Asleep... And Sudden Death!

Even freshly blessed pilgrims aren’t protected from sleepy drivers. It was around 10pm on January 20, 2008. Bus driver Paras Thorat, who had been working continuously and without rest for three days, was tired and sleepy and his driving seemed “rash and negligent.” The 81 pilgrims in his overloaded luxury bus had been to several of Maharashtra’s holiest shrines. They were now at a hairpin bend when, all of a sudden, the huge bus plunged 100 metres down a ghat killing 39 and injuring everybody else inside, except Thorat.

For 38-year-old accounts executive Saumil Gupta*, it was a hard day. Driving from Mumbai towards Goa in heavy rain with his brother Mithun* seated beside him, their little nephew on Mithun’s lap and Saumil’s wife and daughter on the back seat, they were at one point stuck in a traffic jam for over two hours. Then, as they drove on and the sun went down, his car gave trouble and its headlights, too, stopped working. Saumil drove back 20 kilometres to find a garage, where they repaired the car.  As they continued the journey, Saumil was clearly getting tired, but the family had to attend a function the next day.

Mithun kept talking to Saumil to keep him awake. But, by 2:30am, Mithun himself fell asleep. He was startled awake to find that their car had veered off the road and down an incline. Mithun realized that his brother, too, had dozed off at the wheel and the car was sliding towards a ravine. Suddenly, Saumil woke up and jammed on the brakes—or so he thought. Only he’d hit the accelerator instead and the car sped forward until it crashed into a large tree. Saumil’s legs were crushed badly. Thrown against the dashboard, his nephew was bleeding; his wife suffered a mild concussion. “Had the car not hit the tree,” says Mithun, “it would have been a different story.”

In the dark on that still mountain road, help arrived only an hour later when some villagers passing by found them. Later Saumil would undergo surgery and have rods implanted in both his legs. His nephew would require three stitches on the head.

Drowsy drivers can be just as dangerous than drunken ones because, often, they don’t realize how impaired they can be. “Many drivers I’ve interviewed say they go off to sleep regularly at the wheel,” says Nileema Chakrabarty, PhD, environment and traffic psychologist with the Central Road Research Institute (CRRI), New Delhi. “And sleep-deprived drivers can doze off in a flash.”

The Mumbai-Pune Expressway is among India’s best roads. But it has a deadly record. According to highway police sources, 644 mishaps occurred on this 95-km stretch last year, taking 165 lives and leaving 356 people injured. Each year, since it opened in 2000, the number of deaths on the Expressway has risen, and the mishaps here are often attributed to over-speeding well beyond the 80kmph limit. But there’s also another reason, according to Brigadier Subhash C. Malik (retired), now chief project coordinator for IRB Infrastructures Developers Ltd, the company that maintains the Expressway. “A large number of the accidents and incidents on the Expressway happen because drivers tend to doze off,” he says, adding, “I know that many vehicles travelling long distances do not have a second driver on board.”

In fact overspeeding and dozing off form a deadly mix. At 4:15am on a Sunday morning in May last year, 19 people from a wedding party crammed into a jeep were speeding along the Mumbai-Pune Expressway when it hit a huge trailer-truck. Investigators learnt that Nitin Dhumal, 25, the jeep’s driver, had fallen asleep. They also found the mangled jeep’s speedometer still stuck at 130kmph. The accident killed 16 people including Dhumal, who had been driving non-stop all night without a break at the request of the wedding party, although he was tired and sleepy. “In fact, around 13% of all fatal accidents occur in the wee hours between 2am and 6am,” says Rajesh Bansode, a Maharashtra state superintendent of police (Highway Safety).

Sleep is Not Negotiable
At sleep disorder research centres across the world, doctors have studied driver fatigue. “Before you doze, what becomes impaired is your judgment and your insight,” says Dr Mark Mahowald, director of the Minnesota Regional Sleep Disorders Centre, USA, and a professor of neurology. “So what happens to people as they get sleepy is they think, Well, I just have a little way to go, and I’ll be able to make it. They don’t appreciate the fact that if they think they’re sleepy at all, they shouldn’t be driving.”

Adds CRRI’s Chakrabarty: “We sometimes can’t judge some drivers because their eyelids are open and they seem awake even though they may be mentally asleep, since driving is often a reflex action. But suddenly, there occurs a lack of coordination between mind and body, leading to an accident.”

The [US] National Highway Traffic Safety Administration (NHTSA) cautions that microsleep—an involuntary intrusion of sleep or near sleep—can overcome the best intentions to remain awake. In its study “Drowsy Driving and Automobile Crashes,” NHTSA explains: “Often, people use physical activity and dietary stimulants to cope with sleep loss, masking their level of sleepiness. However, when they sit still, perform repetitive tasks (such as driving long distances), get bored or let down their coping defences, sleep comes quickly.”

The Case for Sleep
India is a sleep-deprived nation. A worldwide online survey published in 2005 by consultants The Nielsen Company revealed that 29 percent of Indians went to sleep only after midnight and as many as 61 percent slept for seven hours or less daily.

But what happens if you don’t get enough sleep? Researchers at the University of Pennsylvania School of Medicine reported that subjects whose sleep was restricted to four to six hours per night for two weeks had reduced mental performance comparable with those who hadn’t slept at all for up to two days. More troubling, the sleep-restricted subjects reported feeling only slightly sleepy when their performance was at its worst.

If so, why do we tend to deprive ourselves of sleep? The Nielsen survey also revealed that Indians allow family and children to dictate sleep hours more than in any other country in the Asia-Pacific region.

There are other reasons too. “Lack of sleep is mainly because of our current 24x7 lifestyle,” says Dr Manvir Bhatia, Chairperson—Sleep Medicine at Delhi’s Sir Ganga Ram Hospital. “People do compromise their duration of sleep to accommodate daily work and family pressures. Sleep deprivation affects performance, cognition, mood and emotions. It is also now recognized as a risk factor for diabetes, hypertension, heart disease, metabolic syndrome, obesity, and impaired immunity.”   

Although we may like to consider ourselves more productive when we sleep less, we’re actually much more efficient when we’re rested. Adequate sleep sustains our alertness and mental performance. Remember that normal adults need seven