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Enhancing public health and safety by diagnosing and treating obstructive sleep apnea in the transportation industry: an American Academy of Sleep Medicine position statement.
Das AM, Chang JL, Berneking M, Hartenbaum NP, Rosekind M, Ramar K, Malhotra RK, Carden KA, Martin JL, Abbasi-Feinberg F, Aurora RN, Kapur VK, Olson EJ, Rosen CL, Rowley JA, Shelgikar AV, Trotti LM, Gurubhagavatula I. Enhancing public health and safety by diagnosing and treating obstructive sleep apnea in the transportation industry: an American Academy of Sleep Medicine position statement. Journal of clinical sleep medicine : JCSM : official publication of the American Academy of Sleep Medicine. 2021 Sep 21.
Obstructive sleep apnea (OSA) may lead to serious health, safety, and financial implications - including sleepiness-related crashes and incidents - in workers who perform safety-sensitive functions in the transportation industry. Evidence and expert consensus support its identification and treatment in high-risk commercial operators. An Advanced Notice of Proposed Rulemaking (ANPRM) regarding the diagnosis and treatment of OSA in commercial truck and rail operators was issued by the Federal Motor Carrier Safety Administration (FMCSA) and Federal Railroad Administration (FRA), but it was later withdrawn. This reversal has led to questions about whether efforts to identify and treat OSA are warranted. In the absence of clear directives, we urge key stakeholders, including clinicians and patients, to engage in a collaborative approach to address OSA by following, at a minimum, the 2016 guidelines issued by a Medical Review Board (MRB) of the FMCSA, alone or in combination with 2006 guidance by a joint task force. The current standard of care demands action to mitigate the serious health and safety risks of OSA.