Sleepiness, sleep disordered breathing and accident risk factors in commercial vehicle drivers.

HOWARD ME, DESAI AV, GRUNSTEIN RR, HUKINS C, ARMSTRONG JG, JOFFE D, SWANN P, CAMPBELL DA, PIERCE RJ.: Am J Respir Crit Care Med 2004 Aug 18;[epub ahead of print].
Institute of Breathing and Sleep, Austin Health and University of Melbourne, Heidelberg, Victoria, Australia

Abstract:

Sleep disordered breathing and excessive sleepiness may be more common in commercial vehicle drivers than the general population. The relative importance of factors causing excessive sleepiness and accidents in this population remains unclear. We measured the prevalence of excessive sleepiness and sleep disordered breathing and assessed accident risk factors in 2342 respondents to a questionnaire distributed to a random sample of 3268 Australian commercial vehicle drivers and another 161 drivers among 244 invited to undergo polysomnography. 59.6% of drivers had sleep disordered breathing and 15.8% had obstructive sleep apnea syndrome. 24% of drivers had excessive sleepiness. Increasing sleepiness was related to an increased accident risk. The sleepiest 5% of drivers on the Epworth Sleepiness Scale and Functional Outcomes of Sleep Questionnaire had an increased risk of an accident (odds ratio 1.91, p=0.02 and 2.23, p<0.01 respectively) and multiple accidents (odds ratio 2.67, p<0.01 and 2.39, p=0.01), adjusted for established risk factors. There was an increased accident risk with narcotic analgesic use (odds ratio 2.40, p<0.01) and antihistamine use (odds ratio 3.44, p=0.04). Chronic excessive sleepiness and sleep disordered breathing are common in Australian commercial vehicle drivers. Accident risk was related to increasing chronic sleepiness and antihistamine and narcotic analgesic use.

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Abstract:

Sleep disordered breathing and excessive sleepiness may be more common in commercial vehicle drivers than the general population. The relative importance of factors causing excessive sleepiness and accidents in this population remains unclear. We measured the prevalence of excessive sleepiness and sleep disordered breathing and assessed accident risk factors in 2342 respondents to a questionnaire distributed to a random sample of 3268 Australian commercial vehicle drivers and another 161 drivers among 244 invited to undergo polysomnography. 59.6% of drivers had sleep disordered breathing and 15.8% had obstructive sleep apnea syndrome. 24% of drivers had excessive sleepiness. Increasing sleepiness was related to an increased accident risk. The sleepiest 5% of drivers on the Epworth Sleepiness Scale and Functional Outcomes of Sleep Questionnaire had an increased risk of an accident (odds ratio 1.91, p=0.02 and 2.23, p<0.01 respectively) and multiple accidents (odds ratio 2.67, p<0.01 and 2.39, p=0.01), adjusted for established risk factors. There was an increased accident risk with narcotic analgesic use (odds ratio 2.40, p<0.01) and antihistamine use (odds ratio 3.44, p=0.04). Chronic excessive sleepiness and sleep disordered breathing are common in Australian commercial vehicle drivers. Accident risk was related to increasing chronic sleepiness and antihistamine and narcotic analgesic use.