Consensus criteria for screening commercial drivers for obstructive sleep apnea: Evidence of efficacy

Objective: To validate the recently published consensus criteria for screening commercial drivers for obstructive sleep apnea (OSA). Meth-ods: A large, consecutive case series of commercial drivers was screened for OSA at a single occupational medicine clinic and those screening positive were referred for overnight polysomnography. Results: One hundred ninety (13%) of 1443 individuals having commercial motor vehicle driver examinations screened positive for OSA. None of these would have been detected if the only screening were the questions on the current Commercial Driver Medical examination form. One hundred thirty-four underwent polysomnography, and of those 94.8 % had OSA, which is the best estimate of the positive predictive value of these consensus criteria in a population of truck drivers. Conclusion: The proposed screening criteria have a high positive predictive value in this population. This study lends support for the requirement to screen for OSA in commercial drivers. (J Occup Environ Med. 2008;50: 324–329) T ruck driving is a hazardous occupa-tion, with the third highest fatalityrate among common occupations inthe United States.1 Thus, operating commercial motor vehicles for inter-state commerce or operating large trucks (26,000 pounds gross vehi-cle weight) for intrastate commerce is considered a “safety sensitive po-sition ” and requires a commercial driver’s license and certification of medical fitness through a Commercia