Obstructive Sleep Apnea and the NY Train Derailment

In the early morning of December 1, 2013, train engineer William Rockefeller, Jr. derailed a train at high speed in New York. The train was approaching a sharp curve in the track at a speed of 82 mph in a 30 mph zone when it was thrown on its side; one of the seven cars missed the nearby Harlem River by only a few feet. The accident left four people dead and 70 wounded.

It was subsequently determined that Rockefeller suffered from obstructive sleep apnea, one of the most severe forms of sleep apnea. According to experts, as many as 22 million people in the United States could be suffering from this disorder.

Obstructive sleep apnea is a condition that causes obstruction of the airway during sleep. Though the muscles of the throat relax during sleep, dilator muscles in the throat usually keep the airway open. However in a sleep apnea sufferer, these muscles are weakened or impaired in some way and are unable to keep the throat muscles from relaxing to the point of airway constriction. People suffering from this disorder will stop breathing until a lack of oxygen in the blood triggers the diaphragm to intake air; this causes a loud gasp or snort as the breath is drawn.

Sleep apnea sufferers usually do not realize they have the condition. Symptoms of obstructive sleep apnea include grumpiness and irritability, forgetfulness, persistent headaches, and extreme fatigue.

William Rockefeller, Jr. was unaware that he suffered from obstructive sleep apnea; he had never been tested for the condition prior to the crash. Rockefeller’s lawyer argued that his condition had been “exacerbated by the change in shifts two weeks [before the accident].” The 46-year-old engineer was diagnosed following the crash and was suspended without pay while awaiting trial.

Someone whose sleep is disrupted five times in an hour will experience tiredness the next day. Thirty arousals an hour is considered severe. Tests showed that Rockefeller had as many as 66 disruptions every hour, or 528 sleep disruptions during an eight-hour period – enough to seriously impair his ability to exercise good judgment while operating moving machinery or vehicles.

Rockefeller’s sleep apnea was treated after the accident with a device called a CPAP, a Continuous Positive Air Pressure machine; it provides gentle air pressure to help keep the airways open. After 30 days, he reported that he felt more energetic and overall less sleepy.

Sources:
http://www.theguardian.com/world/2014/apr/07/new-york-train-crash-william-rockefeller-ntsb-report
http://www.webmd.com/sleep-disorders/guide/understanding-obstructive-sleep-apnea-syndrome
http://www.nlm.nih.gov/medlineplus/ency/article/000811.htm
http://www.lohud.com/story/news/local/westchester/2014/04/07/fatal-derailment/7413675/
http://newyork.cbslocal.com/2013/12/01/metro-north-train-derails-near-spuyten-duyvil/
http://www.nbcnews.com/health/health-news/dazed-dangerous-train-engineers-sleep-disorder-common-n74256