Sleep apnea is one of the more than 80 different sleep disorders that can be life-threatening if left untreated. ‘Apnea’ is Ancient Greek meaning ‘without breath’, which is at the heart of why this sleep disorder is so deadly. It’s a sleep disorder that affects around 4% of the general population but affects as much as 35% of truckers, but before diving into the details, let’s get some facts straight and dispel a few myths in the process:
Types of Sleep Apnea: there are actually three types of sleep apnea:
- Central Sleep Apnea (CSA) – occurs when your brain doesn’t send proper signals to the muscles that control breathing
- Obstructive Sleep Apnea (OSA) – occurs when your throat muscles and mouth palate relax and collapse during sleep blocking the airway
- Complex Sleep Apnea Syndrome (CSAS) – occurs when someone has both obstructive sleep apnea and central sleep apnea
Accident Risk
For truckers, the most common form of sleep apnea is Obstructive Sleep Apnea (OSA), which impacts their ability to obtain restorative sleep and remain vigilant behind the wheel. When breathing is constantly interrupted during sleep as the upper airway is periodically blocked for five to ten seconds at a time, the brain is starved of oxygen leading to hypertension and heart disease. OSA also causes sleep to become fragmented resulting in the inability to obtain both deep sleep (which repairs the physical aspects of fatigue) and dream sleep (also known as REM sleep which repairs mental fatigue and deals with mood, memory, and emotion).
Truckers who have OSA may be in bed for up to ten hours but actually, get very little good quality sleep due to the constant interruption to breathing. The combination of sleep fragmentation and interrupted breathing leads to higher levels of drowsiness dramatically increasing the risk of accidents by as much as 250% compared to well-rested drivers.
Symptoms
You may have sleep apnea if you snore loudly, gasp for air during sleep or feel exhausted even after a full night’s sleep. Other symptoms include:
- high blood pressure
- diabetes
- morning headaches
- difficulty staying asleep
- excessive daytime sleepiness
- attention problems
- irritability
- poor memory
- depression
- self-medication dependency (to deal with headaches and help fall asleep)
More severe symptoms include heart attacks and strokes.
Treatments
In most cases, sleep disorders can be easily managed once they are properly diagnosed, so please see a doctor if you continue to have trouble sleeping or are consistently find yourself feeling tired or not well-rested despite spending enough time in bed. Treatments include:
- Tennis Balls: Snoring is a form of sleep disorder caused by disrupted breathing, which is why lying on your side helps and that’s where the tennis ball comes in. If sown onto the back of clothing you wear to bed it will stop you lying on your back.
- Mandibular Advancement Device (MAD): are custom dentist-designed mouth guards help keep your bottom jaw out and up allowing your throat to open and breathing to remain normal during sleep – great for mild OSA.
- Continuous Positive Airway Pressure (CPAP): If you have moderate to severe sleep apnea, you may benefit from a CPAP machine that delivers air pressure through a mask placed over your nose and/or mouth while you sleep. With CPAP the air pressure is just enough to keep your upper airway open, preventing apnea and snoring.
- Surgery: is also an option but is usually only an option after other treatments have failed. Generally, at least a three-month trial of other treatment options is suggested before considering surgery.
- Implants: also known as “sleep apnea pacemakers” are surgically implanted devices in the chest, which detect when breathing slows stimulating the nerve that controls the tongue, moving it up and forward to open the throat.
- Weight Loss: is the most effective long-term treatment for sleep apnea. We tend to put weight on from the bottom up eventually leading to fatty deposits around the neck and throat, which adds weight around the neck area.
- when we lose weight we tend to lose it from the top down and as soon as the weight falls off the face, neck and throat area the upper airway remains more open leading to better sleep quality and ultimately better decisions about nutrition and exercise.
DoT Physicals and Body Mass Index (BMI)
There is a statistical correlation between your neck size and/or your BMI (height divided by weight squared), and the risk of having OSA. This is why the current Department of Transport (DoT) commercial vehicle driver physical requires a physician to take these measurements. If your neck size is greater than seventeen inches for men and sixteen inches for women or your BMI is 30 or greater, you may need to have a sleep study to see if you have a sleep disorder. In severe cases, you may even be placed out-of-service or issued a restricted license until such time as your physician considers you healthy enough to drive a commercial vehicle.