Driver Lifestyles
The Nightime Thief
Driver, have you ever found yourself and your truck parked on the side of the Interstate and wondered how you got there?
Do you find yourself in need of a nap even after a full eight hours of sleep?
Do you find yourself becoming drowsy or even nodding off while driving?
Have you ever considered that you might be a victim of Sleep Apnea?
Some 30 million Americans are victims of a sleep disorder called sleep apnea sickness or in other terms, obstructive sleep apnea, sleep apnea or central sleep apnea. Numerous others are predisposed and have a high risk of developing the sickness. Adult males, have the highest odds at about 50/50 that their breathing is not normal when they are sleeping.
Obstructive Sleep Apnea is a condition in which a narrowing or closure of the upper airway during sleep causes repeated sleep disturbances, and possible complete awakenings, leading to poor sleep quality and excessive daytime sleepiness.
People most likely to have or develop sleep apnea include those who snore loudly and also are overweight, or have high blood pressure, or have some physical abnormality in the nose, throat, or other parts of the upper airway. Sleep apnea sickness seems to run in some families, suggesting a possible genetic basis.
Fatigue and tiredness during the day is one symptom of sleep apnea. Another symptom is loud snoring; if the loud snoring is repeatedly punctuated by brief periods of silence or choking sounds, the individual is certain to have obstructive sleep apnea.
Related sleep apnea symptoms can include:
• Loud snoring
• Change in personality
• Depression
• Rapid weight gain
• Reduced sex drive and impotence
• High blood pressure
• Restless sleep; the repeated struggle to breath can be associated with a great deal of movement.
• Depressed mood and/or irritability
• Snorting, gasping, choking during sleep
• Insomnia
• Frequent nocturnal urination
• Confusion upon awakening
• Difficulty concentrating
• Morning headaches
• Sleep that is not refreshing
• Nocturnal snorting, gasping, choking (may wake self up)
• High blood pressure
• Overweight
• Irritability
• A dry mouth upon awakening
• Excessive perspiring during sleep
• Restless sleep
• Heartburn
During the apneic event, the person is unable to breathe in oxygen and to exhale carbon dioxide, resulting in low levels of oxygen and increased levels of carbon dioxide in the blood. The reduction in oxygen and increase in carbon dioxide alert the brain to resume breathing and cause an arousal.
With each arousal, a signal is sent from the brain to the upper airway muscles to open the airway; breathing is resumed, often with a loud snort or gasp. Frequent arousals, although necessary for breathing to restart, prevent the patient from getting enough restorative, deep sleep.
Sleep apnea is a potentially life-threatening condition that requires medical attention. The risks of undiagnosed obstructive sleep apnea include heart attacks, strokes, impotence, irregular heartbeat, high blood pressure and heart disease.
In addition, obstructive sleep apnea causes daytime sleepiness that can result in accidents, lost productivity and interpersonal relationship problems. The severity of the symptoms may range from mild to severe.
The non-surgical treatments for obstructive sleep apnea are similar to the non-surgical treatments for snoring with a few differences. Treatments include:
*Behavioral changes
*CPAP (continuous positive airway pressure)
*Medications.
Behavioral changes
Behavioral changes are the simplest treatments for mild obstructive sleep apnea, but often the hardest to make.
Occasionally, apneas occur only in some positions (most commonly lying flat on the back). A person can change his or her sleeping position, reduce apneas, and improve their sleep.
Obesity is a contributing factor to obstructive sleep apnea. A healthy lifestyle and diet that encourages weight loss will improve obstructive sleep apnea. Unfortunately, most people with obstructive sleep apnea are tired and do not have much energy for exercise. This is a difficult behavioral spiral since the more tired a person is -- the less they exercise -- the more weight they gain -- the worse the obstructive sleep apnea becomes -- and the more tired they become. Frequently, after obstructive sleep apnea is treated by other methods, people are able to lose weight, and the obstructive sleep apnea improves.
CPAP
The CPAP, a small air compression device, delivers air pressure through a nasal mask worn while sleeping. The pressure creates keeps the airway open and allows the sleeper to breathe normally all night long for uninterrupted and restful sleep. The machine hooks into a 12-volt lighter plug-in or runs on household current. The device must be properly calibrated by a sleep specialist to be effective.
CPAP users say the mask sometimes feels confining or claustrophobic at first, but they get over that as the results of treatment become apparent.
For many cases of sleep apnea sickness, treatment often consists of avoiding sleeping on one's back, even if wearing a mask. To help aid in a comfortable sleep, a pillow should be chosen that allows sleeping on one's side, one that elevates the head and neck allowing the airway passage to open properly while sleeping.
Using a sleep apnea pillow is an unconventional, however beneficial and inexpensive sleep apnea treatment.
Medications
Many medications have been studied for obstructive sleep apnea; however, because obstructive sleep apnea is due to an anatomic airway narrowing, it has been difficult to find a medication that will help. In people with nasal airway obstruction causing obstructive sleep apnea, nasal steroid sprays have been shown to be effective.
People who have obstructive sleep apnea due to obesity may improve with diet medications, if they are effective in helping them lose weight.
There are also new medications to help increase alertness. They may be temporarily successful in increasing attention, however, they do not treat the sleep deprivation or the cause of obstructive sleep apnea.
Sleep apnea and the commercial driver
From 1996 to 1998, the University of Pennsylvania Center for Sleep and Respiratory Neurobiology collected data for a study on the prevalence and consequences of obstructive sleep apnea among commercial vehicle drivers, and involved the overnight laboratory testing of 406 Pennsylvania CDL holders.
The overall findings from this study revealed that 6.9 percent of the 406 participants were diagnosed with severe sleep apnea, 7.9 percent had moderate sleep apnea, 21.2 percent had mild sleep apnea, and 64 percent had none.
The results of the study showed that the prevalence rates of sleep apnea among commercial truck drivers are similar to sleep apnea rates found in other general populations. The study also revealed that the prevalence of sleep apnea depends on the relationship between two major factors - age and degree of obesity as measured by body mass index (BMI) - with the prevalence of sleep apnea increasing with increasing age and BMI.
Another meaningful study finding showed that the prevalence of sleep apnea depends on the average duration of sleep over consecutive nights at home. Short sleep duration, six hours or less per night, results in an increase in the prevalence of sleep apnea.
The MCMIS crash database contains a census of trucks and buses involved in fatal, injury, and tow-away crashes. It is maintained by FMCSA and contains data on trucks and buses in crashes that meet the uniform crash data standards.
And the results of the study?
Interestingly, no compelling statistical evidence was found that supports the hypothesis that sleep apnea increases crash risk among commercial drivers. Furthermore, there was no evidence from the data used in this study to suggest that crash risk is impacted before and after drivers are diagnosed with sleep apnea.
So, the commercial driver with sleep apnea is about as safe as the general population?
No, the health risks that were listed earlier apply to the general population, regardless of occupation.
Drivers and carriers need to know that OSA, the most common of 80 different sleep-related disorders, is usually 100% treatable and virtually fully reversible. For most, there is no surgery, no recovery time, and instant, almost miraculous, improvement.
Related Links:
http://www.sleep-better-pillow.com/index-sleep-apnea-treatment.html
National Sleep Foundation
www.sleepfoundation.org/
NIH - National Center on Sleep Disorders Research
www.nhlbi.nih.gov/sleep
Sleep Center - MayoClinic.com
www.mayoclinic.com/health/sleep/SL99999