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Transit Accidents Linked to Sleep

Aviation regulators don't screen commercial pilots for sleep disorders that can trigger deadly mistakes linked to serious accidents in aviation and other forms of transit, according to investigators and sleep experts.

Accidents on planes, buses, trucks, trains and ships have repeatedly been linked to drowsy operators whose fatigue stemmed from medical conditions, according to a review of federal and local accident records. Several of the accidents were fatal.

While efforts to reduce fatigue in aviation have focused on pilots' schedules, federal accident investigators say pilots and other vehicle operators also need to be screened for sleep disorders. The National Transportation Safety Board (NTSB) is preparing to take a stand on the issue within weeks, according to testimony at a recent public meeting.

"We're very concerned about this," said Mark Rosenker, acting chairman of the NTSB. "It can lead to significant fatigue. Fatigue has been linked to a host of accidents."

Sleep apnea, the most common sleep disorder, can cause acute fatigue and daytime sleepiness. Apnea occurs when a person's air passages become blocked, forcing a wake-up for a gasp for breath. The waking occurs so briefly that many sufferers don't even realize it.

Among the sleep-related accidents cited by the NTSB:

A charter bus accident that killed nine people on Jan. 6, 2008, in Mexican Hat, Utah., was blamed on the driver's "diminished alertness," due in part to his sleep apnea.

The driver of a trolley train that crashed into another train on May 28, 2008, in Newton, Mass., likely fell asleep. Investigators suspected that the overweight driver suffered from apnea, but it could not be proved because she died.

The captain of a Go! airlines regional jet carrying 40 passengers, who fell asleep with his co-pilot for at least 18 minutes over Hawaii on Feb. 13, 2008, had severe undiagnosed apnea. The jet was flying out to sea when the pilots woke up and turned back to their destination.

"Our approach is bury our heads in the sand and hope that it doesn't happen," said Charles Czeisler, director of sleep medicine at Harvard's Brigham & Women's Hospital. "We need to screen for sleep disorders."

Thomas Balkin, chief of Behavioral Biology at the Walter Reed Army Institute of Research and chairman of the National Sleep Foundation, said that a few simple questions can identify people who might have apnea.

No federal agency requires that commercial vehicle operators be screened for sleep disorders, according to NTSB. The Federal Railroad Administration is drafting new rules that could include requiring tests for apnea, the NTSB said.

The Federal Aviation Administration requires pilots to get medical exams every year or six months. While there are no specific screens for sleep disorders, doctors are expected to ask follow-up questions if pilots are obese or have other signs of sleep disorders, said FAA spokeswoman Alison Duquette.

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