title: Risk factors for automobile accidents caused by falling asleep while driving in obstructive sleep apnea syndrome.
abstract: OBJECTIVE
  We examined the risk factors for automobile accidents caused by falling asleep while driving in subjects with obstructive sleep apnea syndrome (OSAS).
  
  
  METHODS
  We asked licensed drivers with history of snoring and excessive daytime sleepiness who had undergone polysomnography (PSG) at the Department of Sleep Medicine/Sleep Disorders Center at Aichi Medical University Hospital to complete the questionnaires on accidents caused by falling asleep while driving. As a subjective measure of sleepiness, we used the Epworth sleepiness scale (ESS). Based on PSG results, 2387 subjects diagnosed with OSAS were divided into three groups according to apnea-hypopnea index (AHI): mild-to-moderate (5 ≤ AHI < 30), severe (30 ≤ AHI < 60), and very severe (AHI ≥ 60). We performed univariate and multivariate logistic regression on variables that might explain falling asleep at the wheel.
  
  
  RESULTS
  We compared results between each group and simple snorers (394 subjects with AHI < 5) and found the group with very severe OSAS reported significantly higher rates of driving when drowsy and having accidents in the past 5 years due to falling asleep.
  
  
  CONCLUSIONS
  Our multivariate analysis suggests that scores on the ESS and patient-reported frequency of feeling drowsy while regular driving and working are related to automobile accidents caused by falling asleep while driving.
authors.affiliation: Department of Sleep Medicine, Aichi Medical University School of Medicine, 1-1 Yazakokarimata, Nagakute, Aichi, 480-1195, Japan.
authors.forename: Aki
authors.initials: A
authors.lastname: Arita
authors.affiliation: Department of Sleep Medicine, Aichi Medical University School of Medicine, 1-1 Yazakokarimata, Nagakute, Aichi, 480-1195, Japan. sasanabe@aichi-med-u.ac.jp.
authors.forename: Ryujiro
authors.initials: R
authors.lastname: Sasanabe
authors.affiliation: Department of Sleep Medicine, Aichi Medical University School of Medicine, 1-1 Yazakokarimata, Nagakute, Aichi, 480-1195, Japan.
authors.forename: Rika
authors.initials: R
authors.lastname: Hasegawa
authors.affiliation: Department of Sleep Medicine, Aichi Medical University School of Medicine, 1-1 Yazakokarimata, Nagakute, Aichi, 480-1195, Japan.
authors.forename: Atsuhiko
authors.initials: A
authors.lastname: Nomura
authors.affiliation: Department of Sleep Medicine, Aichi Medical University School of Medicine, 1-1 Yazakokarimata, Nagakute, Aichi, 480-1195, Japan.
authors.forename: Reiko
authors.initials: R
authors.lastname: Hori
authors.affiliation: Department of Sleep Medicine, Aichi Medical University School of Medicine, 1-1 Yazakokarimata, Nagakute, Aichi, 480-1195, Japan.
authors.forename: Mamiko
authors.initials: M
authors.lastname: Mano
authors.affiliation: Department of Sleep Medicine, Aichi Medical University School of Medicine, 1-1 Yazakokarimata, Nagakute, Aichi, 480-1195, Japan.
authors.forename: Noriyuki
authors.initials: N
authors.lastname: Konishi
authors.affiliation: Department of Sleep Medicine, Aichi Medical University School of Medicine, 1-1 Yazakokarimata, Nagakute, Aichi, 480-1195, Japan.
authors.forename: Toshiaki
authors.initials: T
authors.lastname: Shiomi
mesh_terms: D000063:Accidents, Traffic / Q000517:prevention & control* / Q000706:statistics & numerical data*; D000328:Adult; D000368:Aged; D003430:Cross-Sectional Studies; D006970:Disorders of Excessive Somnolence / Q000139:chemically induced / Q000145:classification / Q000453:epidemiology*; D005260:Female; D006801:Humans; D007564:Japan; D008297:Male; D008875:Middle Aged; D015999:Multivariate Analysis; D017286:Polysomnography; D012307:Risk Factors; D020181:Sleep Apnea, Obstructive / Q000145:classification / Q000175:diagnosis / Q000453:epidemiology*; D011795:Surveys and Questionnaires
keywords: Automobile accidents; Epworth sleepiness sale; Falling asleep; Obstructive sleep apnea; Risk factors