Remember Sleeping Beauty? You know it was a fairy tale because she slept completely and undisturbed for a hundred years and only woke up when Prince Charming arrived on the scene. It simply doesn’t work this way for many of us. A few uninterrupted hours would be spectacular, never mind sleeping for decades. And why should we care? Because sleep is strongly related to good health. People who do not sleep well are at greater risk of having high blood pressure, heart disease, stroke, and diabetes. And truckers with sleep apnea are 250% more likely to cause an accident.
According to Sleep Review Magazine, “Sleep apnea is not uncommon in the general population, but the percentage of truck drivers with the condition is even higher.” A recent study, sponsored by the American Trucking Association and the Federal Motor Carrier Safety Administration, found that 28% of commercial truck drivers have mild to severe sleep apnea. Even if you aren’t falling asleep completely at the wheel, poor sleep decreases your ability to concentrate and react quickly.
Do you snore? Does your bed partner complain about your snoring or that you sometimes stop breathing while you are sleeping? Snoring can be a sign of obstructive sleep apnea (OSA). The term “apnea” comes from the Greek for “without breath” (sounds about right). OSA occurs when the muscles in your throat become too relaxed and the tongue slides back, blocking your airway. As you are trying to breathe, the air is hitting the sides of the throat, struggling to get around the obstruction, and makes a loud noise (snoring) as it is passing through. There generally is not enough air making its way down to your lungs, which is a much worse problem than just the noise of snoring alone.
When this happens, your brain gets the signal that it is not getting enough oxygen and wakes you up so you can breathe. Sometimes people wake up gasping for air or feeling really frightened. Others have no or only a slight awareness of some disturbance in their sleep. There are varying degrees of OSA, ranging anywhere from mild (only stopping breathing a few times a night), to severe, having over 30 apnea events (times that you stop breathing) per hour.
While there are different causes of sleep apnea, OSA is the most common type among truckers. Any type of sleep apnea is particularly dangerous because, as you might imagine, it leaves you very sleepy the following day. Additionally, you might be irritable, wake up with a headache, have funky dreams, and have a harder time losing weight if you are trying. You simply aren’t getting a restful, restorative sleep, and staying awake to drive a truck can be unmanageable. If you are irritable all the time, road rage could become an issue. There is some evidence that sleep apnea can be an inherited condition – if a parent had it, for example, you might inherit it from them. A major risk factor is obesity, and about 50% of truckers are obese.
So, what can you do? Well, first you have to figure out the cause of your problem. If you are experiencing excessive daytime sleepiness and/or snoring and the other symptoms mentioned above, you might need a sleep study. Having had a couple of these myself over the years, I can attest that they are not very fun. But then, neither is waking up while you are drifting into a lane of oncoming traffic!
Once you know what’s going on, there is hope for a treatment. The gold standard for sleep apnea is what’s called PAP treatment – Positive Airway Pressure. It can be Continuous (CPAP) or Bi-level (BiPAP) – a sleep specialist would make that determination depending on your particular needs. These are incredible little machines that can change your life – they certainly did mine. But not everyone can get used to using a PAP machine, so there is another treatment that involves a tiny little machine, something like a pacemaker, called Inspire. No machine, mask, or hose involved, like with PAP machines, but it does involve having the little device implanted into your chest, and is only for people who don’t do well with PAP.
There is no law currently that requires sleep testing for truckers. However, the health care provider doing your DOT physical may suggest a sleep test called “polysomnography” (try to say that five times fast) if you are obese and/or have any other symptoms of difficult sleep (even thin people can have OSA). Some of these studies can be done at home rather than in a sleep lab, saving you a bundle if you are paying out of pocket. If it is determined that you need treatment for sleep apnea, then you must be able to demonstrate to the provider responsible for your CDL medical certification that your condition is improving before they give you your card.
The PAP machines in use today give you a score telling you how long you slept, how many events you had – the number should be going down – and if your mask is fitting well. This information goes right to your health care provider so they can see if you are improving or if adjustments need to be made. And, with an APU (hotel power) on your truck, you can plug in your machine and not worry about idling compliance.
Having said all of the above, the downside to this is the cost. If you do not have health insurance, it can get quite pricey. Or, if you are insured, your insurance might not pay for a sleep study. There could still be help for you, though. Check out www.sleepapnea.org and/or www.sleepfoundation.org to see about alternative options for testing and treatment.
I have had amazing success using my BiPAP – it was like changing from a zombie back to a normal human being! No more falling asleep while I’m driving, have lost almost 40 pounds over the past six months, and I actually initiate exercise now. You just can’t say enough about good sleep. Many of us just suffer in silence, but on the road, the stakes are high. Get on the road to better sleep as soon as you can and become the Sleeping Beauty you have been dreaming about!
~ Norma Stephens Hannigan is a Doctor of Nursing Practice who recently retired after a 43-year career providing direct care and teaching future nurses and nurse practitioners. Dr. Norma has treated many truck drivers at the various clinics she has worked. She currently writes for 10-4 from her home in Newburgh, NY.