Safety Benefits of a Carrier-implemented Sleep Apnea Program for Commercial Motor Vehicle Drivers

The Virginia Tech Transportation Institute (VTTI) collaborated with a leading third-party population sleep health provider, Fusion Health, and two for-hire carriers to perform an independent analysis of the safety benefits of two, carrier-implemented obstructive sleep apnea (OSA) programs for commercial motor vehicle (CMV) drivers (OSAFE). The research team obtained OSA diagnostic and treatment data from Fusion Health and safety and driver information from the participating carriers. The crash types assessed in the analysis included claims-only, on-road, and preventable crashes. To compare OSA-treated drivers to drivers without diagnosed OSA, a matched cohort approach was taken to include treated drivers and drivers without diagnosed OSA. Safety performance was investigated to explore crash rates before and during PAP treatment, crash rates by treatment adherence and average usage, and crash rates before and during treatment for drivers with a previous crash. The main findings from this study include the following: (1) high PAP adherence rates among OSA drivers, with more than 90% of drivers from both carriers meeting full-adherence requirements for PAP compliance; (2) support for the safety benefits of PAP treatment in CMV drivers who were OSA positive and demonstrated full adherence to treatment; (3) pronounced safety benefits for CMV drivers that experienced a crash prior to beginning PAP treatment; (4) a dose-response safety benefit of PAP use among drivers at Carrier A; and (5) for Carrier A drivers with full adherence to PAP, higher rates of claims-only and preventable crashes before and during treatment compared to similar control drivers. Given that fully compliant PAP treatment was associated with reductions in on-road and preventable crashes, carriers should focus on (1) identifying OSA drivers through effective screening programs, (2) providing PAP treatment, (3) monitoring PAP compliance, and (4) providing support to assist drivers in maintaining OSA compliance.