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BMC Med. 2018 Mar 20;16(1):44. doi: 10.1186/s12916-018-1025-7.

Sleep deficiency and motor vehicle crash risk in the general population: a prospective cohort study.

Author information

1
Division of Sleep and Circadian Disorders, Departments of Medicine and Neurology, Brigham & Women's Hospital, 221 Longwood Ave, BLI 225E, Boston, MA, 02115, USA. djgottlieb@partners.org.
2
VA Boston Healthcare System, Boston, MA, USA. djgottlieb@partners.org.
3
Division of Sleep Medicine, Harvard Medical School, Boston, MA, USA. djgottlieb@partners.org.
4
Division of Sleep Medicine, Harvard Medical School, Boston, MA, USA.
5
Department of Neurology, Massachusetts General Hospital, Boston, MA, USA.
6
Division of Sleep and Circadian Disorders, Departments of Medicine and Neurology, Brigham & Women's Hospital, 221 Longwood Ave, BLI 225E, Boston, MA, 02115, USA.

Abstract

BACKGROUND:

Insufficient sleep duration and obstructive sleep apnea, two common causes of sleep deficiency in adults, can result in excessive sleepiness, a well-recognized cause of motor vehicle crashes, although their contribution to crash risk in the general population remains uncertain. The objective of this study was to evaluate the relation of sleep apnea, sleep duration, and excessive sleepiness to crash risk in a community-dwelling population.

METHODS:

This was a prospective observational cohort study nested within the Sleep Heart Health Study, a community-based study of the health consequences of sleep apnea. The participants were 1745 men and 1456 women aged 40-89 years. Sleep apnea was measured by home polysomnography and questionnaires were used to assess usual sleep duration and daytime sleepiness. A follow-up questionnaire 2 years after baseline ascertained driving habits and motor vehicle crash history. Logistic regression analysis was used to examine the relation of sleep apnea and sleep duration at baseline to the occurrence of motor vehicle crashes during the year preceding the follow-up visit, adjusting for relevant covariates. The population-attributable fraction of motor vehicle crashes was estimated from the sample proportion of motor vehicle crashes and the adjusted odds ratios for motor vehicle crash within each exposure category.

RESULTS:

Among 3201 evaluable participants, 222 (6.9%) reported at least one motor vehicle crash during the prior year. A higher apnea-hypopnea index (p < 0.01), fewer hours of sleep (p = 0.04), and self-reported excessive sleepiness (p < 0.01) were each significantly associated with crash risk. Severe sleep apnea was associated with a 123% increased crash risk, compared to no sleep apnea. Sleeping 6 hours per night was associated with a 33% increased crash risk, compared to sleeping 7 or 8 hours per night. These associations were present even in those who did not report excessive sleepiness. The population-attributable fraction of motor vehicle crashes was 10% due to sleep apnea and 9% due to sleep duration less than 7 hours.

CONCLUSIONS:

Sleep deficiency due to either sleep apnea or insufficient sleep duration is strongly associated with motor vehicle crashes in the general population, independent of self-reported excessive sleepiness.

KEYWORDS:

Epidemiology; Motor vehicle accident; Motor vehicle crash; Sleep apnea; Sleep deficiency; Sleep deprivation; Sleep duration

PMID:
29554902
PMCID:
PMC5859531
DOI:
10.1186/s12916-018-1025-7
[Indexed for MEDLINE]
Free PMC Article

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