Driver Fatigue Brought to Light in NYC Bus Crash Investigation

Driver Fatigue

The tragic bus accident that killed 15 people after it violently crashed on I-95 just outside of the Bronx last week has raised multiple questions for federal investigators. Among the causes being investigated by the National Transportation Safety Board was whether the bus driver was so fatigued he was not capable of driving properly. To determine that, they will be checking surveillance video and room records at Mohegan Sun where the bus traveling from, carrying people back to New York City’s China Town.

Although there are numerous questions as to why the driver, a convicted felon, should have even been behind the wheel of the bus in the first place, there is no question that even if fatigue wasn’t the cause of this crash, it is a major cause of crashes--not just for buses, but for trucks, airplanes, trains and boating accidents as well.

Last fall the American Automobile Association (AAA) Foundation for Traffic Safety polled 2,000 drivers. One-third of them admitted to either nodding off or completely falling asleep while they were driving in the past year. The results were surprising, indicating the problem is much more profound than previously expected.

More than half of those polled by AAA reported they fell asleep on a high-speed highway. Although it might seem more common to doze off during long car rides, 59% said they’d been driving under an hour before they had fallen asleep and only 20% had been driving for more than three hours. Twenty-six percent reported that it happened in the middle of the day, between noon and 5pm.

The National Highway Traffic Safety Administration estimates that drowsy driving “results in 1,550 deaths, 71,000 injuries and more than 100,000 accidents each year” and that fifty-seven percent of  driving crashes caused by fatigue involved the driver drifting into other lanes or even off the road.

The cause in this growing US problem can be contributed to many factors, not the least of which is the link between daytime fatigue and snoring. Results of a Canadian study published a few years ago linked drivers with sleep apnea with more than double the risk of car and truck accidents. Sleep loss, whether it is associated with snoring, insomnia, or simply poor sleep habits, impairs a driver’s reaction time. It causes people to lose the ability to perform important tasks, impedes memory, reasoning, and the ability to learn and perform math. Prolonged sleep loss can also lead to depression and hallucinations, and can cause health problems involving the heart and immune system and be a contributing factor to obesity which leads to further health issues such as diabetes.

If you’re feeling fatigued, it’s best to not get behind the wheel at all. Here are some tips to help stay awake while driving. If you are having trouble getting restful sleep, it is important that you speak to your doctor about it, because it is likely more serious that you think.

Originally published in The Huffington Post, for which Dr. Volpi is a regular contributor.

The Importance of Sleep

The medical community and healthy lifestyle advocates see the evidence mounting. Our spouses and children recognize the symptoms even when they don’t know the cause. They all agree: We need a good night’s sleep!

When we don’t get a full night of restful sleep, it can dramatically affect our health and impair our mental function and job performance. It can ruin our relationships with our loved ones. Research also points to a myriad of physical health issues caused by a lack of sleep including obesity, diabetes and heart disease.

How much is a “Good Night’s” Sleep?

A good night’s sleep isn’t just determined by the length of time one sleeps, but how restful, deep and uninterrupted that sleep is throughout the night. Even still, the average minimum amount of sleep required to be considered “a good night’s” sleep is between 7 and 8 hours for adults, with teenagers, children and infants needing more sleep, according to the American Sleep Association.

Lack of sleep can be caused by just not getting to bed when one should because of poor habits like watching TV until the wee hours of the night. Certain medicines, food, smoking and alcohol can all affect the ability to fall asleep, stay asleep, or the restfulness of sleep. Stress is also a big contributor. Usually a person can change their routines, and those with insomnia or stress-related causes can usually be treated by over the counter or prescription medicines. When a lack of sleep is caused by snoring, the issue becomes even more complicated, and the health consequences are much more serious.

Snoring – a Major Cause of Sleep Deprivation

Unlike a sleep disorder, snoring is a physical condition. It is caused when the throat relaxes and the tongue falls into the airway in the back of the throat causing a vibration in the soft tissue during sleep. This vibration is an interruption of airflow through the nose and throat.

It is estimated that more than 40 million Americans snore. Snoring interrupts sleep throughout the night, leaving the snorer with the same mental and physical conditions as someone who is sleep deprived.  There are numerous causes of snoring such as deviated nasal septum, nasal polyps or turbinates. Sinusitis and allergies can cause snoring as can anatomical factors such as abnormally relaxed neck muscles, a large tongue or tonsils and obesity because excessive weight can narrow the windpipe. Smoking, alcohol, sedatives or certain sedating antihistamines can lower muscle tone in the upper airways, and also cause snoring.

Sleep apnea is the most common cause of snoring and also the most dangerous. People who suffer from sleep apnea stop breathing dozens of times during sleep and it is particularly severe and life threatening when there are more than twenty or thirty events per hour. There are three types of sleep apnea, obstructive (OSA), central and mixed, with OSA being the most serious type because it effects blood pressure, the heart and lungs.

The Consequences

Without enough sleep we loose our ability to concentrate and our physical performance suffers. Sleep is necessary for the nervous system to function properly. For example the ability to do math and operate a car are compromised.  Other symptoms include daytime sleepiness, morning headaches, irritability, and poor memory. A person with sleep deprivation can burn-out easily, and it can lead to feelings of depression, mood swings and even hallucinations.

Unfortunately if lack of sleep is caused by snoring, often a person doesn’t even know they snore unless they’re told by a partner. Even when a person knows they snore, they often go untreated because they are embarrassed and hide it, or they don’t know it is a serious problem so they ignore it.

In the case of sleep apnea, there is even more of a toll on the body. Considering an apnea patient is unable to breathe many times throughout the night, their sleep is especially interrupted by episodes of waking up gasping for air. This oxygen deprivation combined with an inability to get a good night’s sleep, causes severe sleep deprivation and other health issues. Apnea can lead to high blood pressure because during apnea events, blood oxygen drops abnormally low, resulting in an increase in blood pressure which can bring about stroke. It can cause lung dysfunction because of low levels of oxygen in the blood and high concentrations of carbon dioxide in lung tissue. Since the heart is sensitive to oxygen levels in the blood, apnea is most dangerous in people who are already prone to heart disease. Arrhythmia is very common as is enlargement of the heart. An estimated 80-85% of sleep apnea patients go untreated, which is a serious health problem in the U.S. today.

Luckily, just as we have learned more about the consequences of sleep deprivation and snoring, today there is also a wide variety of surgical and non-surgical treatment available for snoring sufferers. If you suspect that you snore at night, or have been told by a loved one that you do, it is important to speak to your doctor. He or she can recommend you to an Ear, Nose and Throat Doctor or Otolaryngologist who will provide you with the correct diagnosis and start you on the path of treatment for a lifetime of healthy sleep.


For more information, contact the Manhattan Snoring and Sleep Center: (866) 835-2361 or visit www.drvolpi.com.