Sleep disorder leads to road fatality

A man was yesterday cleared of causing the death of a woman in a traffic accident after a magistrate heard how he had lost control of his car because he suffered from sleep apnea - a medical condition he was not aware of at the time.

Magistrate Abigail Lofaro cleared the man of causing the death of Anna Muscat in Ghajn Tuffieha since the accident was the direct cause of his medical condition.

The magistrate heard how on September 20, 1999, the man went for a drive and as he was headed towards Ghajn Tuffieha he lost control of his car which ended up in a side road and hit Muscat who was there with her husband and son-in-law. The car hit the trees in the area and eventually overturned.

But the man could not remember what had happened. He explained that he suffered from what he thought was an allergy, got tired in the afternoon and could not sleep at night and in the year-and-a-half before the accident he had consulted many doctors about his problem.

On the day of the accident he had visited the doctor as the medication he was on was not effective.

At about 5 p.m. he decided to go for a drive and took his dog with him. He remembered listening to the radio while driving but then, suddenly, he found himself upside down as his car had overturned.

The man remembered unfastening the seat belt and feeling relieved when he realised he had not suffered any injuries. He then got out of the car from the window where a man told him he had killed a woman.

After the accident the man went to see his doctor at St Philip's Hospital. While he was waiting he met Dr Brandon Caruana Montalto and told him what had happened. Dr Caruana Montalto said it was a clear-cut case of sleep apnea.

When Dr Caruana Montalto took the witness stand he explained that the man had the symptoms of this sleeping illness: he snored at night, he dozed off during the day, he often woke up at night and woke up in the morning feeling tired after having slept for eight hours.

The man suffered from a severe case of sleep apnea of which he was not aware.

Dr Caruana Montalto went on to explain that he was a specialist in the field and that sleep apnea was a relatively new illness, which explained why not any doctor could recognise its symptoms.

Anyone who suffered from sleep apnea, the doctor said, was six times more likely to be involved in a traffic accident. This was because, due to an accumulation of sleep deprivation, they nodded off during the day without realising. Since the accident the man has been taking the necessary medication and undergoing the necessary treatment to keep the sleeping disorder under control.

On evaluating the circumstances of the case the magistrate ruled that the accident was the direct cause of the man's medical condition, which he was not aware of.

Police Inspector Joseph Mercieca prosecuted.

The man's name is not being published to protect his identity due to the medical sensitivity of the case.

Three types of apnea

People with untreated sleep apnea experience repeated breathing intervals during their sleep. In fact, the Greek word apnea means without breath.

As explained in the American Sleep Apnea Association (ASAA) website (www.sleepapnea.org), there are three types of apnea. Obstructive apnea is caused by a blockage of the airway; in central sleep apnea, the airway is not blocked but the brain fails to signal the muscles to breathe; while mixed apnea is a combination of the two.

"Despite the difference in the root cause of each type, in all three, people with untreated sleep apnea stop breathing repeatedly during their sleep...

"With each apnea event, the brain briefly arouses people with sleep apnea in order for them to resume breathing but consequently sleep is extremely fragmented and of poor quality," the ASAA explains.

Untreated, sleep apnea may lead to a series of unpleasant effects.

Fortunately, sleep apnea can be diagnosed and treated.