First-Time CPAP Users Feel Refreshed Instead of Fatigued

One small lifestyle change can give sleep apnea patients a whole new lease on life. After only a few weeks sleeping with a CPAP machine, the constant fatigue from the sleep disorder fades, making way for improved energy and mood.

A study published in the January issue of the journal SLEEP provides proof that CPAP can drastically improve your everyday life.

A group of 59 middle-aged adults diagnosed with sleep apnea were randomly assigned to CPAP therapy or a placebo. The participants were instructed to use the equipment each night for three weeks. The group answered a questionnaire about fatigue and other sleep apnea symptoms before and after the treatment period.

Results show the subjects who used CPAP no longer suffered from clinically significant levels of fatigue after treatment. Self-reported energy levels also increased for CPAP users, and daytime sleepiness dropped.

The group that received a sham treatment did not see any benefit.

CPAP has other long-term benefits. It can save your life by reducing heart attack and stroke risk associated with sleep apnea.

Sleep apnea occurs when the muscles relax during sleep, causing the soft tissue in the back of the throat to collapse and block the upper airway. The sleep disorder should never go untreated. If you think you may have sleep apnea, get checked out. Countless sleep centers across the U.S. offer overnight sleep studies for the diagnosis of sleep apnea.

“Flying Cheap”: FRONTLINE Investigates Pilot Safety & Fatigue

Tonight on PBS, FRONTLINE takes a hard look at the regional airline industry in “Flying Cheap.” Are inexperienced, fatigued pilots putting passenger safety at risk?



The industry came under scrutiny a year ago when Continental flight 3407 crashed outside of Buffalo, N.Y. The flight was operated by a regional airline.

The ensuing investigation put a spotlight on the lifestyle of some regional airline pilots: Cross-country commutes. Long hours and low pay. Less experience and training. Sleeping in cramped “crash pads.”

FRONTLINE reports that regional airlines account for more than half of all scheduled domestic flights in the U.S. And they have been responsible for the last six fatal commercial airline accidents. Is pilot fatigue partly to blame?

“Flying Cheap” will be broadcast tonight at 9 p.m. EST on local PBS stations.

In December the Sleep Education Blog reported on sleep and airline safety. Other airline incidents have focused attention on sleep, sleep disorders and pilot fatigue.

Gallup Survey: Did You Feel Well Rested Yesterday?

New Gallup-Healthways survey data show that 29 percent of U.S. adults said they did not feel well rested the day before the survey.

The survey involved 700,000 adults who were contacted by phone. It was conducted in 2008 and 2009. Respondents were asked, “Did you feel well rested yesterday?”

Women were more likely than men to report that they did not feel well rested. Rest also was more elusive for young adults, lower-income adults and those with at least one child in the household.

Older adults appeared to be the best rested. Only 19 percent of adults who were 65 years of age and older said they did not feel well rested.

Feeling well rested also was related to overall well-being. Fifty-one percent of people who were well rested considered themselves to be “thriving.” But only 39% of people who did not feel well rested were thriving.

A recent study suggested that your sleep may improve when you retire. Another study reported that working women sleep less than men.

In October the Sleep Education Blog reported on new survey data about the sleep of people in the U.S. In May it took a closer look at time-use survey data.

So what about you? Did you feel well rested yesterday – or today?

If not, maybe you need to make it a priority to get more sleep at night. Or maybe you need to seek help for a sleep disorder.

Get help for an ongoing sleep problem at an AASM-accredited sleep center near you.

Sleep & Airline Safety: Pilot Fatigue

Last week the NTSB opened the public docket on its investigation of the Oct. 21 incident involving Northwest Airlines flight 188. It was the second incident this year to focus attention on sleep, sleep disorders and pilot fatigue.

For 77 minutes the pilots of flight 188 had failed to respond to radio contact from flight controllers. Then the flight overflew its destination by more than 100 miles.

The pilots claimed that they were distracted while discussing airline policies. But had they fallen asleep?

The NTSB has not yet made a determination of probable cause. But the NTSB interview summary reports that Captain Timothy Cheney went to a sleep disorders center about 15 years ago. He was seeking help for his loud snoring.

He was told that he didn’t have obstructive sleep apnea. But he began to use CPAP therapy voluntarily to control his snoring.

The scenario is eerily similar to an incident that occurred in 2008. A plane went 30 miles past its destination when both pilots fell asleep. One of them was later diagnosed with severe sleep apnea.

Earlier this year a plane crashed in Buffalo, N.Y. All 49 people on board and one person on the ground died in the Feb. 12 accident. It raised concerns about fatigue among the pilots of smaller, regional airlines.

In June the FAA responded by announcing an “expedited review of flight and rest rules.” The FAA also vowed to make pilot fatigue a “high priority.”



The FAA reports that regulations limiting flight time and pilot rest have been in place since the 1940s. An FAA proposal to update the rules in 1995 was never adopted based on “industry comments.”

In August the NTSB sent safety recommendations to the FAA. One recommendation was to “implement a program to identify pilots at high risk for obstructive sleep apnea.” Another was to conduct research examining pilot fatigue in “short-haul operations.”

The NTSB noted that these incidents are not isolated events. From 1995 to 2007 there were at least 17 reports of a flight crew member who fell asleep. In five cases both pilots fell asleep. And a 1999 NASA survey of regional pilots found that 80 percent admitted nodding off during a flight.

Image by caribb

Work & Sleep: A Hard Day’s Night

A new study shows that your job may be affecting how you sleep.

The Dutch study involved 1,163 employees. Sleep quality and fatigue were measured across a one-year time lag.

Results show that exposure to a high-strain work environment was associated with elevated levels of sleep complaints. In contrast, people with a low-strain job had the highest sleep quality; they also had the lowest level of fatigue.

The study supports the Demand/Control Model proposed by Karasek and Theorell. This model suggests that high-strain jobs can have a negative effect on both mental and physical health; job strain can cause fatigue, anxiety, depression and physical illness.

A high-strain job is psychologically demanding. It also restricts your “decision latitude;” this refers to the authority you have to make decisions and use all of your skills.

Last week the Sleep Education Blog reported that workplace bullying increases the risk of disturbed sleep. The study measured 45 forms of bullying such as verbal aggression, criticism, gossiping and threats of physical violence.

In April the Sleep Education Blog reported that female executives may be more prone to sleep problems than male executives. The risk is greatest for women who have isolated, demanding jobs.

How can you prevent job stress from disturbing your sleep? One way is to avoid “bedwork.” Never bring any work to bed with you; instead you should make your bed a refuge from your job.

Get other helpful tips and learn more about job stress and sleep at SleepEducation.com.

Drowsy Sailing: Sleep Deprivation & the U.S. Navy Port Royal Accident

The Honolulu Advertiser reports that sleep loss and fatigue may have been factors in the Feb. 5 grounding of the USS Port Royal, a guided-missile cruiser.

The ship’s captain told the Navy Safety Investigation Board that he was tired when the ship got under way. He got less than five hours of sleep in the previous 24 hours; in the three days leading up to the incident he slept for a total of only 15 hours.

The ship ran aground in shallow waters off the coast of Honolulu. The 9,600-ton cruiser remained stuck for days before efforts to free the ship were successful. The AP reports that the accident caused an estimated $25 million to $40 million in damage to the $1 billion Port Royal.

In April the Sleep Education Blog reported that the U.S. Navy has been paying attention to sleep. There is concern that sleep deprivation can increase mistakes and accidents.

The National Transportation Safety Board also is concerned about safety on the open seas. For years the NTSB has sought to reduce marine accidents caused by human fatigue.

The NTSB is advocating for work-hour limits for mariners based on fatigue research and sleep needs. This was added to the NTSB’s “most wanted” list of safety improvements in 1999. But the NTSB reports that the U.S. Coast Guard has not taken action to address this issue.

Sleep deprivation also may have been a factor in the famous grounding of another ship – the Exxon Valdez. The oil tanker ran aground on March 24, 1989. About 11 million gallons of oil were spilled into Alaska’s Prince William Sound.

The Alaska Oil Spill Commission published a final report on the incident in 1990. It states that the ship’s third mate failed to maneuver the vessel properly.

The mistake may have been caused by fatigue; testimony suggests that he may have been awake and at work for up to 18 hours before the accident.

“It is conceivable that excessive work hours (sleep deprivation) contributed to an overall impact of fatigue, which in turn contributed to the Exxon Valdez grounding," the report concluded.

Image by the U.S. Navy

Surprised by Sleep Apnea: Women, Weight & OSA

Earlier this week Washington Post staff writer Valerie Strauss shared how she discovered that she has obstructive sleep apnea.

The sleep disorder was undetected by some doctors she had seen. And the discovery was a surprise to her. She didn’t fit the description of the typical sleep apnea patient.

Often it is overweight men who have sleep apnea. But as the AASM has reported, women can have sleep apnea too.

And sleep apnea may occur in people who maintain a healthy weight. A study presented last week at SLEEP 2009 found a high rate of sleep apnea in non-obese adults.

What were the warning signs that Strauss had noticed? She often felt tired after waking up. She also was having memory problems. And her husband complained about her loud snoring.

These are common symptoms of sleep apnea. Another recent study shows that people with sleep apnea also may report having fatigue or a lack of energy.

But initially doctors put the blame for her exhaustion on other problems. Maybe she was anxious. Or depressed. Or maybe she was going through a hormonal change.

Finally an overnight sleep study at a sleep disorders center confirmed that sleep apnea was the culprit. During the study she had an average of 27 breathing pauses per hour of sleep.

The diagnosis enabled Strauss to get the treatment she needed. The sleep center ordered a CPAP unit for her and had it delivered to her home; the cost was covered by her health insurance provider.

Now she is able to sleep better, and her snoring has stopped. That’s good news for her and her husband.

Are you at risk for sleep apnea? STOP and find out. You also can answer these questions on SleepEducation.com to learn more about your risk.

On SleepEducation.com you also can learn how a sleep study may be your best investment for long-term health.

Get help for sleep apnea at an AASM-accredited sleep center near you.

Tired & Fatigued: CPAP Improves Daytime Symptoms of Sleep Apnea

Excessive daytime sleepiness is a common symptom of obstructive sleep apnea.

But a new study in the Journal of Clinical Sleep Medicine shows that many people with sleep apnea have other complaints: fatigue, tiredness or a lack of energy. The study also shows that treating sleep apnea with CPAP therapy can help reduce all of these symptoms.

The study involved 313 people with sleep apnea. They had an average age of 55 years.

Before treatment more than half of participants complained of a lack of energy or tiredness. About 46 percent complained of fatigue; a little less than 40 percent complained of sleepiness. Women were more likely than men to report having a lack of energy.

Results show that these daytime symptoms improved in participants who reported using CPAP for five or more hours per night. The change was statistically significant for every complaint except lack of energy.

“We found that sleep apnea patients who used their CPAP regularly…had much greater success in reducing their fatigue, tiredness and sleepiness,” study author Dr. Ronald Chervin told the AASM. “This suggests that sleep apnea may be the cause of these symptoms, as it is a cause of sleepiness.”

Learn more about the warning signs for obstructive sleep apnea. Answer these questions on SleepEducation.com to learn more about your risk for sleep apnea.

Get help for sleep apnea at an AASM-accredited sleep center near you.

Should Drowsy Driving be a Crime?

Is drowsy driving a crime? That is the question that Maryland prosecutors recently faced.

In August a 19-year-old driver fell asleep behind the wheel. She swerved into oncoming traffic on the Chesapeake Bridge and hit a tractor trailer. The crash turned fatal when the truck plunged into the bay, taking the truck driver’s life.

In December prosecutors decided that they would not press criminal charges against the young woman. Instead she would only be cited for motor vehicle violations. Sleep scientist Dr. Charles Czeisler responded with an editorial in the Washington Post on Jan. 4.

Czeisler argues that drowsy driving should be a criminal offense. He writes that drowsy driving is as deadly as drunk driving. Czeisler urges Maryland to develop drowsy-driving legislation.

Together the AASM and the Sleep Research Society crafted model drowsy-driving legislation. It gives states direction on the issue. The model legislation includes exceptions for drivers who have a sleep disorder.

By all accounts drowsy driving is common. A 2002 Gallup survey found that 37 percent of people reported falling asleep or nodding off at least once while driving. Ten percent of drowsy drivers had driven drowsy in the past month.

It is also common for drowsy driving to be deadly. The U. S. National Highway Traffic Safety Administration (NHTSA) reports that drowsy driving is related to more than 1,500 deaths per year.

Yet drowsy driving often goes unreported. Unless the driver admits falling asleep, drowsy driving can be difficult to detect. Czeisler estimates that drowsy-driving crashes take the lives of about 8,000 people in the U.S. each year.

So what do you think? Should it be a crime to drive drowsy?