Treating excessive daytime sleepiness could save your life

Feeling tired during the day, morning headaches, and irritability can all be signs of sleep apnea. In this report by SADE OGUNTOLA, experts warn that this sleeping problem, aside increasing the risk of chronic illnesses like heart attacks, and hypertension, can increase the risk of an accident by over 123 per cent.

 

There are a lot of people that see sleeping as a waste of time and sleep as little as possible, but at the same time, feeling very sleepy during the day can lower productiveness and creativity. It can also increase a driver’s accident risk.

A new study suggests that fatigued drivers, particularly those who suffer from obstructive sleep apnea, are far more likely to cause a motor vehicle accident compared to other drivers on the road.

“People who have sleep apnea are exposed to injury or at a risk of road traffic accidents when driving. They are likely going to doze off and sleep. They lack a refreshing night sleep,” said Dr Ayotunde James Fasunla, a consultant Ear, Nose and Throat surgeon at the University College Hospital (UCH), Ibadan.

He declared that snoring was a common symptom of sleep apnea, adding that the obstruction in the airway due to the complete relaxation of its muscles prevents the body getting enough oxygen during sleep.

He stated: “You know when you snore, you produce noise. There is vibration and that does not allow them to go into deep sleep. That is why when they wake up, they are not refreshed. When the breeze blows on them, they can easily doze off.

“It takes a matter of second to doze off and such a person will veer off the road, run into another oncoming car, the ditch or bush. That is why we always say that if somebody snores or have obstructive sleep apnea, such a person is likely going to sleep on the wheels and then can be involved in an accident.”

Dr Fasunla stated that aside from the body not recuperated from the stress of the previous day during their sleep, snorers since they experience more attention deficit, also stand a higher risk of being involved in an accident.

“They are also prone to accidents at home, work, and so on. For example, in ascending or descending a staircase, they can miss their step and fall, sustaining an injury.”

Sleep apnea is a condition that often goes undiagnosed because many of the symptoms that give a clue that there is a problem such as snoring, breathing pauses, and gasping for air occur during sleep.

It is a chronic sleep disorder in which breathing repeatedly starts and stops during sleep, drastically reducing the quality of sleep and increasing sleepiness.

The potential health impact of insufficient sleep duration was first reported in the 1960s when a survey of over one million adults found that individuals who reported sleeping fewer than seven hours per night had increased mortality compared to those sleeping seven to eight hours per night.

Like short sleep, sleep apnea increases the risk of heart attacks, stroke, hypertension, obesity, diabetes, and depression. Furthermore, insufficient sleep is associated with lapses in attention and the inability to stay focused; compromised problem solving; confusion, irritability and memory lapses; impaired communication and diminished reaction times.

The study was conducted by researchers at Massachusetts’s Brigham and Women’s Hospital. It investigated the link between motor vehicle crashes and two common forms of sleep deprivation in the journal, BMC Medicine.

It found that drivers with Obstructive Sleep Apnea were 123 per cent more likely to crash. Those who suffer from mild to moderate sleep apnea were 13 per cent more likely to experience a crash.

All of its participants were part of the Sleep Heart Health Study, which includes 1,745 men and 1,456 women between the ages of 40 and 89.

Sleeping six hours per night was associated with a 33 per cent increased crash risk, compared to sleeping seven or eight hours per night. These associations were present even in those who did not report excessive sleepiness.

The population-attributable fraction of motor vehicle crashes was 10 per cent due to sleep apnea and nine per cent due to sleep duration less than seven hours.

Insufficient sleep duration and obstructive sleep apnea, two common causes of sleep deficiency in adults, can result in feeling very sleepy during the day, a well-recognised cause of motor vehicle crashes.

In fact, truck drivers are known to be at a particularly high risk for sleep apnea and driver fatigue has been a suspect in a number of fatal crashes involving commercial vehicles.

Factors that characterise a high number of truck drivers such as being middle-aged, male, and obese are also risk factors for sleep apnea.

Globally, the prevalence of snoring among adults varies from the different parts of the world from five to 44 per cent. A study in Abuja puts the overall prevalence of snoring among adults at 31 per cent while the prevalence of clinically Suspected Obstructive Sleep Apneas (CSOSA) was  one per cent.

Conversely, in 2012, researchers at the Lautech Teaching Hospital, Osogbo put the prevalence of snoring among Nigerians with hypertensive at 50 per cent in the Pan African Medical Journal.

It also revealed that almost all the hypertensive snorers reported excessive daytime sleepiness. Male hypertensive subjects had a significantly higher frequency of snoring than their female counterparts.

Conversely, in 2012, experts said in the Brazilian Journal of Otorhinolaryngology, that marital status and blood pressure were significantly associated with obstructive sleep apnea among Nigerian outpatients. Nonetheless, age, hours at work, smoking status and being obese, they said remained predictive of obstructive sleep apnea in Nigeria.

Moreover, trend analysis of fatal road accidents between June 2006 and May 2014 using Nigeria Watch database shows the human factor accounts for up to 90 per cent of accidents.

Human factors include visual acuteness, driver fatigue, poor knowledge of road signs and regulations, illiteracy, health problems, excessive speeding, drug abuse, and over-confidence at the steering wheel.

Driver fatigue crashes, however, are not only a matter of having spent too long behind the wheel; fatigue can also be caused by too little sleep, stress, or time of the day.