In the accident, the engineer unexpectedly fell asleep at the wheel due to a medical condition which causes sleepiness. Anytime a public transit operator becomes drowsy, or worse, falls asleep at the controls, lives are immediately placed in jeopardy. The most prevalent and serious of these conditions is obstructive sleep apnea, which affects an estimated 20 million Americans, most of whom remain undiagnosed.
Those with sleep apnea experience pauses in their breathing during sleep, caused by a temporary collapse of the airway. Each episode of apnea, which can last from 10 seconds to over a minute, leads to reduced oxygen levels in the blood. This can occur dozens to hundreds of times during each night of sleep, and can lead to disruptions in sleep and frequent fluctuations in heart rate and blood pressure.
Untreated sleep apnea can seriously impair health and is linked to strokes, high blood pressure and heart attacks, which are otherwise unexplained. Additionally, sleep apnea can lead to arrhythmias, congestive heart failure, diabetes, and weight gain. More common in men than in women, sleep apnea is characterized by the following signs and symptoms:
- Loud snoring
- Periods of non-breathing during sleep, which may be accompanied by snorting or gasping sounds
- Restless sleep or repetitive arousals, often unnoticed, during sleep
- Feeling sleepy or falling asleep at inappropriate times during the day, such as while driving, working or reading
- Depression, irritability and sexual dysfunction
- Memory loss
Screening tests for sleep apnea include take home devices that monitor breathing and oxygen levels during sleep. These can be useful and cost-effective in many cases. However, the ‘gold standard’ for definitively diagnosing, or ruling out, the presence of sleep apnea is an overnight test in a sleep center known as polysomnography, often dubbed a ‘sleep test’. This comprehensive test monitors and records multiple signals from the body.
If you suspect you may have sleep apnea, ask your doctor if you could benefit from a sleep evaluation.
For more information, visit The Center for Sleep Medicine at The Valley Hospital.
Dr. Jeffrey P. Barasch is the Medical Director at The Center for Sleep Medicine at The Valley Hospital.