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CPAP Reduces the Rates of Car Accidents in Patients with Obstructive Sleep Apnea
Treatment with Nasal CPAP Decreases Automobile Accidents in Patients with Sleep Apnea.
Findley L, Smith C, Hooper J, Dineen M, Suratt PM.
American Journal of Respiratory and Critical Care Medicine 2000; 161:857-859.
Patients with obstructive sleep apnea (OSA) often experience significant daytime sleepiness and, because of this, have a higher risk of car accidents than the general public. Previous studies have shown that treating OSA with continuous positive airway pressure (CPAP) reduces daytime sleepiness and leads to fewer car crashes based on patient self-reporting of accidents. This study from the state of Colorado in the United States looked at car accident rates in patients with untreated and treated OSA. Importantly, the investigators used data from the Ministry of Transportation to confirm the number of accidents caused by the patients. In the study, the diagnosis of OSA was documented on an overnight sleep study. This was followed by a trial of CPAP where pressures on the CPAP machine were adjusted to get rid of OSA. Subsequently, fifty patients (mainly middle-aged, overweight men) with severe OSA were interviewed about their use of CPAP and driving habits, including car accidents. It was found that 36 of the 50 patients used their CPAP regularly (on average about 7.2 hr each night) and the remaining 14 patients did not use it at all. Driving records of the patients were reviewed 2 years before the diagnosis of OSA was made and 2 years afterwards. Patients with untreated OSA had a 7-fold higher car accident rate than the general public both 2 years prior to the diagnosis of OSA and 2 years post. Among the 36 patients whose OSA was treated with CPAP, the car accident rate for the 2-year period after the diagnosis of OSA decreased compared to the 2-year period prior to its diagnosis, to the same rate as that of the average driver in the state of Colorado. In addition, it was shown that patients with OSA report only a third of the number of accidents they are actually involved in. This was proven by comparing the patient self-reported number of car accidents against actual accident records from the Ministry of Transportation. In summary, this study showed that untreated OSA significantly increases the risk of having a car accident and strongly suggested that effective treatment of OSA with CPAP reduces this risk.
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