Obstructive Sleep Apnea Hypopnea Raises Risk of Crashes

Patients with obstructive sleep apnea hypopnea had a greater rate of motor vehicle crashes than did matched controls, and they were three times more likely to be involved in crashes involving personal injury, according to researchers in British Columbia.

“Our data indicate that the increased risk of motor vehicle crash occurs at all levels of OSAH severity,” Dr. Alan T. Mulgrew, of the University of British Columbia, Vancouver, and his colleagues wrote (Thorax 2008 Jan. 30 [Epub doi:10.1136/thx.2007.085464]).

The study involved 783 adult patients who were referred for overnight polysomnography for suspected sleep-disordered breathing. Patients were excluded if they had symptoms of another sleep disorder known to cause daytime sleepiness (periodic limb movement disorder), or if they had another serious medical condition or overt psychiatric disease. They were also excluded if they were already being treated for OSAH.

Overnight polysomnography was performed using conventional instrumentation, and analysis was performed according to the American Academy of Sleep Medicine's recommendations on syndrome definition and measurement techniques. Patients completed a number of surveys on the night of their polysomnography study. Daytime sleepiness was assessed using the Epworth Sleepiness Scale.

All motorists in British Columbia are insured by a single insurance corporation: the Insurance Corporation of British Columbia (ICBC). Objective crash data for patients–including crash severity type–was obtained for 3 years prior to the sleep study.

All patients were matched with an individual control from the ICBC database based on age, gender, type of license, driving experience, and postal region, Dr. Mulgrew said.

Patients were categorized by OSAH severity based on the apnea hypopnea index (AHI): normal polysomnography (AHI of 5 or fewer events per hour), mild OSAH (AHI greater than 5 and up to 15), moderate OSAH (AHI greater than 15 but less than 30), and severe OSAH (AHI of 30 or more per hour).

Most patients (71%) were men, and the average patient age was 50 years. The average AHI was 22.6 events per hour, and the average Epworth Sleepiness Scale score was 10. The mean body mass index (BMI) was 31.8 kg/m

In terms of OSAH severity, 18% of patients had normal polysomnography, 30% had mild OSAH, 26% had moderate OSAH, and 26% had severe OSAH.

In all, there were 374 crashes, of which 251 (67%) happened to patients. In the patient group, 94 of 251 crashes caused minor property damage, 83 crashes caused major property damage, and 74 crashes caused injuries. This compared with 48, 52, and 23 in the control group.

When compared with controls, patients with OSAH had a significantly increased rate of motor vehicle crashes, with relative risks ranging from 1.9 to 2.6. In comparison, patients without OSAH (AHI 0–5 events per hour) were at lower risk of motor vehicle crashes than were patients with OSAH.

The presence of OSAH was linked with a 3.0- to 4.8-fold increase in the rate of more severe motor vehicle crashes.

Within the patient group, there appeared to be a dose-response relationship between OSAH severity and the rate of motor vehicle crashes involving personal injury.

In patients with an AHI of 0–5, motor vehicle crashes involving personal injury accounted for 9% of crashes, compared with 37% in those with an AHI greater than 30.

Compared with patients with an AHI of 0–5, patients with severe OSAH were 6.1 times more likely to be in a crash involving personal injury, the researchers reported.

Patients with obstructive sleep apnea hypopnea had a greater rate of motor vehicle crashes than did matched controls, and they were three times more likely to be involved in crashes involving personal injury, according to researchers in British Columbia.

“Our data indicate that the increased risk of motor vehicle crash occurs at all levels of OSAH severity,” Dr. Alan T. Mulgrew, of the University of British Columbia, Vancouver, and his colleagues wrote (Thorax 2008 Jan. 30 [Epub doi:10.1136/thx.2007.085464]).

The study involved 783 adult patients who were referred for overnight polysomnography for suspected sleep-disordered breathing. Patients were excluded if they had symptoms of another sleep disorder known to cause daytime sleepiness (periodic limb movement disorder), or if they had another serious medical condition or overt psychiatric disease. They were also excluded if they were already being treated for OSAH.

Overnight polysomnography was performed using conventional instrumentation, and analysis was performed according to the American Academy of Sleep Medicine's recommendations on syndrome definition and measurement techniques. Patients completed a number of surveys on the night of their polysomnography study. Daytime sleepiness was assessed using the Epworth Sleepiness Scale.

All motorists in British Columbia are insured by a single insurance corporation: the Insurance Corporation of British Columbia (ICBC). Objective crash data for patients–including crash severity type–was obtained for 3 years prior to the sleep study.

All patients were matched with an individual control from the ICBC database based on age, gender, type of license, driving experience, and postal region, Dr. Mulgrew said.

Patients were categorized by OSAH severity based on the apnea hypopnea index (AHI): normal polysomnography (AHI of 5 or fewer events per hour), mild OSAH (AHI greater than 5 and up to 15), moderate OSAH (AHI greater than 15 but less than 30), and severe OSAH (AHI of 30 or more per hour).

Most patients (71%) were men, and the average patient age was 50 years. The average AHI was 22.6 events per hour, and the average Epworth Sleepiness Scale score was 10. The mean body mass index (BMI) was 31.8 kg/m

In terms of OSAH severity, 18% of patients had normal polysomnography, 30% had mild OSAH, 26% had moderate OSAH, and 26% had severe OSAH.

In all, there were 374 crashes, of which 251 (67%) happened to patients. In the patient group, 94 of 251 crashes caused minor property damage, 83 crashes caused major property damage, and 74 crashes caused injuries. This compared with 48, 52, and 23 in the control group.

When compared with controls, patients with OSAH had a significantly increased rate of motor vehicle crashes, with relative risks ranging from 1.9 to 2.6. In comparison, patients without OSAH (AHI 0–5 events per hour) were at lower risk of motor vehicle crashes than were patients with OSAH.

The presence of OSAH was linked with a 3.0- to 4.8-fold increase in the rate of more severe motor vehicle crashes.

Within the patient group, there appeared to be a dose-response relationship between OSAH severity and the rate of motor vehicle crashes involving personal injury.

In patients with an AHI of 0–5, motor vehicle crashes involving personal injury accounted for 9% of crashes, compared with 37% in those with an AHI greater than 30.

Compared with patients with an AHI of 0–5, patients with severe OSAH were 6.1 times more likely to be in a crash involving personal injury, the researchers reported.

Patients with obstructive sleep apnea hypopnea had a greater rate of motor vehicle crashes than did matched controls, and they were three times more likely to be involved in crashes involving personal injury, according to researchers in British Columbia.

“Our data indicate that the increased risk of motor vehicle crash occurs at all levels of OSAH severity,” Dr. Alan T. Mulgrew, of the University of British Columbia, Vancouver, and his colleagues wrote (Thorax 2008 Jan. 30 [Epub doi:10.1136/thx.2007.085464]).

The study involved 783 adult patients who were referred for overnight polysomnography for suspected sleep-disordered breathing. Patients were excluded if they had symptoms of another sleep disorder known to cause daytime sleepiness (periodic limb movement disorder), or if they had another serious medical condition or overt psychiatric disease. They were also excluded if they were already being treated for OSAH.

Overnight polysomnography was performed using conventional instrumentation, and analysis was performed according to the American Academy of Sleep Medicine's recommendations on syndrome definition and measurement techniques. Patients completed a number of surveys on the night of their polysomnography study. Daytime sleepiness was assessed using the Epworth Sleepiness Scale.

All motorists in British Columbia are insured by a single insurance corporation: the Insurance Corporation of British Columbia (ICBC). Objective crash data for patients–including crash severity type–was obtained for 3 years prior to the sleep study.

All patients were matched with an individual control from the ICBC database based on age, gender, type of license, driving experience, and postal region, Dr. Mulgrew said.

Patients were categorized by OSAH severity based on the apnea hypopnea index (AHI): normal polysomnography (AHI of 5 or fewer events per hour), mild OSAH (AHI greater than 5 and up to 15), moderate OSAH (AHI greater than 15 but less than 30), and severe OSAH (AHI of 30 or more per hour).

Most patients (71%) were men, and the average patient age was 50 years. The average AHI was 22.6 events per hour, and the average Epworth Sleepiness Scale score was 10. The mean body mass index (BMI) was 31.8 kg/m

In terms of OSAH severity, 18% of patients had normal polysomnography, 30% had mild OSAH, 26% had moderate OSAH, and 26% had severe OSAH.

In all, there were 374 crashes, of which 251 (67%) happened to patients. In the patient group, 94 of 251 crashes caused minor property damage, 83 crashes caused major property damage, and 74 crashes caused injuries. This compared with 48, 52, and 23 in the control group.

When compared with controls, patients with OSAH had a significantly increased rate of motor vehicle crashes, with relative risks ranging from 1.9 to 2.6. In comparison, patients without OSAH (AHI 0–5 events per hour) were at lower risk of motor vehicle crashes than were patients with OSAH.

The presence of OSAH was linked with a 3.0- to 4.8-fold increase in the rate of more severe motor vehicle crashes.

Within the patient group, there appeared to be a dose-response relationship between OSAH severity and the rate of motor vehicle crashes involving personal injury.

In patients with an AHI of 0–5, motor vehicle crashes involving personal injury accounted for 9% of crashes, compared with 37% in those with an AHI greater than 30.

Compared with patients with an AHI of 0–5, patients with severe OSAH were 6.1 times more likely to be in a crash involving personal injury, the researchers reported.