Anna Baratelle knew that something just wasn’t right.
 
From the time she was in high school, she often felt fatigued. Episodes of daytime drowsiness and dozing would come unannounced — such as while taking a college exam — and would leave her frustrated and confused. When Anna experienced a sleep attack while working as an X-ray technologist at Children’s Hospital of Philadelphia at the age of 21, she began to truly understand her situation.

Coworkers thought she had suffered a seizure, so they took her to the emergency department at the Hospital of the University of Pennsylvania (HUP), which is located next to CHOP. “After an initial evaluation at HUP’s emergency department, I went to the Crozer Sleep Disorders Center and had a sleep study done,” she says. The study revealed that Anna had narcolepsy, a condition characterized by excessive daytime sleepiness. Patients can fall asleep at any time, but most often it happens while they are at work or driving. Narcolepsy represents one part of the population who are prone to falling asleep at the wheel.

Who Is at Risk?

“All sleep disorders potentially will cause daytime sleepiness and dozing,” says Calvin Stafford, M.D., medical director of the Crozer Sleep Disorders Center at Taylor Hospital. “Most commonly, narcolepsy and sleep apnea are mentioned as culprits but insomnia, shift work, and circadian rhythm problems also are associated with motor vehicle accidents. Nevertheless, insufficient sleep is the primary cause of accidents.”

Drowsy Driving: All-Too-Common

According to the National Highway Traffic Safety Administration, approximately 100,000 police-reported crashes are the direct result of driver fatigue each year. This results in an estimated 1,550 deaths, 71,000 injuries, and $12.5 billion in monetary losses. These figures may be the tip of the iceberg, since currently it is difficult to attribute crashes to sleepiness.

Some causes of drowsy driving, such as lack of sleep, are quite obvious. Others, however, must be determined by a sleep specialist. Sleep deprivation and fatigue make lapses of attention and dozing off more likely to occur.

The Insomnia Connection

If you suffer from insomnia, chances are likely that you could fall asleep at inappropriate times during the day — even while driving. “Sleep deprivation is a leading cause of driver error and accidents,” says Andrew Borson, Ph.D., neuropsychologist for the Sleep Disorders Center. “Avoiding driving when you are seriously sleep-deprived is always a good safety plan, especially at night or when driving long distances. However, insomnia does not always lead to serious sleep deprivation.”

Other Medical Causes

Other sleep disorders can make a person prone to daytime sleepiness.

If you drive drowsy after getting an adequate amount of sleep, and medical conditions that can make you sleepy have been ruled out (such as hypothyroidism or anemia), a sleep study can help get to the real root of the problem. The study can help determine if you have a disorder that causes daytime sleepiness and dozing, such as sleep apnea or narcolepsy. Armed with this information, your doctor will work with you to craft a treatment plan.

Treatment Options

Behavior changes may help those who are sleep-deprived, but for those with a medical condition such as sleep apnea or narcolepsy, this just isn’t enough. For these people, medication is necessary. Anna Baratelle tried several medications before finding one that worked for her through participation in a clinical trial. “Now, I feel like I can do anything I want,” she says. “I drive an hour each way to work, and I do have my moments when I get sleepy. When that happens, I just pull over and take a short nap and I’m fine.”

Now 39 and married to Charlie Baratelle with a 9-year-old son, Nicholas, and a 1-year-old daughter, Arianna, Anna now works on clinical trials, helping to expedite the approval process for drugs that can someday benefit arthritis, neurology and cancer patients. She had gone back to school two years ago to earn her B.S. degree in Clinical Research Administration, but has since put that back on hold to be a mom.

“My condition has actually done a lot for me,” Anna says. “It made me more driven to prove that I can do anything — even with narcolepsy — and actually helped me decide to take my job working on clinical trials. I feel like I am helping more people now, and that makes me feel good.”

For more information, or to make an appointment at the Crozer Sleep Disorders Center at Taylor Hospital, call (610) 595-6272.

Tips to Prevent Drowsy Driving

The National Sleep Foundation and the AAA Foundation for Traffic Safety offer the following tips to help restore alertness when feeling drowsy:

Pull off into a safe area and take a brief nap (15-45 minutes).

Drink a caffeinated beverage to promote short-term alertness (it takes about 30 minutes for caffeine to enter the bloodstream).

Walk around or do a few exercises to get rid of grogginess.

Sleep Disorder Center Gets Upgrade

The Sleep Disorders Center recently completed a system upgrade, resulting in technologically advanced and compact equipment that is used to identify and analyze sleep disorders. In addition, through a conversion to digital equipment, Crozer neurologists are now able to view and analyze EEG studies performed at Crozer via a secure hospital Intranet site at any time, from other CKHS sites or even from home.