The Association between Sleep Apnea and the Risk of Traffic Accidents

Terán-Santos, Joaquín; Jiménez-Gómez, A; Cordero-Guevara, José

doi:10.1056/nejm199903183401104

Cited by 1,091 publications

(599 citation statements)

References 15 publications

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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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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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“…Furthermore, alcohol consumption is more influential in younger drivers (29), and it is generally recognized that younger drivers tend to be more frequently involved in single-vehicle crashes, whereas older drivers are involved more frequently in collisions between two or more vehicles (29,35,37). In any case, the high OR estimate obtained for sleepiness/ drowsiness supports the increasing importance given to this factor in recent years as an immediate cause of traffic crashes (33,(38)(39)(40). In addition, our results once again document the effect of alcohol consumption on the risk of being involved in a traffic crash (33,34,(41)(42)(43).…”

Section: Factors Directly Related With Collisionsmentioning

confidence: 83%

Association of main driver-dependent risk factors with the risk of causing a vehicle collision in Spain, 1990–1999

Lardelli-Claret

Luna

Jiménez-Moleón

et al. 2003

Annals of Epidemiology

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PURPOSE:To assess the strength of association of main driver-dependent risk factors with the risk of causing a collision between vehicles in Spain, from 1990 to 1999. METHODS:The data for this paired-by-collision, case-control study were obtained from the Spanish Dirección General de Tráfico traffic crash database. The study included all 220,284 collisions involving two or more vehicles with four or more wheels, in which only one of the drivers involved committed an infraction. Infractor drivers comprised the case group; noninfractor drivers involved in the same collision were their corresponding paired controls. RESULTS: All driver-dependent factors were associated with the risk of causing a collision. The highest adjusted odds ratio estimates were obtained for sleepiness (64.35; CI, inappropriate speed (28.33; CI,, and driving under the influence of alcohol with a positive breath test (22.32; CI,). An increase in the number of years in possession of a driving license showed a protective effect, albeit the strength of the effect decreased as age increased. CONCLUSIONS: Our results emphasize the urgent need to implement strategies aimed mainly at controlling speeding, sleepiness, and alcohol consumption before driving-the main driver-dependent risk factors for causing a vehicle collision.

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“…2 OSA also causes signifi cant daytime sleepiness, with impaired daytime functioning and increased risk of road traffi c accidents. [3][4][5][6] Uncomplicated snoring occurs in approximately 40% of the adult population in the UK and approximately 10% of these snorers have OSA. 7 Intra-oral appliances were fi rst used for the control of snoring and OSA in Canada and the USA in the late 1980s 8,9 and in the UK in the mid-1990s.…”

Section: Introductionmentioning

confidence: 99%

The attitudes of general dental practitioners and medical specialists to the provision of intra–oral appliances for the management of snoring and sleep apnoea

Jauhar¹,

Lyons

Banham

et al. 2008

Br Dent J

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The Association between Sleep Apnea and the Risk of Traffic Accidents

Abstract: There is a strong association between sleep apnea, as measured by the apnea-hypopnea index, and the risk of traffic accidents.

Cited by 1,091 publications

References 15 publications

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

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

Association of main driver-dependent risk factors with the risk of causing a vehicle collision in Spain, 1990–1999

The attitudes of general dental practitioners and medical specialists to the provision of intra–oral appliances for the management of snoring and sleep apnoea

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