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Individuals with certain sleeping disorders may have a higher risk of crashes, near-crashes or unsafe maneuvering prior to such events, suggests a study.
“The results confirm that some sleep disorders generally increase driving risk as defined by our dependent measures,” wrote Shu-Yuan Liu, a doctoral student, and two colleagues at Virginia Tech, Blacksburg (Sleep. 2018 Apr 1. doi: 10.1093/sleep/zsy023). “Furthermore, the results also provide some insights into how risk varies across specific types of sleep disorder and some moderating factors.”
The study involved licensed drivers who drove at least 3 days a week, had an eligible vehicle in good working condition, and agreed to participate for 1 to 2 years. At the start and end of the study, participants filled out a questionnaire on any medical conditions they had or had been treated for in the past year, any medications they were taking, and any aids they were using for a medical condition.
Among the conditions they were able to select were narcolepsy, sleep apnea, insomnia, shift work sleep disorder, restless legs syndrome (RLS), periodic limb movement disorder, and migraine. All of these conditions have been linked in previous studies to a higher risk of vehicle collisions.
A total of 646 participants, 18.2% of the sample, had one of those disorders: 0.14% had narcolepsy, 7.4% had sleep apnea, 4.8% had insomnia, 3.4% had RLS, 0.37% had shift work sleep disorder, 0.23% had periodic limb movement disorder, and 8.4% had migraine.
Analysis of vehicle data found that female drivers with RLS and any drivers with insomnia had a higher risk of crashes or near-crashes (adjusted odds ratio [AOR] = 2.26 and 1.49, respectively, P less than .05 for both). Drivers with narcolepsy had 9 times greater odds of being involved in a crash or near-crash, but the finding was not statistically significant (AOR = 10.24, P less than .1).
“Drivers who reported frequency of sleepy driving as ‘never,’ ‘rarely,’ and ‘sometimes’ also had higher a risk, indicating that crash or near-crash risk is also associated with sources other than these sleeping disorders,” the authors noted. These drivers’ increased odds of getting into or nearly getting into a crash ranged from 31% to 53% greater (P less than .05).
All drivers with shift work sleep disorder, except for those aged 20-24, had a crash or near-crash rate that was 7.5 times greater than that of drivers without any sleeping disorders. The rate among drivers aged 20-24 with this disorder had a 90% lower rate (risk ratio [RR] = 0.1, P less than .05) compared with control drivers.
When the researchers analyzed the drivers’ maneuvers just before a crash or near-crash, they found females with sleep apnea had a 36% greater odds of doing an unsafe maneuver in crash/near-crash circumstances (AOR = 1.36). (AOR = 3.38 and 3.53, respectively, P less than .05).
The only drivers with a sleeping disorder who were more likely to be involved in crashes of greater severity were those with periodic limb movement disorder (AOR = 1.43, P less than .05).
However, young drivers, senior drivers, and nighttime drivers also all had higher odds of being involved in more severe crashes and in performing unsafe maneuvers prior to a crash or near-crash. Nighttime drivers seemed to be most at risk for these, and they were linked to having more than 5 times greater odds of unsafely maneuvering their vehicles prior to getting into a crash or near crash (AOR = 6.71, P less than .05).
“This is a strong piece of evidence that nighttime driving is less safe than daytime driving and limiting amount of nighttime driving could be one method to moderate road risk for some individuals,” the authors wrote.
The study’s limitations include its observational nature, low numbers of participants with several of the sleeping disorders (at levels below the disorder’s prevalence in the general population), and the complexities involved in what causes a crash or near crash.
One limitation of this study was that sleep hygiene and sleep quality were not examined, even though these might contribute significantly to roadway safety, the researchers noted. This study also did not take into account what medications or other treatment (such as continuous positive airway pressure for those with sleep apnea) the participants might be receiving for their condition.
The study’s implications include the need for physicians to advise patients with insomnia or females with sleep apnea to use caution while driving without “exaggerating risks that introduce undue fear to patients with other sleep disorders and thereby limiting mobility unnecessarily,” the authors wrote. The researchers also suggested that employers consider providing alternative transportation to shift workers and/or that insurance companies offer employers lower rates for offering such alternatives.
SOURCE: Liu Shu-Yuan et al. Sleep J. 2018 Apr 1. doi: 10.1093/sleep/zsy023.
Individuals with certain sleeping disorders may have a higher risk of crashes, near-crashes or unsafe maneuvering prior to such events, suggests a study.
“The results confirm that some sleep disorders generally increase driving risk as defined by our dependent measures,” wrote Shu-Yuan Liu, a doctoral student, and two colleagues at Virginia Tech, Blacksburg (Sleep. 2018 Apr 1. doi: 10.1093/sleep/zsy023). “Furthermore, the results also provide some insights into how risk varies across specific types of sleep disorder and some moderating factors.”
The study involved licensed drivers who drove at least 3 days a week, had an eligible vehicle in good working condition, and agreed to participate for 1 to 2 years. At the start and end of the study, participants filled out a questionnaire on any medical conditions they had or had been treated for in the past year, any medications they were taking, and any aids they were using for a medical condition.
Among the conditions they were able to select were narcolepsy, sleep apnea, insomnia, shift work sleep disorder, restless legs syndrome (RLS), periodic limb movement disorder, and migraine. All of these conditions have been linked in previous studies to a higher risk of vehicle collisions.
A total of 646 participants, 18.2% of the sample, had one of those disorders: 0.14% had narcolepsy, 7.4% had sleep apnea, 4.8% had insomnia, 3.4% had RLS, 0.37% had shift work sleep disorder, 0.23% had periodic limb movement disorder, and 8.4% had migraine.
Analysis of vehicle data found that female drivers with RLS and any drivers with insomnia had a higher risk of crashes or near-crashes (adjusted odds ratio [AOR] = 2.26 and 1.49, respectively, P less than .05 for both). Drivers with narcolepsy had 9 times greater odds of being involved in a crash or near-crash, but the finding was not statistically significant (AOR = 10.24, P less than .1).
“Drivers who reported frequency of sleepy driving as ‘never,’ ‘rarely,’ and ‘sometimes’ also had higher a risk, indicating that crash or near-crash risk is also associated with sources other than these sleeping disorders,” the authors noted. These drivers’ increased odds of getting into or nearly getting into a crash ranged from 31% to 53% greater (P less than .05).
All drivers with shift work sleep disorder, except for those aged 20-24, had a crash or near-crash rate that was 7.5 times greater than that of drivers without any sleeping disorders. The rate among drivers aged 20-24 with this disorder had a 90% lower rate (risk ratio [RR] = 0.1, P less than .05) compared with control drivers.
When the researchers analyzed the drivers’ maneuvers just before a crash or near-crash, they found females with sleep apnea had a 36% greater odds of doing an unsafe maneuver in crash/near-crash circumstances (AOR = 1.36). (AOR = 3.38 and 3.53, respectively, P less than .05).
The only drivers with a sleeping disorder who were more likely to be involved in crashes of greater severity were those with periodic limb movement disorder (AOR = 1.43, P less than .05).
However, young drivers, senior drivers, and nighttime drivers also all had higher odds of being involved in more severe crashes and in performing unsafe maneuvers prior to a crash or near-crash. Nighttime drivers seemed to be most at risk for these, and they were linked to having more than 5 times greater odds of unsafely maneuvering their vehicles prior to getting into a crash or near crash (AOR = 6.71, P less than .05).
“This is a strong piece of evidence that nighttime driving is less safe than daytime driving and limiting amount of nighttime driving could be one method to moderate road risk for some individuals,” the authors wrote.
The study’s limitations include its observational nature, low numbers of participants with several of the sleeping disorders (at levels below the disorder’s prevalence in the general population), and the complexities involved in what causes a crash or near crash.
One limitation of this study was that sleep hygiene and sleep quality were not examined, even though these might contribute significantly to roadway safety, the researchers noted. This study also did not take into account what medications or other treatment (such as continuous positive airway pressure for those with sleep apnea) the participants might be receiving for their condition.
The study’s implications include the need for physicians to advise patients with insomnia or females with sleep apnea to use caution while driving without “exaggerating risks that introduce undue fear to patients with other sleep disorders and thereby limiting mobility unnecessarily,” the authors wrote. The researchers also suggested that employers consider providing alternative transportation to shift workers and/or that insurance companies offer employers lower rates for offering such alternatives.
SOURCE: Liu Shu-Yuan et al. Sleep J. 2018 Apr 1. doi: 10.1093/sleep/zsy023.
Individuals with certain sleeping disorders may have a higher risk of crashes, near-crashes or unsafe maneuvering prior to such events, suggests a study.
“The results confirm that some sleep disorders generally increase driving risk as defined by our dependent measures,” wrote Shu-Yuan Liu, a doctoral student, and two colleagues at Virginia Tech, Blacksburg (Sleep. 2018 Apr 1. doi: 10.1093/sleep/zsy023). “Furthermore, the results also provide some insights into how risk varies across specific types of sleep disorder and some moderating factors.”
The study involved licensed drivers who drove at least 3 days a week, had an eligible vehicle in good working condition, and agreed to participate for 1 to 2 years. At the start and end of the study, participants filled out a questionnaire on any medical conditions they had or had been treated for in the past year, any medications they were taking, and any aids they were using for a medical condition.
Among the conditions they were able to select were narcolepsy, sleep apnea, insomnia, shift work sleep disorder, restless legs syndrome (RLS), periodic limb movement disorder, and migraine. All of these conditions have been linked in previous studies to a higher risk of vehicle collisions.
A total of 646 participants, 18.2% of the sample, had one of those disorders: 0.14% had narcolepsy, 7.4% had sleep apnea, 4.8% had insomnia, 3.4% had RLS, 0.37% had shift work sleep disorder, 0.23% had periodic limb movement disorder, and 8.4% had migraine.
Analysis of vehicle data found that female drivers with RLS and any drivers with insomnia had a higher risk of crashes or near-crashes (adjusted odds ratio [AOR] = 2.26 and 1.49, respectively, P less than .05 for both). Drivers with narcolepsy had 9 times greater odds of being involved in a crash or near-crash, but the finding was not statistically significant (AOR = 10.24, P less than .1).
“Drivers who reported frequency of sleepy driving as ‘never,’ ‘rarely,’ and ‘sometimes’ also had higher a risk, indicating that crash or near-crash risk is also associated with sources other than these sleeping disorders,” the authors noted. These drivers’ increased odds of getting into or nearly getting into a crash ranged from 31% to 53% greater (P less than .05).
All drivers with shift work sleep disorder, except for those aged 20-24, had a crash or near-crash rate that was 7.5 times greater than that of drivers without any sleeping disorders. The rate among drivers aged 20-24 with this disorder had a 90% lower rate (risk ratio [RR] = 0.1, P less than .05) compared with control drivers.
When the researchers analyzed the drivers’ maneuvers just before a crash or near-crash, they found females with sleep apnea had a 36% greater odds of doing an unsafe maneuver in crash/near-crash circumstances (AOR = 1.36). (AOR = 3.38 and 3.53, respectively, P less than .05).
The only drivers with a sleeping disorder who were more likely to be involved in crashes of greater severity were those with periodic limb movement disorder (AOR = 1.43, P less than .05).
However, young drivers, senior drivers, and nighttime drivers also all had higher odds of being involved in more severe crashes and in performing unsafe maneuvers prior to a crash or near-crash. Nighttime drivers seemed to be most at risk for these, and they were linked to having more than 5 times greater odds of unsafely maneuvering their vehicles prior to getting into a crash or near crash (AOR = 6.71, P less than .05).
“This is a strong piece of evidence that nighttime driving is less safe than daytime driving and limiting amount of nighttime driving could be one method to moderate road risk for some individuals,” the authors wrote.
The study’s limitations include its observational nature, low numbers of participants with several of the sleeping disorders (at levels below the disorder’s prevalence in the general population), and the complexities involved in what causes a crash or near crash.
One limitation of this study was that sleep hygiene and sleep quality were not examined, even though these might contribute significantly to roadway safety, the researchers noted. This study also did not take into account what medications or other treatment (such as continuous positive airway pressure for those with sleep apnea) the participants might be receiving for their condition.
The study’s implications include the need for physicians to advise patients with insomnia or females with sleep apnea to use caution while driving without “exaggerating risks that introduce undue fear to patients with other sleep disorders and thereby limiting mobility unnecessarily,” the authors wrote. The researchers also suggested that employers consider providing alternative transportation to shift workers and/or that insurance companies offer employers lower rates for offering such alternatives.
SOURCE: Liu Shu-Yuan et al. Sleep J. 2018 Apr 1. doi: 10.1093/sleep/zsy023.
FROM SLEEP
Key clinical point: Individuals with certain sleeping disorders may have a higher risk of crashes, near-crashes or unsafe maneuvering prior to such events.
Major finding: Drivers with insomnia and female drivers with sleep apnea have 49% and 126% greater odds, respectively, of a crash or near-crash.
Data source: The findings are based on an analysis of naturalistic driving data from 3,541 U.S. drivers between ages 16 and 98.
Disclosures: The data were provided by the Transportation Research Board of the National Academy of Sciences. No external funding was noted. The authors reported having no disclosures.
Source: Liu Shu-Yuan et al. Sleep J. 2018 Apr 1. doi: 10.1093/sleep/zsy023.