OSA and Railroad Crashes

On May 12, 2016, Dr. Klein was to speak in Washington DC to a panel representing the Federal Motor Carrier Safety Administration regarding the concern of Sleep Apnea in our workers of transportation including, highways, railroads, air, and waters.

The rule for presenters is scheduled limit of 3 to 5 minutes.  Dr. Klein was granted a significantly longer period of time. He is a member of the American Sleep and Breathing Academy (ASBA) which instructs physicians, sleep technicians, respiratory therapists, nurses, and dentists that oral appliances are a viable alternative to the CPAP machine. Dr. Klein also spoke of the convenience of home testing (which was an issue that truck drivers addressed since they have a driving schedule that clashes with most sleep testing. Mr. Larry Minor (Administrator for Policy FMCSA) directed a question to Dr. Klein asking if compliancy can be measured. The answer is yes and many were unaware of the technology of the “DentiTrac” (a micro-recorder which can be used to indicate compliancy of truckers wearing their sleep device).

Shannon Watson (Senior Policy Advisor FMCSA) asked Dr. Klein to remain at the podium in case the panel had questions. Eleven varied questions were asked by the doctors and attorney on the panel. One of the topics discussed included cost comparison of Oral Appliances and CPAP.

The Journal of Primary Care March 22, 2016 documents “results show that serious preventable accidents were 5 times higher among truck drivers with OSA who fail to comply” Compliancy of Oral Appliance utilization is shown to be significantly higher in all OSA individuals when the mere fact of wearing the appliance for the full night of sleep and on all nights of sleep is considered.  Success of using a CPAP only 4 hours a night and only 5 nights of the week is a statistic that does not make sense. It allows insurance coverage if met, but what about the other 72% of the sleep time that OSA is not controlled.

Due to the ease of utilization, reduced fees, and enhanced compliancy, the ASBA believes the OA to be a much easier alternative and more superior to major surgery, or the CPAP machine (especially a CPAP in a truck driver or railroad engineer’s closet).