Self-reported sleepiness while driving as a risk factor for traffic accidents in patients with obstructive sleep apnoea syndrome and in non-apnoeic snorers

The obstructive sleep apnoea syndrome (OSAS) is a condition causing daytime sleepiness and has been related to an increased risk for traffic accidents . However, the evidence linking severity of OSAS to a higher rate of automo bile crashes is based on limited data. The aims of this study were to study the traffic accident rate in the last 5 years in patients referred to our sleep clinic because of clinical suspicion of OSAS and to analyse variables related to an increased risk for traffic accidents. A series of 189 consec utive patients with a driving license referred for a sleep study because of OSAS clinical suspicion and a control group (CG) of 40 hospital staff work ers who denied snoring, matched for age and sex with the study population, were studied. Patients underwent a full-night polysomnography and both pati ents and the CG completed a self-answered questionnaire. One hundred and tw enty-two patients were diagnosed as OSAS and 67 patients as non-apnoeic sno rers (NAS). The self-reported number of accidents was significantly higher in OSAS patients compared with CG. The self-reported number of times off th e road was significantly higher in OSAS patients compared with NAS and with CG. Variables associated with an increased risk for traffic accidents were self-reported sleepiness while driving (OR 5, 95% CI 2.3-10.9), having qui t driving because of sleepiness (OR 3, 95% CI 1.1-8.6) and being currently working (OR 2.8, 95% CI 1.1-7.7). We conclude that self-reported sleepiness while driving is associated with an increased risk for traffic accidents i n OSAS patients and in NAS. We suggest that this symptom can be used to ale rt patients and to give priority in the sleep clinic for study and treatmen t.