Sleepiness, sleep-disordered breathing, and accident risk factors in commercial vehicle drivers.
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.
Institute of Breathing and Sleep, Bowen Centre, Austin Health and University of Melbourne, Heidelberg, Victoria, Australia. mark.howard@austin.org.au
Mark E
ME
Howard
Anup V
AV
Desai
Ronald R
RR
Grunstein
Craig
C
Hukins
John G
JG
Armstrong
David
D
Joffe
Philip
P
Swann
Donald A
DA
Campbell
Robert J
RJ
Pierce
D000056:Accident Prevention; D000063:Accidents, Traffic / Q000706:statistics & numerical data*; D000328:Adult; D017677:Age Distribution; D001334:Automobile Driving; D015331:Cohort Studies; D016001:Confidence Intervals; D006970:Disorders of Excessive Somnolence / Q000175:diagnosis / Q000453:epidemiology*; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D016017:Odds Ratio; D017286:Polysomnography; D015995:Prevalence; D011336:Probability; D011793:Queensland / Q000453:epidemiology; D018570:Risk Assessment; D012720:Severity of Illness Index; D017678:Sex Distribution; D012891:Sleep Apnea Syndromes / Q000175:diagnosis / Q000453:epidemiology*; D011795:Surveys and Questionnaires