Published ahead of print on August 18, 2004, doi:10.1164/rccm.200312-1782OC
Am. J. Respir. Crit. Care Med., Volume 170, Number 9, November 2004, 1014-1021
A more recent version of this article appeared on November 1, 2004
Submitted on January 6, 2004
Accepted on August 11, 2004
Sleepiness, Sleep Disordered Breathing and Accident Risk Factors in Commercial Vehicle Drivers
Mark E Howard1*, Anup V Desai2, Ronald R Grunstein2, Craig Hukins3, John G Armstrong3, David Joffe2, Philip Swann4, Donald A Campbell5, and Robert J Pierce1
1 Institute of Breathing and Sleep, Austin Health and University of Melbourne, Heidelberg, Victoria, Australia,
2 Woolcock Institute of Medical Research, University of Sydney, Royal Prince Alfred Hospital and Royal North Shore Hospitals, Sydney, New South Wales, Australia,
3 Department of Respiratory Medicine, Princess Alexandra Hospital, Wolloongabba, Queensland, Australia,
4 Vicroads, Department of Road Safety, Kew, Victoria, Australia,
5 Monash Medical Centre, Monash Institute of Health Services Research, Clayton, Victoria, Australia
* To whom correspondence should be addressed. E-mail: mark.howard{at}austin.org.au.
Sleep disordered breathing and excessive sleepiness may be more common in commercial vehicle drivers than 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 2342 respondents to a questionnaire distributed to a random sample of 3268 Australian commercial vehicle drivers and another 161 drivers among 244 invited to undergo polysomnography. 59.6% of drivers had sleep disordered breathing and 15.8% had obstructive sleep apnea syndrome. 24% 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 1.91, p=0.02 and 2.23, p<0.01 respectively) and multiple accidents (odds ratio 2.67, p<0.01 and 2.39, p=0.01), adjusted for established risk factors. There was an increased accident risk with narcotic analgesic use (odds ratio 2.40, p<0.01) and antihistamine use (odds ratio 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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