A study published in ERJ Open Research suggests that regularly using multiple methods to stay awake while driving might indicate severe sleepiness due to obstructive sleep apnea (OSA).
Individuals with OSA typically experience loud snoring, intermittent breathing during sleep, and frequent awakenings. Although it is estimated that one in five people suffers from OSA, most are unaware of their condition. Untreated, OSA leads to extreme drowsiness, significantly increasing the risk of vehicular accidents.
The research highlights the potential of using certain behaviours, such as opening car windows, consuming caffeinated beverages, or increasing radio volume, as indicators to identify drivers at heightened risk of incidents due to OSA.
This study, led by Dr Akshay Dwarakanath and his team at St James’s University Hospital in Leeds, UK, compared 119 untreated OSA patients with 105 individuals without the disorder. Participants were queried about their general and driving-specific sleepiness, strategies employed to combat drowsiness while driving, and any history of driving incidents.
The research findings are significant, revealing that those with OSA were more likely to adopt multiple alertness strategies while driving compared to their non-OSA counterparts. Notably, nearly a third of the OSA group reported frequently using over three techniques to stay awake, a practice nonexistent among the control group. Furthermore, OSA patients engaging in multiple strategies not only felt generally sleepier but also reported a higher incidence of crashes—22.8% versus 2.4% among those using fewer strategies.
Standard methods among OSA sufferers included adjusting the car environment by opening windows or using caffeinated drinks, as well as behavioural tactics like singing, adjusting seating positions, chewing gum, taking breaks for physical activity, and even stopping to refresh themselves with cold water.
Dr Dwarakanath emphasized the clinical challenge in assessing patients’ fitness to drive, mainly when it affects their employment, especially for professional drivers. Nonetheless, he stressed the responsibility of medical professionals to advise against driving when there is a substantial risk of accidents.
The study underscores the crucial role of healthcare providers in inquiring about these adaptive strategies during clinical assessments. They can serve as indirect indicators of sleepiness and aid in identifying patients who may be more susceptible to driving-related accidents. This approach could empower healthcare providers to better manage the risks associated with untreated OSA in drivers.
More information: Akshay Dwarakanath et al, An exploratory study evaluating the use of coping strategies while driving in obstructive sleep apnoea syndrome patients and controls, ERJ Open Research. DOI: 10.1183/23120541.00638-2023
Journal information: ERJ Open Research Provided by European Respiratory Society
