Chest
Clinical Investigations: Sleep and BreathingAccidents in Obstructive Sleep Apnea Patients Treated With Nasal Continuous Positive Airway Pressure: A Prospective Study
Section snippets
Materials and Methods
The objective of the study was to evaluate over a 1-year period the effects of treatment with CPAP in terms of clinical symptoms, quality of life, activity, and use of medical care as part of a larger study designed to evaluate the benefit obtained with CPAP treatment, which was conducted in 59 centers working with the ANTADIR (French respiratory homecare network). The present report relates to data concerning accidents; the other results of the study will be reported elsewhere.
Results
Table 1 shows the main characteristics of the 893 patients who were included in the study.
There were no differences in age and sex ratio between patients treated with CPAP (n = 893) and those receiving other treatments or untreated (n=380); patients treated with CPAP had higher body mass index (BMI), lower daytime PaO2, higher daytime PaCO2, and lower FEV1 and vital capacity than those receiving other treatments or untreated; as a group, they comprised higher percentages of patients with BMI
Discussion
This study indicates a dramatic decrease in the number of accidents, including traffic, home, and work accidents, occurring over equal periods of time in OSA patients treated with nCPAP. It also shows that in addition to traffic accidents, which have been investigated extensively, OSA patients are also exposed to other types of accidents, whose decrease with CPAP treatment suggest that they are related to the disease.
There are several limitations to the study that should be discussed before
APPENDIX
Investigators: P. Meekel, CH. Troyes; O. Gérin, Clinique Prévallon Cottage, Marseille; F. Philip-Joet, CHU Nord, Marseille; J.N. Prévost, CHU Côte de Nacre, Caen; J. Vincent, CHG SaintLouis, La Rochelle; O. Reybet-Degat, CHU de la Trouhaude, Dijon; S. Arabs, CHG Lannion; S. Lacroix, CH Dujassic de la Rivière, Périgueux; V. Gillet, Don du Souffle, Besançon; L. Vascaut, Hôpital La Muse, St Sébastien de Morsent; F. Martin, CH Victor Jousselin, Dreux; Léophonte, Hôpital de Rangueil, Toulouse;
ACKNOWLEDGEMENTS
The authors are grateful to V. GrilletLanoir and M. Coisy-Vialettes for preparing the questionnaires and for coordinating the data collection, to N. Rolland for the statistical analysis, and to B. Fleury and M. Tiberge for their thoughtful comments on the manuscript.
References (27)
- et al.
Vigilance and automobile accidents in patients with sleep apnea or narcolepsy
Chest
(1995) - et al.
Sleep apnea patients have more automobile accidents [letter]
Lancet
(1987) - et al.
Overnight nasal CPAP improves hypersomnolence in sleep apnea
Chest
(1986) - et al.
Recovery of alertness after CPAP in apnea
Chest
(1989) - et al.
Daytime sleepiness after long-term nasal continuous positive airway pressure (CPAP) treatment in obstructive sleep apnea syndrome
J Neurol Sci
(1992) - et al.
Effect of continuous positive airway pressure treatment on daytime function in sleep apnoea/hypopnoea syndrome
Lancet
(1994) - et al.
Self-reported use of CPAP and benefits of CPAP therapy: a patient survey
Chest
(1996) - et al.
Somnolence et syndrome d'apnées du sommeil: analyse de 188 questionnaires (102 malades et 86 témoins)
Neurophysiol Clin
(1993) - et al.
Sleepiness and motor vehicle accidents
Int Clin Psychopharmacol
(1988) - et al.
Somnolence et accidents de la circulation routière: importance du diagnostic
Neurophysiol Clin Clin Neurophysiol
(1991)
Rotating shift work, sleep, and accidents related to sleepiness in hospital nurses
Am J Public Health
J Sleep Res
An overview of sleepiness and accidents
J Sleep Res
Cited by (167)
Individual and socioeconomic impact of sleep related breathing disorders
2023, Encyclopedia of Sleep and Circadian Rhythms: Volume 1-6, Second EditionWhat is the motor vehicle crash risk for drivers with a sleep disorder?
2022, Transportation Research Part F: Traffic Psychology and BehaviourThe economic and societal burden of excessive daytime sleepiness in patients with obstructive sleep apnea
2020, Sleep Medicine ReviewsSleep health as an issue of public safety
2019, Sleep and HealthInflammatory Mediators in Obstructive Sleep Apnea
2018, NeuroinflammationSleepiness, driving, and motor vehicle accidents: A questionnaire-based survey
2016, Journal of Forensic and Legal Medicine
Study supported by the Ministère de la Recherche et de la Technologie, by the Caisse Nationale d’Assurance Maladie des Travailleurs Salariés, and by the TAEMA, Pierre Médical, and SEFAM companies.
Manuscript revision accepted July 30.
- †
A complete list of investigators is located in the Appendix