The Brotherhood of Locomotive Engineers, which wants its members to know about the dangers of the potentially life-threatening condition known as sleep apnea, is supporting the first ever National Sleep Apnea Awareness Day this month.
Sleep apnea is a common sleep disorder marked by interruptions in breathing. "Apnea" is a Greek word meaning "without breath." Each time breathing stops, the brain signals those with sleep apnea to arouse briefly from sleep in order to resume breathing. Consequently, sleep is fragmented and of poor quality. People with untreated sleep apnea often are unaware of the awakenings, but are extremely sleepy during the day, according to the American Sleep Apnea Association.
"An important part of the ASAA's mission is to increase the public's
awareness of sleep apnea so that the millions of people with unrecognized
sleep apnea can be diagnosed and treated properly," 
said Christin
L. Engelhardt, executive director of the American Sleep Apnea Association.
"It is with that purpose in mind that the ASAA established Monday,
March 29, as the first National Sleep Apnea Awareness Day."
Engineers need to be aware
Understanding sleep apnea, which afflicts about 12 million Americans, is important to the BLE because fatigue is an issue that many locomotive engineers confront on a daily basis. Being overly tired can hamper a locomotive engineer's job performance and result in unsafe working conditions or even accidents.
"The odd hours and rigorous schedules locomotive engineers are forced to work can lead to fatigue," said BLE International President Clarence Monin. "It's important for our members to get good, quality sleep whenever they can. Sleep apnea can be a serious problem for engineers because it prevents them from getting the deep, restive sleep they need to go to work every day and stay safe during those 12-hour shifts behind the throttle."
As a part of National Sleep Apnea Awareness Day, BLE members are asked to determine their "snore score" by reviewing the chart below. This simple test is designed to help determine whether or not you suffer from sleep apnea.
If untreated, sleep apnea has potentially serious health consequences. Besides falling asleep on the job and causing a serious collision or derailment, sleep apnea can lead to high blood pressure, cardiovascular complications and memory problems. Effective diagnostic tools and treatment options for sleep apnea are available and proper treatment can improve the quality of life for people with the condition.
Two types of sleep apnea
There are two types of sleep apnea: central and obstructive.
Central sleep apnea, which is less common, occurs when the brain fails to send the appropriate signals to the breathing muscles to initiate respiration. Obstructive sleep apnea is far more common and occurs when air cannot flow into or out of the person's nose or mouth although efforts to breathe continue.
During the night, the number of involuntary breathing pauses may be as high as 30 or more per hour. The breathing pauses are almost always accompanied by snoring, although not everyone who snores has this condition. The frequent interruptions of deep, restorative sleep often lead to early morning headaches and daytime sleepiness.
Sleep apnea is more common in men, although women and people in all age groups suffer from the condition. Four percent of middle-aged men and 2 percent of middle-aged women have sleep apnea. People who most likely have or develop sleep apnea include those who snore loudly and also are overweight or have high blood pressure. The condition seems to run in families.
Sleep apnea results in the afflicted person feeling very sleepy and having difficulty concentrating and working during the day. Consequences also include depression, irritability, sexual dysfunction and learning or memory difficulties.
Diagnostic tests
The condition can be diagnosed in a variety of ways, including a polysomnography, which is a test that records a variety of body functions during sleep such as the electrical activity of the brain, eye movement, muscle activity, heart rate, respiratory effort, air flow and blood oxygen levels.
Another diagnosis comes from the Multiple Sleep Latency Test, which measures the speed of falling asleep. In this test, patients are given several opportunities to fall asleep during the course of a day when they would normally be awake. People without sleep problems usually take an average of 10 to 20 minutes to fall asleep. Individuals who fall asleep in less than 5 minutes likely require some treatment for sleep disorders.
Three ways to relief
There are three ways to treat sleep apnea. First is a modification of behavioral factors, such as losing weight, avoiding alcohol or sedatives before sleep, and changing the position in which one sleeps.
The second way to treat sleep apnea is through continuous positive airway pressure, or CPAP. In this form of treatment, the patient wears a mask during sleep that forces air through the nasal passages. The mask helps prevent the loss of oxygen that forces the patient to wake up and interrupt sleep.
The third alternative is surgery. A wide variety of procedures, ranging from a tonsillectomy to using lasers to remove soft tissue at the back of the palate, all help reduce sleep apnea.
The ASAA was founded in 1990 as a non-profit organization by persons with apnea and concerned health care providers and researchers. The ASAA's mission:
"To reduce injury, disability and death from sleep apnea and to enhance the well-being of those affected by this common disorder. The ASAA promotes education and awareness, the ASAA AWAKE Network of voluntary mutual support groups, research and continuous improvement of care."
BLE Special Representative W.L. "Sonny" Hamm suffered from sleep apnea for years before seeking relief.
"I had snoring problems for a long time, then last fall I sought medical help and discovered I had a very serious case of sleep apnea," Brother Hamm said.
His sleep apnea was so bad that during medical tests, doctors found that he woke up 59 times in one hour of sleep.
He now sleeps soundly every night with the help of a continuous positive air pressure mask, or CPAP mask.
During treatment, Brother Hamm developed a good working relationship with his doctor, Cathy Hankey, a member of the American Sleep Apnea Association Board of Directors.
She recommended him for a vacant position on the Board, and today, Brother Hamm is one of three organized labor representatives on the ASAA Board of Directors.
BLE Vice-President Bill Walpert is also on the ASAA Board, as is a representative from the International Brotherhood of Teamsters.
In recent months, Brother Hamm has become a strong advocate of sleep apnea testing.
"By having yourself tested, it can save your life," Hamm said. "The number one problem with sleep apnea is falling asleep at the wheel. You tend to get real sleepy in the afternoon, and that contributes to accidents."
In addition to conducting BLE business, Hamm also spreads the word about sleep apnea.
"I encourage any locomotive engineer out there to get tested," Hamm said. "I bet there are hundreds of engineers out there with sleep apnea. If any of our guys have any inkling that they have a problem, I urge them to get it checked out. It's a lifesaver."
For an informal sleep apnea test, please check your "snore score" by using the box at the bottom of this page.
If you answer "yes" to one or more of the questions, you should consult your physician or sleep specialist about sleep apnea.
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