How Sleep Apnea Affects Drivers, Operators, and Train Conductors

On September 29, 2016, a transit train bound for New Jersey failed to stop at the station in Hoboken, costing the life of a female bystander and injuring several people. A few months later, a similar incident occurred in January, 2017 in Brooklyn, which injured more than 100 people. Later findings determined the cause of the accidents — both conductors fell asleep on duty, and sleep apnea was to blame. Unfortunately, cases of accidents due to obstructive sleep apnea (OSA) aren’t rare. Over the past few years, there have been several documented incidents involving trucks, trains, and bus crashes due to operators falling asleep while on duty.

Certain skills such as spatial awareness and hand-eye coordination are required for driving; a lack of concentration can result in accidents. Around 20% of driving accidents have occurred due to sleepiness and fatigue. Most such accidents in the U.S. have occurred in the afternoon or at night when concentration levels hit rock bottom.

Some lack of concentration can occur due to certain medical conditions. Over the past 20 years, the number of traffic accidents due to sleep apnea have been well documented, and many studies have shown accidents tends to occur when the severity of OSA is high. One’s sleep pattern is drastically affected by sleep apnea, and this sleepiness is so excessive that the rate of road-related accidents increases for OSA patients.

However, with sleep apnea, it is not confirmed which aspect of the sleep disturbance affects one’s driving skills. Since OSA alters sleep patterns, it also disrupts alertness and performance during the day. A person may not be able to focus and stay awake if this condition is left untreated. Many patients say they do not fall asleep while driving, however, they need not fall asleep to get caught in an accident; less attention and losing focus can also cause accidents.

Sleep apnea screening and treatment has been proposed by the metropolitan transportation authority for all train and bus conductors and engineers. It involves evaluating the Body Mass Index of each employee, looking at their sleep patterns, and asking questions about their medical histories. Further examination is needed for those who are at risk, followed by a session on potential treatment.

In OSA, the patient ceases to breathe for a period of time. There may be little or no airflow when the person tries to breathe. If the condition is not treated, it can become life-threatening. Some of the serious health issues caused by OSA are:

• High blood pressure
• Diabetes
• Depression
• Poor memory
• Heart disease
• Recurring headache
• Poor performance

Various factors may increase the risk of sleep apnea, including obesity, smoking, alcohol, sedative use, old age, being male, and neck circumference. If the airway is partially blocked while sleeping, air cannot flow properly, reducing the blood oxygen level. If it drops significantly, it forcees the brain to disturb one’s sleep. Repeated instances of this may trigger the production of stress hormones, which will cause further health issues.

In order to reduce one’s risk, individuals should lose weight, avoid smoking, and exercise on a regular basis. Moreover:

• Regular sleep schedule: An adequate amount of sleep reduces the risk of sleep apnea, so be sure to get at least eight hours of sleep each night.

• Don’t take sedatives or sleeping pills: These medications relax the tissue in the upper airway, making breathing difficult when the person is asleep.