Sleep disordered breathing and subjective excessive daytime sleepiness in relation to the risk of motor vehicle crash: the Toon Health Study

Ryotaro Matsuo,Koutatsu Maruyama,Kiyohide Tomooka,Ai Ikeda,Hiroo Wada,Takeshi Tanigawa,Isao Saito

doi:10.1038/s41598-020-74132-7

Ryotaro Matsuo, Koutatsu Maruyama + Show 5 more

Open Access

https://doi.org/10.1038/s41598-020-74132-7

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Abstract

Sleep disordered breathing (SDB) is a significant cause of motor vehicle crash (MVC). We conducted a prospective cohort study among 1047 Japanese community-dwellers to detect whether the presence or absence of subjective excessive daytime sleepiness (EDS) affect the association of SDB with a risk of MVC. SDB was assessed by a single airflow monitor which measured the respiratory disturbance index (RDI) during one-night, and participants were classified into the SDB group (RDI ≥ 10) and non-SDB group (RDI < 10). Subjective EDS was defined as Japanese version of Epworth Sleepiness Scale scores ≥ 11. A follow-up questionnaire five years after the baseline ascertained history of MVC over the period. Multivariable logistic regression analysis examined the association between SDB and MVC after stratification by subjective EDS. The multivariable-adjusted odds ratios (95% confidence interval) for MVC among the female SDB group were 1.66 (1.05–2.63) compared with the non-SDB group, and this association was more evident in females without subjective EDS [1.84(1.02–3.32)], but not among those with subjective EDS. There was no significant association in males. These findings indicate that SDB screening should be recommended regardless of subjective EDS to prevent SDB-related MVC among general population, particularly in females.

Highlights

Sleep disordered breathing (SDB) is characterized by episodes of apneas and hypopneas during sleep and this condition is widely prevalent in the general population[1]
While a large number of studies have assessed the relationship between SDB and motor vehicle crash (MVC), only a prospective cohort study examined the association of sleep apnea with or without subjective excessive daytime sleepiness (EDS) on the risk of MVC14
The major finding of the present study is to demonstrate the significant association between SDB and risk of MVC in female participants, and this association was more evident among those without subjective EDS

Summary

Introduction

Sleep disordered breathing (SDB) is characterized by episodes of apneas and hypopneas during sleep and this condition is widely prevalent in the general population[1]. Other study reported that there are relatively many SDB patients who do not have subjective EDS in general p opulation[12]; the reason for this discrepancy may be due to subjective assessment of EDS being underestimated by chronic sleep d eprivation[13] and differences among individuals[11]. While a large number of studies have assessed the relationship between SDB and MVC, only a prospective cohort study examined the association of sleep apnea with or without subjective EDS on the risk of MVC14. The aim of this study was to examine whether individuals with SDB were at increased risk of MVCs, independent of subjective EDS in a prospective cohort study among Japanese community dwelling population

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