Every night, millions of Americans deal with the effects of obstructive sleep apnea. Much to the frustration of their sleep partners, sufferers of this sleep disorder toss and turn, often snoring loudly and jolting themselves awake. The cycle is repeated often hundreds of times each night and leaves the sufferer exhausted and unrested in the morning.
According to the National Sleep Apnea Foundation, the disorder affects more than 18 million Americans (and possibly many more), and the vast majority of cases are undiagnosed. But sleep apnea is far from a minor annoyance; its effects can be potentially deadly. Left untreated, obstructive sleep apnea has been linked to high blood pressure, heart disease, stroke, diabetes, depression and other problems. And one particular effect can have far-reaching consequences — daytime drowsiness from the lack of restful sleep can lead to falling asleep while driving.
After a September train crash in Hoboken, New Jersey, in which one person was killed and at least 114 were injured, the Federal Railroad Administration announced it will issue a “strong recommendation” that train operators be tested regularly for sleep apnea. In the Hoboken crash, engineer Thomas Gallagher tested positive for sleep apnea after the crash, but he had passed a physical a couple of months before the crash. Gallagher reported feeling rested when he showed up for work that morning, but has no memory of the crash before waking up on the floor of the engineer’s cab.
Sleep apnea has also been blamed for a number of other train crashes, some fatal. According to the AP’s story, New York’s Metro-North service started testing its engineers for obstructive sleep apnea in 2013, after a deadly crash. Since then, 51 of 438 engineers tested positive for the disorder and treatment for them was ordered.
Sleep apnea, of course, isn’t a new problem; nor are the potential deadly effects. In 2015, the Centers for Disease Control and Prevention reported that drowsy driving resulted in 72,000 crashes in 2013, resulting in 44,000 injuries and 800 deaths. However, the CDC report notes that those statistics may be very conservative. Studies have repeatedly shown that many of us are driving tired, and (particularly on longer trips) can fall asleep easily.
In March, the Federal Railroad Administration and the National Transportation Safety Board sought public input on the potential impacts of testing railroad workers and commercial motor vehicle drivers for obstructive sleep apnea. And the NTSB issued new guidance requiring that airlines test their pilots for the disorder on a regular basis and require treatment to be allowed back into the cockpit.
The actions came after at least 34 troubling incidents (and possibly many more), such as a 2008 Go! Airlines flight in which two pilots fell asleep on a short-hop flight between Honolulu and Hilo, Hawaii. The pilots flew their plane, 40 passengers and a flight attendant 26 miles past their island destination into open ocean and did not respond to air traffic controllers for more than 18 minutes. After their safe return, the captain was tested and found to have “undiagnosed severe OSA.”
FRA Administrator Sarah Feinberg told the Associated Press that the agency is considering that all railroad operators be screened for obstructive sleep apnea and other sleep and fatigue disorders. While the issue has been of concern for years, Feinberg told the AP it’s time to take action. “At this point it’s unacceptable to wait any longer,” she said. “This is one more thing railroads can do to keep their passengers safe and the communities they’re traveling through safe.”
For more about sleep apnea, its causes and treatments, visit http://www.sleepapnea.org/.