Sleep-disordered breathing and motor vehicle accidents in a population-based sample of employed adults
Sleep-disordered breathing and motor vehicle accidents in a population-based sample of employed adults
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DOI：
10.1093/sleep/20.8.608
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发表时间：
1997-01-01
期刊：
影响因子：
5.6
通讯作者：
Palta, M
中科院分区：
文献类型：
--
作者：
Young, T;Blustein, J;Palta, M
研究一直表明，睡眠呼吸暂停患者有很高的事故率，但临床人群以外的相关性的普遍性受到质疑。这项研究的目的是确定普通人群中未被识别的睡眠呼吸障碍（从轻度到重度）是否与机动车事故有关。该样本包括913名受雇的成年人，他们参加了一项正在进行的睡眠呼吸障碍自然史研究。睡眠呼吸障碍状态通过实验室夜间多导睡眠描记术确定，机动车事故（MVA）历史记录来自1988年至1993年全州范围内所有交通违规和事故的数据库。与没有睡眠呼吸障碍的人相比，每小时睡眠呼吸暂停和呼吸不足5次或更多[呼吸暂停低通气指数（AHI）>5]的男性在5年内发生至少一次事故的可能性明显更高（习惯性圈套器的校正比值比= 3.4，AHI 5-15的校正比值比= 4.2，AHI >15的校正比值比= 3.4）。男性和女性结合AHI >15（与无睡眠呼吸障碍相比）在5年内发生多起事故的可能性显著增加（比值比= 7.3）。这些结果表明，在一般人群中，未被识别的睡眠呼吸障碍与机动车事故的发生有关。如果这种关联是因果关系，未被识别的睡眠呼吸障碍可能占机动车事故的很大一部分。
Studies have consistently shown that sleep apnea patients have high accident rates, but the generalizability of the association beyond clinic populations has been questioned. The goal of this investigation was to determine if unrecognized sleep-disordered breathing in the general population, ranging from mild to severe, is associated with motor vehicle accidents. The sample comprised 913 employed adults enrolled in an ongoing study of the natural history of sleep-disordered breathing. Sleep-disordered breathing status was determined by overnight in-laboratory polysomnography and motor vehicle accident (MVA) history was obtained from a statewide data base of all traffic violations and accidents from 1988 to 1993. Men with five or more apneas and hypopneas per hour of sleep [apnea-plus-hypopnea index (AHI) >5], compared to those without sleep-disordered breathing, were significantly more likely to have at least one accident in 5 years (adjusted odds ratio = 3.4 for habitual snarers, 4.2 for AHI 5-15, and 3.4 for AHI >15). Men and women combined with AHI >15 (vs. no sleep-disordered breathing) were significantly more likely to have multiple accidents in 5 years (odds ratio = 7.3). These results, free of clinic selection bias, indicate that unrecognized sleep-disordered breathing in the general population is linked to motor vehicle accident occurrence. If the association is causal, unrecognized sleep-disordered breathing may account for a significant proportion of motor vehicle accidents.