Sleep Apnea and Automobile Crashes

Sleep apnea is a common sleeping disorder that can lead to motor vehicle accidents, morbidity and mortality in patients who suffer from the disorder. It is a disorder in which the airway closes or narrows during sleep, resulting in low oxygen levels, gasping in one’s sleep and pauses in the sleep pattern due to waking up from shortness of breath.

The breath pauses can last from a second or two to up to a minute or more. It can happen thirty times or more per hour and, after gasping awake, the patient can breathe normally for a minute or two. The person is likely to be a snorer. The person also is likely to snort, choke or gasp in his sleep. Most patients are men but women can suffer from it as well.

Sleep apnea is difficult to diagnose as the patient himself may not know that these things are happening in his sleep. His sleeping partner often notes the presence of breathing stoppage or gasping in the sleep and will send the person to the doctor. There aren’t any blood tests or similar tests to detect sleep apnea. It often is diagnosed by a sleep study in which the person sleeps at a sleep facility or at home with a special monitor on that can detect the presence of breath stoppage and low oxygen.

Most sleep apnea is called “obstructive sleep apnea”, which means there is an actual blockage in the airway leading to low oxygen. The blockage of the airway involves the falling in of the soft tissue. Those who are obese have a greater chance of having sleep apnea, due to the increase in tissue in the upper airway. People with large tonsils also have a chance of getting obstructive sleep apnea. Some people have “central sleep apnea” in which the brain fails to send a signal for the person to breathe.

Sleep apnea can be dangerous because it causes impairment in a person’s performance, especially with boring tasks or when driving. Sleep apnea is associated with an increase in the number and severity of motor vehicle accidents because the person falls asleep at the wheel due to extreme fatigue caused by sleep apnea. A motor vehicle accident can be the first sign of a problem with sleep apnea. Commercial drivers are at a particular risk because they’re on the road for a long period of time and are driving dangerous materials or a very large truck that can do a lot of damage if the driver falls asleep at the wheel.

The challenge is for doctors to assess the specific risk of sleep apnea and accident risk in men or women who have daytime fatigue. If they are known snorers or known to be obese, perhaps a sleep apnea study should be done at a sleep clinic. This is the only way to prove a person actually has a sleep disorder like sleep apnea. Because a sleep apnea patient may never actually have an accident, it is not a good idea to restrict the person from driving. Rather it is a better idea to treat the person for sleep apnea and keep them on the road.

There should be education, especially of over the road truckers, of the dangers of sleep apnea so that, if they find a change in their daytime wakefulness, they might choose to be evaluated for the condition.