CPAP Blog

We can probably share one of these sad stories every single day but let’s sum up a couple of weeks worth of news related to sleepy drivers who kill and injure themselves and others.

In previous post we highlighted how a lot of truck drivers are at risk from OSA,  the DVLA’s stance on sleep apnoea patients driving and general statistics mainly in the UK regarding driving deaths related to sleep. Now let’s look at the latest headlines on this topic.

In Canada, a truck driver was convicted after killing a police officer. He admitted being sleepy shortly before the accident. Whether he was suffering from sleep apnea or not, this quote sums up the situation for many drivers:

Dr. Charles Samuels said Smith may have had his eyes open but wasn’t processing what he was seeing. Samuels said truckers such as Smith often only get four or five hours of sleep a night, and live like that for decades.

In Springfield USA a driver slammed into a train after falling asleep,  whilst here in the UK a lorry driver killed two after falling asleep at the wheel, ploughing into a traffic hold-up. He was sentenced for four years and banned from driving for eight.

The court heard that after emergency services raced to the scene Walker climbed from his cab and told a fire officer: “It’s all my fault”.

Walker originally told police he had been sending a message on his lorry’s on-board computer, but he later confessed he had fallen asleep.

Walker, who pleaded guilty to two charges of causing death by dangerous driving, was also disqualified from the roads for eight years.

In India, another driver fell asleep on the highway and caused another car to crash into and kill four people. Further East, in Australia we find yet another truck driver not getting enough sleep and causing a fatal fireball after slamming into a line of cars.

“At the time of the crash Mr Hodge would have been severely sleep deprived with a disrupted circadian rhythm,” he said.

Dr Odell said the need to “recharge your physical and mental batteries” was physiological and people paid the price if they didn’t sleep.

This Reuters piece reveals how a young American girl got killed when she fell asleep at the wheel and they report in the US alone, more than 1,550 people die annually from drowsy driving. The include more fatal driving stories too. Yet another US based fatality was reported on goblueridge.net.

Another Briton was sentenced, seven years this time, after killing four people when driving under the influence and drowsy from lack of sleep. And a Hungarian bus driver injured 24 of his passengers when crashing his bus in Austria. Evidence suggests he too fell asleep.

And finally, out of the ones we found covering the last 3 weeks alone, in Sweden a bus driver fell asleep at the wheel and risked the lives of 18 young dancers and their guardians. Prosecutors called for the driver to be jailed for causing bodily harm.

That’s 11 accidents reported in the last 21 days or so. No wonder statistics show sleepy driving is as dangerous as drink-driving. But we don’t see any big campaigns for driver awareness!

If you drive regularly for long periods, make sure you are rested and get your health checked out. You may be suffering from a sleep related disorder which will keep you tired for the rest of your life unless you get treated.

A somewhat surreal question but it was actually asked in an online forum, this particular user wondered how a zero gravity environment would affect his CPAP machine. I don’t know whether he’s a mate of Richard Branson, about to have a space holiday, but it’s an interesting topic regardless of this person’s motives.

Others chime in and split the question in two. How does zero gravity or weightlessness affect OSA and how does it affect CPAP?

I’m not aware of any scientific research done to this effect (wrong, see below) but it doesn’t hurt theorizing about the possible outcome. As someone in that forum thread mentions, the lack of gravity could mean the airway wouldn’t collapse in the first place, avoiding apnoea events altogether. Oftentimes it is indeed the soft palate at the top of the throat collapsing down, blocking the airway so without gravity, perhaps this wouldn’t happen. But if this tissue still hangs about like something floating in space, not necessarily pulling down but perhaps left or right, it could still narrow the airpipe and cause hypopnea events, still causing trouble to the heart, blood and body in general.

As far as the CPAP is concerned, I don’t think much would differ. As long as you’re inside a spacecraft with air available for the machine to pump around, nothing changes. The humidifier chamber may need adjusting to keep water inside and I suspect the dreaded rain-out is a non-issue as water wouldn’t drop back down. But as far as the basic idea of pumping air is concerned, I can’t think of any gravitation dependent components. If you are going on a space trip, do remember to strap the CPAP to your back, or somewhere else secure. And make sure the mask fits inside the helmet.

Discover Magazine has some related tips in their article called 20 Things You Didn’t Know About Living in Space. Most importantly for CPAP users, they report that fluids move upwards so nasal congestion is a common issue for astronauts. For that reason, perhaps consider hanging upside down! At number 6, they also confirm snoring reduces when in space, referring to this journal about the effects of micro-gravity on sleep-disordered breathing. So there is research after all!

With 16 sunrises a day, you can also expect a seriously disrupted bio-rhythm. Bring some shades or use bright light therapy to combat jet lag. You can probably forget about your 9 hour lie-in. Not that you would, when on the Virgin Galactic!

In a related thread on another forum, a scuba diver asks about using CPAP in a hyperbaric chamber. One person replies saying in the documentation of his wife’s CPAP, he finds no mention of use of CPAP in high oxygen environments. If these machines aren’t tested in such settings, it is advisable to not use them there without confirming with the manufacturer.

No doubt, we’ll have more space travel tips for CPAP users later

New research, published in the Journal of Clinical Endocrinology & Metabolism, shows that CPAP therapy lowers cortisol in apneic patients. Cortisol, also known as the stress hormone, is known to increase blood pressure, reduce immune system activity and lower bone formation, amongst many other effects.

Doctor Vgontzas of Penn State University College of Medicine and his research partners concluded:

Nonpsychologically distressed, normally sleeping, obese men had low cortisol secretion. The cortisol secretion was slightly activated by SA and returned to low by CPAP use. The low cortisol secretion in obesity through its inferred hyposecretion of hypothalamic CRH might predispose the obese to sleep apnea.

I have to say most of this type of lingo (”hypothalamic-pituitary-adrenal axis activity” anyone?) is well over my head but in the forums, we had been wondering about the more intricate details of sleep apnea and the effects of it and CPAP on the various processes in the body. Research like this piece it all together slowly.

See in the forums:

• Does CPAP change blood/oxygen relationship
• Red blood cell count
• The wake up cell