The large trucks called 18-wheelers are threatening enough due to their sheer size and weight, but an added problem today makes them even more dangerous: a combination of sleep apnea and 18-wheelers.
Sleep apnea — also known as obstructive sleep apnea (OSA) — is a sleep disorder experienced often by obese persons. It involves shallow or interrupted breathing during sleep, a condition of which sufferers are not aware. Such persons then tend to be markedly fatigued or drowsy during their waking hours.
While awake, a person’s throat muscles help keep airways open so air flows into the lungs. But during sleep, such muscles relax and the throat narrows.
For most persons that isn’t a problem, but for those with sleep apnea, the airway can become partly or fully blocked. This interrupts sleep until the body responds to insufficient air in the lungs by tightening the upper airway muscles and opening the windpipe. Such opening and resumption of breathing often occurs with a choking or snorting sound.
The condition of OSA can be caused by obesity. An overweight person has additional soft fat tissue thickening the windpipe’s wall. That thickening narrows the windpipe and causes sleep apnea.
While snoring could be an indicator of sleep apnea, sleep apnea is a very different condition than snoring. Sufferers’ breathing may be interrupted as many as 400 times during the night, lasting 10 to 30 seconds each time, after which breathing resumes with a snort. By interrupting the sleep cycle so many times, sleep apnea causes great fatigue during the day.
Even so, sleep apnea sufferers may not be aware that they have the condition. Thus, it is wise to be alert to sleep apnea symptoms.
According to WebMD.com, sleep apnea symptoms include:
Reportedly, some additional indicators or symptoms of sleep apnea may include high blood pressure, type 2 diabetes, restless legs, bruxism, heartburn or acid reflux, a large tongue or crowded pharynx, cardiac conditions and erectile dysfunction.
Also, persons who are over age 50 and have close relatives suffering from obstructive sleep apnea may be at high risk of experiencing it themselves.
A strong link exists between sleep apnea and obesity — and obesity is a problem for many truckers who drive big rigs, diesel trucks, tractor trailers, semi trucks, 18 wheelers or other large trucks. In fact, according to a New York Daily News report, truckers top the list of obese workers by job type in Washington state.
Further, the National Institute for Occupational Safety and Health (NIOSH) reports that American long-haul truckers have twice the obesity levels of the adult working population in general. That report stemmed from a study published in the American Journal of Industrial Medicine and also reported by the Centers for Disease Control and Prevention (CDC).
Drowsy driving already is a problem for many truckers due to their long, monotonous shifts on roads, often late at night. Though the trucking industry is required to limit drivers’ hours and ensure they get proper rest, some drivers — facing unrealistic deadlines — do not get the appropriate amount of rest and do not keep accurate logs of their work.
Combining driver fatigue from long hours with sleep apnea common to obese drivers is a dangerous mix. Truckers may fall asleep at the wheel, or at least be drowsy enough to lose alertness and to slow their reaction times.
An enormous 18-wheeler truck moving at high speeds on a busy highway with a drowsy driver who may even fall asleep is a seriously dangerous situation for motorists.
As for why many truckers are obese, their jobs can lend themselves to this. Drivers spend many hours sitting at the wheel day after day, and many get little exercise. Truckers also may eat more food to divert themselves from the monotony of seemingly relentless driving.
Though truckers can be aware that they are obese, they may not be aware that they also suffer from obesity-influenced sleep apnea. Thus, they may not have their sleep apnea treated, and they can wind up driving while drowsing anyway, placing other persons on our roads in danger.
As for how deadly is truckers’ sleep apnea, the Federal Motor Carrier Safety Administration reports over 750 persons are killed and 20,000 are injured yearly because of fatigued commercial vehicle drivers.
In a separate Harvard University study of more than 450 truckers working for 50 different trucking lines, it was estimated that 20% of all big rig wrecks were because truckers fell asleep at the wheel. That study recommended that truckers be tested for obesity.
Also, the FMCSA reports that a fourth of licensed commercial drivers suffer some degree sleep apnea, with 17% having mild sleep apnea, 5% having moderate cases and 4% having severe cases. Truckers with moderate to severe sleep apnea can be disqualified from driving if the condition is diagnosed and not treated.
Such conditions can be deadly. Among many 18-wheeler accidents which could have been caused by sleep apnea was a Kentucky crash in which a semi truck drifted across a median on I-65 and hit several other oncoming vehicles head-on, including a van with many passengers. At least 11 persons perished in that crash.
Also, in Houston a speeding tractor trailer slammed into the back of another big truck on I-10 late at night. The driver of the rear vehicle died.
With this crisis at hand, how can truckers reduce sleep apnea? While not all truckers and trucking lines favor testing or crack-downs on sleep apnea among drivers, some large trucking companies with larger resources have become proactive in terms of testing, screening and treating drivers for sleep apnea.
Diagnoses can be made in a number of ways, including a physical exam in a doctor’s office; home sleep tests (HST); and a polysomnogram (PSG).
The most common form of testing is a PSG. For this, wires are attached to patients to monitor various body functions while they sleep, including heart rate, blood pressure, eye movements and brain activity. This test is administered by a physician.
A home sleep test can be conducted in several ways at the patient’s convenience, often with small electronic devices which can deliver results wirelessly to a physician’s office. Medicare now approves coverage for home sleep apnea testing. This test is not administered by a physician and is less expensive.
Once a sleep apnea diagnosis is confirmed, treatments often involve CPAP, or Continuous Positive Airway Pressure. This treatment is delivered via a machine and a mask which help patients to breathe more easily during sleep by increasing air pressure in the throat so the airway doesn’t collapse during inhalation.
Another apnea treatment is APAP, or Automatic Positive Airway Pressure. Like CPAP, APAP employs non-invasive machines to deliver pressurized air by means of a mask worn by the patient and keeps airways free from obstructions during sleep.
Unlike CPAP machines, which are set at only one pressure setting, APAP has two pressure settings, low and high, and will vary during the night as it adjusts to the body’s needs.
A third form of apnea tests is Bilevel Positive Airway Pressure, or Bilevel PAP. Again using a mask over the nose, this test delivers more air pressure during inhaling than during exhaling. Also, such pressures may be lower than those used for CPAP.
Non-medical means of treating OSA can involve achieving substantial weight loss, following good sleep hygiene, and avoiding caffeine, tobacco, alcohol or respiratory depressants before bedtime.
Suffering from sleep apnea is no excuse for a truck driver to fall asleep at the wheel and injure or kill innocent people. Families of victims may wish to explore sleep apnea 18-wheeler lawsuits to protect their legal rights. They can do so by contacting the 18 wheeler attorneys at Jim Adler & Associates for a free legal case review.