Clinical sleep apnea syndrome is common among long-haul truckers. A significant barrier to diagnosis and treatment is loss of time from work. We wanted to evaluate a group of truckers at high risk for sleep apnea using an “in cab” apnea screening tool followed by automatic cpap titration. The protocol was designed to minimize the driver's time away from the job.
Drivers were recruited from a local long haul company. All drivers had a valid CDL with medical clearance certification. Berlin questionnaire was administered for screening. Positives were further screened with a hand held PVT device,and FOSQ was administered. An in-cab Apnea-Link(TM) screener was used for SDB detection. Positive result patients were treated with Auto titrating CPAP. FOSQ and PVT were repeated at the end of the study. An Attended Split night PSG was done for confirmation of OSA diagnosis and treatment CPAP pressures.
The Mean ESS was 12 pre and 7 post treatment Fosq mean was 40 pre and 21 post treatment. Mean RDI was 31(APNEA LINK) and AHI(Diagnostic-PSG)was 56. CPAP auto mean pressures varied less than 2 cm compared to PSG titration. Autoset Compliance logs averaged 5.25 hours usage per night.
1. Drivers are willing to undergo diagnosis and treatment for OSA if there is minimal loss of time from work. 2. Apnea Link(TM)RDI varied significantly from PSG determined RDI. 3. Similar titration pressures were found comparing Autotitration with attended PSG. 4. Above average CPAP utlization was found but there was significant variation between individual drivers.
1. Use of outpatient screening coupled with automatic cpap treatment devices show reasonable clinical utility. 2. Future protocols should specifically take into consideration time away from work.3. Elimination of punitive consequences were important to the drivers 4. Remaining major barrier remains the driver's hectic and unpredictable schedule.
John Roehrs, Grant monies (from industry related sources) Res Med foundation provided the funds to do this study. The grant was unrestricted; No Product/Research Disclosure Information