Risk and Severity of Motor Vehicle Crashes in Patients With Obstructive Sleep Apnoea/Hypopnoea

An increased motor vehicle crash (MVC) risk appears to have an association with obstructive sleep apnoea/hypopnoea (OSAH). Its crash pattern impact, however, has not been described well, particularly in regard to crash severity. In order to determine whether the severity of crashes in patients referred for suspected sleep-disordered breathing investigation was influenced by OSAH severity, a study was undertaken. Provincial insurance records provided objective crash data (including crash nature) for 783 suspected-OSAH patients for three years prior to polysomnography. There was comparison with data for 783 controls matched by age and sex. The mean age of the patient group was 50 years, and was 71% male, with a mean Epworth Sleepiness Scale score of ten and a mean apnoea-hypopnoea index (AHI) of 22 events per hour. In the three year period, 252 patients and 123 controls were involved in crashes, for a total of 375. An increased MVC rate was experienced by patients with mild, moderate, and severe OSAH when compared with controls, with respective 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). An increased MVC rate (relative risk 1.5 (95% CI 0.9 to 2.5), p = 0.21) was not seen in patients with normal polysomnography and suspected OSAH (AHI 0-5). A substantially higher MVC rate was seen in mild, moderate, and severe OSAH patients than controls with respective 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) when OSAH's impact on MVC associated with personal injury was examined, while similar crash rates were experienced by patients without OSAH in comparison to controls with a relative risk of 0.6 (95% CI 0.2 to 2.5). Very severe MVCs, such as those involving pedestrians or cyclists or head -on collisions, were rare, but patients with OSAH (p = 0.06) were involved in 80%. The authors conclude that patients with OSAH experience increased MVC rates, and personal injury is associated with disproportionately increased MVC rates.

• Authors:
  • Mulgrew, A T
  • Nasvadi, G
  • Butt, A
  • Cheema, R
  • Fox, N
  • Fleetham, J A
  • Ryan, C F
  • Cooper, P
  • Ayas, N T
• Publication Date: 2008-6

Language

• English

Media Info

• Media Type: Print
• Features: Figures; References; Tables;
• Pagination: pp 536-541
• Serial:
  • Thorax
  • Volume: 63
  • Issue Number: 6
  • Publisher: British Medical Association
  • EISSN: 1468-3296
  • Serial URL: http://thorax.bmj.com/

Subject/Index Terms

• TRT Terms: Apnea; Crash severity; Crashes; Injuries; Risk assessment; Sleep disorders
• Uncontrolled Terms: Motor vehicle accidents; Patterns
• Subject Areas: Highways; Passenger Transportation; Safety and Human Factors; I83: Accidents and the Human Factor;

Filing Info

• Accession Number: 01115599
• Record Type: Publication
• Files: TRIS
• Created Date: Nov 29 2008 8:06AM