Guest Post on Sleep Labs by Edwin C. Frost, R.R.T
In the wake of the deadly crash that severely injured comedian Tracy Morgan and killed his friend, James “Jimmy Mack” McNair, the issue of trucker fatigue has once again been brought to the national forefront.
Kevin Roper, the driver of the Walmart tractor-trailer that hit Morgan’s limo bus, admitted that he was sleepless for 24 hours prior to the accident. It is undetermined as to whether Roper was simply suffering from driver’s fatigue, or if there were underlying issues that contributed to the accident.
One of the contributors to driver fatigue and drowsiness is sleep apnea. “The Federal Motor Carrier Safety Administration’s (FMCSA) goal is to reduce commercial vehicle related fatalities and injuries. A FMCSA study found is that an estimated 28% of Commercial driver’s license (CDL) holders suffered from some form of sleep apnea ranging from mild (17.6%), to moderate (5.8%) to severe (4.7%).”(1)
If you hold a CDL, you may be required by your employer or doctor to be tested for sleep apnea. Depending on the company policy, you might be required to use their company doctor for your DOT physical exam. If this is not a company requirement, you may go to the certified healthcare provider of your choice.
“The current DOT regulations include BMI and neck size as key indicators for sleep apnea that medical examiners will be looking for during recertification physical exams. The DOT currently wants anyone with a BMI of 35 or greater to have a sleep study performed as well as anyone with a neck size of 17 inches or greater (for males) and 16 inches or greater (for females) to have a sleep study done.”(1)
The medical examiner will furnish one copy of the results to the person who was examined and complete a Medical Examiner’s Certificate.(2) Because “recommendations” were released last year, medical practitioners are erring on the side of caution. Licensed medical practitioners can be held liable for negligence if they suspect sleep apnea but fail to treat it.
The good news is that if you are diagnosed with sleep apnea, it is readily treated and may help prevent and improve such diseases as diabetes, hypertension, and heart disease.(3, 4) Getting tested and treated for sleep apnea is important for driver safety, health and well-being, and livelihood. Having the right treatment and support for sleep apnea can change your life.
Sleep companies and hospitals are fully aware of all of this — and many are holding truckers hostage because of it.
It all starts with a sleep test, which can cost thousands of dollars in a hospital lab setting. Moreover, most insurance companies will only pay a portion of the cost. Depending on your coverage, the remaining portion could cost the average person up to $3,000 for one overnight test, and if you haven’t met your deductible, you can tack on another two or three grand for the second “CPAP trial” test.
Because insurance companies usually have a set group of labs they use, patients typically do not “shop around” based on price because they often feel they have no other choice. You can, and must shop for the best deal! Call other accredited sleep labs in your area, give them your insurance information, and see what your out of pocket costs will be. If you are paying cash, negotiate!
What many patients don’t know is that there is a much more affordable option — a home sleep apnea test. While an in-lab test is more comprehensive, insurance companies will pay for and prefer an in-home test, if prescribed by a doctor. The costs to the insurer and patient are substantially less painful. Look for a Type III, DOT-approved diagnostic testing device, the kind of test that can be conducted privately by a patient, overnight, right at home, at an affordable price.
Once commercial drivers have been diagnosed with sleep apnea, they are often referred to a local sleep company for their setup and equipment. Many truckers are self-insured, uninsured, or UNDER-insured, and have to pay quite a bit out of pocket for the equipment they so desperately need. Sleep companies charge insurance companies top dollar for CPAP machines, masks, tubing and other supplies. This means that you may think you are getting a deal by only paying a percentage of the cost, but you really aren’t.
To complicate matters, the uninsured are often guided to generalized medical supply stores that charge super-inflated prices for the equipment, but more often than not, do not have a sleep expert on staff to answer their questions and guide them through the process.
This is a problem, because getting a sleep test and a machine is not the end of the road. If drivers test positive for sleep apnea and they are set up on certain CPAP treatments, they have to be able to meet compliance requirements when using CPAP machines. In order to meet DOT regulations, CDL holders need to use their machines for 70% of the week, which is roughly 4 hours a night for 5 nights a week.(1)
Furthermore, while compliance regulations vary from area to area within the USA, failure to comply with these regulations for any reason can result in suspension or revocation of one’s CDL.(5, 6)
To be successful with your therapy, you need expert guidance and support. This is a situation where it pays to do your homework. You need a team that
- completely understands this crisis;
- puts people first and profit second;
- works with clients to find the best prices available;
- listens to and understands clients’ needs;
- helps clients stay compliant; and
- assists clients with getting their compliance reports to their providers to help them understand their therapy.
You should immediately find out what your insurance company charges for equipment and then weigh your options. If you have to meet a $750.00 deductible or more — or have to “rent” the equipment over the course of 10-13 months for upwards of $100 per month — you need to research other options.
Is there a DOT home sleep study for less than $200? Yes!
Can a reliable CPAP machine, mask and supplies be found for well under $750.00? Absolutely!
If you need a typical CPAP machine and mask, this can easily be achieved. More complicated forms of apnea require different devices such as an AUTO-CPAP or BiPAP.
The right company will work with you to find the right equipment that fits into almost any budget and be there to provide unlimited support throughout your therapy.
Edwin C. Frost has been a Registered Respiratory Therapist for over 20 years and serves as President and Chief Clinical Officer of CPAP America. He can be reached toll-free at 1-800-569-0167 or online at CPAPAmerica.com.
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1. sleephealthier.com/pec_dot-requirements.php (no longer online)
6. moga.mo.gov/mostatutes/stathtml/30200007681.html (no longer online)