Sleepiness, Sleep-disordered Breathing, and Accident Risk Factors in Commercial Vehicle Drivers

Institute of Breathing and Sleep, Bowen Centre, Austin Health and University of Melbourne, Heidelberg, Victoria, Australia.
American Journal of Respiratory and Critical Care Medicine (Impact Factor: 13). 11/2004; 170(9):1014-21. DOI: 10.1164/rccm.200312-1782OC
Source: PubMed


Sleep-disordered breathing and excessive sleepiness may be more common in commercial vehicle drivers than in 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 2,342 respondents to a questionnaire distributed to a random sample of 3,268 Australian commercial vehicle drivers and another 161 drivers among 244 invited to undergo polysomnography. More than half (59.6%) of drivers had sleep-disordered breathing and 15.8% had obstructive sleep apnea syndrome. Twenty-four percent 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 [OR] 1.91, p = 0.02 and OR 2.23, p < 0.01, respectively) and multiple accidents (OR 2.67, p < 0.01 and OR 2.39, p = 0.01), adjusted for established risk factors. There was an increased accident risk with narcotic analgesic use (OR 2.40, p < 0.01) and antihistamine use (OR 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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    • "Sleepiness is an on-going occupational hazard amongst professional heavy vehicle drivers as a result of long work hours, sleep restriction, circadian influences, irregular shifts and sleep disorders, all of which are related to increased accident risk (Folkard, 1997; Howard et al., 2004). "
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    • "or sleep quality , short sleep time and increased sleep pressure with increased crash risk ( Horne and Reyner , 1995 ; Sagberg , 1999 ) . Our previous validation study in a subcohort of the current population demonstrated that severe daytime sleepiness expressed as ESS≥16 was associated strongly with risk of MVA . A similar finding was reported by Howard et al . ( 2004 ) , while the ESS was not proven to predict MVA risk in other OSA populations ( Amra et al . , 2012 ) . Therefore , the ESS is likely to reflect components of vigilance and cognitive function that are not sufficiently sensitive or specific to identify all OSA patients at risk ."
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    Full-text · Article · Jun 2014 · Journal of Sleep Research
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