Sleep Apnea, Sleep Debt and Daytime Sleepiness Are Independently Associated with Road Accidents. A Cross-Sectional Study on Truck Drivers

Sergio Garbarino; Paolo Durando; Ottavia Guglielmi; Guglielmo Dini; Francesca Bersi; Stefania Fornarino; Alessandra Toletone; Carlo Chiorri; Nicola Magnavita

doi:10.1371/journal.pone.0166262

Sleep Apnea, Sleep Debt and Daytime Sleepiness Are Independently Associated with Road Accidents. A Cross-Sectional Study on Truck Drivers

PLoS One. 2016 Nov 30;11(11):e0166262. doi: 10.1371/journal.pone.0166262. eCollection 2016.

Authors

Sergio Garbarino^{1

2}, Paolo Durando², Ottavia Guglielmi¹, Guglielmo Dini², Francesca Bersi², Stefania Fornarino¹, Alessandra Toletone², Carlo Chiorri³, Nicola Magnavita⁴

Affiliations

¹ Department of Neuroscience, Rehabilitation, Ophthalmology, Genetics and Maternal/Child Sciences (DINOGMI), University of Genoa, Genoa, Italy.
² Department of Health Sciences, Postgraduate School in Occupational Medicine, University of Genoa and Occupational Medicine Unit, IRCCS AOU San Martino IST, Genoa, Italy.
³ Department of Educational Sciences, University of Genoa, Genoa, Italy.
⁴ Institute of Public Health, Università Cattolica del Sacro Cuore, Rome, Italy.

Abstract

Background: Recent research has found evidence of an association between motor vehicle accidents (MVAs) or near miss accidents (NMAs), and excessive daytime sleepiness (EDS) or its main medical cause, Obstructive Sleep Apnea (OSA). However, EDS can also be due to non-medical factors, such as sleep debt (SD), which is common among professional truck drivers. On the opposite side, rest breaks and naps are known to protect against accidents.

Study objectives: To investigate the association of OSA, SD, EDS, rest breaks and naps, with the occurrence of MVAs and NMAs in a large sample of truck drivers.

Methods: 949 male truck drivers took part in a cross-sectional medical examination and were asked to complete a questionnaire about sleep and waking habits, risk factors for OSA and EDS.

Results: MVAs and NMAs were reported by 34.8% and 9.2% of participants, respectively. MVAs were significantly predicted by OSA (OR = 2.32 CI95% = 1.68-3.20), SD (OR = 1.45 CI95% = 1.29-1.63), EDS (OR = 1.73 CI95% = 1.15-2.61) and prevented by naps (OR = 0.59 CI95% = 0.44-0.79) or rest breaks (OR = 0.63 CI95% = 0.45-0.89). NMAs were significantly predicted by OSA (OR = 2.39 CI95% = 1.47-3.87) and SD (OR = 1.49 CI95% = 1.27-1.76) and prevented by naps (OR = 0.52 CI95% = 0.32-0.85) or rest breaks (OR = 0.49 CI95% = 0.29-0.82).

Conclusions: When OSA, SD or EDS are present, the risk of MVAs or NMAs in truck drivers is severely increased. Taking a rest break or a nap appear to be protective against accidents.

MeSH terms

Accidents, Occupational / statistics & numerical data*
Accidents, Traffic / statistics & numerical data*
Adult
Automobile Driving / statistics & numerical data*
Cross-Sectional Studies
Disorders of Excessive Somnolence / epidemiology*
Disorders of Excessive Somnolence / physiopathology
Humans
Italy / epidemiology
Male
Risk Factors
Sleep Apnea, Obstructive / epidemiology*
Sleep Apnea, Obstructive / physiopathology
Sleep Stages / physiology*
Surveys and Questionnaires
Work Schedule Tolerance

Grants and funding

Medical examinations were funded by the CNH-Iveco Industrial Corporation (Grant number 25171877) within the “CNH Iveco Industrial Check-Stop Project", an international project for road safety, supported by the European Union Road Safety Action and the Italian Ministry of Transport. The funders had no role in study design, data collection and analysis, decision to publish, or preparation of the manuscript. Print expenses will be covered with University funds from NM.