A killer – in the blink of an eye
PETALING JAYA: Dr Julius Goh Liang Chye of Universiti Malaya remembers his childhood journeys back to Kedah from Kuala Lumpur very well.
'As children, we always depended on our father to do the heavy lifting, including driving long hours during festive seasons.
'One particular journey took a frightening turn when he briefly dozed off at the wheel, jolting awake just in time to avoid a crash,' he said.
ALSO READ: Apnoea – something to lose sleep over
'At that time, we were unfamiliar with the term microsleep,' said Dr Goh, who is now a consultant otorhinolaryngologist at Universiti Malaya's Faculty of Medicine.
Otorhinolaryngology deals with conditions affecting the ear, nose and throat (ENT), some of which have the potential to affect sleep quality.
Experts agree: (From left) Siti Zaharah, Louis and Dr Goh say microsleep poses a menace that threatens road safety everywhere.
Road safety experts as well as the medical fraternity now want sleep management, in particular addressing microsleep, to be part of the lexicon, given the immense potential of sleep-deprived persons causing accidents whether at the workplace or on the road.
Dr Goh, who specialises in sleep surgery and medicine, said fatigue-related crashes are often under reported, yet they pose a significant risk, particularly among drivers who embark on long-haul journeys with inadequate rest.
While microsleep is frequently associated with obstructive sleep apnoea, other sleep disorders can also contribute to its occurrence.
'These conditions include insomnia, restless legs syndrome, epilepsy and narcolepsy may all lead to episodes of microsleep, making accurate diagnosis by a medical professional essential,' said Dr Goh.
Dr Louis Adaikalam, president of the Malaysia Sleep Apnea Association, said there are enough hints that microsleep is behind a significant number of road crashes in Malaysia.
'In fact, microsleep has been linked to several major industrial accidents, along with lots of road accidents,' he said.
He believes that the emergence of the gig economy is also a contributing factor to sleep deprivation, where some people attempt to be e-hailing drivers or couriers after their official day job.
'Some people are sacrificing sleep to earn more, and of course, there is obstructive sleep apnoea and other sleep-related issues that need medical diagnosis.
'For example, fatigue can also be caused by diabetes or heart problems, which in turn, can lead to more dangerous driving such as greater risk-taking on the road,' said Louis.
Malaysian Institute of Road Safety Research director-general Assoc Prof Dr Siti Zaharah Ishak said a collaboration is on the cards with a company to offer courses on managing microsleep at the workplace.
'This is being done through capacity-building and innovative training,' she said.
Get enough rest: Based on statistics provided by the police, drivers falling asleep due to fatigue caused over 1,300 fatalities on the road.— AZMAN GHANI/The Star
'Miros will also conduct more studies on sleep deprivation and its relation to road safety.'
In 2023, Malaysia recorded 598,635 incidents that resulted in 6,443 fatalities, with nearly two-thirds of deaths coming from motorcyclists and pillion riders.
Based on the last statistics provided by the police, 1,305 fatalities were attributed to drivers falling asleep due to fatigue between 2011 and 2021.
Datuk Ng Koong Sinn, president of the Malaysia Trucking Federation, said drivers under his company must take a 30-minute break after every four hours of driving.
'They are only allowed to drive up to eight hours a day, while the daily work hours (inclusive of driving) cannot exceed 12 hours.'
Another major logistics grouping, the Association of Malaysian Hauliers, acknowledged the risks posed by fatigue and microsleep among commercial drivers.
'Many of our members have implemented internal policies such as ensuring drivers are sufficiently rested before long hauls, providing safety bonuses for accident-free records, and encouraging break intervals where possible,' said association secretary Mohamad Azuan Masud.
'However, the reality on the road now poses several operational challenges. Long waiting times at port terminals, container depots and customer premises often stretch a driver's working hours unpredictably.
'The common practice of customers only allowing deliveries during office hours further restricts flexibility, while the ongoing driver shortage worsens the situation.
'Additionally, peak-hour road ban on heavy vehicles and a lack of proper rest facilities or parking bays at many R&R stops along highways make it harder for drivers to rest safely and on schedule,' said Azuan.
'Our members remain committed to upholding safety and continue to find ways to support their drivers through better scheduling, incentives, and the adoption of technology like Advanced Driver Assistance Systems where feasible.'
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The Star
2 days ago
- The Star
Apnoea – something to lose sleep over
PETALING JAYA: Microsleep refers to brief, involuntary episodes of sleep lasting just a few seconds during a person's waking hours. This naturally makes it frightening if it happens to a driver, as a vehicle can travel quite a distance in just seconds. The danger of microsleep is real. Based on the last statistics provided by the police, 1,305 fatalities were attributed to drivers falling asleep due to fatigue between 2011 and 2021. There are many causes of unsatisfactory or inadequate sleep that contributes to microsleep, and one area that continues to draw research is sleep breathing disorders, including sleep apnoea. 'During sleep, the brain and body goes through various stages of rest and recovery. As sleep deepens, our airway muscles progressively relax and narrow the air passage. Soft tissues of the airway also progressively lose their strength and responsiveness with age, inflammation and disease, thus restricting air flow,' said Assoc Prof Dr Yap Yoke Yeow, an Ear, Nose, and Throat (ENT) specialist with the KPJ Johor Specialist Hospital. Dr Yap Yoke Yeow 'This can happen many times during sleep and even cut off the supply of oxygen to our lungs periodically. To ensure we are able to continue breathing, our brain would then interrupt the sleep cycle and 'wake' us so that airflow is restored. 'As such, our sleep isn't as restful as it should be, and people who suffer from this ailment could wake up feeling tired. 'Apnoea is defined as the absence of airflow through the nose or mouth for more than 10 seconds at a time. When one experiences more than 30 episodes of apnoea in seven hours of sleep, that is classified as severe obstructive sleep apnoea (OSA),' he said. In view of the importance of a good night's rest, Dr Yap added that medical attention should be sought if one suffers from excessive daytime sleepiness or microsleeps. Management of sleep breathing disorders range from lifestyle changes to myofunctional therapy, where a therapist helps the patient retrain orofacial muscles (controlling the tongue, lip and cheek areas) to improve functions like breathing – especially in addressing mouth breathing, swallowing and speech. Other than surgery, interventions for difficult cases of OSA include using Continuous Positive Airway Pressure (through a machine that delivers a constant stream of air through a mask or nasal prongs while the patient sleeps), as well as wearing a mandibular advancement device (MAD) to sleep. MAD is a custom-made device that gently pulls the lower jaw (mandible) forward, which in turn nudges the tongue forward so that the airway can be opened to reducing breathing obstructions. 'Parents should also monitor the jaw and facial development of their young child as it impacts various aspects of a child's life, including the ability to breathe properly, among others. Proper development can prevent issues down the line that includes difficulty breathing, including sleep apnoea,' he said. Experts say people should also look at improving sleep hygiene, which refers to practices that promote quality sleep. These include sleeping and waking according to a consistent schedule, avoiding stimulants like caffeine or nicotine and heavy meals close to bedtime, reduce mobile device screen time at least an hour before sleep, while exercising regularly, and avoiding intense workouts close to bedtime.
The Star
2 days ago
- The Star
A killer – in the blink of an eye
PETALING JAYA: Dr Julius Goh Liang Chye of Universiti Malaya remembers his childhood journeys back to Kedah from Kuala Lumpur very well. 'As children, we always depended on our father to do the heavy lifting, including driving long hours during festive seasons. 'One particular journey took a frightening turn when he briefly dozed off at the wheel, jolting awake just in time to avoid a crash,' he said. ALSO READ: Apnoea – something to lose sleep over 'At that time, we were unfamiliar with the term microsleep,' said Dr Goh, who is now a consultant otorhinolaryngologist at Universiti Malaya's Faculty of Medicine. Otorhinolaryngology deals with conditions affecting the ear, nose and throat (ENT), some of which have the potential to affect sleep quality. Experts agree: (From left) Siti Zaharah, Louis and Dr Goh say microsleep poses a menace that threatens road safety everywhere. Road safety experts as well as the medical fraternity now want sleep management, in particular addressing microsleep, to be part of the lexicon, given the immense potential of sleep-deprived persons causing accidents whether at the workplace or on the road. Dr Goh, who specialises in sleep surgery and medicine, said fatigue-related crashes are often under reported, yet they pose a significant risk, particularly among drivers who embark on long-haul journeys with inadequate rest. While microsleep is frequently associated with obstructive sleep apnoea, other sleep disorders can also contribute to its occurrence. 'These conditions include insomnia, restless legs syndrome, epilepsy and narcolepsy may all lead to episodes of microsleep, making accurate diagnosis by a medical professional essential,' said Dr Goh. Dr Louis Adaikalam, president of the Malaysia Sleep Apnea Association, said there are enough hints that microsleep is behind a significant number of road crashes in Malaysia. 'In fact, microsleep has been linked to several major industrial accidents, along with lots of road accidents,' he said. He believes that the emergence of the gig economy is also a contributing factor to sleep deprivation, where some people attempt to be e-hailing drivers or couriers after their official day job. 'Some people are sacrificing sleep to earn more, and of course, there is obstructive sleep apnoea and other sleep-related issues that need medical diagnosis. 'For example, fatigue can also be caused by diabetes or heart problems, which in turn, can lead to more dangerous driving such as greater risk-taking on the road,' said Louis. Malaysian Institute of Road Safety Research director-general Assoc Prof Dr Siti Zaharah Ishak said a collaboration is on the cards with a company to offer courses on managing microsleep at the workplace. 'This is being done through capacity-building and innovative training,' she said. Get enough rest: Based on statistics provided by the police, drivers falling asleep due to fatigue caused over 1,300 fatalities on the road.— AZMAN GHANI/The Star 'Miros will also conduct more studies on sleep deprivation and its relation to road safety.' In 2023, Malaysia recorded 598,635 incidents that resulted in 6,443 fatalities, with nearly two-thirds of deaths coming from motorcyclists and pillion riders. Based on the last statistics provided by the police, 1,305 fatalities were attributed to drivers falling asleep due to fatigue between 2011 and 2021. Datuk Ng Koong Sinn, president of the Malaysia Trucking Federation, said drivers under his company must take a 30-minute break after every four hours of driving. 'They are only allowed to drive up to eight hours a day, while the daily work hours (inclusive of driving) cannot exceed 12 hours.' Another major logistics grouping, the Association of Malaysian Hauliers, acknowledged the risks posed by fatigue and microsleep among commercial drivers. 'Many of our members have implemented internal policies such as ensuring drivers are sufficiently rested before long hauls, providing safety bonuses for accident-free records, and encouraging break intervals where possible,' said association secretary Mohamad Azuan Masud. 'However, the reality on the road now poses several operational challenges. Long waiting times at port terminals, container depots and customer premises often stretch a driver's working hours unpredictably. 'The common practice of customers only allowing deliveries during office hours further restricts flexibility, while the ongoing driver shortage worsens the situation. 'Additionally, peak-hour road ban on heavy vehicles and a lack of proper rest facilities or parking bays at many R&R stops along highways make it harder for drivers to rest safely and on schedule,' said Azuan. 'Our members remain committed to upholding safety and continue to find ways to support their drivers through better scheduling, incentives, and the adoption of technology like Advanced Driver Assistance Systems where feasible.'
New Straits Times
3 days ago
- New Straits Times
#HEALTH: The 'hard' truth: ED rising among young Malaysian men
ONCE thought of as an ageing man's problem, erectile dysfunction, or ED, is becoming an issue that young Malaysian men are now grappling with. Since bedroom woes are rarely discussed openly in the country, these problems persist among them, resulting in turmoil at home and broken Deputy Health Minister Datuk Lukanisman Awang Sauni said that two out of three Malaysian men are at risk of ED. The 2019 National Health and Morbidity Survey also indicates that 31.6 per cent of men aged 18 and above have moderate to severe levels of ED. ED is a condition in which a man is unable to maintain an erection that's sufficient for sexual intercourse. It can range from an inability to achieve an erection at all, to difficulty sustaining one throughout intercourse, says senior consultant urologist and lecturer at the Faculty of Medicine, Chancellor Tuanku Muhriz Hospital UKM, Professor Datuk Dr Zulkifli Md Zainuddin. Some men may still be able to get an erection, but not consistently, while others may be unable to achieve one despite having sexual desire, he says. Age is a primary factor in ED as the natural ageing process leads to physiological changes in men, such as a decline in testosterone levels and reduced blood vessel function. However, most cases of ED among younger men are caused by other health-related factors that are on the rise, such as diabetes, heart disease, obesity, high blood pressure and low testosterone levels. "These conditions disrupt blood flow, which is essential for normal erectile function." Mental health problems, including stress and depression, are also contributing factors, he adds. Studies show that more young men are experiencing stress due to increasingly complex life pressures, including work-related stress, financial issues and unstable personal relationships. This trend is concerning to health experts not just because it affects sexual function, but also because it may reflect declining health and can serve as an early indicator of coronary heart disease. Dr Zulkifli says young men are more likely to lead sedentary lifestyles, neglect healthy eating habits and engage in smoking and drinking alcohol, and avoid physical exercise. "These habits increase the risk of developing illnesses that contribute to ED. "Coupled with a lack of awareness about sexual health, young men become more vulnerable to this issue." AN UNDENIABLE FACT We are seeing more men in their 30s and 40s presenting with erectile dysfunction in Malaysia. It's not just ageing - it's modern life, says Prince Court Medical Centre consultant urologist Dr Datesh Daneshwar. "Sleep deprivation, vaping, poor metabolic health, and rising testosterone deficiency all contribute to the condition." With 54.4 per cent of Malaysians either overweight or obese based on the National Health and Morbidity Survey 2023, and rising rates of diabetes and high blood pressure, the spillover into the bedroom is only to be expected. In Malaysia, more men are experiencing ED at a younger age due to rising rates of diabetes, obesity and stress, says Dr Datesh. Prevention is possible - regular health screenings, clean living and early intervention can make a huge difference. "We need to move away from the idea that ED is inevitable." While "occasional difficulty" in the bedroom is common, persistent ED is not normal at any age, he says. Many men believe it's just part of getting older, but this mindset is dangerous. Dr Datesh says with a proper lifestyle, hormonal balance and vascular health, many men can maintain good sexual function well into their 70s. However, there's a deep cultural stigma in Malaysia where ED is concerned. Men feel ashamed, emasculated, or worry they'll be judged if they open up about their problems. "ED is a treatable medical condition, not a personal failure." These days, more men are starting to come forward, especially when their relationships are affected, but too many still suffer in silence or try unsafe supplements, he adds. "The fear of seeing a doctor is stronger than the problem itself. We must normalise these conversations." ED clinics should be discreet, respectful and scientifically grounded - not run by profit-driven "miracle cure" shops, says Dr Datesh. ED affects far more than sex, he says. It erodes confidence, emotional connection, and self-worth. In Malaysia, where intimacy is rarely discussed openly, many couples suffer in silence. YOUNG AND IMPOTENT Awareness about ED treatment is growing, particularly with discussions on social media, enabling more men to access information about available treatment options, says Dr Zulkifli. However, many turn to unproven remedies. "They may buy unapproved medications or follow advice from unreliable sources, such as so-called 'TikTok doctors." In fact, those with ED should seek treatment from medical professionals rather than relying on vague or risky recommendations. "Proper treatment must be based on an accurate diagnosis by a healthcare professional to avoid unwanted side effects or health risks," says Dr Zulkifli. TREATMENT OPTIONS Recommended treatments for ED include the use of medications such as PDE5 inhibitors, which have been proven effective in helping patients achieve satisfactory erections. "There are various PDE5 inhibitors to suit the sexual needs of patients. Some act within just 10 minutes, while others can last up to 36 hours and more," says Dr Zulkifli. However, patients need to have realistic expectations and understand that treatment may take time, especially for older men, he adds. Aside from medication, other treatments include hormone therapy, vacuum devices, penile injections, and in some cases, surgical implantation of penile prostheses. Each treatment must be tailored to the individual and monitored by doctors. LIFESTYLE CHANGES However, treatment with medication alone is not enough. A healthy lifestyle plays a crucial role in the success of ED treatment. Avoiding harmful habits like smoking, drinking alcohol and physical inactivity is essential. Consistent physical activity can improve blood circulation and boost health, says Dr Zulkifli. Furthermore, maintaining a balanced diet with plenty of vegetables, fruits and antioxidant-rich foods can help preserve vascular health and enhance sexual function. He also says that mental and emotional factors must not be overlooked. "Men with ED often face self-confidence issues and strain in their personal relationships. "Therefore, psychological support is important to help them cope with the emotional impact of sexual problems." Therapy such as counselling or support from partners can help reduce stress and improve the mental wellbeing of men experiencing ED. Young men with health issues or unhealthy lifestyles are encouraged to seek treatment early and adopt healthy habits to address this problem. "Taking early steps to care for sexual health and adopting a healthy lifestyle can help prevent ED and improve quality of life." With greater awareness and proper treatment, young men no longer need to feel ashamed or isolated when facing ED. THE HIDDEN FACTOR ONE often-missed cause of ED is Chronic Pelvic Pain Syndrome (CPPS), a poorly understood condition involving nerve and muscle dysfunction in the pelvis. CPPS is surprisingly common in younger men and often mislabelled as prostatitis, says Prince Court Medical Centre consultant urologist Dr Datesh Daneshwar. It causes pain, anxiety, and sexual dysfunction. Many men suffer silently for years because no one connects their pelvic pain to their ED. While stress associated with our modern lifestyle is a major trigger for ED, it doesn't act alone. ED often reflects a deeper problem involving hormones, circulation, pelvic muscle tension, or nerve hypersensitivity, especially in men with undiagnosed CPPS, he says. "In Malaysia, I see many men who've been wrongly treated for prostatitis with repeated antibiotics when the real issue is pelvic floor dysfunction causing pain and erection problems." CPPS is a silent epidemic - poorly recognised, under-treated and closely linked to ED. "So yes, stress plays a role, but it often sets off a chain of physical changes that get missed if we don't look deeper." When ED is linked to pelvic pain or CPPS, men may avoid intimacy altogether for fear of discomfort, embarrassment or failure. Their partners may misinterpret this as disinterest. Over time, this creates tension and emotional distance. But with the right help, including pelvic pain assessment, couples can regain intimacy, says Dr Datesh. "We must teach men and their partners that ED and CPPS are medical conditions, not personal flaws."
