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Time to prevent train collision and derailments caused by untreated obstructive sleep apnea (OSA)

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Posted by Murphy Siding on Saturday, May 19, 2018 9:58 PM

selector
psychiatrist/sleep specialist

How do those two things tie together?

Thanks to Chris / CopCarSS for my avatar.

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Posted by BaltACD on Saturday, May 19, 2018 8:10 PM

Electroliner 1935
I like (and wish more were} companies that are as intelligent and employee considerate as Shadow the Cats Owner's and Randy's are. BaltACD, I, like you, have some concerns about "junk science and dislike that there are the adverisers that find Doctors who will say many things for money, but there are risks to all of us from those that deny facts. When kids don't get imunizations because their parents believe that imunizations cause autism, other kids are at risk. And while it is not possible to put a price on a life, the cost of train wrecks is not insignifcant, and if it is the train you and your loved ones are riding on, wouldn't you want to know your engineer was not going to fall asleep at the throttle. OK, I know. PTC will prevent it. But the world is NOT flat. Science works but there are charlatans that will try to manipulate you for their gain. I wonder if BaltACD's comments are in jest. Balt, do you wear a seat belt when you race? Or do you buckle-up all the time? My brother and I installed seat belts in our Dads' 1952 ford in 1954 before they were standard equipment and I never drive without buckling. They Save lives. So lets take advantage of what can improve our lives. 

Part and parcel of my getting my 1st car back in 1963 is that my parents mandated that I install seat belts in it.  Every car I have owned since have had them (even when not factory installed).  I got rid of my 2003 Durango with 359K on the clock for one reason and one reason alone - the $500+ cost of replacing the driver's seat belt that would no longer extend.  My race cars for the past 30 years have 6 point seat belt systems that get replaced every 3 to 5 years by rule at roughly $200 a pop.  Since 2011 it is also required that I use a Head And Neck System (HANS) of restraint to prevent basel skull fractures (what killed Dale Earnhardt Sr.).

We now live in the world of fake news - it becomes increasingly difficult to sift through all the reports one sees about what is good or bad for you.  One day something is 'good' and seeminly the next it is determined to be 'bad'.  Personally I try to weigh all the 'options' and make my own decisions based upon the best information available - as I understand the information.

I have stayed at Holiday Inn's from time to time but they have never conveyed the 'Expert' crown for any of my areas of knowledge.  As we all know, nothing is perfect and S..T happens!

Never too old to have a happy childhood!

              

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Posted by Electroliner 1935 on Saturday, May 19, 2018 6:42 PM

Like Semper Vaporo,and Randy, I use a CPAP (actually, a Bi-PAP) machine and appreciate it. Use is 100% >7hr/night Just came back from Washington DC and took it with me. TSA guy (I asked) said he sees a lot of them as he was checking it. Small hastle for a good nights sleep. Also, Medicare covers 80% of CPAP costs and my supplement takes care of the 20%. 

I like (and wish more were} companies that are as intelligent and employee considerate as Shadow the Cats Owner's and Randy's are. BaltACD, I, like you, have some concerns about "junk science and dislike that there are the adverisers that find Doctors who will say many things for money, but there are risks to all of us from those that deny facts. When kids don't get imunizations because their parents believe that imunizations cause autism, other kids are at risk. And while it is not possible to put a price on a life, the cost of train wrecks is not insignifcant, and if it is the train you and your loved ones are riding on, wouldn't you want to know your engineer was not going to fall asleep at the throttle. OK, I know. PTC will prevent it. But the world is NOT flat. Science works but there are charlatans that will try to manipulate you for their gain. I wonder if BaltACD's comments are in jest. Balt, do you wear a seat belt when you race? Or do you buckle-up all the time? My brother and I installed seat belts in our Dads' 1952 ford in 1954 before they were standard equipment and I never drive without buckling. They Save lives. So lets take advantage of what can improve our lives. 

Sorry for the length.

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Posted by Shadow the Cats owner on Wednesday, May 16, 2018 2:41 PM

Selector why ours is so low is very simple.  Good pay good well maintained equipment we also treat our drivers as humans when it comes to home time aka familes health insurance that is very good along with several paid holidays and the biggest one for my brats at work we pay for any parking they need on the road their Sat radios.  We make them realize that hey there are good companies our there and they do not want to leave.  

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Posted by selector on Wednesday, May 16, 2018 9:00 AM

Shadow the Cats owner

...  So the carrier on its own started a OSA treatment program. 

This is good.  Very commendable in my view.

Shadow the Cats owner

All drivers diagnosed with it are given the same machine we supply hoses masks humdifier tanks everything needed. 

Darn...and we were doing so well!!  I may be reading too much into this statement, but if it's true on the face, it's bad. People have different needs for PAP.  Some, like me, can get by with straight CPAP at low pressures.  Others with complex apnea need a $3K auto-servo ventilator. If the 'everybody gets the same machine' is an auto capable one, then at least there's that much, but a proper diagnosis must...MUST...be accorded each person who is then to be given the appropriate treatment. This means different capabilities for the equipment.

Shadow the Cats owner

...But then we have such a low turnover rate it isn't funny.  I think in the last 6 months we had 20 new faces come into the office as drivers.  They are all still here. 

 

Wow.  If that's a decently low turnover inside of a mere 6 months, and it's atypical for a trucking company these days....[..gulp!..].

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Posted by tree68 on Tuesday, May 15, 2018 9:36 PM

charlie hebdo
So if you need a medical procedure or medication, will you ignore the junk science and lying statistics and just eat some mashed potatoes seasoned with dimes?

Sure!  The dimes will pass...

And I'll be sure not to get any innoculations, because they might cause autism!

Remember - doctors once touted cigarettes as being good for you.  

Medical research has saved untold lives, but any more you have to look at who did what research to get a feel for what's real, and what's so much blather, designed to sell something.

We can't forget that when I was young, we were going to "cure cancer in our lifetime."  Do you really think that's going to happen as long as there are companies making millions on treating cancer patients?  Take the profit out of cancer treatment and true cures will arrive shortly thereafter.

LarryWhistling
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Everyone goes home; Safety begins with you
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Posted by charlie hebdo on Tuesday, May 15, 2018 9:13 PM

tree68
Like the researcher who "proved" (according to accepted research procedures) that dimes cause cancer. As Disraeli said - "There's lies, damned lies, and statistics."  And research results are often the product of who is doing the research, and why. 

So if you need a medical procedure or medication, will you ignore the junk science and lying statistics and just eat some mashed potatoes seasoned with dimes?

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Posted by tree68 on Tuesday, May 15, 2018 7:48 PM

charlie hebdo
...empirical medical research...

Like the researcher who "proved" (according to accepted research procedures) that dimes cause cancer.

As Disraeli said - "There's lies, damned lies, and statistics." 

And research results are often the product of who is doing the research, and why. 

That said, I'll go along with the probability that obesity is a factor with OSA, but if it is, maybe we need to take a look at what's causing the obesity (like irregular work schedules, f'rinstance).

LarryWhistling
Resident Microferroequinologist (at least at my house) 
Everyone goes home; Safety begins with you
My Opinion. Standard Disclaimers Apply. No Expiration Date
Come ride the rails with me!
There's one thing about humility - the moment you think you've got it, you've lost it...

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Posted by zardoz on Sunday, May 13, 2018 9:13 PM

BaltACD
And all of them ate mashed potatoes.  So mashed potatoes is the causitive factor.

Oh no! I'm S.O.L.

mmmmmmm, mashed potoatoes Dinner

Good thing pizza wasn't implicated; if it was, I'd be toast....

 

mmmmmmm, toast.

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Posted by zugmann on Sunday, May 13, 2018 8:56 PM

charlie hebdo
A factual article link from NIH. The linkage with overweight and obese is clear. Of course some thin people may suffer also, but weight is a strong risk factor for OSA.

My carrier is doing sleep apnea studies for anyone with a BMI over a certain percentage when they take their recert physicals.  Also if other factors are met.

It's hard to keep active when you spend 10+ hours a day sitting on your butt in a cab (truck or train).  Add to that the different shifts, and weekly schedule changes... well, yeah.

It's been fun.  But it isn't much fun anymore.   Signing off for now. 


  

The opinions expressed here represent my own and not those of my employer, any other railroad, company, or person.t fun any

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Posted by BaltACD on Sunday, May 13, 2018 1:58 PM

charlie hebdo
 
BaltACD
 
charlie hebdo
A factual article link from NIH. The linkage with overweight and obese is clear.  Of course some thin people may suffer also, but weight is a strong risk factor for OSA.

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3021364/ 

And all of them ate mashed potatoes.  So mashed potatoes is the causitive factor.  Birth is the leading cause of eventual death! 

You clearly don't understand statistics and research.  Yet youcontinually make inane posts about them.  Most of us respect what you did and if we dared suggest it was just BS, we'd be flailed because we wouldn't have a clue what dispatchers do. I would suggest you try to be a bit more open-minded about empirical medical research as opposed to non-expert opinions.

Inane responses to inane satements - joining your crowd!

Never too old to have a happy childhood!

              

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Posted by charlie hebdo on Sunday, May 13, 2018 1:46 PM

BaltACD

 

 
charlie hebdo
A factual article link from NIH. The linkage with overweight and obese is clear.  Of course some thin people may suffer also, but weight is a strong risk factor for OSA.

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3021364/

 

And all of them ate mashed potatoes.  So mashed potatoes is the causitive factor.  Birth is the leading cause of eventual death!

 

You clearly don't understand statistics and research.  Yet youcontinually make inane posts about them.  Most of us respect what you did and if we dared suggest it was just BS, we'd be flailed because we wouldn't have a clue what dispatchers do. I would suggest you try to be a bit more open-minded about empirical medical research as opposed to non-expert opinions.

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Posted by BaltACD on Sunday, May 13, 2018 12:30 PM

charlie hebdo
A factual article link from NIH. The linkage with overweight and obese is clear.  Of course some thin people may suffer also, but weight is a strong risk factor for OSA.

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3021364/

And all of them ate mashed potatoes.  So mashed potatoes is the causitive factor.  Birth is the leading cause of eventual death!

Never too old to have a happy childhood!

              

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Posted by charlie hebdo on Sunday, May 13, 2018 11:09 AM

A factual article link from NIH. The linkage with overweight and obese is clear.  Of course some thin people may suffer also, but weight is a strong risk factor for OSA.

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3021364/

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Posted by Shadow the Cats owner on Sunday, May 13, 2018 8:20 AM

My boss does the same thing as your carrier rvos1979.  Why we lost one of our founders to OSA when he passed out behind the wheel of his truck going around a curve of an exit ramp and rolled his truck about 15 years ago.  The guy was beanpole thin also and no health issues what so ever.  So the carrier on its own started a OSA treatment program.  All drivers diagnosed with it are given the same machine we supply hoses masks humdifier tanks everything needed.  But then we have such a low turnover rate it isn't funny.  I think in the last 6 months we had 20 new faces come into the office as drivers.  They are all still here. 

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Posted by erikem on Saturday, May 12, 2018 10:07 AM

rvos1979

This has been a tough one to write.........

Randy,

May have been tough to write, but the effort you put into comes through.

 - Erik

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Posted by rvos1979 on Saturday, May 12, 2018 7:26 AM

This has been a tough one to write.........

Being in trucking, there have been programs in the works to test for sleep apnea, and some companies have gone further in testing for and treating it.  I switched to one of those companies in 2015 (hint: they pull orange trailers), and had the opportunity to get tested. The in-home test said I was negative, but I was referred to having an overnight study done, the results of which put me in the mild-to-moderate category of sleep apnea. At one point, I had stopped breathing for something like 90 seconds, if I remember what the doctor had told me correctly. So, on the CPAP machine I went. Noticed a difference the first night, when I slept completely through the night, instead of waking up two to three times during the night. I also didn't wake up with a dry throat in the morning anymore, which was confirmed a couple months later when I fell asleep without the CPAP, and woke up with a sore throat, which lasted for two days. Yes, it is a pain to have the machine with me, I have to break it down and set it up every time I change beds (from house to sleeper, and vice versa), and some places make it interesting to set up in. My company is nice enough to provide all the equipment to us, including regular shipments of consumables (masks, hoses, filters, humidifier tanks, etc) at no charge, and I had no out of pocket costs for the sleep studies, other than lost income from the overnight study, which I had to travel to.

Unfortunately, my company is one of the rare ones that paid for all the testing and therapy, other companies force the drivers to pay for the study, and then the equipment, if their insurance will not cover it. This can amount to several thousand dollars just for the study, then add costs for machines and consumables on top of that. The older machines you had to send in the data from your CPAP when requested, my newest machine has a built in WIFI hotspot that sends the data automatically. I still have to request for a data summary every time I go to the DOT doctor to renew my medical card, compliance is required to retain CDL privelidges.

I am honestly not sure what the best way is to go about screening people for sleep apnea, I dont think the proposal of being above a certain body mass index is a good way to go, as you can be thin and have sleep apnea. It may come down that it may be required that all people performing safety sensitive jobs be screened. Some guidance would be nice, but I don't see that happening from the feds anytime soon. I do agree that the underlying issue of fatigue from a non-standard sleep schedule is also a big issue, both rail and truck. Dealing with the costs of all the testing and compliance is another problem, and I don't see any resolution in that area anytime soon either........

Randy Vos

"Ever have one of those days where you couldn't hit the ground with your hat??" - Waylon Jennings

"May the Lord take a liking to you and blow you up, real good" - SCTV

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Posted by Eddie Sand on Saturday, May 12, 2018 1:41 AM

Although I actually worked in or around the rail industry for only or a few months, I spent most of my 45-year career working non-traditional hours -- probably because I have the "lighthouse keeper" personality common to introverts, and try to avoid the politicized nature of most large-office jobs. So I think I can attest to the point that changing between shifts can be more stressful than working consistently at non-typical hours, particularly when going onto a late-night assignment with limited rest.

One of the worst schedules I ever had to cope with was a "compressed swing" arrangement: two days on the afternoon-to-midnight, followed by two on the "day watch" (usually Saturday/Sunday) -- which wasn't that bad. But i was then expected to get a few hours rest in the evening, followed by a midnight-to-8AM ordeal. (You can't force yourself to sleep, and liquor and pills pose their own risks.) I'm given to understand that this one was at one time a fairly common practice for air traffic controllers (where it was known as a "rattler") and might have figured in a particularly ugly crash in Lexington, KY about ten years ago.

The problem has been around for years, but it appears that it's begun to get some serious attention only recently.

 

 

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Posted by Euclid on Friday, May 11, 2018 8:03 AM

The common belief used to be that the main problem from working nights was not getting enough sleep.  The problem with rotating shifts was that they include working nights plus they are harder to get used to than working any one time shift. 

Now, the latest medical determination is that the problem is working third shift and less of a problem working second shift.  So shift work sleep disorder is only caused by working second or third shift to any extent.  it is not caused by insufficient sleep, but rather is caused by interruption of the circadian rhythms.

Not getting enough sleep is a separate problem that is not caused directly by the shift time, but is more likely with night shift work because the daytime is generally more disruptive to sleep. 

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Posted by BaltACD on Thursday, May 10, 2018 11:01 PM

tree68
 
Euclid
Now it is believed that shift work sleep disorder can be caused by simply working a night shift only. 

I had an uncle who worked straight mids.  He always looked beat...

I prefered a straight 3rd trick schedule - while it takes some time to get used to it, once you are, you get the amount of sleep you need.  Getting used to it CAN BE A BEAR!

Swapping around tricks either in regular relief assignments or on extra boards totally wrecks any knind of repeatable schedule.

Some official positions I worked had a month daylight and a month nights.  Just as you were getting accustomed to the night schedule you were off of it.

Never too old to have a happy childhood!

              

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Posted by Convicted One on Thursday, May 10, 2018 9:39 PM

tree68
- but if you're a hammer, everything looks like a nail.  Next thing you know, everybody will be diagnosed with it.

I know what you mean.  The symptoms and cited causes appear a little bit too "tailor made" to suit the chronic complainers, if you ask me.

"Okay, since you are fat, and smoke, and snore, and are sometimes irritable,  and won't voluntarily give up those things that are causing it, we're just going to label it a disease and hold your ability to earn a living over your head until you do comply"

Unfortunately I snore like a lawnmower. And on more than just one occassion I've been blessed to have well meaning samaritans try and convince me that I MUST  have sleep apnea, and should go get something done for my own good, when I know for a fact that their true motive is to just get a hose tethered to my face so they won't have to listen to me snore.

I mean I NEVER,  ever wake up feeling any shortness  of breath, or desperate to breathe, and so long as I get in bed early enough for at least 5 hours of sleep, I feel well rested each morning.

But since some aspect of my existance happens to fit a mold which others would like to alter, eventually they are going to find their reason.

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Posted by tree68 on Thursday, May 10, 2018 8:59 PM

Euclid
Now it is believed that shift work sleep disorder can be caused by simply working a night shift only.

I had an uncle who worked straight mids.  He always looked beat...

LarryWhistling
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Everyone goes home; Safety begins with you
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Come ride the rails with me!
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Posted by edblysard on Thursday, May 10, 2018 12:12 PM

Not fair at all, Aimee does the same thing, no matter when or where, she can close her eyes and be out in under 10 seconds...Sad

23 17 46 11

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Posted by BaltACD on Thursday, May 10, 2018 9:18 AM

Euclid
 
BaltACD
 
Euclid
If this goes forward, I don't believe that everyone will be diagnosed with OSA.  But everyone will have to be tested if they work a nighshift.  The testing is worrisome because a person's job is at stake.  If I was in this position to be tested, I would not necessarily trust the diagnosis. 

The effects of sleep apena hit in daylight too.  EVERYONE will need to be tested, not just nightshift employees, and I would also no trust the diagnosis. 

I am not sure about that.  It used to be believed that shift work sleep disorder was caused by working rotating shifts.  Now it is believed that shift work sleep disorder can be caused by simply working a night shift only.  As you say, the effects of shift work sleep disorder can manifest during the daytime.  But can you get shift work sleep disorder if you only work days?

In any case, I would not be surprised if eventually it will come down to a decision to test everybody regardless of when they work or if they work.

Evidence suggests that sleep apena is linked with obesity - do obese people work during daylight hours?  We also have annecdotal evidence that sleep apena also affects 'bone skinny' people, therby establishing a case that sleep apena can affect anyone.  The matter of working day or night then becomes moot.

I have not been diagnosed with sleep apena.  During the bulk of my career that I worked nights - my day's sleep was 5-6 hours.  Now that I have been retired my nights sleep is 6-7 hours.  I can fall asleep anytime I desire - day or night.  

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Posted by Euclid on Thursday, May 10, 2018 7:49 AM

BaltACD
 
Euclid
If this goes forward, I don't believe that everyone will be diagnosed with OSA.  But everyone will have to be tested if they work a nighshift.  The testing is worrisome because a person's job is at stake.  If I was in this position to be tested, I would not necessarily trust the diagnosis. 

 

The effects of sleep apena hit in daylight too.  EVERYONE will need to be tested, not just nightshift employees, and I would also no trust the diagnosis.

 

I am not sure about that.  It used to be believed that shift work sleep disorder was caused by working rotating shifts.  Now it is believed that shift work sleep disorder can be caused by simply working a night shift only.  As you say, the effects of shift work sleep disorder can manifest during the daytime.  But can you get shift work sleep disorder if you only work days?

In any case, I would not be surprised if eventually it will come down to a decision to test everybody regardless of when they work or if they work.

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Posted by BaltACD on Wednesday, May 9, 2018 9:03 PM

Euclid
If this goes forward, I don't believe that everyone will be diagnosed with OSA.  But everyone will have to be tested if they work a nighshift.  The testing is worrisome because a person's job is at stake.  If I was in this position to be tested, I would not necessarily trust the diagnosis. 

The effects of sleep apena hit in daylight too.  EVERYONE will need to be tested, not just nightshift employees, and I would also no trust the diagnosis.

Never too old to have a happy childhood!

              

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Posted by zardoz on Wednesday, May 9, 2018 8:51 PM

Euclid

If this goes forward, I don't believe that everyone will be diagnosed with OSA.  But everyone will have to be tested if they work a nighshift.  The testing is worrisome because a person's job is at stake.  If I was in this position to be tested, I would not necessarily trust the diagnosis. 

 

Coming soon to a bedroom near you: Big Brother watching you sleep.

 

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Posted by zardoz on Wednesday, May 9, 2018 8:44 PM

selector
Do robots develop sleep apnea?

How about Darth Vader? "He's more machine than man" (Obi-Wan Kenobi)

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Posted by zugmann on Wednesday, May 9, 2018 10:37 AM

Bkeppen
All of the other issues you raise are valid concerns that contribute to fatigue, however, if you have to deal with all those issues and you have moderate to severe sleep apnea, you are a safety risk to yourself and others. The compliance standard is a minimum of four hours per night, 70% of days. In other words, four hours per night in 7 out of ten days. Not a difficult standard to meet. Railroads are required by the 2008 Rail Safety Improvement Act to address those other factors, but FRA has dropped the ball on that as well. Bottom line, have run trains myself, I do not want to be out there meeting trains on single track or CTC territory who have moderate to severe sleep apnea.

Man, even the forums have commercials anymore.

It's been fun.  But it isn't much fun anymore.   Signing off for now. 


  

The opinions expressed here represent my own and not those of my employer, any other railroad, company, or person.t fun any

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