Risk Factors for Motor Vehicle Accidents in Obstructive Sleep Apnoea Patients with Long-Term Continuous Positive Airway Pressure Therapy.

In this study, we aim to establish risk factors for sleepiness while driving, motor-vehicle accidents and near miss incidents in obstructive sleep apnoea patients with long-term continuous positive airway pressure (CPAP) therapy. We performed a cross-sectional study on 1327 consecutive CPAP-treated obstructive sleep apnoea (OSA) patients who were scheduled for a routine 5-year follow-up in 2019-2020 at Turku University Hospital. We obtained data of self-reported sleepiness while driving, motor vehicle accidents and near-miss events via questionnaires and classified patients accordingly in different groups. We then compared demographic parameters, CPAP adherence, blood gas samples and OSA-related symptoms via standardised questionnaires and applied standard statistical tests. Sufficient data was available from 1018 (76.7%) of 1327 patients. Two hundred and seventeen patients (21.3%) reported sleepiness while driving, near-miss situations or motor vehicle accidents while driving. These patients were younger (mean age 60 vs. 66 years), and scored higher on Epworth Sleepiness Scale (mean 6.7 vs. 4.3), Insomnia Severity Index (mean 3.1 vs. 1.9) and Depression Scale (mean 7.1 vs. 4.8) than other patients (p < 0.001 on all scores). Sleepiness while driving was more likely in those with weight gain of more than 5 kg within 5 years (58.6% vs. 40.0%, p = 0.019). CPAP adherence was similar across the groups. Capillary blood gases did not correlate with poor CPAP adherence or sleepiness while driving. In conclusion, sleepiness while driving in OSA patients with long-term CPAP therapy was associated with weight gain as well as depressive and insomnia symptoms.