STUDY OBJECTIVES: Drowsy driving related to obstructive sleep apnea (OSA) represents an important public health problem with limited data on the effect of positive airway pressure (PAP) therapy. We hypothesize that PAP therapy will reduce self-reported drowsy driving in a large clinic-based OSA cohort. METHODS: Drowsy driving (self-reported near-accidents/accidents) incidents from baseline to after PAP therapy (stratified by adherence) were compared in a cohort of 2,059 patients with OSA who initiated PAP therapy from January 1, 2010 to December 31, 2014. Multivariable logistic regression models evaluated the dependence of change in drowsy driving incidents on other factors, including change in Epworth Sleepiness Scale (ESS) and Patient Health Questionnaire-9 (PHQ9) scores. RESULTS: In the entire cohort (age 56.0 ± 13.1 years, 45.4% female, 76.0% white, average follow-up 124.4 ± 67.3 days), drowsy driving incidents reduced from 14.2 to 6.9% after PAP therapy (P < .001). In subgroups, drowsy driving incidents reduced from 14% to 5.3% (P < .001) in patients who self-reported adherence to PAP therapy and 14.1% to 5.3% (P < .001) in patients objectively adherent to PAP therapy. For each one-point improvement in Epworth Sleepiness Scale score, the odds of drowsy driving decreased by about 14% (odds ratio 0.86, 95% confidence interval 0.82 to 0.90). CONCLUSIONS: In this clinic-based cohort, drowsy driving improved after adherent PAP usage, with greater drowsy driving risk for those with greater sleep propensity. This highlights the importance of and need for routine drowsy driving assessments and careful clinical attention to PAP adherence and sleep propensity in this population. Our findings should be confirmed and may be used to provide support for initiatives to address the public health issue of drowsy driving.
STUDY OBJECTIVES:Drowsy driving related to obstructive sleep apnea (OSA) represents an important public health problem with limited data on the effect of positive airway pressure (PAP) therapy. We hypothesize that PAP therapy will reduce self-reported drowsy driving in a large clinic-based OSA cohort. METHODS:Drowsy driving (self-reported near-accidents/accidents) incidents from baseline to after PAP therapy (stratified by adherence) were compared in a cohort of 2,059 patients with OSA who initiated PAP therapy from January 1, 2010 to December 31, 2014. Multivariable logistic regression models evaluated the dependence of change in drowsy driving incidents on other factors, including change in Epworth Sleepiness Scale (ESS) and Patient Health Questionnaire-9 (PHQ9) scores. RESULTS: In the entire cohort (age 56.0 ± 13.1 years, 45.4% female, 76.0% white, average follow-up 124.4 ± 67.3 days), drowsy driving incidents reduced from 14.2 to 6.9% after PAP therapy (P < .001). In subgroups, drowsy driving incidents reduced from 14% to 5.3% (P < .001) in patients who self-reported adherence to PAP therapy and 14.1% to 5.3% (P < .001) in patients objectively adherent to PAP therapy. For each one-point improvement in Epworth Sleepiness Scale score, the odds of drowsy driving decreased by about 14% (odds ratio 0.86, 95% confidence interval 0.82 to 0.90). CONCLUSIONS: In this clinic-based cohort, drowsy driving improved after adherent PAP usage, with greater drowsy driving risk for those with greater sleep propensity. This highlights the importance of and need for routine drowsy driving assessments and careful clinical attention to PAP adherence and sleep propensity in this population. Our findings should be confirmed and may be used to provide support for initiatives to address the public health issue of drowsy driving.
Authors: Kim L Ward; David R Hillman; Alan James; Alexandra P Bremner; Laila Simpson; Matthew N Cooper; Lyle J Palmer; Annette C Fedson; Sutapa Mukherjee Journal: J Clin Sleep Med Date: 2013-10-15 Impact factor: 4.062
Authors: Sutapa Mukherjee; Sanjay R Patel; Stefanos N Kales; Najib T Ayas; Kingman P Strohl; David Gozal; Atul Malhotra Journal: Am J Respir Crit Care Med Date: 2015-06-15 Impact factor: 21.405
Authors: Kingman P Strohl; Daniel B Brown; Nancy Collop; Charles George; Ronald Grunstein; Fang Han; Lawrence Kline; Atul Malhotra; Alan Pack; Barbara Phillips; Daniel Rodenstein; Richard Schwab; Terri Weaver; Kevin Wilson Journal: Am J Respir Crit Care Med Date: 2013-06-01 Impact factor: 21.405
Authors: Jason M Doherty; Catherine M Roe; Samantha A Murphy; Ann M Johnson; Ella Fleischer; Cristina D Toedebusch; Tiara Redrick; David Freund; John C Morris; Suzanne E Schindler; Anne M Fagan; David M Holtzman; Brendan P Lucey; Ganesh M Babulal Journal: Sleep Date: 2022-06-13 Impact factor: 6.313
Authors: Samantha Y Starkey; Daniel R Jonasson; Stephanie Alexis; Susan Su; Ravinder Johal; Paul Sweeney; Penelope M A Brasher; John Fleetham; Najib Ayas; Teddi Orenstein; Iqbal H Ahmed Journal: CJC Open Date: 2020-12-03