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Sleepiness, Sleep-disordered Breathing, and Accident Risk Factors in Commercial Vehicle Drivers

Institute of Breathing and Sleep, Austin Health and University of Melbourne; Department of Road Safety, Vicroads; Australia Monash Institute of Health Services Research, Monash Medical Centre, Victoria; Woolcock Institute of Medical Research University of Sydney, Royal Prince Alfred Hospital and Royal North Shore Hospitals, New South Wales; and Princess Alexandra Hospital, Queensland, Australia

Correspondence and requests for reprints should be addressed to Dr. Mark Howard, Institute of Breathing and Sleep, Bowen Centre, Austin Health, Heidelberg, Victoria, Australia, 3084. E-mail: mark.howard{at}austin.org.au

Sleep-disordered breathing and excessive sleepiness may be more common in commercial vehicle drivers than in the general population. The relative importance of factors causing excessive sleepiness and accidents in this population remains unclear. We measured the prevalence of excessive sleepiness and sleep-disordered breathing and assessed accident risk factors in 2,342 respondents to a questionnaire distributed to a random sample of 3,268 Australian commercial vehicle drivers and another 161 drivers among 244 invited to undergo polysomnography. More than half (59.6%) of drivers had sleep-disordered breathing and 15.8% had obstructive sleep apnea syndrome. Twenty-four percent of drivers had excessive sleepiness. Increasing sleepiness was related to an increased accident risk. The sleepiest 5% of drivers on the Epworth Sleepiness Scale and Functional Outcomes of Sleep Questionnaire had an increased risk of an accident (odds ratio [OR] 1.91, p = 0.02 and OR 2.23, p < 0.01, respectively) and multiple accidents (OR 2.67, p < 0.01 and OR 2.39, p = 0.01), adjusted for established risk factors. There was an increased accident risk with narcotic analgesic use (OR 2.40, p < 0.01) and antihistamine use (OR 3.44, p = 0.04). Chronic excessive sleepiness and sleep-disordered breathing are common in Australian commercial vehicle drivers. Accident risk was related to increasing chronic sleepiness and antihistamine and narcotic analgesic use.

Key Words: accidents, traffic • antihistamines • narcotic analgesics • obesity

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