By Sibasish Dey
Sleep deprivation and road safety have a strong connection. Sleep deprivation among drivers often leads to fatal road accidents. How obstructive sleep apnea is one of the most significant hazards for road safety?
In the modern-day and age, sleep disorders are quite common among scores of people across the world. Among the most common ones is obstructive sleep apnea (OSA), which has affected nearly a billion people worldwide. Even though so many people face this problem, there is hardly any discussion about its impact on society.
Looking at the bigger picture, one could easily see how Obstructive sleep apnea is one of the most significant hazards for road safety, putting many others at risk. But before we do that, let’s look at what Obstructive sleep apnea is and why it has become so common among people.
What is sleep apnea?
Obstructive Sleep apnea is a sleep breathing disorder that occurs due to the cessation of breathing during sleep due to obstruction of the upper airway. This, in turn, affects an individual’s neurocognitive functioning during the day. In OSA, during sleep, throat muscles and tongue abnormally relax, blocking the upper airway. This action obstructs the body’s natural air intake resulting in episodes of apnea, followed by repeated awakening in the middle of their sleep due to the lack of oxygen. As a result, of which the sleep architecture becomes distorted and the quality of sleep deteriorates.
Around 80% of the sleep apnea cases go undiagnosed, as many people would not be aware of it.
Fatigue, daytime sleepiness, morning headaches and lack of concentration are some of the symptoms of sleep apnea, among others. Unfortunately, 80% of the cases of sleep apnea go undiagnosed, as many people would not be aware of it. Instead of getting proper medical treatment for this, a general practice among people is to roll over it and take short term measures that hardly resolve this problem.
Usually, a regular working person counters sleepiness with a cup of coffee or other beverages. However, it would be safe to say that this pattern can heavily affect their health in the long run. More importantly, this sleepiness induced by OSA results in dire consequences for road safety in the present day itself.
How sleep apnea poses a threat to road safety?
It is a common understanding that the alertness of every driver is vital for the safety of the people, not just inside of the vehicle but every other person on the road.
Sleep disorders increase the risk of road accidents by 300%.
According to a World Bank study, sleep disorders increase the risk of road accidents by 300% with research indicating that approximately 4.3% of all motor vehicle accidents and 4.5% of all workplace injuries are attributable to SDB.
It has also been demonstrated that individuals with OSA have a 2.3 higher risk of RTA than compared to the general population. (Reference: Karimi, M., et al., Sleep apnea-related risk of motor vehicle accidents is reduced by continuous positive airway pressure: Swedish Traffic Accident Registry data. Sleep, 2015. 38(3): p. 341-9.)
The costs associated with these and other sleep loss-related accidents are high, reaching $32.7 billion in 2015 in the USA, and $518 million in 2010 in Australia.
Around 28 million people in India were suffering from severe obstructive sleep apnea and most of these cases remain undiagnosed.
The problem of sleep apnea is highly rampant in India as well. As per the Lancet research conducted in 2019, about 28 million people suffer from severe obstructive sleep apnea while also considering that most cases remain undiagnosed. This country only makes up 1% of vehicles globally yet accounts for 11% of deaths due to road accidents worldwide. India witnesses an average of 4.5 lakh road accidents every year, claiming around 1.5 lakh lives, corresponding to about 53 road accidents in every 4 minutes and a person killed.
Now that we have understood the graveness of road accidents in India, let’s look at how sleep apnea factors in. Sleep apnea and other sleeping disorders commonly occur in commercial drivers who drive for long hours and across the states in most cases. Jobs like these can significantly impact the sleep schedule of a driver, which are among the root causes of the resulting disorders. According to a study published by AIIMS in Neurology India Journal, more than 20% of road accident victims suffer from sleep apnea and other disorders. In another study conducted at KGMU-Lucknow, nearly 23% of truck drivers suffered from obstructive sleep apnea.
How can this problem be tackled?
The first step is obviously to increase the awareness about this disorder among the masses, however, another pragmatic solution is engagement by policy-makers addressing this problem head-on and taking all the necessary steps.
In the European Union countries and in Australia, the policy frameworks for long-haul drivers are in place and in certain situations require mandatory assessment for sleep disorders like obstructive sleep apnea. The Government of India has taken measures to curb this problem. However, given the density of this problem, several more initiatives need to be taken to counter road accidents caused by sleeping disorders. These may include proper regulations for health check-ups of long-distance drivers, educating them about the importance of proper sleep, and many more.
Despite the major challenges, proactive measures and long-term planning can go a long way in solving such problems and making the roads safer than ever!
(Sibasish Dey is Head of Medical Affairs, Asia and Latin America, ResMed.)
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