title: Sleep Apnea, Sleep Debt and Daytime Sleepiness Are Independently Associated with Road Accidents. A Cross-Sectional Study on Truck Drivers.
abstract: BACKGROUND
  Recent research has found evidence of an association between motor vehicle accidents (MVAs) or near miss accidents (NMAs), and excessive daytime sleepiness (EDS) or its main medical cause, Obstructive Sleep Apnea (OSA). However, EDS can also be due to non-medical factors, such as sleep debt (SD), which is common among professional truck drivers. On the opposite side, rest breaks and naps are known to protect against accidents.
  
  
  OBJECTIVE
  To investigate the association of OSA, SD, EDS, rest breaks and naps, with the occurrence of MVAs and NMAs in a large sample of truck drivers.
  
  
  METHODS
  949 male truck drivers took part in a cross-sectional medical examination and were asked to complete a questionnaire about sleep and waking habits, risk factors for OSA and EDS.
  
  
  RESULTS
  MVAs and NMAs were reported by 34.8% and 9.2% of participants, respectively. MVAs were significantly predicted by OSA (OR = 2.32 CI95% = 1.68-3.20), SD (OR = 1.45 CI95% = 1.29-1.63), EDS (OR = 1.73 CI95% = 1.15-2.61) and prevented by naps (OR = 0.59 CI95% = 0.44-0.79) or rest breaks (OR = 0.63 CI95% = 0.45-0.89). NMAs were significantly predicted by OSA (OR = 2.39 CI95% = 1.47-3.87) and SD (OR = 1.49 CI95% = 1.27-1.76) and prevented by naps (OR = 0.52 CI95% = 0.32-0.85) or rest breaks (OR = 0.49 CI95% = 0.29-0.82).
  
  
  CONCLUSIONS
  When OSA, SD or EDS are present, the risk of MVAs or NMAs in truck drivers is severely increased. Taking a rest break or a nap appear to be protective against accidents.
authors.affiliation: Department of Neuroscience, Rehabilitation, Ophthalmology, Genetics and Maternal/Child Sciences (DINOGMI), University of Genoa, Genoa, Italy.|Department of Health Sciences, Postgraduate School in Occupational Medicine, University of Genoa and Occupational Medicine Unit, IRCCS AOU San Martino IST, Genoa, Italy.
authors.forename: Sergio
authors.initials: S
authors.lastname: Garbarino
authors.affiliation: Department of Health Sciences, Postgraduate School in Occupational Medicine, University of Genoa and Occupational Medicine Unit, IRCCS AOU San Martino IST, Genoa, Italy.
authors.forename: Paolo
authors.initials: P
authors.lastname: Durando
authors.affiliation: Department of Neuroscience, Rehabilitation, Ophthalmology, Genetics and Maternal/Child Sciences (DINOGMI), University of Genoa, Genoa, Italy.
authors.forename: Ottavia
authors.initials: O
authors.lastname: Guglielmi
authors.affiliation: Department of Health Sciences, Postgraduate School in Occupational Medicine, University of Genoa and Occupational Medicine Unit, IRCCS AOU San Martino IST, Genoa, Italy.
authors.forename: Guglielmo
authors.initials: G
authors.lastname: Dini
authors.affiliation: Department of Health Sciences, Postgraduate School in Occupational Medicine, University of Genoa and Occupational Medicine Unit, IRCCS AOU San Martino IST, Genoa, Italy.
authors.forename: Francesca
authors.initials: F
authors.lastname: Bersi
authors.affiliation: Department of Neuroscience, Rehabilitation, Ophthalmology, Genetics and Maternal/Child Sciences (DINOGMI), University of Genoa, Genoa, Italy.
authors.forename: Stefania
authors.initials: S
authors.lastname: Fornarino
authors.affiliation: Department of Health Sciences, Postgraduate School in Occupational Medicine, University of Genoa and Occupational Medicine Unit, IRCCS AOU San Martino IST, Genoa, Italy.
authors.forename: Alessandra
authors.initials: A
authors.lastname: Toletone
authors.affiliation: Department of Educational Sciences, University of Genoa, Genoa, Italy.
authors.forename: Carlo
authors.initials: C
authors.lastname: Chiorri
authors.affiliation: Institute of Public Health, Università Cattolica del Sacro Cuore, Rome, Italy.
authors.forename: Nicola
authors.identifier: http://orcid.org/0000-0002-0988-7344
authors.initials: N
authors.lastname: Magnavita
mesh_terms: D000062:Accidents, Occupational / Q000706:statistics & numerical data*; D000063:Accidents, Traffic / Q000706:statistics & numerical data*; D000328:Adult; D001334:Automobile Driving / Q000706:statistics & numerical data*; D003430:Cross-Sectional Studies; D006970:Disorders of Excessive Somnolence / Q000453:epidemiology* / Q000503:physiopathology; D006801:Humans; D007558:Italy / Q000453:epidemiology; D008297:Male; D012307:Risk Factors; D020181:Sleep Apnea, Obstructive / Q000453:epidemiology* / Q000503:physiopathology; D012894:Sleep Stages / Q000502:physiology*; D011795:Surveys and Questionnaires; D014940:Work Schedule Tolerance