According to a study by researchers at UCSD School of Medicine, each year potentially 980 lives could be saved and $11.1 billion in automobile-accident costs could be avoided if drivers who suffer from obstructive sleep apnea were successfully treated with continuous positive airway pressure (CPAP).

CPAP is a treatment where the patient wears a mask over the nose during sleep and pressure from an air blower forces air through the nasal passages, preventing the throat from collapsing while the individual sleeps.

But most of the people with obstructive sleep apnea don't even realize they have the condition and don't get help.

Published this spring in the journal Sleep, the UCSD research team noted sleep-deprived drivers with obstructive sleep apnea cause 1,400 fatalities each year. As a result of poor quality sleep, persons with sleep apnea experience excessive daytime sleepiness, which can lead to motor vehicle crashes.

In their study, medical research data from 1980 to 2003 was analyzed to investigate the relationship between auto collisions and obstructive sleep apnea in untreated individuals.

"Qualitatively, the scientific community has known for approximately 20 years that sleep apnea increases the risk for automobile crashes. This is the first study to quantify the impact of obstructive sleep apnea on society, which is quite significant," noted the study's primary author, Dr. Alex Sassani, a UCSD medical student when the study was conducted and a current resident in UCSD's Department of Radiology.

"The consequences of untreated obstructive sleep apnea are great, both in terms of monetary costs and lives disrupted," he said. "This is an enormous burden that demands attention."

Saving lives, money

Past studies have shown that drivers with obstructive sleep apnea have a higher rate of collisions than do individuals without the disorder. In fact, studies comparing alcohol-impaired subjects to individuals with untreated obstructive sleep apnea show that persons with untreated sleep apnea perform as poorly on simulated steering and psychomotor reaction time tests as legally intoxicated individuals.

"It is estimated that as many as 40 million Americans have undiagnosed sleep apnea," said the paper's senior author, Dr. Terence Davidson, a professor of surgery at UCSD. "Dr Sassani's study clearly demonstrates that these people are falling asleep while driving, killing themselves and innocent bystanders. It is time for American medicine and the American people to wake up to sleep."

The UCSD investigators noted the prevalence of obstructed sleep apnea in drivers is estimated at 3 percent, or 4.7 million drivers. A recent study of 1,391 commercial truck drivers found that 28 percent had obstructive sleep apnea, with more than one-third characterized as moderate to severe. Sassani indicated that in one year alone ---- the year 2000 ---- more than 800,000 drivers with the condition were involved in motor-vehicle accidents.

The researchers estimate that 980 of the 1,400 fatalities each year will be avoided with treatment, based on a 70 percent success rate with the continuous positive airway pressure treatment.

While the annual cost of treating sleep apnea patients is approximately $3.18 billion, including screening costs, the researchers noted that collision costs for accidents caused by sleep apnea patients were $15.9 billion annually. These collision costs would be reduced annually by $11.1 billion, using a 70 percent effectiveness rate.

Tips if you snore

1. Lose weight. Though there are some thin people who snore, there are very few obese ones who don't. Extra fatty tissue around the neck helps to strangle air passageways.
   
2. Cut down on alcohol, or at least don't drink in the evening.
   
3. Avoid tranquilizers, sleeping pills, sedatives and antihistamines as they reduce muscle tone even more than normal during sleep.
   
4. Get regular exercise. Exercise will improve breathing and overall fitness as well as help with weight loss.
   
5. Give up smoking which is likely to cause bronchitis or other chronic respiratory diseases.
   
6. Don't sleep on your back.
   
7. Try a humidifier in the room. Lack of humidity in the air dries out mucous membranes in the nose and throat which can aggravate snoring.
   
8. Make certain the bedroom is thoroughly cleaned and dusted. Avoid long pile carpets, elaborate curtains and bedspreads as well as down comforters and pillows. Allergies to pollens and other airborne irritants can cause swelling of the mucous membranes and overproduction of mucous.
   
9. Don't let animals into the bedroom because dander and hair can exacerbate allergies and hay fever.
   
10. Check for food allergies. For some people, milk, MSG or some artificial food additives and colorings can trigger an allergic reaction.
    
11. Try some aromatic herbs and oils (i.e. Eucalyptus) which can help dilate breathing passages and improve breathing. Try eating more garlic (or garlic tablets) as it is a natural decongestant.
    
12. Sleep without a pillow and/or on a firm mattress. Being perfectly flat helps straighten the airway.

From Michael Van Straten, The Good Sleep Guide published by Kyle Cathie Limited, London, 1990. First published under the title "Just Don't Lie Thereä"