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The National Transportation Safety Board has again sent letters recommending that screening be put in place for sleep apnea. They cite a great number of accidents that are caused through sleep apnea and want all truck drivers, train drivers, bus drivers, pilots and ship pilots screened for the disorder.

Letters of recommendation have been sent to the U.S. Coast Guard, Federal Motor Carrier Safety Administration, and the Federal Aviation Administration as well as local transit agencies. Data has been collected not just in the USA but also across Canada, Australia, Switzerland, Germany and Spain. The results are in accordance that Obstructive Sleep Apnea (OSA) may be responsible for 5 to 10 per cent of all traffic accidents.

It is believed that screening is necessary, as many people do not even realize they have the disorder. When an OSA sufferer is asleep (and only then) the throat collapses cutting off the airway. Oxygen levels drop and breathing stops. With a load snore the sufferer’s throat then pops open and they start breathing again until the next episode. This occurs on average between 250 and 400 times a night. The patient usually remains blissfully unaware of their interrupted breathing.

This interrupted sleep causes fatigue in normal waking hours. As the body requires sleep sufferers sometimes fall asleep even if very briefly when they should be awake. This of course is where the major danger for accidents can occur. In January 2008 two airline pilots fell asleep and their plane flew on past its destination point in Hawaii and out to sea. Air traffic controllers managed to raise them and no harm was done. The captain was found to have sleep apnea.

Other incidents have not been so fortunate and lives have been lost. In some cases of car, truck, train and air accidents it has not always been possible to confirm that sleep apnea was in fact the cause, though it often seems the most likely explanation.

The main companies are well aware of the issue and consider it of concern. Transportation Department spokeswoman Sasha Johnson says they are tightening their standards for medical certification of drivers. The FAA has also said they will consider the board’s recommendations when drafting new rules to address the issues of pilot fatigue. The Federal Railroad Association is also in the process of drafting new regulations.

The National Transportation Safety Board wants to see the development of programs to identify the disorder put in place. Many people believe that sleep apnea screening should not only be included in commercial transportation but also in the private sector.

Sleep apnea is generally treatable once it is diagnosed. Treatment can vary depending on both the identified causes and the severity of the disorder. For some people lifestyle changes are all that is required. For others a mouthpiece or special breathing device may be needed. In some cases surgery may be recommended. It is estimated that around 7 per cent of adults suffer from a moderate degree of sleep apnea. That is quite a few people out on the roads, in the air, and at sea who may be unknowingly putting themselves and others in danger.

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