Sleep Apnea and Drowsy Driving

“When I die, I want to go peacefully in my sleep like my Grandfather did – not screaming, like the passengers in his car.” – Anonymous

No one gets in a car with the intention of falling asleep or hitting something or someone; that’s why crashes are called accidents. But how many times have you caught yourself drifting off to sleep at the wheel of your car? Maybe you have already experienced an accident caused by fatigue. Whether it was an isolated incident or has happened more than once, this article is for you, your loved ones and all of us on the road.

The National Highway Traffic Safety Administration (NHTSA) National Center for Statistics and Analysis recorded more than 416,000 police-reported crashes involving fatigue and drowsy driving between 2005 and 2009. These crashes resulted in 4,430 fatalities. This is likely a low estimate; the NHTSA notes less than one-half of all crashes are police reported.

How might we know when an accident is caused by drowsy driving? It often takes a witness who observed someone drifting out of their lane, or the absence of skid marks at the scene. Law enforcement may not consider asking questions about fatigue and, of course, drivers themselves may not realize they fell asleep at the wheel. And, then, there are those drivers who just don’t divulge that they did.

You don’t have to have a diagnosed sleep disorder to find yourself fatigued behind the wheel, putting yourself and others at risk. Everyone needs to take responsibility to assure safety first. Just as you should not drive under the influence of alcohol, you should not drive under the influence of sleep deprivation.

In today’s world, sleep deprivation is common. People are worried about their economic survival, and are suffering with insomnia and the serious sleep deprivation it causes. Seasonal Affective Disorder during winter months brings on depression and insomnia. Shift workers frequently experience circadian rhythm disorders which throw off the natural body clock. Sleepiness is also a common side effect of prescribed medications taken routinely by millions of Americans. There is a laundry list of symptoms for sleep apnea and one of them is falling asleep easily during the day, while watching TV or when driving. The monotony of driving may cause fatigue for anyone, but coupled with sleep deprivation from undiagnosed or untreated sleep apnea the risk is exponentially higher.

There is an interesting phenomenon called automatic behavior that occurs when one is excessively sleepy. It is common in patients with narcolepsy but any sleep deprived person can experience it and often with no subsequent memory of the act. During automatic behavior, a person can perform routine tasks, such as driving, while essentially in a sleep state. Have you ever done a routine task at home or work and later had no memory of it? Lose your keys, find them later but have no memory of putting them in that particular spot? Have you ever been driving, arrived at your destination and realized you had no memory getting from point A to point B? Automatic behavior can happen to anyone; when it happens with frequency, it’s a red flag.

If you are a sleepy person you should not be behind the wheel of a car, period. Please take the responsibility to be evaluated for a sleep disorder. At least rule out a sleep disorder, then you can narrow down other potential medical reasons for being sleepy. If you have sleep apnea and still find yourself experiencing daytime sleepiness and drowsiness behind the wheel, it is an indication that your therapy may not be working. A solution might be as simple as a CPAP titration and readjustment of your CPAP pressure. Report all sleepiness or the return of your original apnea symptoms to your physician to resolve.

Edward Grandi, executive director of the American Sleep Apnea Association, reminds us that “sleep apnea is a debilitating and life threatening ailment that is estimated to affect over 22 million Americans.  Most don’t know it. Untreated, it can lead to depression, heart disease, diabetes and car crashes.”

An overnight sleep study called a polysomnogram is the method used to diagnose sleep disorders. It’s a simple overnight stay in a hospital sleep lab or clinic. Covered by insurance, a sleep study is painless and very telling. A myriad of data is collected including tracking one’s brain waves to evaluate sleep architecture, heart monitoring and oxygen levels are also recorded. Sleep disorders are treatable. Leaving a sleep disorder untreated can be life threatening. Please, don’t be a drowsy driver.