Automobile Accidents Involving Patients with Obstructive Sleep Apnea

Findley, Larry J.; Unverzagt, Mark E.; Suratt, Paul M.

doi:10.1164/ajrccm/138.2.337

Cited by 508 publications

(248 citation statements)

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“…Work-related accidents caused by sleepiness accounted for $24.7 billion of those costs. (13)(14)(15) Subjective and objective measures, as well as clinical assessments, can be used to investigate EDS. Polysomnography, the multiple sleep latency test and the maintenance of wakefulness test are the principal diagnostic tools currently available.…”

Section: Introductionmentioning

confidence: 99%

Portuguese-language version of the Epworth sleepiness scale: validation for use in Brazil

et al. 2009

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Objective: The aim of this study was to develop a Portuguese-language version of the Epworth sleepiness scale (ESS) for use in Brazil. Methods: The steps involved in creating the ESS in Brazilian Portuguese (ESS-BR) were as follows: translation; back-translation; comparison (by a committee) between the translation and the back-translation; and testing in bilingual individuals. The ESS-BR was applied to a group of patients who were submitted to overnight polysomnography in order to identify obstructive sleep apnea-hypopnea syndrome (OSAHS), insomnia and primary snoring. A control group was composed of subjects with a history of normal sleep habits, without reported snoring. Results: A total of 114 patients and 21 controls were included. The 8-item scores of the ESS-BR had an overall reliability coefficient of 0.83. The study group was composed of 59 patients with OSAHS, 34 patients with primary snoring and 21 patients with insomnia. One-way ANOVA demonstrated significant differences in ESS-BR scores among the four diagnostic groups (p < 0.001). Post-hoc tests between groups showed that the ESS-BR scores of the patients with insomnia did not differ from those of the controls (p > 0.05). The ESS-BR scores were significantly higher for OSAHS patients and for primary snorers than for controls (p < 0.05). In addition, the scores for OSAHS patients were significantly higher than were those for primary snorers (p < 0.05). Conclusions: The results of the present study demonstrate that the ESS-BR is a valid and reliable instrument for the assessment of daytime sleepiness, equivalent to its original version when applied to individuals who speak Brazilian Portuguese.Keywords: Validation studies; Sleep disorders; Cross-cultural comparison; Disorders of excessive somnolence. ResumoObjetivo: Desenvolver uma versão da escala de sonolência de Epworth (ESE) para o português para uso no Brasil. Métodos: A versão no português do Brasil (ESE-BR) foi desenvolvida de acordo com as seguintes etapas: tradução; retrotradução; comparação entre a tradução e a retrotradução (por um comitê); e aplicação em indivíduos bilín-gues. A ESE-BR foi aplicada a um grupo de pacientes submetidos à polissonografia de noite inteira para identificar síndrome da apneia-hipopneia obstrutiva do sono (SAHOS), insônia e ronco primário. Um grupo controle foi composto de indivíduos com história de hábitos normais de sono, sem ronco aparente. Resultados: Um total de 114 pacientes e 21 controles foram incluídos. Os 8 itens do ESE-BR tiveram um coeficiente de confiabilidade total de 0,83. O grupo em estudo foi composto por 59 pacientes com SAHOS, 34 pacientes com ronco primário e 21 pacientes com insônia. One-way ANOVA demonstrou diferenças significativas nos escores do ESE-BR entre os quatro grupos diagnósticos (p < 0,001). Testes post hoc entre grupos pareados mostraram que os escores do ESE-BR para insones não diferiram daqueles dos controles (p > 0,05). Os escores dos pacientes com SAHOS e nos roncadores primários foram significativamente maiores que os...

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Section: Introductionmentioning

confidence: 99%

Portuguese-language version of the Epworth sleepiness scale: validation for use in Brazil

et al. 2009

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“…OSA is characterized by repetitive collapse of the pharyngeal airway during sleep, yielding hypoxia, hypercapnia, and arousal from sleep to reestablish airway patency [2]. The associated consequences include daytime sleepiness [3], decreased cognitive performance, decreased quality of life [4], increased risk of automobile and industrial accidents [5,6], and adverse cardiovascular sequelae [7][8][9][10]. Treatment of OSA leads to improvements in many of these adverse outcomes and may reduce healthcare costs [11][12][13].…”

Section: Introductionmentioning

confidence: 99%

Automated detection of sleep disordered breathing using a nasal pressure monitoring device

Grover

Pittman

2008

Sleep Breath

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To assess the accuracy of a single channel portable monitoring device (RUSleeping™ RTS, Respironics, Murrysville, PA) that measures nasal pressure (a surrogate for airflow) to detect sleep disordered breathing (SDB). Twenty-five adult patients referred to a community sleep laboratory with suspected obstructive sleep apnea (OSA) participated in this investigation. The portable monitoring device was used in the sleep laboratory to acquire data concurrently with a standard multi-channel polysomnogram (PSG) to assess SDB. Respiratory events were scored manually on the PSG using standard criteria for clinical research to quantify an apnea-hypopnea index (AHI) based on events during sleep. The portable monitoring device automatically calculated an unedited respiratory event index (REI) based on recording time. These data were then compared using the Pearson product-moment correlation coefficient, Bland-Altman analysis, receiver operating characteristic (ROC) curves, and likelihood ratios. All 25 subjects completed the study. Mean age of subjects was 42.4±12.9 years and mean body mass index was 31.0± 7.4 kg m −2 . There was good agreement between the REI and the AHI (R=0.77, p<0.001, mean difference 2.6 events per hour [2 SD: 39.8] using a Bland-Altman plot). The area under the ROC curve for detecting SDB (PSG AHI greater than or equal to five events per hour) with the REI was 0.94 (95% CI 0.84-1.0). For an REI >11.9 events per hour, the sensitivity was 0.89 (95% CI 0.65-0.99) and the specificity was 0.86 (95% CI 0.42-1.0) with a likelihood ratio of 6.2 for a positive test (LR+) and 0.13 for a negative test (LR−). Similar results were observed for detecting moderatesevere SDB (PSG AHI≥15 events h −1 ) using REI >15.2 events h −1 . In a population of subjects with suspected OSA, this portable monitoring device can automatically quantify an REI that compares well to the AHI scored manually on a concurrent PSG. Such a device may prove useful to assess SDB in high risk populations with self-administered testing in ambulatory settings such as the home.

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“…(11,(19)(20)(21) The decrease in the performance of drivers has been observed by various researchers. (19,21,22) In view of what has been presented above, the objective of the present study was to determine the prevalence of and identify factors associated with OSAS in a population of truck drivers. …”

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confidence: 99%

Síndrome da apneia obstrutiva do sono em motoristas de caminhão

Lemos

Marqueze

Sachi³

et al. 2009

J. bras. pneumol.

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Objective: To determine the prevalence of obstructive sleep apnea syndrome (OSAS), as well as to identify factors associated with a greater risk of developing OSAS, among truck drivers. Methods: The study population comprised 209 truck drivers (mean age, 38.8 years; 98.5% males) at two branches of a transportation company. The mean body mass index was 26.5 ± 4.4 kg/m 2 . The participants completed questionnaires regarding sociodemographic data, physical activity and OSAS. The prevalence of OSAS was estimated using the Berlin Questionnaire, associations between OSAS and the factors studied being assessed through univariate and multivariate regression analysis. Results: The prevalence of OSAS in the population was 11.5%. Of the 209 truck drivers, 72 (34.5%) reported having fallen asleep while driving and 81 (38.7%) reported snoring. The following variables were found to present statistically significant associations with OSAS: informal employment (OR = 0.27; p = 0.01); body mass index ≥ 25 kg/m 2 (OR = 13.64; p = 0.01); and poor sleep quality (OR = 3.00; p = 0.02). Conclusions: The prevalence of OSAS in this study was lower than that reported in other studies of truck drivers and yet higher that that observed for the general population. In addition, our results suggest that work characteristics, such as employment status, are associated with OSAS. These data show the relevance of considering work activity in studies of factors associated with OSAS.Keywords: Sleep apnea, obstructive; Sleep disorders; Questionnaires. ResumoObjetivo: Estimar a prevalência da síndrome da apneia obstrutiva do sono (SAOS) e verificar os fatores associados à chance de desenvolver SAOS em motoristas de caminhão. Métodos: A população desse estudo constituiu-se de motoristas de caminhão de duas filiais de uma empresa transportadora (n = 209), com idade média de 38,8 anos, sendo 98,5% do sexo masculino. O índice de massa corpórea médio foi de 26,5 ± 4,4 kg/m 2 . Os participantes responderam questionários sobre dados sociodemográficos, atividade física e SAOS. A prevalência de SAOS foi estimada por meio do Questionário de Berlim e sua associação com os fatores estudados foi verificada pela análise de regressão univariada e multivariada. Resultados: A prevalência de SAOS na população foi de 11,5%. Dos 209 motoristas, 72 (34,5%) referiram dormir ao volante enquanto dirigiam ao menos uma vez e 81 (38,7%) referiram roncar durante o sono. As variáveis estatisticamente significativas associadas à SAOS foram vínculo empregatício informal (OR = 0,27; p = 0,01), índice de massa corpórea ≥ 25 kg/m 2 (OR = 13,64; p = 0,01) e qualidade do sono ruim (OR = 3,00; p = 0,02). Conclusões: Apesar de a prevalência de SAOS ter sido inferior à observada em outros estudos com motoristas, essa prevalência é superior à da população em geral. Os resultados ainda sugerem que as características do trabalho, entre as quais o vínculo de trabalho, estão associadas à SAOS. Esses dados evidenciam a relevância de se levar em consideração a atividade de trabalho em est...

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Automobile Accidents Involving Patients with Obstructive Sleep Apnea

Cited by 508 publications

References 4 publications

Portuguese-language version of the Epworth sleepiness scale: validation for use in Brazil

Portuguese-language version of the Epworth sleepiness scale: validation for use in Brazil

Automated detection of sleep disordered breathing using a nasal pressure monitoring device

Síndrome da apneia obstrutiva do sono em motoristas de caminhão

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