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Pilots and Commercial Drivers Should be Screened for Sleep Disorders

The National Sleep Foundation (http://www.sleepfoundation.org/alert/ntsb-makes-recommendations-sleep-apnea?utm_source=NSF+Alert&utm_campaign=3f724bfd5d-NSF_Alert_8_18_098_18_2009&utm_medium=email) is reporting on the recommendations made by the National Transportation Safety Board (www.ntsb.gov) after they investigated the case of the pilot and co-pilot falling asleep on a flight from Honolulu to Hilo. It was found that likely the pilot’s untreated obstructive sleep apnea (OSA) was a major contributing factor as well as flight schedules.

They are making recommendations that all pilots be screened for sleep disorders, especially for sleep apnea, which can make people profoundly sleep deprived and make it very difficult for them to stay awake during any sedentary activity. The repeated collapse of the throat while sleeping leads to repeated micro-arousals because the brain senses the falling oxygen levels and rising CO2 and knows that something is wrong. During the brief awakenings  (so brief that a person doesn’t usually remember), the person gasps for air and then falls back into sleep only to start the whole disruptive process all over again.

There are now several airplane crashes that are thought to have occured because of pilot fatigue and the associated poor judgement and slowed reflexes.  There are many large industrial disasters that were ruled in the end to have happened because someone fell asleep on the job, e.g.  the Three Mile Island nuclear accident and the Exon Valdex oil spill.

There is an increasing awareness and concern among sleep specialists and highway safety experts about the prevalence of drowsy driving among all drivers, but especially commerical divers.  The National Highway Traffic Safety Administration (www.nhtsa.gov) estimates that 100,000 crashes occur each year due to drowsey driving involving 76,000 injuries and 1,500 deaths.  This is just an estimate because most crashes are single driver accidents.  The tell-tale signs, which unfortuneately most police are not taught to look for, are:  (1) Single Driver; (2) Time of accident is either very late at night or during the circadian dip that occurs in the afternoon; (3) No attempt to avoid the crash (which makes drowsy driving very deadly).  In April 2009, the National Highway Traffic Safety issued its review of a  prototype for a Drowsy Driver Warning System to be used by commercial drivers.  The report concluded that this is promising technology and more development in this area is likely to occur over the next few years. See the full report at ( http://www.nhtsa.gov/portal/site/nhtsa/menuitem.54757ba83ef160af9a7ccf10dba046a0/

 Auto manufacturers are looking into offering such devices for passenger vehicles.  But we don’t want millions of sleepy people relying on such devices in order to continue to drive drowsy.  I encourage my readers to see a sleep specialist if they have problems sleeping at night or are unusually sleepy in the daytime for unknown reasons. I urge people to take drowsy driving as seriously as they do drunk driving:  It can be just as deadly.

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