title: Elevated risk of sleepiness-related motor vehicle accidents in patients with obstructive sleep apnea syndrome: a case-control study.
abstract: OBJECTIVE
  The present case-control study aimed to determine whether obstructive sleep apnea syndrome (OSAS) patients are at an increased risk for sleepiness-related motor vehicle accidents (MVAs) than controls and to identify disease-related factors associated with accident risk.
  
  
  METHODS
  Demographic, anthropometric, clinical, and polysomnographic parameters of 312 OSAS patients were compared with 156 age- and sex-matched primary snoring subjects.
  
  
  RESULTS
  The rate of OSAS patients reporting accident was higher than snoring subjects (21.2% vs. 11.5%, P = .011), and OSAS was associated with an increase in accident risk (odds ratio = 2.06, 95% confidence interval [CI], 1.17 to 3.61, P = .012). Younger OSAS patients (P = .001) and those who were male (P = .001), had greater neck circumference (P = .002), had a higher Epworth sleepiness score (ESS; P < .0001), and had a higher apnea-hypopnea index (AHI; p = .039) had more MVAs than OSAS patients. Daytime sleepiness was associated with a 2.74-fold increase (95% CI, 1.54 to 4.87, P = .001) in accident risk. In multiple logistic regression analysis, accident risk was associated with neck circumference (P < .031) and ESS (P < .0001). In addition, accident risk could be excluded in OSAS patients with neck circumference < 43 cm and ESS < 11 (sensitivity 33.3%, specificity 85.8%).
  
  
  CONCLUSIONS
  The present results show that OSAS patients have a twofold higher risk of traffic accidents than control subjects, and increased neck circumference and excessive daytime sleepiness are useful in predicting OSAS patients at higher risk of having accidents.
authors.affiliation: a Department of Chest Diseases , Ege University School of Medicine , Izmir , Turkey.
authors.forename: Ozen K
authors.initials: OK
authors.lastname: Basoglu
authors.forename: Mehmet Sezai
authors.initials: MS
authors.lastname: Tasbakan
mesh_terms: D000063:Accidents, Traffic / Q000706:statistics & numerical data*; D000328:Adult; D016022:Case-Control Studies; D006970:Disorders of Excessive Somnolence / Q000453:epidemiology*; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D009333:Neck / Q000033:anatomy & histology; D012189:Retrospective Studies; D018570:Risk Assessment; D020181:Sleep Apnea, Obstructive / Q000150:complications*