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Train of Thought: Sleep Apnea a Factor in Fatal Rail Crashes

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Sleep apnea was recently revealed as a factor in two deadly railroad accidents, and this life-threatening sleep disorder is the driving force behind an effort to require train operators and commercial truck drivers to undergo additional screening to improve rail safety.

Sleep Apnea and Driving

Obstructive sleep apnea (OSA), the most common form of sleep apnea, is characterized in part by repeat episodes in which breathing stops during sleep. These breathing interruptions, which are often accompanied by loud snoring and brief awakenings, prevent your body from receiving healthy, restful sleep.

Over time, the lack of sleep impairs your cognitive skills, dulls your reaction time and causes daytime drowsiness, among other adverse effects. As we noted in an earlier post, about 8 million Americans admit to nodding off while driving at least once per month, and traffic accidents related to drowsy driving—including those in which sleep apnea may have been a factor—claim the lives of thousands each year.

Sleep apnea is to blame for fatal rail crashes

The Deadly Effects of Sleep Apnea

The primary health dangers of OSA include an increased risk for high blood pressure, heart attack, heart disease and stroke. But sleep apnea also poses a risk to others when those who suffer from the condition get behind the wheel of a motor vehicle or the controls of a train.

It was recently disclosed that the engineer involved in September’s fatal commuter-train crash in New Jersey was diagnosed with sleep apnea about a month after the accident that killed one person and injured many others. According to a CNN report, the accident investigation is ongoing, and it remains unknown whether sleep apnea led the engineer to fall asleep on the job, as was the case in a 2013 New York transit accident that killed four.

Last week, the National Transportation Safety Board (NTSB) pinned the cause of a deadly 2014 train crash in Arkansas on crew fatigue associated with irregular work schedules and sleep apnea. That accident killed the train’s engineer and conductor, both of whom may have been asleep at the controls, according to an Associated Press article.

Rules for Sleep Apnea Testing, Treatment

New Jersey Transit changed its sleep apnea testing and treatment policy in the aftermath of the deadly September crash. A Nov. 21 USA Today Network report states that engineers diagnosed with OSA must prove they are receiving treatment and have their symptoms under control before being allowed to operate a train.

Meanwhile, the Federal Railroad Administration (FRA) is pursuing its recommendation that railroad companies test train operators for sleep apnea during routine medical examinations already mandated by the U.S. Department of Transportation, according to the trade publication Overdrive. The FRA would further like railroad companies to install inward-facing cameras in train cabs to record engineers’ actions and aid with investigations.

Sleep Apnea Treatment

Many sleep apnea treatment plans currently in place for train operators and commercial truck drivers employ CPAP as a first line of defense. CPAP is an acronym for continuous positive airway pressure, and CPAP therapy delivers a continuous oxygen flow through a mask worn during sleep.

Many patients find the mask uncomfortable, however, and discontinue its use before treatment can be effective. Those seeking a less-cumbersome option—including those unable to adhere to CPAP—may want to consider the oral appliances sometimes referred to as bite splints or mandibular advancement devices (MADs). These devices are custom designed for each person’s unique bite structure to hold the jaw in its proper resting position and promote an open airway during sleep.

Denver neuromuscular dentist Dr. Kevin Berry is dedicated to helping sleep apnea sufferers restore natural, restful sleep. Please call the TMJ Therapy & Sleep Center of Colorado at (303) 691-0267 to schedule your consultation.

We Look Forward to Seeing You!

TMJ Therapy & Sleep Center of Colorado
- Dr. Kevin Berry
1660 S Albion Street #1008
Denver, CO 80222

(303) 691-0307

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