Mandatory Sleep Apnea Screening for Everyone?

November 4, 2009

Written by neha · Filed Under obstructive sleep apnea, Videos | 2 Comments

Mandatory Sleep Apnea Screening for Everyone?

October 23, 2009

This is an incredible story, but unfortunately, it probably happens more often than you think. The NTSB (National Transportation and Safety Board) recently investigated a Hawaiian airline incident where both pilots fell asleep and missed their destination by 18 minutes. Air traffic control was able to wake up the pilots, who turned around and landed the passenger plane safely. The captain was later diagnosed with obstructive sleep apnea.

There are numerous other reports of train, bus and tracker trailer accidents, many of them fatal due to the driver having suspected obstructive sleep apnea.

After a long investigation, the NTSB recommended that all long-distance truckers, airline pilots, bus drivers, merchant ship pilots, and train operators should be screened for obstructive sleep apnea. This is a step in the right direction, but what about the rest of the population?

It’s been estimated that 24% of middle aged men and 9% of women have at least mild sleep apnea. This is one of the most often cited statistics from 1993. I would think that with the obesity epidemic, the numbers are now much higher. A recent study looking at active independent seniors (ages 71-87) showed that 55% had significant sleep apnea. These numbers are much higher for seniors that are hospitalized.

You don’t have to be a commercial pilot, truck or bus driver to be at risk for sleep apnea. Everyone is at risk. If you have untreated sleep apnea, you are over 6 times more likely to get into an accident. Your reaction times are worse than being legally drunk. Snoring alone alone without sleep apnea also increased your risk by 300%.

Truckers will argue that most commercial accidents are caused by passenger vehicles. All it takes is one sleepy passenger car driver to cause a major bus accident.

Interestingly, another study showed that snoring men with daytime sleepiness or witnessed apneas drive more than others. It’s a scary thought. What they’re probably doing is to choose an activity where sustained vigilance is needed, but unintentionally, they are placing themselves and others at increased risk.

I admit that there are logistical and financial implications to putting into place a universal screening program for sleep apnea. Besides the costs alone, what do we do with people who can’t drive the bus or work at all while waiting to be cleared? What about all the people who can’t tolerate any of the treatment options? Do they go on disability? Do they have to switch to other careers?

On the other hand, the potential benefits are enormous. Treating the remaining 90% of undiagnosed sleep apnea patients will significantly lower the cost of providing healthcare since it’ll prevent or significantly lessen the severity of many medical conditions such as hypertension, diabetes, obesity and cardiovascular disease.

Given all these issues, what do you think about universal screening? Please respond with your comments in the box below.

Written by Steven Park · Filed Under Blog, obstructive sleep apnea | 8 Comments