The Deadly Consequences of Undiagnosed Sleep Disorders


Undiagnosed sleep apnea as the cause of a major railroad accident is cause enough for concern. What if it was a possible cause for at least two such mishaps on the same Metro-North Railroad in one year, and a ticking bomb for some more?


The National Transportation Safety Board (NTSB)’s recently released report identified undiagnosed sleep apnea as what led a Metro-North Railroad engineer to fall asleep as the train he was driving through Bronx toward the Grand Central sped through an acute curve killing 4 passengers and injuring 61 more. An undetected broken pair of joint bars in the May 2013 collision in Bridgeport, Connecticut (this injured about 65 people) also suggests such fatigue as the main reason, say the NTSB.


“Dazed” and “almost like mesmerized” was how he felt, said the engineer in the Bronx accident, William Rockefeller. NTSB investigators faulted the authorities for the driver’s shifting work schedule in aggravating his undiagnosed severe obstructive sleep apnea.


Could effective preventive measures have saved this accident? Screening for sleep disorders could certainly have, say the NTSB and cited lack of such measures as contributing factors. Other technical safety measures that were absent, according to NTSB, were the absence of an advanced train-control system that would have automatically triggered the train’s brakes, lack of a comprehensive track maintenance program and stringent inspection requirements, and a decision to defer scheduled repairs.


A hard lesson learnt is that prizing on-time performance of trains over safety does not lead to happy endings. A harder lesson is the undeniable fact that even the most advanced safety features depend on the ‘employee on-the-job’ well being – and proactive screening for and treatment of sleep disorders may well be the difference between life and death.


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