SINDROMUL DE APNEE OBSTRUCTIVÃ ÎN SOMN (SAOS) ȘI ACCIDENTELE RUTIERE
For many years traffic accidents represent an important concern in the world and was
proven that excesive sleepiness, decreased vigilance of falling asleep in traffic are involved in
many car accidents. Aim: To asses the correlation between obstructive sleep apnea (OSA)
syndrome severity, the lenght of nocturnal arterial oxygen desaturation period and the patients
answers to the Epworth Sleepiness Scale Questionnaire (ESS) and Berlin Questionnaire (BQ).
Material and method: We used the records of patients admited in Iaºi Pneumology Clinical
Hospital with obstructive sleep apnea syndrome between 2007-2008, including only those
patients which drive the car daily and excluding those patiernts with comorbidities which could
increase the nocturnal arterial oxygen desaturation. The study group (33 patients) have been
assessed through polysomnography and some specific questions from ESS and BQ. We
identified those patients involved in traffic accidents due to sleepiness. The correlation between
obstructive sleep apnea syndrome severity (reflectd by Apnea-Hipopnea Index - AHI), the
lenght of the nocturnal arterial oxygen desaturation period (<90%) and the answers the
answers to ESS and BQ were assessed. Results: Two patients presented mild severity sleep
apnea syndrome, 15 presented moderate severity and 16 high severity sleep apnea syndrome.
The correlation of AHI with ESS (r=0,59, p<0.001) and BQ (r=0.47, p<0.05)were
significant while the correlation with nocturnal arterial oxygen desaturation period had no
significance (r=0.29, p<0.05). Conclusion: Patients with moderate or severe OSA present a
high degree of diurnal sleepiness which could affect the driving capacity
breathing among middle-aged adults. N Engl J Med 1993; 328: 12301235.
2. Young T, Blustein J, Finn L, Palta M. Sleep-disordered breathing and motor vehicle accidents in
a populationbased sample of employed adults. Sleep 1997; 20: 608613.
3. Barbe F, Pericas J, Munoz A, Findley L, Anto JM, Agusti AG. Automobile accidents in patients
with sleep apnea syndrome. An epidemiological and mechanistic study. Am J Respir Crit Care Med
1998; 158: 1822.
4. Connor J, Whitlock G, Norton R, Jackson R. The role of driver sleepiness in car crashes: a
systematic review of epidemiological studies. Accid Anal Prev 2001; 33: 3141.
5. Terán-Santos J, Jiménez-Gómez A, Cordero-Guevara J, Cooperative Group Burgos-Santander. The
association between sleep apnea and the risk of traffic accidents. N Engl J Med 1999; 340: 847-851.
6. Findley LJ, Unverzagt ME, Suratt PM. Automobile accidents involving patients with obstructive
sleep apnea. Am Rev Respir Dis 1988; 138: 337-340.
7. Young T, Blustein J, Finn L, Palta M. Sleep-disordered breathing and motor vehicle accidents in a
population-based sample of employed adults. Sleep 1997; 20: 608-613.
8. Barbe F, Pericas J, Munoz A, Findley L, Anto JM, Agusti AG. Automobile accidents in patients
with sleep apnea syndrome: an epidemiological and mechanistic study. Am J Respir Crit Care Med
1998; 158: 18-22.
9. George CF, Boudreau AC, Smiley A. Effects of nasal CPAP on simulated driving performance in
patients with obstructive sleep apnoea. Thorax 1997; 52: 648-665.
10. Engleman HM, Asgari-Jirhandeh N, McLeod AL, Ramsay CF, Deary IJ, Douglas NJ. Self-reported
use of CPAP and benefits of CPAP therapy: a patient survey. Chest 1996; 109: 1470-1476.
11. Haraldsson PO, Carenfelt C, Lysdahl M, Tornros J. Long-term effect of uvulopalatopharyngoplasty
on driving performance. Arch Otolaryngol Head Neck Surg 1995;121:90-94.
12. Minemura H, Akashiba T, Yamamoto H et al. Traffic accidents in obstructive sleep apnea patients
and effect of nasal CPAP treatment. Nippon Kyobu Shikkan Gakkai Zasshi 1993; 31: 1103-1108.
13. *** National Center for Sleep Disorders Research, National Highway Traffic Safety Administration
Expert Panel. Drowsy driving and automobile crashes. Washington, D.C.: National Highway
Transportation Safety Association, 1998. (DOT HS 808 707.)
14. Calverley PM, Brezinova V, Douglas NJ, Catterall JR, Flenley DC. The effect of oxygenation on
sleep quality in chronic bronchitis and emphysema. Am Rev Respir Dis 1982; 126: 206-210.
15. Cormick W, Olsen LG, Hensley MJ, Saunders NA. Nocturnal hypoxemia and quality of sleep in
patients with chronic obstructive lung disease. Thorax 1986; 41: 846-854.
16. Pakola SJ, Dinges DF, Pack AI. Review of regulations and guidelines for commercial and
noncommercial drivers with sleep apnea and narcolepsy. Sleep 1995; 18: 787-796.
Once an article is accepted for publication, MSJ requests a transfer of copyrights for published articles.
COPYRIGHT TRANSFER FORM FOR
REVISTA MEDICO-CHIRURGICALĂ A SOCIETĂȚII DE MEDICI ȘI NATURALIȘTI DIN IAȘI /
THE MEDICAL-SURGICAL JOURNAL OF THE SOCIETY OF PHYSICIANS AND NATURALISTS FROM IASI
We, the undersigned authors of the manuscript entitled
warrant that this manuscript, which is submitted for publication in the REVISTA MEDICO-CHIRURGICALĂ, has not been published and it is not under consideration for publication in another journal.
- we give the consent for publication in the REVISTA MEDICO-CHIRURGICALĂ, in printed and electronic format and we transfer unconditioned and complete the copyright of this manuscript to the REVISTA MEDICO-CHIRURGICALĂ, in the event of its acceptance.
- the manuscript does not break the intellectual property rights of any other person.
- we have read the submitted version of the manuscript and we are fully responsible for the content.
Names and signatures of authors / copyright owners (the following sequence is the authorship of the article):
N.B. All the authors must sign this form