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Abstract
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OBJECTIVES: The present case-control study aimed to determine whether obstructive sleep apnea syndrome (OSAS) patients are at an increased risk for sleepiness-related motor vehicle accidents (MVAs) than controls and to identify disease-related factors associated with accident risk.
METHODS: Demographic, anthropometric, clinical, and polysomnographic parameters of 312 OSAS patients were compared with 156 age- and sex-matched primary snoring subjects.
RESULTS: The rate of OSAS patients reporting accident was higher than snoring subjects (21.2% vs. 11.5%, P =.011), and OSAS was associated with an increase in accident risk (odds ratio = 2.06, 95% confidence interval [CI], 1.17 to 3.61, P =.012). Younger OSAS patients (P =.001) and those who were male (P =.001), had greater neck circumference (P =.002), had a higher Epworth sleepiness score (ESS; P <.0001), and had a higher apnea-hypopnea index (AHI; p =.039) had more MVAs than OSAS patients. Daytime sleepiness was associated with a 2.74-fold increase (95% CI, 1.54 to 4.87, P =.001) in accident risk. In multiple logistic regression analysis, accident risk was associated with neck circumference (P <.031) and ESS (P <.0001). In addition, accident risk could be excluded in OSAS patients with neck circumference < 43 cm and ESS < 11 (sensitivity 33.3%, specificity 85.8%).
CONCLUSIONS: The present results show that OSAS patients have a twofold higher risk of traffic accidents than control subjects, and increased neck circumference and excessive daytime sleepiness are useful in predicting OSAS patients at higher risk of having accidents.
Language: en |