Once again, undiagnosed sleep
apnea is in the news, as the cause of the September 29, 2016 Hoboken Commuter
train crash. It was also the cause of a
New York City commuter train crash in 2013 and of freight train crashes in 2011
in Iowa, and in 2013 in Missouri. According to a CBSnews.com report on 11/21/16),
“Metro-North started testing for
sleep apnea after the 2013 crash. Metro-North’s screening program has found
sleep apnea in 51 of its 438 engineers and trainees, spokesman Aaron Donovan
said. They are undergoing treatment, he said. Now Federal regulators are
urging railroads across the country to test train operators for obstructive
sleep apnea.”
“Sleep
apnea is especially troubling for the transportation industry because sufferers
are repeatedly awakened and robbed of rest as their airway closes and their
breathing stops, leading to dangerous daytime drowsiness. Studies have long
concluded that people with the disorder have diminished performance in multiple areas during the daytime.
“You end up with an
engineer who is so fatigued they’re dosing off, they’re falling asleep in these
micro bursts and they often have no memory of it, and they’re operating a
locomotive at the time, so they’re putting hundreds of people in danger,” (Sarah)Feinberg
(of the Federal Railroad Administration) said.
“Airplane pilots
with sleep apnea aren’t allowed to fly unless they’ve been successfully
treated. Regulators are also pushing for bus and truck drivers to get tested.”
Treatment
for sleep apnea may include:
Sleep
hygiene measures such as: going to sleep the same time every night and getting
up at the same time every morning in order to train your body when it should be
sleeping, sleeping in a dark room, using the bedroom only for sleeping, and
avoiding blue light from televisions, tablets and smart phones before bedtime.
Sleeping
with a Continuous Positive Airway Pressure (CPAP) mask over the mouth and
nose. The air which blows into the mouth
and nose keeps the airway open so that it doesn’t collapse when the airway
muscles collapse during sleep.
Sleeping
with a dental appliance which positions the lower jaw forward, so that the jaw
position holds the airway open despite the collapse of the airway muscles
during sleep.
In
extreme cases there are surgeries which either cut away soft tissue or
reposition bones to change the anatomy of the face and jaws, so that the airway
is not obstructed during sleep.
All
of these treatment options have side effects, but the consequences of leaving
sleep apnea untreated are far more severe.
If you, or someone you know, is interested in treating their sleep apnea
with a dental appliance, schedule a consultation appointment with Dr. Judith
Okun to discuss your options and questions.
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