Habitually Sleepy Drivers Have a High Frequency of Automobile Crashes Associated with Respiratory Disorders during Sleep

Abstract

Sleepiness is a common cause of traffic crashes with a cost of billions of dollars per year. A recent study has found that 2 to 3% of drivers are habitually sleepy while driving. However, there has not been a controlled study to define the characteristics, driving performance, or automobile crash rate of habitually sleepy drivers. The prevalence of respiratory disorders during sleep, and whether these respiratory disorders contribute to the increased automobile crash frequency, is unknown in habitually sleepy drivers. We interviewed 4,002 randomly selected drivers to define the prevalence of drivers who are habitually sleepy while driving. We studied the habitually sleepy drivers and an age- and sex-matched control group of drivers. These studies included reporting of daytime sleepiness, automobile crashes, driving performance and sleep studies. Of the 4, 002 drivers interviewed, 145 (3.6%, confidence interval [CI] = 3.1 to 4.3) were habitually sleepy while driving. The habitually sleepy drivers reported a significantly higher frequency of auto crashes than control subjects (the adjusted odds ratio [OR] was 13.3, CI = 4. 1 to 43). The habitually sleepy drivers had a significantly higher prevalence of respiratory sleep disorders than control subjects. For a total respiratory events index (apneas, hypopneas, and other respiratory effort-related arousals) >/= 15 the adjusted OR was 6.0, CI = 1.1 to 32. In the habitually sleepy drivers group, the frequency of sleep apnea (apnea-hypopnea index) between subjects with or without auto crashes was not statistically different. However, if we consider total respiratory events index, this frequency of respiratory sleep disorders was significantly higher in subjects with automobile crashes (the adjusted OR for a total respiratory event index >/= 15 was 8.5, CI = 1.2 to 59). Habitually sleepy drivers are a large group of drivers (1 of 30 drivers) who are involved in several fold more automobile crashes than control subjects. As these excess auto crashes can be explained in part by the presence of respiratory disorders during sleep, which are treatable, many automobile crashes in these sleepy drivers may be preventable. Our findings suggest that asking about excessive sleepiness while driving may better predict which subjects with breathing disorders during sleep have crashes than asking about overall sleepiness.

Síndrome das apnéias-hipopnéias obstrutivas do sono: associação com gênero e obesidade e fatores relacionados à sonolência

“…Another study, which investigated 4,002 nonprofessional drivers, demonstrated a significant correlation between traffic accidents and the degree of sleepiness. (11) However, the authors found no association between accidents and AHI. It has been shown that a higher frequency of traffic accidents is also associated with factors other than OSAHS: the use of alcohol, chronic sleep deprivation and narcolepsy (21) ; restless legs syndrome and periodic limb movements (22) ; and circadian rhythm sleep disorders (23) and the use of medication.…”

“…(18,19) Among the consequences of OSAHS-related EDS is the greater frequency of traffic accidents due to drivers falling asleep at the wheel. (11) Of the patients studied, 15.3% reported having accidents the level of systemic arterial pressure was associated with obesity and with OSAHS severity. The major limitation of the present study was the lack of a control group composed of genderand age-matched individuals.…”

“…It leads to cognitive impairment and reduced reflexes, thereby increasing the risk of traffic accidents and other mishaps. (11) In addition, EDS can have significant repercussions for work, social life and quality of life. (12) However, the factors associated with EDS are not well known.…”

Sleep Disordered Breathing, Insomnia Symptoms, and Sleep Quality in a Clinical Cohort of US Hispanics in South Florida

“…49,50 In the multicenter, population based SHHS, 23% of Hispanic participants had EDS. 44 Bouscoulet et al 40 determined EDS prevalence to be 16.4% (95% CI 15.3-17.5) among adults ≥ 40 years old, living in 4 large Latin American cities, using a single question "Is it difficult for you to stay awake during the daytime at least 3 days a week?"…”

All-cause mortality in males with sleep apnoea syndrome: declining mortality rates with age

“…here is a large body of evidence linking obstructive sleep apnoea (OSA) syndrome with atherogenic processes [1][2][3][4], cardiovascular morbidity, in particular with hypertension [5][6][7][8][9][10][11], as well as with vehicle accidents and work-related accidents [12][13]. Although there have been reports of increased rates of mortality in sleep apnoea patients [14][15][16], these reports, based on small groups, did not examine the contributing role of obesity, nor the relationship with the severity of sleep apnoea syndrome.…”