Sleep Apnoea Patients Have More Automobile Accidents

George, Charles F.; Nickerson, Peter; Hanly, Patrick J.; Millar, Tom; Kryger, Meir H.

doi:10.1016/s0140-6736(87)90974-3

Cited by 234 publications

(124 citation statements)

References 4 publications

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“…Drivers with OSAS have an increased crash risk that is in the neighborhood of 2-4 times that of the general population (Findley et al, 1995;George et al, 1987;Teran-Santos et al, 1999;Wu & YanGo, 1996). Affected individuals typically have fragmented sleep periods associated with snoring and intermittent airway obstruction.…”

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

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“…Prva ozbiljnija istraživa-nja počinju od George-a i saradnika [49], koji su 1987. godine utvrdili dvostruko veći rizik od saobraćajnih udesa kod OSA pacijenata u odnosu na zdrave kontrole. Findley 1988. godine nalazi 2,6 puta veću stopu udesa u odnosu na prosek u Virdži-niji, a trećina OSA ispitanika je imala udes u proteklih 5 godina [50].…”

Section: Osa I Saobraćajne Nezgodeunclassified

Excessive sleepiness and the risk of obstructive apnoea syndrome in professional ambulance drivers

Popević¹,

Milovanović²

2014

Engrami

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Saobraćajni traumatizam predstavlja značajan problem u zemljama Evrope i sveta. Ukupan broj saobraćajnih nezgoda u Srbiji pokazuje trend pada,uz porast teških telesnih povreda i smrtnih ishoda, a gubici u opremi i uslugama mere se milijardama dinara. Prekomerna pospanost u vožnji je direktno uzročno-posledično povezana sa nastankom saobraćajnih nezgoda. Smatra se da 20-25% nezgoda u Evropi nastaje kao posledica prekomerne pospanosti. Poremećaji disanja u snu, pre svega sindrom opstruktivne apneje u spavanju (OSA) imaju veliki uticaj na pojavu prekomerne pospanosti, pospanosti za volanom i nastanak saobraćajnih udesa. Procenjuje se da 13% muškaraca i 6% žena uzrasta 30-70 godina boluje od umerene do teške forme bolesti, a da kod 85% pacijenata oboljenje nije prepoznato. Prevalenca OSA je 26-50% u populaciji profesionalnih vozača. Vozači sa nelečenom ili nedijagnostikovanom OSA imaju dva do sedam puta veći rizik od saobraćajne nezgode. Primena terapije OSA dovodi do redukcije pospanosti i saobraćajnih nezgoda. U velikom broju zemalja postoji obaveza zdravstvenih pregleda vozača na prisustvo OSA. U Srbiji ne postoje epidemiološki podaci o prevalenci OSA, o učestalosti prekomerne pospanosti ili OSA u populaciji vozača učesnika saobraćajnih nezgoda. Preliminarna istraživa-nja na uzorku profesionalnih vozača ukazuju da trećina ispitanika ima prekomernu pospanost i povećan rizik od OSA koji su povezani sa pojavom saobraćajnih nezgoda.Ključne reči: apneja u spavanju, prekomerna pospanost, saobraćajne nezgode, vozači

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“…This increased risk of crashes was fi rst recognized in the 1980s and has since been reported by multiple investigators. 2,3 In this regard, a meta-analysis has shown a 3.71-fold increase in the relative risk for motor vehicle crashes for individuals with untreated OSA. 4 Sleepiness related crashes generally result from falling asleep while driving or from impairment of the cognitive, perceptual, or motor abilities essential to the complex task of driving.…”

Section: S C I E N T I F I C I N V E S T I G a T I O N Smentioning

confidence: 99%

“…The obvious concern is that these patients are at higher risk for driving related accidents. 2,3 In this regard, practitioners have asked whether it would be advisable to start a newly diagnosed OSA patient on a stimulant medication approved for treatment of residual EDS (e.g., armodafinil) while they are awaiting initiation of CPAP treatment. 22 However, an additional concern is that prior use of stimulant treatment might negatively impact subsequent CPAP compliance.…”

Section: S C I E N T I F I C I N V E S T I G a T I O N Smentioning

confidence: 99%

Effects of Armodafinil on Simulated Driving and Self-Report Measures in Obstructive Sleep Apnea Patients prior to Treatment with Continuous Positive Airway Pressure

Kay

Feldman²

2013

Journal of Clinical Sleep Medicine

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versus real driving that evaluated the effects of fatigue and sleepiness, the investigators concluded that for some variables (e.g., fatigue and lane crossings) the two methodologies were comparable. 9 It is now well recognized that the risk of motor vehicle crashes for OSA patients is signifi cantly decreased following treatment with nasal continuous positive airway pressure (CPAP). 10It has been estimated that there is at least a 50% reduction in crash risk.2,11 Improved driving safety is also refl ected in bet- S C I E N T I F I C I N v E S T I G A T I O N SO bstructive sleep apnea syndrome (OSA) is the most common medical disorder causing excessive daytime sleepiness (EDS).1 Untreated individuals with OSA have an increased risk of motor vehicle crashes. This increased risk of crashes was fi rst recognized in the 1980s and has since been reported by multiple investigators.2,3 In this regard, a meta-analysis has shown a 3.71-fold increase in the relative risk for motor vehicle crashes for individuals with untreated OSA. 4Sleepiness related crashes generally result from falling asleep while driving or from impairment of the cognitive, perceptual, or motor abilities essential to the complex task of driving. The impact of sleepiness on driving performance has been demonstrated by driving simulator studies investigating the effects of sleep deprivation and CNS sedatives.5 In general, these studies have demonstrated that drivers with OSA perform worse than matched controls on driving simulators. 6 Using the AusEd driving simulator, investigators found that OSA patients performed worse than controls on 4 of 5 outcomes: lane position variability, crash frequency, and performance on measures of divided attention.7 Researchers using the STI driving simulator found poor simulated driving performance in OSA patients was related to EEG evidence of attention lapses.8 Lane position variability was the most sensitive measure for assessing and quantifying impairment. In a study investigating simulated bRIEF SUMMARYCurrent knowledge/Study Rationale: This study investigated a strategy for improving driving safety in OSA patients during the interval between the fi rst contact of the clinician with the patient and the initiation of CPAP. The study was designed to assess the effect of armodafi nil on simulated driving performance prior to the initiation of CPAP treatment and to determine the impact of this treatment on subsequent CPAP compliance.Study Impact: Results demonstrate that 2 weeks of treatment with armodafi nil improved simulated driving performance prior to the initiation of CPAP therapy and had no impact on subsequent CPAP compliance. The study also provided evidence of the marked improvement in driving performance following 6 weeks of treatment with CPAP (after discontinuation of the drug treatment phase of the study).

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Sleep Apnoea Patients Have More Automobile Accidents

Cited by 234 publications

References 4 publications

Driver performance in the moments surrounding a microsleep

Driver performance in the moments surrounding a microsleep

Excessive sleepiness and the risk of obstructive apnoea syndrome in professional ambulance drivers

Effects of Armodafinil on Simulated Driving and Self-Report Measures in Obstructive Sleep Apnea Patients prior to Treatment with Continuous Positive Airway Pressure

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