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. 2013 Oct 15;9(10):1013-21.
doi: 10.5664/jcsm.3072.

Excessive daytime sleepiness increases the risk of motor vehicle crash in obstructive sleep apnea

Kim L Ward  1 , David R Hillman, Alan James, Alexandra P Bremner, Laila Simpson, Matthew N Cooper, Lyle J Palmer, Annette C Fedson, Sutapa Mukherjee
Affiliations

Excessive daytime sleepiness increases the risk of motor vehicle crash in obstructive sleep apnea

Kim L Ward et al. J Clin Sleep Med. .

Abstract

Study objectives: (1) To describe the incidence rate of motor vehicle crashes (MVCs) in patients with obstructive sleep apnea (OSA); and (2) to investigate MVC risk factors in OSA patients.

Methods: A retrospective case-series observational study was conducted using data from the West Australian Sleep Health Study at a tertiary hospital-based sleep clinic. Participants were patients (N = 2,673) referred for assessment of suspected sleep disordered breathing. Questionnaire data were collected including age, sex, years of driving, near-misses and MVCs, sleepiness, and consumption of alcohol and caffeinated drinks. Overnight laboratory-based polysomnography was performed using standard methodology.(1) Poisson univariate and negative binomial multivariable regression models were used to investigate associations between risk factors and MVC and near-miss risk in patients with untreated OSA.

Results: In patients with untreated OSA, the crash rate was 0.06 MVC/person-year compared with the general community crash rate of 0.02 MVC/person-year. The rate ratio comparing very sleepy men with normal men was 4.68 (95% CI 3.07, 7.14) for near-misses and 1.27 (95% CI 1.00, 1.61) for crashes, after adjusting for confounders. In women there was a significant association with sleepiness score (p = 0.02) but no dose effect across quartiles.

Conclusions: Untreated OSA is associated with an increased risk of near-misses in men and women and an increased risk of MVCs in very sleepy men. There is a strong association between excessive daytime sleepiness and increased report of near-misses. Our data support the observation that it is those patients with increased sleepiness regardless of OSA severity who are most at risk.

Keywords: Motor vehicle crashes; gender; near-misses; obstructive sleep apnea; severity; sleepiness.

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Figures

Figure 1
Figure 1. Near-miss rate and severity of OSA for men and women
Error bars represent 95% CI. Asterisks represent a significant difference between men and women where p < 0.001. See Table 3 for number of subjects in each group.
Figure 2
Figure 2. Near-miss rate and subjective sleepiness for men and women
Error bars represent 95% CI. Asterisks represent a significant difference between men and women where p < 0.001. See Table 3 for number of subjects in each group.
Figure 3
Figure 3. Crash rate and severity of OSA for men and women
Error bars represent 95% CI. Asterisks represent a significant difference between men and women where p < 0.001. See Table 3 for number of subjects in each group.
Figure 4
Figure 4. Crash rate and subjective sleepiness for men and women
Error bars represent 95% CI. Asterisks represent a significant difference between men and women where p < 0.001. See Table 3 for number of subjects in each group.
See this image and copyright information in PMC

References

    1. American Academy of Sleep Medicine Task Force, Sleep-related breathing disorders in adults: recommendations for syndrome definition and measurement techniques in clinical research. The Report of an American Academy of Sleep Medicine Task Force. Sleep. 1999;22:667–89. - PubMed
    1. Tregear S, Reston J, Schoelles K, Phillips B. Obstructive sleep apnea and risk of motor vehicle crash: systematic review and meta-analysis. J Clin Sleep Med. 2009;5:573–81. - PMC - PubMed
    1. Teran-Santos J, Jimenez-Gomez A, Cordero-Guevara J. The association between sleep apnea and the risk of traffic accidents. Cooperative Group Burgos-Santander. N Engl J Med. 1999;340:847–51. - PubMed
    1. Sagaspe P, Taillard J, Chaumet G, et al. Maintenance of wakefulness test as a predictor of driving performance in patients with untreated obstructive sleep apnea. Sleep. 2007;30:327–30. - PubMed
    1. Mulgrew AT, Nasvadi G, Butt A, et al. Risk and severity of motor vehicle crashes in patients with obstructive sleep apnoea/hypopnoea. Thorax. 2008;63:536–41. - PubMed

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