Hits and misses: screening commercial drivers for obstructive sleep apnea using guidelines recommended by a joint task force.
Platt AB; Wick LC; Hurley S; Soto-Calderon H; Wieland W; Staley B; Maislin G; Gurubhagavatula I
J Occup Environ Med 2013 Sep; 55(9):1035-1040
OBJECTIVE: To evaluate joint task force criteria-based screening for severe obstructive sleep apnea (s-OSA) in commercial drivers. METHODS: Among a community-based cohort of licensed commercial vehicle drivers, we assessed utility of the joint task force criteria. We conducted full, 14-channel overnight polysomnography in all drivers, defining s-OSA as an apnea-hypopnea index of 30 or more per hour. RESULTS: One hundred of 104 drivers with successful polysomnography studies were predominantly obese (median body mass index = 32.8 kg/m; interquartile range = 26.8 to 37.4) and had a median apnea-hypopnea index of 20.6 per hour (interquartile range = 10.0 to 34.2). Examination-based criteria were more effective (sensitivity = 80%; negative posttest probability [nPTP] = 17%) than symptom-based criteria (sensitivity = 63%; nPTP = 23%). Examination and symptom-based criteria combined had high sensitivity (97%) and low nPTP (7%), but poor specificity (19%). CONCLUSIONS: Examination-based criteria missed 20% of s-OSA cases. Combining examination with confidentially reported symptoms improved sensitivity but required confirmatory polysomnography in 86%, supporting universal screening of all drivers.
Sleep-disorders; Humans; Men; Women; Trucking; Truck-drivers; Motor-vehicles; Statistical-analysis; Body-weight
Alec B. Platt, MD, MSCE, FCCP, 2608 Keiser Blvd, Wyomissing, PA 19610
Journal of Occupational and Environmental Medicine
University of Pennsylvania