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Study: Sleep Apnoea Sufferers & Motor Vehicle Crashes

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  • #1

    Study: Sleep Apnoea Sufferers & Motor Vehicle Crashes

    In a study recently published:

    Risk and severity of motor vehicle crashes in patients with obstructive sleep apnoea/hypopnoea
    http://thorax.bmj.com/cgi/content/full/63/6/536?rss=1
    Background: Obstructive sleep apnoea/hypopnoea (OSAH) appears to be associated with an increased risk of motor vehicle crashes (MVCs). However, its impact on crash patterns, particularly the severity of crashes, has not been well described. A study was undertaken to determine whether OSAH severity influenced crash severity in patients referred for investigation of suspected sleep-disordered breathing. Methods: Objective crash data (including the nature of crashes) for 783 patients with suspected OSAH for the 3 years prior to polysomnography were obtained from provincial insurance records and compared with data for 783 age- and sex-matched controls. The patient group was 71% male with a mean age of 50 years, a mean apnoea-hypopnoea index (AHI) of 22 events/h and a mean Epworth Sleepiness Scale score of 10. Results: There were 375 crashes in the 3-year period, 252 in patients and 123 in controls. Compared with controls, patients with mild, moderate and severe OSAH had an increased rate of MVCs with relative risks of 2.6 (95% CI 1.7 to 3.9), 1.9 (95% CI 1.2 to 2.8) and 2.0 (95% CI 1.4 to 3.0), respectively. Patients with suspected OSAH and normal polysomnography (AHI 0–5) did not have an increased rate of MVC (relative risk 1.5 (95% CI 0.9 to 2.5), p = 0.21). When the impact of OSAH on MVC associated with personal injury was examined, patients with mild, moderate and severe OSAH had a substantially higher rate of MVCs than controls with relative risks of 4.8 (95% CI 1.8 to 12.4), 3.0 (95% CI 1.3 to 7.0) and 4.3 (95% CI 1.8 to 8.9), respectively, whereas patients without OSAH had similar crash rates to controls with a relative risk of 0.6 (95% CI 0.2 to 2.5). Very severe MVCs (head-on collisions or those involving pedestrians or cyclists) were rare, but 80% of these occurred in patients with OSAH (p = 0.06). Conclusion: Patients with OSAH have increased rates of MVCs, and disproportionately increased rates of MVCs are associated with personal injury.


    Conclusion: Patients with OSAH have increased rates of MVCs, and disproportionately increased rates of MVCs are associated with personal injury.
    In summary, patients with OSAH have an increased rate of MVC compared with patients without OSAH and age- and sex-matched controls. Patients with OSAH are particularly prone to MVCs associated with personal injury, and this increased risk occurs even in patients with mild OSAH. Subjective daytime sleepiness does not appear to be particularly helpful in terms of risk prediction for MVC, which indicates a need for alternative strategies to assess driving performance. Treatment with continuous positive airway pressure has been shown to normalise crash rates and improve vigilance in patients with OSAH. MVCs associated with OSAH are potentially preventable. Increasing public awareness of the symptoms and risks of OSAH together with improved access to diagnosis and treatment is likely to confer major cost savings to society in addition to benefiting individual patients.
    Interesting and important findings. These types of arguments were also taken into account in the NICE report.

    How many near misses or crashes did you experience which you attributed to your sleepiness pre-treatment?
    Tags: None
  • #2
    Non maybe

    It may vary if you have been a life long sufferer you may be a safer driver than "normal" people. Simply you may have taken less risks.

    People who develop apnea in later life may be more of a problem.

    I have never broken a bone, I have had two minor car accidents, these were in the mornings and I was driving too fast, in both cases, with 30 years between them.

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