Insufficient sleep rather than the apnea-hypopnea index can be associated with sleepiness-related driving problems of Japanese obstructive sleep apnea syndrome patients residing in metropolitan areas

Abstract

Objective: Obstructive sleep apnea syndrome (OSAS) and insufficient sleep might increase the risk of drowsy driving and sleepiness-related vehicular accidents. This study retrospectively investigated the factors associated with these driving problems, particularly addressing OSAS severity and sleep amounts of affected drivers.

Methods: This study examined 161 patients (146 male and 15 female) with OSAS (apnea-hypopnea index [AHI] ≥ 5) who drove on a routine basis and who completed study questionnaires. To investigate factors associated with drowsy driving during the prior year and sleepiness-related vehicular accidents or near-miss events during the prior five years, logistic regression analyses were performed with age, body mass index, monthly driving distance, habitual sleep duration on weekdays, the Japanese version of Epworth Sleepiness Scale score, AHI, and periodic limb movement index as independent variables.

Results: Of the patients, 68 (42.2%) reported drowsy driving experiences, and 86 (53.4%) reported sleepiness-related vehicular accidents or near-miss events. Analyses revealed the following: older age (46-65 years, ≥66 years) was negatively associated with drowsy driving (p <0.05, p <0.05), and habitually shorter sleep duration on weekdays (≤6 hours) was positively associated with drowsy driving (p <0.01). Habitual sleep duration of ≤6 hours (p <0.01) and Epworth Sleepiness Scale score of ≥11 (p <0.01) were positively associated with sleepiness-related vehicular accidents and near-miss events. However, AHI was not associated with these driving problems.

Conclusion: Insufficient sleep, rather than severity of OSAS, was associated with sleepiness-related driving problems in these Japanese OSAS patients.

Keywords: Excessive daytime sleepiness; Insufficient sleep; Obstructive sleep apnea; Vehicular accident.