The NTSB recently finished up their review of a fatal train derailment in New York. What they found is that the driver actually fell asleep behind the wheel while driving the train. He reached speeds of 82mph in a 30mph section of track. As a result the trail derailed and four passengers lost their lives.
After the accident the driver was diagnosed with obstructive sleep apnea syndrome (OSA) and treated.
Sleep apnea has many causes but a common end point of causing physical blockages in the throat and upper airway in the deepest phases of sleep. This causes (sometimes drastic) fluctuations in blood oxygen levels, blood pressure, and heart rate. These fluctuations eventually cause the brain to “snap you out of it” causing a slight awakening, usually just to a lighter phase of sleep and allow the patient to take a breath and temporarily restore breathing.
When this happens over and over through the night many symptoms develop. Usually among the first is being extra sleepy, or hypersomnolence, through the day. While this may be no more serious than an afternoon nap, it also causes hundreds of thousands of automobile accidents a year.
The body also responds very poorly to fluctuations and chronic dips in oxygen levels. This leads to elevated risks of sudden heart attack, fatal arrhythmia, or even stroke. Blood pressure will start to creep upwards (hypertension), and the patient may begin to suffer from depression. Rising levels of adrenaline at night may also cause enuresis, or the need to urinate often through the night.
Treatment options for OSA are varied. The best studied and “most reliable most of the time” treatment option is positive airway pressure (PAP, CPAP or BiPAP). Other options such as oral appliance therapy and surgery also have proven benefits are typically considered when PAP therapy fails. Mild snoring is at times effectively treated with cauterization type procedures that may be done in the office. Recently however these cauterization or ablation procedures have been taken far out of context and I now hear them advertised on the radio to treat all kinds of true sleep apnea. Beware! Usually these procedures are not covered by insurance and basically are useless moneymakers!
If you are concerned about severe snoring or sleep apnea, we can help you arrange testing either from an Atlanta-area sleep lab or even from home most of the time.