Citation

Mcnicholas WT. Sleep Med. Clin. 2019; 14(4): xiii-xiv.

Affiliation

School of Medicine, University College Dublin, Department of Respiratory and Sleep Medicine, St. Vincent's Hospital Group, Merrion Road, Dublin 4, Ireland; First Affiliated Hospital of Guangzhou Medical University, Guangzhou, China. Electronic address: walter.mcnicholas@ucd.ie.

Copyright

(Copyright © 2019, Elsevier Publishing)

DOI

10.1016/j.jsmc.2019.08.008

PMID

31640879

Abstract

Speed and alcohol consumption are widely recognized contributory factors to motor vehicle accidents (MVA) and are almost universally regulated throughout the world by speed limits and blood/urine/breath alcohol levels while driving. In recent decades, there has been growing recognition that sleep disturbances and disorders with consequent sleepiness during the waking hours also represent important contributing factors to driving accident risk. However, this risk is difficult to quantify by objective measures such as are employed for speed and alcohol, which inevitably result in sleepiness being a less well-documented contributing factor to MVA. Nonetheless, driving while sleepy confers a similar increased accident risk as driving with a blood alcohol level above the legal limit for most countries. Various reports estimate that sleepiness represents a major contributing factor in about 20% of serious MVA and is particularly likely to be a major factor in MVA on major highways where monotonous driving at relatively high speed is common.

Fatigue and sleepiness because of sleep dysfunction are most common in circumstances of poor sleep hygiene where the affected individual spends too little time in bed and/or experiences disturbed sleep due to poor lifestyle habits. Specific medical disorders may also contribute to sleep disturbance, the most important of which is obstructive sleep apnea (OSA). OSA is widely reported to increase MVA risk 2- to 3-fold, but this increased risk is removed by effective treatment, which underlines the practical importance of recognition and treatment. Indeed, several jurisdictions have introduced regulations that preclude untreated patients with moderate or severe OSA associated with sleepiness from driving unless effectively treated ...

Language: en