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


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.

DOI: 10.5664/jcsm.3072
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@article{Ward2013ExcessiveDS, title={Excessive daytime sleepiness increases the risk of motor vehicle crash in obstructive sleep apnea.}, author={Kim L. Ward and David R. Hillman and Alan L. James and Alexandra P. Bremner and Laila Simpson and Matthew N. Cooper and Lyle J. Palmer and Annette C Fedson and Sutapa Mukherjee}, journal={Journal of clinical sleep medicine : JCSM : official publication of the American Academy of Sleep Medicine}, year={2013}, volume={9 10}, pages={1013-21} }