The sleep apnea epidemic is quickly growing out of control. The National Transportation Safety Board is reporting that people are falling asleep at the wheel across the country. Two New York City commuter train crashes may be a direct result of undiagnosed obstructive sleep apnea. This condition repeatedly disrupts sleep upwards of hundreds of times per night. As a result, people aren’t getting the rest they need. This in turn lowers their ability to focus, response time, and increases daytime drowsiness. This makes for a deadly combination when operating any type of vehicle.
The NTSB strongly believes that mandatory screening could have prevented the accidents. Just these two occurances left one person dead and more than 200 other people injured. In both instances, the trains were traveling at higher than normal speeds. They were also accelerating as they entered the train stations rather than decelerating. NPR.org reports:
The NTSB says the common sleep disorder is likely what caused the train operators to nod off as they pulled into the stations.
Both trains were going at higher-than-permitted speeds, accelerating as they entered the stations and smashed through bumping posts at the ends of the tracks. In the Hoboken crash, one woman was killed by falling debris on the platform and 110 people were hurt. While in the Brooklyn crash, 108 people were treated for injuries. In both incidents, the engineers of the commuter trains told investigators they could not remember what had happened during the final few minutes preceding the crashes.
Over the past several years, obstructive sleep apnea also known as OSA, has been the cause for several accidents. These fatigue-related crashes are occurring on the rails as well as on the roads across the country. In many instances, the accidents have been fatal for either the driver or an innocent bystander. NPR.org continues:
The Obama administration had been drafting a rule to require train operators, as well as truck and bus drivers, to be screened and treated for obstructive sleep apnea, but the Trump administration recently quashed it.
“I don’t know how many board meetings I’ve sat through either on highway or rail [crashes] that have involved [obstructive sleep apnea],” said Chairman Robert Sumwalt at Tuesday’s NTSB meeting on the Hoboken and Brooklyn crashes. “And it could be screened and treated.”
Sumwalt says he is “mystified” by the actions of the Federal Railroad Administration and the Federal Motor Carrier Safety Administration to pull the regulation.
“I’m extremely disturbed that [they’ve] withdrawn this sleep apnea screening proposal,” he said. “It’s unacceptable to me.”
In August of 2017, the U.S. Department of Transportation suspended the federal rule requiring sleep apnea testing and treatment. Instead, individual railroad operators must now decide how they will handle this issue. Commercial pilots and pilots of private airplanes must undergo sleep apnea screening and treatment. It only makes sense to have the same screening requirements for truck drivers and train engineers.
“It … makes no sense to me that one DOT agency, the Federal Aviation Administration, is taking what appears to be a reasonable approach for obstructive sleep apnea [while the other agencies withdrew the proposals]. I’m not sure why there’s a difference within DOT modal agencies,” Sumwalt said.
“The traveling public deserves alert operators,” he said. “That’s not too much to ask.”
The NTSB places some blame for the two train crashes on their respective agencies. New Jersey Transit was at fault for not following sleep apnea protocol. Long Island Rail Road, along with its parent agency the Metropolitan Transportation Authority were also at fault for not testing engineers prior to the crash.
Now, all involved agencies have updated their policies. They now require obstructive sleep apnea screening for all bus and train operators as well as locomotive engineers. If any individual tests positive for the condition then they must begin treatment before they can get back to work.
One of the reasons that OSA is so dangerous is that so many people carry on through life undiagnosed. This sleep disorder is notoriously difficult to diagnose and many individuals aren’t aware they’re suffering from the condition. Requiring screening ensures that the individuals responsible for the lives of thousands of Americans across the country aren’t suffering from this dangerous disorder.
While it’s important to screen individuals in the public transportation sector, it’s also important that citizens across the country take the necessary precautions. The American Academy of Sleep Medicine advises that individuals with sleep apnea are 2.5 times more likely to be in a motor vehicle accident. Thankfully, the sleeping disorder responds very well to treatment. The AASM reports:
“This study provides very strong evidence that obstructive sleep apnea patients have an increased traffic accident risk and that this risk can be modified if CPAP treatment is used adequately,” said principal investigator and senior author Dr. Ludger Grote, associate professor at the Center for Sleep and Vigilance Disorders at the Sahlgrenska Academy at the University of Gothenburg in Gothenburg, Sweden.
The AASM reports that obstructive sleep apnea (OSA) is a common sleep disease afflicting at least 25 million adults in the U.S. Sleep apnea warning signs include snoring and choking, gasping or silent breathing pauses during sleep. The AASM and other partners in the National Healthy Sleep Awareness Project, which is funded by the Centers for Disease Control and Prevention, urge anyone with symptoms of sleep apnea to visit www.stopsnoringpledge.org to pledge to “Stop the Snore” by talking to a doctor.
For some patients, CPAP therapy isn’t an option. Thankfully there are numerous other treatment methods on the market to help those suffering from OSA. For example, oral appliance therapy is quickly growing in popularity due to the ease and comfort of treatment.
Mark Levy DDS, a sleep medicine expert, specializes in creating these custom oral appliances that help prevent sleep apnea occurrences. To learn more, reach out to Dr. Levy and his expert staff.