Sleep Apnea and Driving Risk

Patients with OSA have an increased risk for car accidents.

Many studies have been performed that demonstrate that patients with untreated sleep apnea have a higher rate of motor vehicle collisions compared to the general population.

One study in the New England Journal of Medicine found that people with sleep apnea with an apnea-hypopnea index (AHI) > 10/hr had an increased risk of motor vehicle collisions of 6.3 times the control group!

What can be done about this?

Patients treated with CPAP have reduced car accidents.

Studies have demonstrated that patients with OSA who use CPAP consistently have improved driving skills as tested using driving simulators. Additionally, studies have demonstrated a reduction in motor vehicles collisions with the use of CPAP.

A study in Colorado compared the number of motor vehicle collisions in patients with OSA who used CPAP compared to those who did not use CPAP over a 2 year period. Accident history was obtained from the Department of Motor Vehicle accident reports. The 50 patients who were studied had a high previous car accident rate of 0.07 accidents per driver per year (compared to 0.01 accidents per driver per year for all drivers in Colorado) prior to the diagnosis of sleep apnea. The 36 patients who used CPAP decreased the car accident rate to 0 over the 2 year period while the 14 patients who did not use CPAP continued to have a car accident rate of 0.07 accidents per driver per year.

A similar study was performed in Ontario, Canada. 210 patients with OSA were studied. Patients with untreated sleep apnea had an elevated rate of car accidents (0.18 accidents per driver per year compared to 0.06 accidents per driver per year in the control group). After treatment with CPAP, the accident rate decreased to the same as the control group (0.06 accidents per driver per year). Patients who did not use CPAP continued to have an elevated accident rate (0.15 accidents per driver per year).

REFERENCES:

The association between sleep apnea and the risk of traffic accidents.

N Engl J Med. 1999 Mar 18;340(11):847-51.

Driving and automobile crashes in patients with obstructive sleep apnoea/hypopnoea syndrome.

Thorax. 2004 Sep;59(9):804-7.

Reduction in motor vehicle collisions following treatment of sleep apnoea with nasal CPAP.

Thorax. 2001 Jul;56(7):508-12.

Treatment with nasal CPAP decreases automobile accidents in patients with sleep apnea.

Am J Respir Crit Care Med. 2000 Mar;161(3 Pt 1):857-9.