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How sleep apnea causes trucking accidents?

Truck drivers are 11x more likely to suffer from sleep apnea than the general population

Sleep apnea is one of the more than 80 different sleep disorders that can be life-threatening if left untreated. ‘Apnea’ is Ancient Greek meaning ‘without breath’, which is at the heart of why this sleep disorder is so deadly. It’s a sleep disorder that affects around 4% of the general population but affects as much as 35% of truckers, but before diving into the details, let’s get some facts straight and dispel a few myths in the process:

Types of Sleep Apnea: there are actually three types of sleep apnea:

  1. Central Sleep Apnea (CSA) – occurs when your brain doesn’t send proper signals to the muscles that control breathing
  2. Obstructive Sleep Apnea (OSA) –  occurs when your throat muscles and mouth palate relax and collapse during sleep blocking the airway
  3. Complex Sleep Apnea Syndrome (CSAS) – occurs when someone has both obstructive sleep apnea and central sleep apnea

Accident Risk

For truckers, the most common form of sleep apnea is Obstructive Sleep Apnea (OSA), which impacts their ability to obtain restorative sleep and remain vigilant behind the wheel. When breathing is constantly interrupted during sleep as the upper airway is periodically blocked for five to ten seconds at a time, the brain is starved of oxygen leading to hypertension and heart disease. OSA also causes sleep to become fragmented resulting in the inability to obtain both deep sleep (which repairs the physical aspects of fatigue) and dream sleep (also known as REM sleep which repairs mental fatigue and deals with mood, memory, and emotion). 

Truckers who have OSA may be in bed for up to ten hours but actually, get very little good quality sleep due to the constant interruption to breathing. The combination of sleep fragmentation and interrupted breathing leads to higher levels of drowsiness dramatically increasing the risk of accidents by as much as 250% compared to well-rested drivers.


You may have sleep apnea if you snore loudly, gasp for air during sleep or feel exhausted even after a full night’s sleep. Other symptoms include:

  • high blood pressure
  • diabetes
  • morning headaches
  • difficulty staying asleep
  • excessive daytime sleepiness
  • attention problems
  • irritability
  • poor memory
  • depression
  • self-medication dependency (to deal with headaches and help fall asleep)

More severe symptoms include heart attacks and strokes.


In most cases, sleep disorders can be easily managed once they are properly diagnosed, so please see a doctor if you continue to have trouble sleeping or are consistently find yourself feeling tired or not well-rested despite spending enough time in bed. Treatments include:

  • Tennis Balls: Snoring is a form of sleep disorder caused by disrupted breathing, which is why lying on your side helps and that’s where the tennis ball comes in. If sown onto the back of clothing you wear to bed it will stop you lying on your back. 
  • Mandibular Advancement Device (MAD): are custom dentist-designed mouth guards help keep your bottom jaw out and up allowing your throat to open and breathing to remain normal during sleep – great for mild OSA.  
  • Continuous Positive Airway Pressure (CPAP): If you have moderate to severe sleep apnea, you may benefit from a CPAP machine that delivers air pressure through a mask placed over your nose and/or mouth while you sleep. With CPAP the air pressure is just enough to keep your upper airway open, preventing apnea and snoring.
  • Surgery: is also an option but is usually only an option after other treatments have failed. Generally, at least a three-month trial of other treatment options is suggested before considering surgery.
  • Implants: also known as “sleep apnea pacemakers” are surgically implanted devices in the chest, which detect when breathing slows stimulating the nerve that controls the tongue, moving it up and forward to open the throat.
  • Weight Loss: is the most effective long-term treatment for sleep apnea. We tend to put weight on from the bottom up eventually leading to fatty deposits around the neck and throat, which adds weight around the neck area.
  • when we lose weight we tend to lose it from the top down and as soon as the weight falls off the face, neck and throat area the upper airway remains more open leading to better sleep quality and ultimately better decisions about nutrition and exercise. 

DoT Physicals and Body Mass Index (BMI)

There is a statistical correlation between your neck size and/or your BMI (height divided by weight squared), and the risk of having OSA. This is why the current Department of Transport (DoT) commercial vehicle driver physical requires a physician to take these measurements. If your neck size is greater than seventeen inches for men and sixteen inches for women or your BMI is 30 or greater, you may need to have a sleep study to see if you have a sleep disorder. In severe cases, you may even be placed out-of-service or issued a restricted license until such time as your physician considers you healthy enough to drive a commercial vehicle. 


  1. Bob Stanton

    Minor correction.

    “This is why the current Department of Transport (DoT) commercial vehicle driver physical requires a physician to take these measurements.”

    Fmcsa Medical Examiner guidance does NOT require BMI or other sleep apnea related measurements.

    Screening for sleep apnea is the best medical expert opinion of the examiner. Specific sleep apnea guidance without full formal rulemaking was prohibited by Congress in 2014 under public law 113-45. Fmcsa started but withdrew rulemaking in 2017 so there are NO requirements.

  2. Noble1

    speaking about sleep disorders let’s look a little further into it !


    Quote :
    Understanding the Importance of Employee Mental Health
    By Michael Galvan | 02/10/2016
    A mental health focus is important for employers. Work can sometimes worsen or in some cases even cause mental disorders in employees.

    These disorders can result in extended suffering, depressed mood, high stress, burnout, anxiety, demoralization, substance abuse, and sleep deficiencies.

    Some mental conditions often mean an employee will miss time from work, or not be effective at their job. Employees with high-stress positions are often at an increased risk for worsening or sometimes developing mental health conditions.”
    End quote .

  3. Rick Angle

    First of all, sleep apnea IS a ‘thing’, though it’s become just like anything else that pharmaceutical companies drool over. Enough said. The real danger is denying and defying circadian rhythm: You can’t get away from it, you can’t change it, you can’t alter it. Your brain is not wired to concentrate 100% after the sun goes down. Simple. Be the smart trucker who parks it and shuts his eyes at night. Could be 10-2, 12-4, or 2-6. Pick the time period that seems to work best. Your brain expects you to close your eyes when it’s dark, to refresh, so DO IT.

  4. dutchman

    My ear ,nose and throat Dr. say’s sleap apnea is is malarchy as most people that get tested tend to only have sinus issue that most are treataable so a person wouldn’t need a machine to force air dwn there throat…

  5. Benjamin Steinfeld

    This is a crock… The fmcsa have already determined that sleep apnea does not cause an increase in accidents …. If you want to know what is really causing the accidents why dont you take a good look at ELD’s and drivers running like a bat out of hell becaiae we only have x amount of time left before we HAVE to be in a SAFE spot for the night..

  6. Just another driver

    I love mental handjobs!, They are really great !
    Once again, another fine example of our wonderful over restrictive society. Yes, truck drivers – the people that no one cares about, but every one points fingers at- have done it again. These pariahs,second class citizens with their low IQs,big bellies and nasty attitude are the reason so many accidents and so many inocent overzealous highly responsible rule following curteous and polite law abiding citizens have lost their lives at the hands of these vermin.
    But fear no more, our righteous government with the help of industry savvy experienced officials at the helm of a 5 letter agency, have deviced a new weapon to destroy this plague that haunts America’s highways. Sleep apnea.
    Drivers crash and kill inocent Americans because they are fatigued, but they are fatigued because they are fat and snore mainly for their love of fast foods which relates to their low IQs they don’t exercise don’t eat healthy foods and are generally unpleasant to deal with.right? I mean after all they get 10hrs off every day isn’t that enough?
    NO IT IS NOT!!!!!!
    Drivers are fatigued because their job is a mental job, you have to be alert 100% of the time, drivers don’t have the luxury of 10min breaks of pushing back from their desks and close their eyes for a minute they don’t work 8 hrs a day off on weekends and holidays, access to healthy foods and a gym at the end of the day, hell,! sometimes you can’t even go to the bathroom either because there isn’t one or there’s nowhere to park.
    But no one gives a shit!
    Instead let’s make it again their fault, let’s again make their life more difficult, let’s remind them again how un important and how expendable they are.
    The average driver OTR, regional and even local, sleeps 5-6 hrs a day why? Because they have to do everything a civilian accomplishes in 16 hrs in 10
    What do you mean?
    In 10 hrs a driver has to park inspect document his truck and trailer twice that’s 1 hr ,get something to eat,eat it, shower, do laundry, get supplies, that’s 2hrs because of the Long lines at all the over congested truck stops, 6 hrs of sleep leaving you with 1 hr to chill, call family, pay bills online, etc, that’s if you managed to get a a truck stop and didn’t runned out of hrs.
    If truck stops had gyms instead of selling beer and cigarettes to drivers and had gyms, offered a kitchen area and sold healthy foods in addition to fast foods, if drivers only drove two 4 hr increments with a break in between they will be less mentally tired the real source of their fatigue, in shape and ready to hit the road and
    supply chains, shorter routes, preset scheduled pick ups, drop and hook, outside of the city delivery hubs supplied by 18wheelers and final miled by an army of straight trucks it’s a solution.
    This creates more jobs, less trucks in cities, less wasted time in city traffic at shipper and receivers, less wear and tear on drivers equipment and roadways, and more rest and more time to get and stay healthy lower insurance expenses across the board and yes healthy fit drivers equals no obesity which translates to no sleep apnea.
    Sleep apnea is a byproduct of the abuse today drivers are subject to.
    Obese, unhealthy,unfit drivers are a direct result of the idontgiveashitisms from companies, politicians, officials and the rest of ancillary truck driver industry surrounding them. who are only focus is optics and the bottom line.
    Drivers are unfit and fatigued because the industry exploits them, the government constraints them and society doesn’t give a shit.
    Drivers are expected to function at 100% every day, they can’t get sick, have a life, have functional relationships, sleep and shower like the rest of civilians, have a normal schedule.
    Society asks and demands from them like they do no other, yet they get back less than others.
    They are and after though, a nuisance, some society has to deal with and to top it off they are reminded they are a dime a dozen, when they complain they get fired and they shouldn’t complain because they get payed and if you don’t like it, there’s the door.

    1. Noble1

      Just another driver
      Your comment pretty much expresses a point I have been advocating . The only way this industry can be restructured reasonably is by reasonable and savvy truck drivers such as yourself .

      However , if we allow ourselves to think that the one’s we give control to ,and those that we allow to control this industry , will improve it for us the drivers , then we’re dreaming .

      Their “solution” will be automated trucks .

      If WE change our mentalities and unite , then we may have a chance . If those of us that have proper mentalities were to unite , we would not only restructure the industry , but we ourselves would be firing a ton of unreasonable drivers . We would have to retrain them , and have self improvement programs which all of us would need to attend on a regular basis .

      In my humble opinion …………

      P.S , don’t forget to vote , LOL !

    2. David

      Amen my friend. I have sleep apnea and worked for swift for 6 months. They gave me a new truck that would only idle between the temps of below 34 or above 72 or something like that. When the batteries got low a bunk alarm would go off to warn you that the batteries were low and would shut everything off. Tried to get them to correct or do something and took to Freightliner to have them look at it. They said the 2018 Cascadia with the new Cummins motors could not be changed. They still ignored until I got drowsey and went into the soft shoulder, over corrected and put truck on its side. Terminated and ruined from working for any major carriers for 5 yrs.

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