New York Train Derailment Thought Related to Operator Fatigue

Well, what many of us in the sleep health sciences feared might be the case appears to have been confirmed:  the operator of the New York commuter train that jumped off its rails early Sunday morning, December 1st, reportedly told federal investigators that he had “nodded” and “zoned out” just prior to the derailment.

 

The crash, which occurred in the Bronx and resulted in the death of four passengers and the injury of dozens, occurred when the train passed through a sharp turn at speeds much higher than recommended:  according to reports from the National Transportation Safety Board, onboard recorders clocked the train to be moving at a blazing-fast 82 miles per hour just prior to the crash (the speed limit at the track curve was 30 miles per hour).  Data also reportedly demonstrate that brakes were applied heavily and the throttle cut shortly (five seconds) before the locomotive and all seven coaches jumped off the tracks.  Reportedly, the train driver, 46 year-old William Rockefeller, told NTSB investigators that “I was in a daze” just prior to the crash.  Investigators appear to have have concluded that Rockefeller likely had experienced a “microsleep,” dozing briefly while operating the train.

I don’t know Rockefeller’s personal circumstances that may have been associated with this tragic incident.  But I can tell you in general terms is that excessive daytime sleepiness is a very common, under-recognized problem, one with the potential for huge adverse consequences for people who work in various industries, particularly ones that require substantial mental attention and high degrees of performance and concentration.  The medical literature abounds with data regarding the extent to which work performance may deteriorate with chronic sleep deprivation, for example.  As one may imagine, such mental deterioration may then lead to industrial accidents and fall-asleep vehicular crashes.  It is well known that excessive daytime sleepiness is associated with reduced performance and human error due to:

Slow or defective information processing
Non-response and/or delayed response
Slow (increased) reaction time
Reduced vigilance
Decreased situational awareness
Lapses in judgment
Reduced accuracy of short-term memory
Accelerated decrements in performance

There are several important problems associated with addressing the issue of excessive daytime sleepiness.  First, sleepiness during the day can be caused by all sorts of things, including deliberate sleep deprivation, irregular or rotating work schedules, jet lag, medications, alcohol, insomnia, or intrinsic sleep disorders such as untreated obstructive sleep apnea.  Second, daytime sleepiness is often insidious; it creeps up on you ’til before you know it, you’re struggling to stay awake and alert during the day every day.  Third, daytime sleepiness is not painful (until you get into a car wreck, of course), making it less likely that people will seek to have the problem evaluated by a health care professional.

So I’d like to provide some quick and dirty rules for you, in light of this most recent tragedy.

1.  Do what you can to get proper amounts of sleep.  The vast majority of adults require between 7.5 and 8 hours of sleep per night.  If you’re sleep-deprived, try going to bed tonight a little bit earlier than usual, like by 10-15 minutes.  A couple nights later, go to bed 10-15 minutes earlier than that.  Gradually increase the total amount of sleep per night, to as close to 7.5 to 8 hours per night as possible.  If you suddenly go to bed a couple hours earlier than you usually do, you may experience insomnia, and you may well end up going back to your usual pattern of sleep deprivation.

2.  Do what you can to get proper amounts of sleep regularly, i.e., as close to every night as you can.  Your body clock “wants” you to be regular in terms of your bed timing.  If you tend to “sleep in” on non-workdays, for example, the very fact that you are sleeping in may be an indicator that you need more sleep during other times of the week than what you’re allowing yourself to have.

3.  If you are struggling to stay awake and alert during the day despite proper amounts of sleep at night, seek medical attention.  You may want to see a person like me, a physician sleep specialist, if that is the case.

Sleep well, everyone, and stay safe.

 

Fox News’ Tucker Carlson Falls Asleep on Air

 

The other day, Fox correspondent and commentator Tucker Carlson was caught sleeping while taping the show Fox & Friends.  When he awoke he appeared not to be aware that he had been on air during his nap.  Take a look:

I understand that there were media references to narcolepsy (a sleep disorder associated with nocturnal sleep disruption, daytime sleep attacks, and other symptoms) pertaining to Carlson’s on-air snooze, and that he afterwards stated that he had found his nap refreshing.  However, if you listen to the above video carefully, you will hear him suggest that sleep deprivation may have been to blame:  “I sat in for Sean Hannity last night. It went late and all of a sudden I was sitting there and I was just having these happy thoughts and just dozed off.”

Alas, falling asleep on-air is a phenomenon not new to Fox News.  Just for fun, I present to you yet another incident, this time from the Fox affiliate in Austin, Texas:

This sort of thing shows up in the media from time to time:  someone in a televised program dozing on-air.  It also makes sense for morning reporters and anchors particularly to be prone to this problem, because they typically have to awaken so early to go to work.  Everybody’s having a great time with this latest episode with Carlson, too, as you can imagine:  “Tuckered Carlson!” “Fox Snooze!”  Though these incidents are kind of funny to watch, they also are an opportunity for people like me–who work in the realm of sleep medicine–to make some important points about daytime sleepiness.  Here goes:

1.  Daytime sleepiness is much more commonly caused by plain ol’ sleep deprivation than by narcolepsy.  Most adults require around 7.5-8 hours of sleep per night to feel fully rested, and in our American culture many of us do not make time for this much sleep, at least consistently.  How many people do you know that regularly get 7.5-8 hours of sleep each night?  Sleep deprivation may well be the single most common cause of daytime sleepiness in the U.S.  Narcolepsy, though not necessarily a rare disorder, is much less common than sleep deprivation.

2.  A tendency to fall asleep by accident during the day is not equal to or the same as having narcolepsy.  Narcolepsy is a central nervous system disease, of which daytime sleepiness is a cardinal symptom; however, it is a very complex sleep disorder that we in sleep medicine continue to strive to understand through research.  Many other things can cause daytime sleepiness:  sleep deprivation; irregular sleep schedules; insomnia; untreated sleep apnea; the list goes on and on.

3.  If you really DO have narcolepsy, a brief (15-20 minute) nap usually IS refreshing.  This is one of many potentially distinguishing clinical features of narcolepsy; a brief nap in the setting of sleep deprivation alone may or may not be refreshing, and can often cause the napper to feel worse, not better, upon awakening, because only a small amount of the “sleep debt” was “paid back” during that nap.  For my narcoleptic patients, I in fact typically recommend scheduled naps as part of their management regimen.  But just because you find your naps refreshing doesn’t necessarily mean you have narcolepsy either.

Have a great Labor Day, everyone!