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Excessive daytime sleepiness increases the risk of motor vehicle crash in obstructive sleep apnea

Our objectives were to describe the incidence rate of motor vehicle crashes (MVCs) in patients with obstructive sleep apnea (OSA) and to investigate MVC risk...

Authors:
Ward KL, Hillman DR, James A, Bremner AP, Simpson L, Cooper MN, et al.

Authors notes:
Journal of Clinical Sleep Medicine. 2013;9(10):1013-1021

Keywords:
Gender, Motor vehicle crashes, Near-misses, Obstructive sleep apnea, Severity, Sleepiness

Abstract:
Our objectives were to describe the incidence rate of motor vehicle crashes (MVCs) in patients with obstructive sleep apnea (OSA) and to investigate MVC risk factors in OSA patients.

In patients with untreated OSA, the crash rate was 0.06 MVC/person-year compared with the general community crash rate of 0.02 MVC/person-year.

The rate ratio comparing very sleepy men with normal men was 4.68 for near-misses and 1.27 for crashes, after adjusting for confounders.

In women there was a significant association with sleepiness score (p = 0.02) but no dose effect across quartiles.

Untreated OSA is associated with an increased risk of near-misses in men and women and an increased risk of MVCs in very sleepy men.

There is a strong association between excessive daytime sleepiness and increased report of near-misses.

Our data support the observation that it is those patients with increased sleepiness regardless of OSA severity who are most at risk.