1. Risk Factors for Sleepiness at the Wheel and Sleep-Related Car Accidents Among Patients with Obstructive Sleep Apnea: Data from the French Pays de la Loire Sleep Cohort
- Author
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Sabil A, Bignard R, Gervès-Pinquié C, Philip P, Le Vaillant M, Trzepizur W, Meslier N, and Gagnadoux F
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sleepiness ,accidents ,near-miss accidents ,french drivers ,osa ,early risk prediction ,Psychiatry ,RC435-571 ,Neurophysiology and neuropsychology ,QP351-495 - Abstract
AbdelKebir Sabil,1 Remi Bignard,2 Chloé Gervès-Pinquié,3 Pierre Philip,4 Marc Le Vaillant,3 Wojciech Trzepizur,2 Nicole Meslier,2 Frédéric Gagnadoux2 1Clinical Research Department, Cloud Sleep Lab, Paris, France; 2Department of Respiratory and Sleep Medicine, University Hospital of Angers, Angers, France; 3Biostatistics Department, Pays de la Loire Respiratory Health Research Institute, Beaucouzé, France; 4Sleep, Attention and Neuropsychiatry Unit, University of Bordeaux, CNRS, SANPSY USR 3413, and CHU Pellegrin, Bordeaux, FranceCorrespondence: AbdelKebir SabilClinical Research Department, Cloud Sleep Lab, 29 rue Louis Braille, Paris, FranceTel +33 648 01 00 21Email kebir.sabil@cloudsleeplab.comPurpose: We aimed to determine the risk factors of sleepiness at the wheel among patients with obstructive sleep apnea (OSA) and to determine factors that were independently associated with reported sleep-related near-miss accidents or car accidents.Patients and Methods: This retrospective study was conducted on 843 OSA patients from the French Pays de la Loire sleep cohort database. Each patient completed surveys including anthropometric data, medical history, professional status, and data on alcohol and tobacco use. Epworth sleepiness scale (ESS) and sleep quality questionnaires were administered. Regarding driving, data were collected on occurrence of sleepiness-related near-misses or car accidents, and on distance driven per year. The primary dependent variable of interest was reported sleepiness at the wheel.Results: On multivariable regression analysis, reported sleepiness at the wheel (n=298) was independently associated with younger age (p=0.02), male gender (p=0.009), marked nocturnal hypoxemia (p=0.006), lower BMI (p=0.03), absence of cardiovascular disease (p=0.022), executives or high degree jobs (p=0.003) and reported difficulty-maintaining sleep (p=0.03). Only past experience of sleepiness at the wheel (OR 12.18, [6.38– 23.25]) and an ESS ≥ 11 (OR 4.75 [2.73– 8.27]) were independently associated with reported car accidents (n=30) or near-miss accidents (n=137).Conclusion: In patients newly diagnosed with OSA, the risk of car accident seems multifactorial, and its evaluation should include multiple parameters such as patient self-reported sleepiness at the wheel, occurrence of sleepiness-related accidents, anthropometry, professional status, and insomnia complaints. Thus, it is possible to evaluate this risk and advise patients as early as the first visit at the sleep medicine clinic without waiting for the results of the sleep study.Keywords: sleepiness, accidents, near-miss accidents, French drivers, OSA, early risk prediction
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- 2021