams, in addition to a host of other physical exams, tests and screening to fulfill all the many types of occupational health and safety needs drivers have.

This is good news for the nearly $800 billion trucking industry, which is a lifeline for the nation during the coronavirus pandemic even more than ever before. Concentra makes DOT certification and results reporting easy because it is administered electronically in a paperless environment. You get results faster and employers see results through Concentra’s employer portal.