Sleep Apnea: A Deadly Cause of Trucking Fatigue

 In Trucking Accident

You may have heard that sleep apnea can shorten your life, but you probably heard about it in the context of links to heart disease or high blood pressure — not highway crashes involving 80,000 pound trucks.

Unfortunately, the link between sleep apnea and truck wrecks is very real. Obstructive sleep apnea (OSA) is a known cause of fatigue, which in turn plays a role in between 13 and 31 percent of all trucking accidents, according to different estimates from the National Transportation Safety Board (NTSB) and the Department of Transportation (DOT) — both of which acknowledge that fatigue tends to defy tracking and often goes underreported since truck drivers are hesitant to admit that their own drowsiness played a part in a crash.

According to the American Academy of Sleep Medicine (AASM), OSA afflicts at least 25 million adults in the U.S., including more than 20 percent of commercial truck drivers, and it often leads to symptoms of fatigue and daytime sleepiness. The overall effect of widespread OSA and the accompanying fatigue has led the DOT to call OSA “a critical safety issue” for all sectors in the transportation industry.

Fortunately, reasonable reforms could cut down on the hazards of fatigued driving among truckers, according to groups like the AASM — but regulators need to act quickly.

RELATED: Truck Driver Fatigue and Employee Coercion: A Deadly Pairing

“Sensible, evidence-based management plans have great potential to improve the health of commercial motor vehicle drivers and train operators while reducing the devastating accidents that can result from untreated sleep apnea,” said AASM President Dr. Nathaniel Watson in a March interview with Fleet Owner magazine. “The comprehensive development and swift implementation of evidence-based sleep apnea policies is necessary to protect the well-being of transportation operators and maximize public safety.”

Why Truckers Struggle with Sleep Apnea

Examining why sleep apnea plagues the trucking industry in particular requires following a thread that leads back to the fundamental work conditions that define long-haul trucking: long, sedentary hours in the cab, high stress from tight deadlines, limited choices for healthy meals, and even fewer opportunities for exercise. Statistics regarding the health of long-haul truckers provide some idea of the long-term effects of such a lifestyle, and they paint a gloomy picture.

According to a 2014 study from the National Institute for Occupational Safety and Health (NIOSH), long-haul truck drivers in the U.S. had a 69 percent rate of obesity — twice as high as that of the general adult working population — and were also more likely to smoke cigarettes and exhibit other risk factors for chronic disease.

The link between excess weight and OSA is well-established: obesity is the most common cause of obstructive sleep apnea, and obese people are four times more likely to suffer from sleep apnea compared to a person of normal weight, according to the Mayo Clinic.

If obesity causes OSA, and OSA leads to drowsy driving, it stands to reason that obesity itself would be associated with an increased accident risk, and that’s exactly what some recent statistics show. In November of 2015, for example, a research team reported in the journal Accident Analysis & Prevention that truck drivers with a BMI higher than 35 (“severely obese”) were 43 to 55 percent more likely to crash during their first two years on the road than drivers with a normal BMI.

The direct link between obesity and trucking accident risk makes it clear: the battle against fatigue-related trucking crashes isn’t just a fight against sleep apnea. It’s a reckoning for an industry whose workers’ ongoing health crisis has put in jeopardy their ability to safely drive massive commercial trucks.

DOT Aims New Regulations at Diagnosing and Treating OSA

In March, the DOT announced that it would hear public comments regarding the impacts of screening, evaluating, and treating commercial truck drivers and rail workers for obstructive sleep apnea. That announcement came after the NTSB last year urged the DOT to take action on sleep apnea screening by adding “require medical fitness for duty” on its Most Wanted List of transportation safety improvements for 2016.

The period for public comments closed on July 8, which means that screening and treatment requirements for sleep apnea in commercial truck drivers could begin to take effect in the coming months.

As with other recent efforts in trucking safety reform, though, a number of trucking companies and lobbying groups have argued against the new rules — which prominent sleep experts and trucking safety advocates support — on the grounds that current data regarding the links between OSA, fatigue, and large truck crashes aren’t strong enough to drive policy decisions.

“There is insufficient data linking OSA and higher crash rates,” Norita Taylor, spokeswoman for the Owner-Operator Independent Drivers Association (OOIDA), told in an email. “OSA testing can also be quite costly to drivers, both in terms of dollars and time, and if required by a Certified Medical Examiner, is rarely covered by standard medical insurance.”

Dr. Watson of the AASM, though, pointed out in comments to that sleep apnea is associated with drowsiness and fatigue as well as cardiovascular disease, diabetes, and high blood pressure — all of which come with costs in terms of trucker health and public safety. He pointed to a recent report by a market research firm indicating that diagnosing an individual with sleep apnea can save thousands of dollars in economic costs versus leaving the condition undiagnosed and untreated.

“The disease is costing people money whether they treat it or not,” Watson said. “They can pay more, and be dangerous and have a lower quality of life, or they can pay less, and be safer on the roadways and have a higher quality of life in the long run.”

Contact the Truck Wreck Justice Team if You’ve Been Injured

If you or a loved one has been injured in a crash involving a large truck or bus, please contact the Truck Wreck Justice team at Truck Wreck Justice today to schedule a free consultation. To do so, either complete our brief contact form or give us a call at (866) 580-HURT.

During your consultation, we can discuss the incident in question and determine your legal options. Statutes of limitations do apply to truck wreck cases, so please don’t wait to get in touch with us.


Carstensen, M. (2016, June 16). Feds inching toward implementing possible sleep apnea screening for truckers. Retrieved from

Diseases and conditions: Sleep apnea. (2015, August 25). Mayo Clinic. Retrieved from

Jones, K. (2016, March 9). FMCSA takes “first step” to sleep apnea rule. Fleet Owner. Retrieved from

Mouawad, J., & Harris, E. A. (2014, June 16). Truckers resist rules on sleep, despite risks of drowsy driving. The New York Times. Retrieved from

National Institute for Occupational Safety and Health. (January 16, 2014). New NIOSH study sheds light on long-haul truck driver health [press release]. Centers for Disease Control and Prevention. Retrieved from

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