The association between sleep apnea and the risk of traffic accidents
The association between sleep apnea and the risk of traffic accidents
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DOI：
10.1056/nejm199903183401104
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发表时间：
1999-03-18
影响因子：
158.5
通讯作者：
Cordero-Guevara, J
中科院分区：
文献类型：
--
作者：
Terán-Santos, J;Jiménez-Gómez, A;Cordero-Guevara, J
背景与方法嗜睡和注意力不集中可能是交通事故的原因之一。我们对睡眠呼吸暂停和交通事故风险之间的关系进行了病例对照研究。病例患者是102名司机，他们在1995年4月至12月期间发生公路交通事故后在西班牙布尔戈斯或桑坦德的医院接受紧急治疗。对照组为152例随机选择的初级保健中心在同一城市和匹配的病例患者的年龄和性别。在家中使用呼吸道多导睡眠图筛查患者的睡眠呼吸暂停，并使用常规多导睡眠图确诊。计算每位参与者的呼吸暂停低通气指数（呼吸暂停和低通气发作的总次数除以睡眠小时数）。与没有睡眠呼吸暂停的患者相比，呼吸暂停低通气指数为10或更高的患者发生交通事故的优势比为6.3（95%置信区间为2.4至16.2）。在调整了潜在的混杂因素（如饮酒、视力屈光障碍、体重指数、驾驶年限、年龄、交通事故史、使用引起嗜睡的药物和睡眠时间表）后，这种关系仍然显著。在呼吸暂停低通气指数为10或更高的受试者中，发生事故的风险在那些在事故发生当天饮酒的人中高于那些没有饮酒的人。结论睡眠呼吸暂停（以呼吸暂停低通气指数测量）与交通事故风险之间存在很强的相关性。（N Engl J Med 1999; 340：847-51.）(C)1999年，马萨诸塞州医学会。
Background and Methods Drowsiness and lack of concentration may contribute to traffic accidents. We conducted a case-control study of the relation between sleep apnea and the risk of traffic accidents. The case patients were 102 drivers who received emergency treatment at hospitals in Burgos or Santander, Spain, after highway traffic accidents between April and December 1995. The controls were 152 patients randomly selected from primary care centers in the same cities and matched with the case patients for age and sex. Respiratory polygraphy was used to screen the patients for sleep apnea at home, and conventional polysomnography was used to confirm the diagnosis. The apnea-hypopnea index (the total number of episodes of apnea and hypopnea divided by the number of hours of sleep) was calculated for each participant.Results The mean age of the participants was 44 years; 77 percent were men. As compared with those without sleep apnea, patients with an apnea-hypopnea index of 10 or higher had an odds ratio of 6.3 (95 percent confidence interval, 2.4 to 16.2) for having a traffic accident. This relation remained significant after adjustment for potential confounders, such as alcohol consumption, visual-refraction disorders, body-mass index, years of driving, age, history with respect to traffic accidents, use of medications causing drowsiness, and sleep schedule. Among subjects with an apnea-hypopnea index of 10 or more, the risk of an accident was higher among those who had consumed alcohol on the day of the accident than among those who had not.Conclusions There is a strong association between sleep apnea, as measured by the apnea-hypopnea index, and the risk of traffic accidents. (N Engl J Med 1999; 340:847-51.) (C) 1999, Massachusetts Medical Society.