Saturday, February 24, 2018

Better Sleep Makes Better Boaters

January 1, 2014 by · Leave a Comment 

Yawn sleepImagine you’re out with a friend who’s had a few drinks. If he says to you, “Hey, let’s take the boat out!” you’d decline the offer.  What would your answer be, however, if that same friend was sober but had gotten very little sleep the night before?

Many people think that their cognitive abilities remain the same when tired, but that’s false, according to the National Sleep Foundation. On driving simulator tests, sleep-deprived people do as poorly, or even worse, than those who are intoxicated.sleep disorders


All people’s sleeping and waking patterns are regulated by a 24-hour biological process known as “circadian rhythm.” Our individual sleeping and waking tempos are affected by genetics as well as signals from the environment, such as sunrise and sunset. These patterns may be affected by stress, pregnancy, medications, menopause, alcohol, caffeine, nicotine, vigorous exercise, changes in work shifts, and jet lag.  Medical conditions such as asthma, depression, sleep/wake disorder, restless leg syndrome, acid reflux/heartburn, and sleep apnea can cause major disruptions as well. As we age, sleep issues become more common due to changes in health and, perhaps, increased use of medication.

The U.S. Coast Guard (USCG) reports that, in 2012, the primary contributing factor in boating accidents was operator inattention. That’s more common than any other factor, even violating navigation rules, excessive speed, alcohol use, machinery failure, and weather. Boaters must always maintain constant vigil over crucial information to make critical decisions (termed “situational awareness” by the USCG). It takes clear-eyed focus and mental energy to consider a boat’s intended route, other boats in the vicinity, proper equipment operation, weather conditions, known and sudden obstacles, passenger needs. When a pilot can’t fully concentrate for any reason, the likelihood of accidents increases. The Exxon Valdez oil spill and the Staten Island Ferry crash, for examples, both involved fatigue and drowsiness.

Sleep apnea is the most common sleep complaint. This usually chronic condition causes breathing to pause for seconds or even minutes multiple times every night, depriving the body of a continual supply of oxygen. The gaps in breathing may occur as gravity allows the tongue to fall back and block the airway, or as a result of a neural misfiring in the brain.  Addressing apnea for sufferers is crucial, not just because of irritating snoring or inadequate sleep, but because continual lack of oxygen can contribute to other life-threatening or chronic medical conditions. The American College of Occupational and Environmental Medicine (ACOEM) estimates the annual medical costs for untreated sleep apnea in the U.S. at $80 billion, including approximately 38,000 deaths related to cardiovascular problems and the expenses of disability and lost productivity.

drBarryChaseDr. Gary Chase, a dentist specializing in sleep apnea and a diplomat with the Clinical Sleep Disorder Society, says that, “seventy percent of men and 40 percent of women over age 60 have sleep apnea.”  While the condition is more common in people who are overweight or who have asthma, Dr. Chase believes that human evolution may play a large role in the increasing numbers of affected individuals.  “If you look at photos of people from 100 years ago,” he explains, “even then their lower faces were broader. Today we tend to have a more narrow lower face and a more narrow breathing passage.”

Then there’s the snoring associated with apnea, as people rouse themselves from a pause in breathing. It’s so irritating, says Dr. Chase, that “people have been kicked off boating trips for snoring!”

The common doctor-prescribed treatment for sleep apnea is the Constant Positive Airway Pressure (CPAP) machine, which Dr. Chase finds too cumbersome for many sufferers. “The CPAP is so big and bulky to wear and to carry around. We call it the Darth Vader mask,” he says. “It’s noisy, has to be plugged in, and a lot of people end up with sinusitis because it blows air into your sinuses.”  As an alternative, Dr. Chase offers a much smaller oral device to his patients. “It’s like a sports mouth piece, custom made, FDA-approved as a medical device, so insurance usually covers it. People tell us what a difference it’s made in their lives.” Oral device from Dr. Chase

Insomnia is another sleep disorder that affects approximately 23 percent of all U.S. workers, reports ACOEM, resulting in an annual cost to employers of over $63 billion in medical expenses and lost productivity.   While insomnia may be treated with medication and behavioral therapy, prevention strategies should be tried first. “People suffering from sleep disorders such as insomnia can try adoption of good lifestyle habits and proper sleep practices before turning to medications and other remedies,” advises Barry Eisenberg, ACOEM’s Executive Director. “However, as the effects of sleep disorders— and potential underlying causes— vary from person to person, treatment depends on the condition, and those chronically affected should consult a physician.”

Often people assume that they can “get used to” sleeping less than what their bodies require, but the reality is that we are not that adaptable. According to Dr. Chase, “A boater who is sleep-deprived cannot make quick and clear decisions, putting everyone onboard and nearby at risk. Proper sleep is irreplaceable; it can’t be restored through nutritional supplements, energy drinks, or cups of caffeine.”

By Patricia Knap

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