Sleep and Breathing

, Volume 8, Issue 2, pp 61–72 | Cite as

The Role of Sleep-Disordered Breathing, Daytime Sleepiness, and Impaired Performance in Motor Vehicle Crashes—A Case Control Study

  • Ruth N. Kingshott
  • Jan O. Cowan
  • David R. Jones
  • Erin M. Flannery
  • Andrew D. Smith
  • G. Peter Herbison
  • D. Robin Taylor
Original Article


Study Objective: To examine levels of sleep-disordered breathing, daytime sleepiness, and impaired performance in 60 motor vehicle crash drivers and 60 controls matched for age, gender, and body mass index. Measurements and Results: All participants underwent polysomnography and daytime function assessments. Cases reported significantly higher levels of driver sleepiness (% sleepiness: mean ± SD; cases: 26 ± 17% controls: 16 ± 12% p= 0.003) and demonstrated slower reaction times on a sustained attention task (p= 0.02). There was a trend for more objective sleepiness in cases (maintenance of wakefulness test: cases: 17 ± 4 minutes; controls: 18 ± 3 minutes, p= 0.06) despite no differences in general subjective sleepiness (Epworth score: cases: 8 ± 4; controls: 8 ± 4; p= 0.93). There were no significant differences in polysomnography measures between groups (apneas + hypopneas per hour slept: cases: 8 ± 9; controls: 9 ± 16; p= 0.89; arousals per hour slept: cases: 18 ± 8; controls: 21 ± 12; p= 0.11). Conclusion: Crash drivers demonstrated significantly more driver sleepiness, slower reaction times and a trend for greater objective sleepiness compared with well-matched controls. However, the findings in crash drivers were independent of medical causes of sleep fragmentation, with both cases and controls showing moderate levels of unrecognized mild sleep-disordered breathing. Crash prevention strategies should focus on increasing personal awareness of the risks of sleepiness behind the wheel in all individuals.


Sleep-disordered breathing traffic crashes sleepiness performance MWT 


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Copyright information

© Thieme Medical Publishers, Inc. 2004

Authors and Affiliations

  • Ruth N. Kingshott
    • 1
    • 4
  • Jan O. Cowan
    • 1
  • David R. Jones
    • 3
  • Erin M. Flannery
    • 1
  • Andrew D. Smith
    • 1
  • G. Peter Herbison
    • 2
  • D. Robin Taylor
    • 1
  1. 1.Departments of Respiratory ResearchUniversity of OtagoDunedinNew Zealand
  2. 2.Departments of Social and Preventive MedicineUniversity of OtagoDunedinNew Zealand
  3. 3.Departments of Tom McKendrick Sleep LaboratoryDunedin HospitalDunedinNew Zealand
  4. 4.Respiratory Research Unit, Dunedin School of MedicineUniversity of OtagoDunedinNew Zealand

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