Screening for Obstructive Sleep Apnea During Commercial Driver Medical Examinations

OBJECTIVE: To evaluate consensus criteria for screening commercial drivers for obstructive sleep apnea (OSA). METHODS: Consecutive drivers underwent OSA screening using Joint Task Force consensus criteria at commercial driver medical examinations. Outcomes included: clinical yield of screening; and drivers' compliance with polysomnography (PSG) referrals and OSA treatment. RESULTS: Among 456 drivers, 53 (12%) were referred for PSG, and 20/20 were confirmed to have OSA, supporting a high positive predictive value. The other 33 drivers referred for PSG were lost to follow-up but demonstrated no significant differences from those with confirmed OSA. After diagnosis, only one of 20 drivers with confirmed OSA demonstrated treatment compliance. CONCLUSIONS: Drivers identified by the consensus criteria have a high likelihood of OSA. Drivers' poor compliance with PSGs and OSA treatment support federally mandated screening of commercial drivers.