Home Issue 2017-08-11 Truckers and Sleep Apnea: Feds Say The ‘No Rule’ rules continue

Truckers and Sleep Apnea: Feds Say The ‘No Rule’ rules continue


After a 2013 Long Island Rail Road crash that killed four people and a fatal train wreck in Hoboken, NJ last year were linked to obstructive sleep apnea – along with at least eight other significant road and rail accidents — the National Transportation and Safety Bureau recommended a rule that all truck drivers and train engineers be tested for the sleep disorder. This week, Federal agencies withdrew support for such regulation as the Trump administration continues its campaign to drastically slash federal regulations.

People with sleep apnea – characterized by loud snoring and periodic breathing stoppages while sleeping – wake up many times during sleeping hours. The worst cases involve hundreds of incidents of involuntary arousal an hour during sleep. The result is a groggy, fatigued individual.

The Federal Railroad Administration (FRA) and Federal Motor Carrier Safety Administration (FMCSA) have withdrawn requests for regulation that would have required sleep apnea testing.

Therapy with a CPAP positive pressure machine is the first line of treatment for sleep apnea

In private testing, the Metro-North railroad that serves the New York City suburbs, found that 11.6 percent of its engineers have sleep apnea.

And the engineer in the 2013 Metro-North crash told investigators he felt strangely “dazed” and fell asleep at the controls just before the train sped into a 30-mph curve at 80 mph. Subsequent testing showed the man had a severe, undiagnosed case of sleep apnea.

Late last year, the FRA issued a safety advisory that was meant as a stopgap measure urging railroads to begin testing while the rules made their way through the legislative process. Without Congressional approval the federal agencies have no teeth to pursue cases of individuals involved in sleep apnea-related accidents and the companies that employ them.

Both the FRA and the NTSB objected to scuttling the plan, citing public safety concerns.

Senate Minority Leader Chuck Schumer said he will push federal agencies to reconsider regulation.

Train engineers are currently required to undergo vision and hearing testing at least every three years and some railroads require annual physicals, but there are no federal standards for comprehensive medical exams. Amtrak engineers and those from most major passenger railroads are required to be tested for sleep apnea.

The only regulations facing truck drivers is a limit to the amount of time that can be spent behind the wheel in a 24-hour period. The FMCSA is considering updating a 2015 bulletin to medical examiners about physical qualifications and respiratory dysfunction like apnea.


  1. The headline is WRONG!!!

    The Fmcsa notice withdrawing rulemaking did not change that untreated sleep apnea is a dq condition for a dot physical.

    The notice went on that Fmcsa plans to issue new guidance to medical examiners.

    This will create issue with the 2014 Congressional mandate in public law,113-45 which requires formal rulemaking on sleep apnea.

    Medical examiner’s have posted widely they plan to continue to screen using the medical examiner’s best professional judgement.

    What happens long term will be another story as the issue has become political through Senate Minority leader Chuck Schumer calling for renewing sleep apnea rulemaking

  2. Agree the headline is misleading. There is already a rule 49CFR391.41b(5) regarding respiratory conditions which sleep apnea falls under. The new rule would have clarified specific “hows” for examiners to follow regarding risk and screening criteria, testing, treatment and compliance monitoring.

    As examiners, we have relied on guidelines published since 2006 with the Joint Statement on Sleep Apnea conauthored by Natalie Hartenbaum, MD, to the 2007-8 medical expert panel reports and finally the 2012 MRB-MSACC recommendations to FMCSA, revised and reiterated last year, to make these decisions.

    The lack of a new rule leaves the “how” to the medical examiner’s discretion in following these guidelines rather than outright requiring them.

    In no way does it mean commercial drivers and engineers should not or will not be evaluated for sleep apnea.

    Lawrence Earl, MD, Medical Director, The National Academy of DOT Medical Examiners (NADME.org)

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