Sleep Apnea and Driving Risk
Patients with OSA have an increased risk for car accidents.
Many studies have been performed
that demonstrate that patients with untreated sleep apnea have a higher
rate of motor vehicle collisions compared to the general population.
One study in the New
England Journal of Medicine found that people with sleep apnea with an
apnea-hypopnea index (AHI) > 10/hr had an increased risk of motor
vehicle collisions of 6.3 times the control group!
What can be done about
this?
Patients treated with CPAP have reduced car accidents.
Studies have
demonstrated that patients with OSA who use CPAP consistently have improved
driving skills as tested using driving simulators. Additionally, studies have
demonstrated a reduction in motor vehicles collisions with the use of CPAP.
A study in Colorado compared
the number of motor vehicle collisions in patients with OSA who used CPAP
compared to those who did not use CPAP over a 2 year period. Accident history was obtained from
the Department of Motor Vehicle accident reports. The 50 patients who were
studied had a high previous car accident rate of 0.07 accidents per driver
per year (compared to 0.01 accidents per driver per year for all drivers in
Colorado)
prior to the diagnosis of sleep apnea.
The 36 patients who used CPAP decreased the car accident rate to 0
over the 2 year period while the 14 patients who did not use CPAP continued
to have a car accident rate of 0.07 accidents per driver per year.
A similar study was
performed in Ontario, Canada. 210 patients with OSA were
studied. Patients with
untreated sleep apnea had an elevated rate of car accidents (0.18 accidents
per driver per year compared to 0.06 accidents per driver per year in the
control group). After treatment
with CPAP, the accident rate decreased to the same as the control group
(0.06 accidents per driver per year).
Patients who did not use CPAP continued to have an elevated accident
rate (0.15 accidents per driver per year).
REFERENCES:
The association between
sleep apnea and the risk of traffic accidents.
N Engl
J Med. 1999 Mar 18;340(11):847-51.
Driving and automobile
crashes in patients with obstructive sleep apnoea/hypopnoea
syndrome.
Thorax. 2004 Sep;59(9):804-7.
Reduction in motor
vehicle collisions following treatment of sleep apnoea
with nasal CPAP.
Thorax. 2001 Jul;56(7):508-12.
Treatment with nasal
CPAP decreases automobile accidents in patients with sleep apnea.
Am J Respir
Crit Care Med. 2000 Mar;161(3
Pt 1):857-9.
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