Reducing Motor-Vehicle Collisions, Costs, and Fatalities by Treating Obstructive Sleep Apnea Syndrome

Sassani, Alex; Findley, Larry J.; Kryger, Meir H.; Goldlust, Eric J.; George, Charles F.; Davidson, Terence M.

doi:10.1093/sleep/27.3.453

Cited by 402 publications

(231 citation statements)

References 33 publications

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“…However, there are data suggesting that the cumulative effects of chronic repeated episodes of nocturnal hypoxia may also cause irreversible cognitive deficits (Nowak et al, 2006). Regardless of the mechanism by which these deficits occur, improperly treated OSAS has been estimated to cause over $11 billion in motor vehicle crash costs (Sassani et al, 2004). An additional problem is that some individuals with OSAS are unaware of the degree of their sleepiness and cognitive impairment (Engleman et al, 1997;Horstmann et al 2000).…”

Section: Introductionmentioning

confidence: 99%

Driver performance in the moments surrounding a microsleep

Boyle

Tippin

Paul

et al. 2008

Transportation Research Part F: Traffic Psychology and Behaviou

132

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This study examined if individuals who are at increased risk for drowsy-driving because of obstructive sleep apnea syndrome (OSAS), have impairments in driving performance in the moments during microsleep episodes as opposed to during periods of wakefulness. Twenty-four licensed drivers diagnosed with OSAS based on standard clinical and polysomnographic criteria, participated in an hour-long drive in a high-fidelity driving simulator with synchronous electroencephalographic (EEG) recordings for identification of microsleeps. The drivers showed significant deterioration in vehicle control during the microsleep episodes compared to driving performance in the absence of microsleeps on equivalent segments of roadway. The degree of performance decrement correlated with microsleep duration, particularly on curved roads. Results indicate that driving performance deteriorates during microsleep episodes. Detecting microsleeps in real-time and identifying how these episodes of transition between wakefulness and sleep impair driver performance is relevant to the design and implementation of countermeasures such as drowsy driver detection and alerting systems that use EEG technology.

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Section: Introductionmentioning

confidence: 99%

Driver performance in the moments surrounding a microsleep

Boyle

Tippin

Paul

et al. 2008

Transportation Research Part F: Traffic Psychology and Behaviou

132

View full text Add to dashboard Cite

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“…1 More than 800,000 drivers were involved in OSA-related motor vehicle collisions in the United States during 2000 at a cost of 1,400 lives. 2 Compared with a reference group from the general population, individuals with OSA are also at a higher risk of being involved in an occupational accident due to reduced wakefulness, vigilance, and attention. 3 Furthermore, OSA and associated ES impair patients' quality of life, particularly vitality and social functioning.…”

mentioning

confidence: 99%

Recognizing and Managing Obstructive Sleep Apnea in Primary Care

Culpepper¹,

Roth²

2009

Prim. Care Companion J. Clin. Psychiatry

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Objective: This review aims to impart information regarding recognition of obstructive sleep apnea (OSA) and associated excessive sleepiness (ES) in the primary care setting in order to provide optimal care to patients with this common but serious condition. This review will also discuss the prevalence and treatment of depression in patients with OSA.Data Sources: A MEDLINE search of articles published between 1990 and 2008 was conducted using the search terms obstructive sleep apnea AND excessive sleepiness, obstructive sleep apnea AND depression, and obstructive sleep apnea AND primary care. Searches were limited to articles in English concerned with adult patients.Study Selection: In total, 239 articles were identified. Articles concerning other sleep disorders and forms of apnea were excluded. The reference lists of identified articles were searched manually to find additional articles of interest.Data Synthesis: Primary care physicians can aid in the diagnosis of OSA and associated ES by being vigilant for lifestyle and physical risk factors associated with this condition. In addition, primary care physicians should maintain a high level of clinical suspicion when presented with illnesses that are commonly comorbid with OSA, such as psychiatric disorders and depression, in particular. Conversely, assessment of patients with OSA for common comorbidities may also improve a patient's prognosis and quality of life.Conclusions: Primary care physicians play a vital role in recognizing OSA and ES. These clinicians are crucial in supporting their patients during treatment by ensuring that they have clear, concise information regarding available therapies and the correct application and maintenance of prescribed devices.

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“…In a second analysis, we fixed the value at the cost of a crash attributable to OSAS at $8,200/driver/crash based on computations using federal data for large trucks(29), while assuming the odds ratio for a crash given OSAS equaled 2.5 (26).…”

Section: Expenses Of Osas-attributable Crashesmentioning

confidence: 99%

“…This value includes the costs of medical treatment, emergency services, property damage, lost productivity, and a monetary value of the pain, suffering, and reduced quality of life experienced by the victim and his/her family. A recent meta-analysis using passenger car data indicates that OSAS is associated with an odds ratio (OR) for traffic accidents of 2.5 (26). We used this estimate in our base calculations.…”

Section: Expenses Of Osas-attributable Crashesmentioning

confidence: 99%

Estimated cost of crashes in commercial drivers supports screening and treatment of obstructive sleep apnea

Gurubhagavatula

Nkwuo

Maislin

et al. 2008

Accident Analysis & Prevention

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Sleep apnea among commercial drivers may increase the risk of fall-asleep crashes, which incur large expenses. Drivers of passenger cars whose apnea is treated experience lower crash risk. Among community-based holders of commercial driver's licenses, we considered three methods for identifying sleep apnea syndrome: 1) in-lab polysomnography; 2) selective in-lab polysomnography for high-risk drivers, where high risk is first identified by body mass index, age and gender, followed by oximetry in a subset of drivers; and 3) not screening. The costs for each of these three programs equaled the sum of the costs of testing, treatment of identified cases, and crashes. Assuming that treatment prevents apnea-related crashes, polysomnography is not costeffective, because it was more expensive than the cost of crashes when no screening is done. Screening with BMI, age and gender, however, with confirmatory in-lab polysomnography only on high-risk drivers was cost-effective, as long as a high proportion (73.8%) of screened drivers accepts treatment. These findings indicate that strategies that reduce reliance on in-laboratory polysomnography may be more cost-effective than not screening, and that treatment acceptance may need to be a condition of employment for affected drivers.

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Reducing Motor-Vehicle Collisions, Costs, and Fatalities by Treating Obstructive Sleep Apnea Syndrome

Abstract: Annually, a small but significant portion of motor-vehicle collisions, costs, and deaths are related to OSAS. With CPAP treatment, most of these collisions, costs, and deaths can be prevented. Treatment of OSAS benefits both the patient and the public.

Cited by 402 publications

References 33 publications

Driver performance in the moments surrounding a microsleep

Driver performance in the moments surrounding a microsleep

Recognizing and Managing Obstructive Sleep Apnea in Primary Care

Estimated cost of crashes in commercial drivers supports screening and treatment of obstructive sleep apnea

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