Better Business Hub

Introduction

Sleep apnea doesn’t mean the end of the road for drivers or their employers. It’s a common problem and can be relatively straightforward and affordable to remedy. Drivers shouldn’t be reluctant to get diagnosed and treated. Transport companies should offer support (including medical leave and treatments) to keep their drivers on the road.

Sleep apnea occurs when breathing stops and starts during sleep. Essentially there are two types: obstructive (where the throat muscles relax and close off the airways) and central (where the brain doesn’t send the right signals to the muscles that control breathing). A third type, complex sleep apnea, occurs when someone has obstructive and central sleep apnea.

“A peer-reviewed article published in the Australian medical research journal ‘SLEEP’  found that 41 per cent of drivers may have undiagnosed obstructive sleep apnea,” says Adam Gibson, NTI’s Transport and Logistics Risk Engineer. “It’s a shocking number given that sleep assessments are readily available and treatment can greatly improve quality of life.”

This article is a short guide – for drivers and their managers – to detecting, diagnosing and managing sleep apnea.

Drivers: signs

There’s concern among drivers that getting diagnosed with sleep apnea will cost them their licence. However, with some simple treatment and lifestyle changes, you can manage it effectively. Better still, fixing your sleep problem will benefit you in other areas. Your mood, alertness, energy levels, overall health and sociability will improve.

The STOP-BANG protocol covers the critical risk factors: 

• Snoring: Do you snore loudly?
• Tired: Do you feel tired or sleepy during the day?
• Observed: Have you been observed to stop breathing during sleep?
• Pressure: Do you have high blood pressure?
• BMI: Is your body mass index greater than 35?
• Age: Are you 51 years or older?
• Neck: Is your neck circumference greater than 40cm?
• Gender: Are you male?

If you answer ‘yes’ to three or more of the above, you are at risk of sleep apnea. But even this may not tell the whole story, as Adam notes. “You can be a superbly fit triathlete and suffer from CSA [central sleep apnea],” he says. 

“But obstructive is far more common, so lifestyle and health factors do play a role in most cases.”

Other signs include insomnia and waking with a headache or dry mouth. If you feel tired and lethargic during the day, it’s worth getting checked.

Managers: signs

The critical signs for managers to watch out for are tiredness and poor mood. Sleep apnea causes sleep deprivation. Getting less than six hours of sleep a night has roughly the same effect on alertness and judgment as a 0.05 per cent blood alcohol reading.

If a driver is frequently tired, irritable, angry, inattentive, or (seemingly) careless, they might suffer from sleep apnea.

Driver management systems (DMSes) are another excellent source of data. Frequent fatigue incidents or driving aids triggering more often than expected can also signal that a driver has sleep problems. 

“You either have sleep apnea, or you don’t. Diagnosis doesn’t change that fact,” says Adam. “It’s better to have a diagnosis and get treatment. Managers should support their drivers because it’s better for everyone, it’s better for the business.”

“Managers can play a critical role in taking away the fear that a diagnosis will cost drivers their licence. It won’t if it is effectively managed, but that needs to be communicated clearly and often.”

Drivers: solutions

The good news is that sleep apnea is – in most cases – easily treated. First, take care of your health. Moderate your food and alcohol intake and get some light exercise. Even a daily 10-minute walk makes a difference. If you smoke, cut down or quit. Listen to any advice your GP gives you – and act on it.

Your doctor or specialist may advise you to get a continuous positive airway pressure (CPAP) machine. It’s a small pump connected to a facemask. It sends a steady flow of oxygen to your mouth and nose, keeping your airways open and helping you to sleep better. 

Get a machine for home use. Get a portable unit if you go camping or fishing overnight. And if you sleep in your truck, talk to your boss about getting a suitable inverter fitted to power a unit.

You might need to try a few different models until you find the one that works best for you, but it’s worth the effort. You can hire different machines, so if the first one you use doesn’t solve your problems, or if it’s uncomfortable, try another. 

Once you’ve settled on a suitable machine, it’s no exaggeration to say it can change your life.

“We’ve seen cases where it’s like the driver has ‘de-aged’ by twenty years,” says Adam. “Once you get back to a normal sleeping pattern, life just becomes so much better. Alertness, mood, energy … they all bounce back.”

Managers: solutions

From a management perspective, it’s vital to support your drivers. If they (or you) suspect sleep apnea, make sure they’ve got paid leave to visit a GP. If you suspect a few drivers are suffering, organise a clinic to visit your premises and offer free checks to all drivers.

If you have any drivers with a diagnosis, support their treatment by fitting pure-sine-wave inverters in your trucks with sufficient capacity to power their CPAP machines. They cost a few hundred dollars at most, which is a minuscule sum compared to the cost of a write-off or other fatigue incident. Some fleets are installing inverters in all their trucks as a matter of course. It’s cheaper per unit, and it means every vehicle in your fleet is CPAP machine-ready.

“It doesn’t matter whether you’ve got one truck or a dozen or a hundred,” Adam says. “The cost of adding inverters is nothing in comparison to the cost of a fatigue crash.”

“If drivers need them, then they’re the single most cost-effective improvement you can make to driver safety and the bottom line.”

As drivers get treatment, support them with flexible scheduling (such as shorter runs while they get sorted with a CPAP machine). Also, take care when they come back from holidays – if they’ve been away without a machine, it may take a few days for their device at home to get their sleep back to normal. Again, scheduling shorter runs or lighter duties might be a sensible precaution.

But as always, the most important aspect is your culture. You should always strive to have a supportive and positive workplace. Supporting your drivers through a sleep apnea diagnosis and treatment sends a very positive message. 

Sleep apnea doesn’t have to cost drivers their licences. It doesn’t have to cause fatigue incidents. All it takes is goodwill and common sense. And no good business should lack those.

1. This article contains general information only. It does not take into account your personal, medical or business circumstances. It is not intended to substitute professional medical advice. Always seek the guidance of your doctor or other qualified healthcare professional with any questions you may have regarding your health or a medical condition. Whilst all due care has been taken, you must not rely on the information as an alternative to medical, legal, legislated regulatory and compliance requirements associated with your business activities. NTI.M002.32.10122021
2. This article has been developed as part of NTI’s The Business of Safety series with the aim of helping transport and logistics businesses become safer and more sustainable. The Business of Safety is funded by the NHVR’s Heavy Vehicle Safety Initiative, supported by the Australian Government.