It’s common knowledge that it is dangerous to drive if you’re sleepy. How many times have we heard of ourselves or our close ones talk about ‘that one time’ we had to drive for long hours to reach somewhere and there just wasn’t enough time to accommodate sleep. There will be plenty of instances and it’s never a pleasant story. Now, think about truck or bus drivers who have to be behind the wheel for long hauls. What if they haven’t had a good sleep or what if they are suffering from a sleep disorder that they aren’t even aware of? This creates quite simply a catastrophic recipe for disaster on the road, not only jeopardising the safety of the driver but also the occupants in the vehicle and other road users around.
In a country that accounts for 11% of global road accidents and where truckers are overworked, focus on matters of healthy sleep is all the more relevant. A study from last year conducted by SaveLIFE Foundation and Mahindra found that truck drivers in India drive 12 hours a day covering about 417 km, with almost one in two admitting that they drive when sleepy or tired.
Obstructive Sleep Apnea (OSA) is a disorder many people suffer from but it goes undetected because of lack of testing or the realisation that it actually could create sticky situations when it comes to road safety. We got in touch with Dr Sibasish Dey, Head, Medical Affairs, Asia and Latin America, ResMed, who explains what sleep apnea is, its negative impact and what can be done to help.
What is Obstructive Sleep Apnea (OSA) and how it is dangerous behind the wheel?
Sleep apnea is a chronic sleep disorder that causes breathing trouble at night and can lead to daytime sleepiness, fatigue, loss of concentration, etc. Globally, close to 1 billion people suffer from sleep apnea, 80% of which goes undiagnosed.
The latest numbers according to a study by Lancet in 2019 suggest that there are 28 million sleep apnea patients in India.
According to a Swedish survey, comparing road traffic accidents assessed for OSA patients and the general population, patients with OSA had a 2.3–2.6 times higher risk of road traffic accidents than the general population.
Up to 20% of accidents are caused by driver inattention. Untreated sleep-disordered breathing (SBD) can result in excessive daytime sleepiness, which leads to a reduced level of alertness. The risk of driving whilst sleepy could be as dangerous as driving under the influence of alcohol.
In professional groups, such as taxi or truck drivers, the presence of OSA has been shown to increase the risk of RTAs by 300%.
In research published in AIIMS Neurology India, over 20% of all road accident victims were found suffering from SDB and OSA. A similar study conducted in the King George’s Medical University in Lucknow where truck drivers were screened, revealed that over 23% of them have sleep deprivation.
Drowsy drivers can cause fatal accidents. Even a small amount of sleep loss can have measurable outcomes. For e.g., if only 5 hours of sleep is provided for 4 consecutive nights, it impairs task performance to the same degree as blood alcohol level of 0.6%.
Several studies have revealed that, in comparison, persons with OSA have an elevated risk of falling asleep while driving and are more likely to cause accidents. Moreover, a mishap associated with the drowsiness of drivers is graver than other RTA, as drowsy drivers frequently do not make accurate responses before the accident.
What can the government consider doing to curb road traffic accidents?
Some countries conduct regular tests to ensure safety. For example, Australia tests commercial vehicle drivers once every three years for drivers aged 49 or under, and yearly for drivers aged 50 or over. In 2014, the EU introduced a directive to be adopted in all member states that if sleep apnea is suspected, drivers must seek diagnosis, and can only return to driving once the condition is under control.
There is currently very minimal awareness on this subject in India, The government must drive a sleep awareness campaign to educate people about the importance of sleep. Right now, they have policies related to various non-communicable diseases such as diabetes, and unhealthy sleep is the primary cause of these non-communicable diseases. So, it must be monitored.
In addition, OEMs should educate their customers and their clients to spread awareness about this. Even petrol pumps can be used – a poster about sleep on a petrol pump can help a lot.
Sleep testing infrastructure in India
Sleep testing has evolved and has gone from sleep labs to bedrooms today, due to the evolution of cloud-connected technologies. ResMed’s products such as OneSleepTest, Home Sleep test, ApneaLink Air have proven to be effective tools for the diagnosis of sleep apnea. These are affordable tests are cost somewhere around Rs 5,000–7,000 per kit.
However, these tests are specifically for mild to moderate sleep disorders. In the case of severe sleep disorders, there is polysomnography, which is studied in sleep labs, and cost somewhere around Rs 50,000.
For truck drivers, ResMed recommends the STOP – BANG questionnaire, which is affordable, to test if they have symptoms of sleep apnea and basis the results, they can go in for the treatment required.
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