Page 16: of Maritime Reporter Magazine (September 2015)

GOVERNMENT UPDATE

Sleep Apnea

BY DENNIS BRYANT n June 23, 1995, the cruise Vengeance was pushing two barges, the port from the NTSB and the American ed numerous transportation accidents, ship Star Princess, carrying tank barge Kirby 30406 being the for- Academy of Sleep Medicine and quali- across all modes, where sleep apnea was 1,568 passengers and 639 crew, ward barge. The tanker experienced ? ed support from the American Pilots the leading or contributory cause.

O grounded on charted and marked Pound- several unintended diversions, culmi- Association (APA). stone Rock in the Lynn Canal of Alaska. nating in it striking the moored cargo Diagnosis

Although there were no deaths or inju- vessel. Despite the towboat putting its De? nition The medical professional may suspect ries, the ship’s bottom was ripped open. engines full astern, a collision between The Mayo Clinic describes sleep ap- that an individual suffers from sleep ap-

Repairs cost $21.16 million. The Nation- the tanker and the forward barge of the nea as “a potentially serious sleep disor- nea based on existing symptoms, such al Transportation Safety Board (NTSB) tow ensued. There were no deaths or in- der in which breathing repeatedly stops as excessive daytime sleepiness and determined that the probable cause was juries, but there was a signi? cant oil spill and starts.” The most common type is fatigue. A formal sleep study is then the pilot’s poor performance, which and signi? cant damage to the vessels in- obstructive sleep apnea in which the undertaken. This study, normally per- may have been exacerbated by chronic volved. The NTSB determined that the throat muscles relax while the individual formed in a clinical setting, establishes fatigue caused by sleep apnea. Among primary cause of the casualty was the sleeps, blocking the airway. This leads an objective diagnosis indicator linked other things, the NTSB recommended failure of the pilot on the tanker to cor- to a deprivation of oxygen (hypoxia) in to the number of apneic (interrupted) that the U.S. Coast Guard advise pilots rect the shearing motions that began as a the blood stream and an excess of car- events per hour of sleep. Mild obstruc- about sleeping disorders such as sleep result of the late initiation of a turn at a bon dioxide (hypercapnia). In extreme tive sleep apnea (OSA) is generally con- apnea and review its medical standards, mild bend in the waterway. Contributing cases, which are rare, this may result in sidered to have between 5 and 15 events guidelines, and examination forms to to the casualty was the pilot’s fatigue, death. Commonly though, sleep apnea per hour, moderate OSA has between 15 ensure that they require disclosure and caused by his untreated obstructive sleep interrupts normal sleep (even if the in- and 30 events per hour, and severe OSA appropriate evaluation of the history apnea and his work schedule. dividual is unaware of the interruption, has in excess of 30 per hour. An apneic or presence of any medical conditions, The Coast Guard recently announced as is quite common), making sleep less event generally is de? ned as a minimum symptoms, or medication use that would a proposed change to its policy regarding restful. The individual has issues with ten-second interval between breaths, affect an individual’s ? tness for duty as speci? c medical conditions, including excessive daytime sleepiness and im- with either a neurological arousal (a a pilot. obstructive sleep apnea, which it would paired alertness, slower reaction times, three-second or greater shift in EEG fre-

On 23 January 2010, the tanker Eagle consider in determining whether a medi- and vision problems. Sleep apnea in- quency) or a blood oxygen desaturation

Otome was inbound in the Sabine-Nech- cal waiver is warranted for merchant creases one’s risk of driving accidents of 3% or greater, or both.

es Canal en route Beaumont, Texas. The mariners applying for new or renewed and work-related accidents. It can also general cargo vessel Gull Arrow was merchant mariner credentials (MMCs). exacerbate moodiness, belligerence, as What can be done?

docked at a facility on the Canal unload- The proposal, particularly with regard well as decreasing drive (including the While surgery may be called for in ing cargo. The outbound towboat Dixie to sleep apnea, has received strong sup- sex drive). The NTSB has document- extreme cases, most often obstructive (Copyright: iStock image) 16 Maritime Reporter & Engineering News • SEPTEMBER 2015

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