Abstract
Purpose
We investigated the prevalence of sleep problems, such as obstructive sleep apnea (OSA), insomnia, and daytime sleepiness in commercial motor vehicle (CMV) drivers compared with that in the general population.
Methods
This is a cross-sectional study comparing sleep habits and sleep problems in 110 truck drivers with 1001 matched controls from the general population. The assessment was based on self-administered questionnaires that included the Berlin questionnaire, the insomnia severity index, and the Epworth sleepiness scale (ESS). Multivariate regression analysis was performed to determine whether CMV drivers were independently associated with these sleep problems compared with controls.
Results
The prevalence of a high risk of OSA and insomnia was 35.5% and 15.2%, respectively, in CMV drivers, which was significantly higher than in controls with a prevalence of 12.2% and 4.1%, respectively (P < 0.001 for both). Although CMV drivers showed higher ESS scores than controls, the prevalence of daytime sleepiness did not differ between the two groups (19.1% vs. 16.8%, P = 0.54). After adjusting for covariates, CMV drivers had 3.68 times higher odds (95% CI 2.29–5.84) of OSA and 2.97 times higher odds (95% CI, 1.46–6.06) of insomnia compared with controls. However, the degree of daytime sleepiness was not independently associated with CMV drivers.
Conclusions
The prevalence of OSA and insomnia in CMV drivers was higher than that in the general population. Daytime sleepiness was associated with increased BMI, depression, OSA, and short sleep duration, regardless of CMV driving as an occupational factor.
Similar content being viewed by others
References
World Health Organization (2015) Global status report on road safety 2015. http://www.who.int/violence_injury_prevention/road_safety_status/2015/en/. Accessed Aug 1 2018
Spiers HJ, Maguire EA (2007) Neural substrates of driving behaviour. Neuroimage 36(1):245–255. https://doi.org/10.1016/j.neuroimage.2007.02.032
World Health Organization (2004) World report on road traffic injury prevention. http://www.who.int/violence_injury_prevention/publications/road_traffic/world_report/en/. Accessed Aug 1 2018
Bioulac S, Micoulaud-Franchi J-A, Arnaud M, Sagaspe P, Moore N, Salvo F, Philip P (2017) Risk of motor vehicle accidents related to sleepiness at the wheel: a systematic review and meta-analysis. Sleep 40(10):zsx134. https://doi.org/10.1093/sleep/zsx134
Lyznicki JM, Doege TC, Davis RM, Williams MA, for the Council on Scientific A, American Medical A (1998) Sleepiness, driving, and motor vehicle crashes. JAMA 279(23):1908–1913. https://doi.org/10.1001/jama.279.23.1908
Vennelle M, Engleman HM, Douglas NJ (2010) Sleepiness and sleep-related accidents in commercial bus drivers. Sleep Breath 14(1):39–42. https://doi.org/10.1007/s11325-009-0277-z
Howard ME, Desai AV, Grunstein RR, Hukins C, Armstrong JG, Joffe D, Swann P, Campbell DA, Pierce RJ (2004) Sleepiness, sleep-disordered breathing, and accident risk factors in commercial vehicle drivers. Am J Respir Crit Care Med 170(9):1014–1021. https://doi.org/10.1164/rccm.200312-1782OC
Colvin LJ, Collop NA (2016) Commercial motor vehicle driver obstructive sleep apnea screening and treatment in the United States: an update and recommendation overview. J Clin Sleep Med 12(1):113–125. https://doi.org/10.5664/jcsm.5408
Choi S, Oh C, Kim M (2014) Risk factors related to fatal truck crashes on Korean freeways. Traffic Injury Prevention 15(1):73–80. https://doi.org/10.1080/15389588.2013.778989
Hwangbo Y, Kim WJ, Chu MK, Yun CH, Yang KI (2013) Association between weekend catch-up sleep duration and hypertension in Korean adults. Sleep Med 14(6):549–554. https://doi.org/10.1016/j.sleep.2013.02.009
Kang K, Park K-S, Kim J-E, Kim S-W, Kim Y-T, Kim J-S, Lee H-W (2013) Usefulness of the Berlin questionnaire to identify patients at high risk for obstructive sleep apnea: a population-based door-to-door study. Sleep Breath 17(2):803–810. https://doi.org/10.1007/s11325-012-0767-2
Catarino R, Spratley J, Catarino I, Lunet N, Pais-Clemente M (2014) Sleepiness and sleep-disordered breathing in truck drivers : risk analysis of road accidents. Sleep Breath 18(1):59–68. https://doi.org/10.1007/s11325-013-0848-x
Teran-Santos J, Jimenez-Gomez A, Cordero-Guevara J (1999) The association between sleep apnea and the risk of traffic accidents. Cooperative Group Burgos-Santander. N Engl J Med 340(11):847–851. https://doi.org/10.1056/nejm199903183401104
Tregear S, Reston J, Schoelles K, Phillips B (2009) Obstructive sleep apnea and risk of motor vehicle crash: systematic review and meta-analysis. J Clin Sleep Med 5(6):573–581
Tregear S, Reston J, Schoelles K, Phillips B (2010) Continuous positive airway pressure reduces risk of motor vehicle crash among drivers with obstructive sleep apnea: systematic review and meta-analysis. Sleep 33(10):1373–1380. https://doi.org/10.1093/sleep/33.10.1373
George CF (2001) Reduction in motor vehicle collisions following treatment of sleep apnoea with nasal CPAP. Thorax 56(7):508–512. https://doi.org/10.1136/thorax.56.7.508
Pack AI, Maislin G, Staley B, Pack FM, Rogers WC, George CF, Dinges DF (2006) Impaired performance in commercial drivers: role of sleep apnea and short sleep duration. Am J Respir Crit Care Med 174(4):446–454. https://doi.org/10.1164/rccm.200408-1146OC
Hui DS, Chan JK, Ko FW, Choy DK, Li TS, Chan AT, Wong KK, Lai CK (2002) Prevalence of snoring and sleep-disordered breathing in a group of commercial bus drivers in Hong Kong. Intern Med J 32(4):149–157. https://doi.org/10.1046/j.1444-0903.2001.00196.x
Meuleners L, Fraser ML, Govorko MH, Stevenson MR (2015) Obstructive sleep apnea, health-related factors, and long distance heavy vehicle crashes in Western Australia: a case control study. J Clin Sleep Med 11(4):413–418. https://doi.org/10.5664/jcsm.4594
Cui R, Tanigawa T, Sakurai S, Yamagishi K, Iso H (2006) Relationships between sleep-disordered breathing and blood pressure and excessive daytime sleepiness among truck drivers. Hypertens Res 29(8):605–610. https://doi.org/10.1291/hypres.29.605
Bixler EO, Vgontzas AN, Ten Have T, Tyson K, Kales A (1998) Effects of age on sleep apnea in men: I. Prevalence and severity. Am J Respir Crit Care Med 157(1):144–148. https://doi.org/10.1164/ajrccm.157.1.9706079
Kim J, In K, Kim J, You S, Kang K, Shim J, Lee S, Lee J, Lee S, Park C, Shin C (2004) Prevalence of sleep-disordered breathing in middle-aged Korean men and women. Am J Respir Crit Care Med 170(10):1108–1113. https://doi.org/10.1164/rccm.200404-519OC
Fernandez-Mendoza J, Calhoun S, Bixler EO, Pejovic S, Karataraki M, Liao D, Vela-Bueno A, Ramos-Platon MJ, Sauder KA, Vgontzas AN (2010) Insomnia with objective short sleep duration is associated with deficits in neuropsychological performance: a general population study. Sleep 33(4):459–465. https://doi.org/10.1093/sleep/33.4.459
Uehli K, Mehta AJ, Miedinger D, Hug K, Schindler C, Holsboer-Trachsler E, Leuppi JD, Künzli N (2014) Sleep problems and work injuries: a systematic review and meta-analysis. Sleep Med Rev 18(1):61–73. https://doi.org/10.1016/j.smrv.2013.01.004
Perrier J, Bertran F, Marie S, Couque C, Bulla J, Denise P, Bocca M-L (2014) Impaired driving performance associated with effect of time duration in patients with primary insomnia. Sleep 37(9):1565–1573. https://doi.org/10.5665/sleep.4012
Philip P, Sagaspe P, Lagarde E, Leger D, Ohayon MM, Bioulac B, Boussuge J, Taillard J (2010) Sleep disorders and accidental risk in a large group of regular registered highway drivers. Sleep Med 11(10):973–979. https://doi.org/10.1016/j.sleep.2010.07.010
Garbarino S, Magnavita N, Guglielmi O, Maestri M, Dini G, Bersi FM, Toletone A, Chiorri C, Durando P (2017) Insomnia is associated with road accidents. Further evidence from a study on truck drivers. PLoS One 12(10):e0187256. https://doi.org/10.1371/journal.pone.0187256
Garbarino S, Durando P, Guglielmi O, Dini G, Bersi F, Fornarino S, Toletone A, Chiorri C, Magnavita N (2016) Sleep apnea, sleep debt and daytime sleepiness are independently associated with road accidents. A cross-sectional study on truck drivers. PLoS One 11(11):e0166262. https://doi.org/10.1371/journal.pone.0166262
Kim J, Keenan BT, Lim DC, Lee SK, Pack AI, Shin C (2018) Symptom-based subgroups of Koreans with obstructive sleep apnea. J Clin Sleep Med 14(3):437–443. https://doi.org/10.5664/jcsm.6994
Talmage JB, Hudson TB, Hegmann KT, Thiese MS (2008) Consensus criteria for screening commercial drivers for obstructive sleep apnea: evidence of efficacy. J Occup Environ Med 50(3):324–329. https://doi.org/10.1097/JOM.0b013e3181617ab8
Korean Statistical Information Service (2017) Summary figures by size of revenue and sub-group of industry. Statistics Korea. http://kosis.kr/statHtml/statHtml.do?orgId=101&tblId=DT_1I100010&conn_path=I2. Accessed Feb 6 2019
Funding
This work was supported by a National Research Foundation of Korea (NRF) grant funded by the Ministry of Education (No. NRF-2017R1D1A1B04035931) and a grant from the Soonchunhyang University Research Fund.
Author information
Authors and Affiliations
Corresponding author
Ethics declarations
Conflicts of interest
The authors declare that they have no conflict of interest.
Ethical approval
All procedures performed in studies involving human participants were in accordance with the ethical standards of the institutional and/or national research committee and with the 1964 Helsinki declaration and its later amendments or comparable ethical standards.
Informed consent
Informed consent was obtained from all individual participants included in the study.
Additional information
Publisher’s note
Springer Nature remains neutral with regard to jurisdictional claims in published maps and institutional affiliations.
Rights and permissions
About this article
Cite this article
Sunwoo, JS., Shin, DS., Hwangbo, Y. et al. High risk of obstructive sleep apnea, insomnia, and daytime sleepiness among commercial motor vehicle drivers. Sleep Breath 23, 979–985 (2019). https://doi.org/10.1007/s11325-019-01805-7
Received:
Revised:
Accepted:
Published:
Issue Date:
DOI: https://doi.org/10.1007/s11325-019-01805-7