Due to the nature of the job and long hours on the road, tractor-trailer drivers and other commercial drivers already have a hard time maintaining a quality sleep schedule. Not having quality sleep can quickly become dangerous if it interferes with functioning and concentration, especially while operating a large vehicle. A sleep disorder called sleep apnea is one reason as to why many truck drivers may not be getting the quality sleep they need. Read more from our national truck accident attorneys.
What is Sleep Apnea?
We have all had experience waking up feeling exhausted after a seemingly full nights sleep. Unfortunately, this can be the norm for those diagnosed with the sleep apnea. Lack of adequate sleep can lead to a variety of health risks, as well as psychological consequences that prove equally detrimental. Imagine having to function a moving vehicle weighing over 50,000 pounds while feeling like you haven’t slept at all the night before. This can be the hazardous reality of truck drivers with untreated or undiagnosed sleep apnea, not receiving the benefits of sleep they should be receiving.
Assuming there are no sleep abnormalities, a person will advance through the three non-REM (rapid eye movement) phases of sleep before entering the REM cycle. Throughout the non-REM stages, a person slowly enters into a deep sleep in which their body temperature, blood pressure and heart rate slow, ultimately leading to a boost to their immune system. In the REM phase—the part of sleep where one dreams—the bodily functions return to a level comparable to when one is awake. Researchers have discovered that REM sleep improves learning and memory, and contributes to overall emotional and mental health. During the REM phase, breathing is shallow and irregular, and it is not abnormal for breathing to stop altogether for short moments—a phenomenon known as apnea. However, when periods of breathing pauses are frequent during sleep, this can lead to the sleep disorder called sleep apnea.
Sleep apnea is a medical disorder characterized by the restriction of sufficient airflow during sleep, resulting in sleep disruption. The relaxation of the upper airway muscles leads to interruptions in breathing that can lead to a variety of health risks and lack of quality sleep. If you have sleep apnea, your breathing may repeatedly pause for 10 seconds or more at any given time, or result in periods of shallow breathing—both of which drastically impact your overall sleep quality. Some symptoms of sleep apnea include drowsiness, trouble concentrating or forgetfulness, and enduring headaches.
There are three different types of sleep apnea that are important to distinguish between. The most common is Obstructive Sleep Apnea (OSA), in which the airway actually becomes blocked. Obstructive sleep apnea is classified by its severity: severe OSA means you have more than 30 episodes of breathing pauses per hour, moderate OSA means you have between 15-30 episodes of breathing pauses per hour, and with mild OSA you have between 5-15 episodes of breathing pauses per hour of sleep. There is also Central Sleep Apnea, where there is no physical barrier blocking the airway, but your brain fails to send the necessary signals to your respiratory muscles to breathe. Complex sleep apnea is the combination of obstructive and central sleep apnea. Regardless of the kind of disorder, sleep apnea leads to decreased oxygen supply to the brain and reduces the oxygenation of the blood, causing an extreme mental and physical toll.
Sleep apnea has become a prevalent public health threat, affecting at least 22 million American adults—an astonishing 80% undiagnosed. The disorder affects about 3% of people that fall into a normal weight category, yet 1 out of every 5 obese people suffer from sleep apnea. The correlation between weight and sleep apnea is widely accepted, and is likely a result of extra tissue in the back of one’s throat that can easily block the airway or fat in the upper stomach that pushes against the lungs. However, because the disruptions in breathing are during sleep, it is very possible that people unknowingly have it and are not receiving treatment.
Sleep apnea is more common among men than it is women, the most frequent target being a man over 40, especially if he is overweight or obese. This is particularly concerning given that truck driving is a largely male dominated profession. With a large portion of the population untreated, it is essential that sleep apnea receive the attention it deserves, not only to help the lives of those afflicted, but also to prevent the plethora of auto accidents that are a result of drowsy driving.
There are certain indicators that researchers have discovered to be associated with sleep apnea. According to Alan Schwartz, M.D., director of the Johns Hopkins Sleep Disorders Center, there are four warning signs that may be indicative of sleep apnea. The first is being a noisy sleeper, which may include loud snoring, snorting or gasping. Snoring is not necessary to have the disorder, yet the two often go hand-in-hand. The second is restlessness during sleep, including kicking or jerking. The third is if you are perpetually tired, and especially if you find yourself falling asleep during the day. Fourth and finally, if you fit the profile. It is important to be aware that if you fall into certain risk groups, such as if you are male or overweight, you may want to talk to a doctor even if you don’t notice any obvious symptoms.
According to sleep specialist Jonathan Jun, M.D., “Sleep apnea may be noticed more by the bed partner than by the sleeper. Your bed partner might notice that your breathing pauses, or they may complain of your loud snoring.” Since many truck drivers do not often have a bed partner, it may be harder for them to recognize that they have the disorder, thus increasing the risk of operating a large and heavy vehicle while suffering from undiagnosed or untreated sleep apnea.
Statistics About Sleep Apnea Related Truck Accidents
There has been an abundance of research on the link between traffic accidents and sleep apnea. One study conducted by the New England Journal of Medicine compared patients with obstructive sleep apnea to a control group, finding that those with apnea had an odds ratio of 6.3 out of 10 for having a traffic accident, much higher than those in the control group. The results were still significant while controlling for confounding variables including alcohol consumption, visual-refraction disorders, BMI, years of driving, age, sleep schedule, medications causing drowsiness, and history of traffic accidents. The research also suggested that the risk of accident increased among drivers who had consumed alcohol on the day of the accident.
In 2009, a study published in The Journal of Clinical Sleep Medicine did a meta-analysis of previous studies to attempt to provide a systematic review of the link between sleep apnea and traffic accidents. Researchers Tregear et. al (2009) found that drivers with Obstructive Sleep Apnea are significantly at a risk for a motor vehicle crash that is almost double of drivers without sleep apnea. The limitation of this study is that there are few studies that analyzed commercial vehicles, so the data largely reflects private drivers. This is one of the issues that the Federal Motor Carrier Safety Administration (FMCSA) focuses on, a group devoted to preventing traffic accidents for commercial vehicles.
Furthermore, a large-scale 2015 study conducted in the journal Sleep adjusted for traffic exposure, driving distance and time period—all variables that previous studies largely failed to account for. Researchers Karimi et. all (2015) found a 2.5-fold increased motor vehicle accident risk in patients with obstructive sleep apnea, consistent with previous research. The researchers also found that effective treatment of sleep apnea through CPAP therapy was associated with fewer accidents, and that the risk factor most associated with motor vehicle accidents was severe daytime sleepiness, not severity of sleep apnea. Other risk factors include long annual driving distance, which is especially concerning for truck drivers.
Accidents Caused by Truck Drivers Falling Asleep at the Wheel
Truck drivers are notorious for falling asleep behind the wheel. Just last week three were hospitalized after a truck driver fell asleep in Russell Colorado. Stories like this are ubiquitous across the United States, and all over the world. In fact, at least 13 percent of all truck accidents are a result of driver fatigue. Daytime sleepiness is most closely associated with sleep deprivation due to sleep disturbances such as sleep apnea.
According to the Center for Disease Control and Prevention, approximately 1 out of every 25 adult drivers report having fallen asleep while driving in the last 30 days. In 2013, the National Highway Traffic Safety Administration estimates that drowsy driving was the root of 72,000 crashes, 44,000 injuries, and 800 deaths, and government statistics suggest drowsy driving to be responsible for 1-3% of accidents. However, it is known that these numbers are underestimated, and that the prevalence rate is likely much higher. The AAA Foundation for Traffic Safety conducted a study to estimate the true proportion of accidents, and concluded that drowsy driving was the culprit of 6% of all crashes in which a vehicle was thereafter towed, 7% of crashes where an injury was sustained, 13% of crashes involving hospitalization, and 21% of crashes involving a fatality. This means that an average of 328,000 total crashes, 109,000 crashes resulting in injury and 6,400 fatal crashes were due to drowsy driving.
A 2006 study by Klauer et. al measured drowsiness through in vehicle cameras measuring slack of muscle tone in the face and prolonged eyelid closures. The researchers found that approximately 22-24% of crashes involved moderate to severe drowsiness. Data trends reveal that individuals more likely to drive while drowsy are commercial drivers such as operators of tow-trucks, tractor trailers, or buses, shift workers who drive at night or have long shifts, and drivers with untreated sleep disorders, such as sleep apnea. Drowsy driving can slow reaction time, which is particularly worrisome considering commercial vehicle operators need more time for their vehicle to come to a complete stop.
Impact of Untreated Sleep Apnea on Drivers
Truck drivers who do not get quality sleep are not only threatening themselves, but are dangerous to every other driver on the road. Of all occupations in the United States, drivers in the trucking industry comprise of 12% of all worker deaths, the third highest occupational fatality rate. A standard tractor-trailer is enormously heavier than a private vehicle, thus requiring more attention to be able to successfully switch lanes, make turns, and come to a complete stop. If a driver has sleep apnea that is untreated, it is possible that drowsiness or trouble concentrating could impact their ability to drive properly. Furthermore, if a truck driver falls asleep behind the wheel, they are putting their lives and the lives of others in danger.
Though obstructive sleep apnea affects a large portion of the general population, it evidently affects commercial drivers to a much larger degree. In a sample size of over 3000 commercial drivers, Howard et. al estimated that 50% were at risk for sleep apnea. In a recent study co-authored by Virginia Tech Transportation Tech researchers, more than 1,600 drivers diagnosed with obstructive sleep apnea were compared to the control group of drivers unlikely to have a sleep disorder. The drivers with sleep apnea were provided treatment. The study found that the drivers who refused treatment would have 70 preventable serious truck accidents, compared to 14 crashes by both drivers with sleep apnea who accepted treatment and the control group. Along these same lines, researchers at Virginia Tech recently discovered that drivers who do not attempt to adhere to a mandated treatment program are five times more likely to get into an accident.
University of Pennsylvania sleep researchers are suggesting specific steps that the Federal Motor Carrier Safety Administration should take to better alleviate this problem. The researchers urge them to “develop strategies to identify impaired drivers through objective testing, implement programs to identify and test drivers with severe sleep apnea and monitor that they stick to their treatment, and introduce programs to assess and promote longer durations of sleep among commercial drivers.”
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Trucking accidents don’t discriminate, leaving victims emotionally, physically, and economically devastated. If you were injured or involved in a fatigue-related truck accident, call our office to speak with our team of truck accident lawyers. We are committed to the task of ensuring justice, and allowing an injured person to feel they are in good hands to rebuild their life. Call for a free consultation, or leave a message and we will return your call within 24 hours.