Clinical and Polysomnographic Correlates of Subsequent Police-Recorded Motor Vehicle Accidents in Obstructive Sleep Apnea Patients: One- and Two-Year Follow-Up After Diagnostic Laboratory Polysomnography
Year: 2026
Type: article
Abstract: Background and Objectives: Obstructive sleep apnea (OSA) and excessive daytime sleepiness are associated with motor vehicle accident (MVA) risk, but it remains uncertain whether routinely available clinical and polysomnographic measures characterize subsequent objectively recorded crash risk after diagnostic sleep evaluation. Materials and Methods: We conducted a retrospective cohort study of adults aged ≥ 20 years who underwent diagnostic attended overnight laboratory polysomnography for suspected OSA at a regional hospital in Taiwan between 2012 and 2016. Clinical and polysomnographic data were linked to police-recorded MVA data and health administrative records using encrypted identifiers. The primary outcome was any all-cause police-recorded MVA within 1 year after polysomnography. An additional 2-year analysis was conducted in a separately selected cohort with complete 2-year ascertainment. Firth penalized logistic regression was used, with ESS and AHI evaluated in separate models adjusted for age and sex. Results: The 1-year cohort included 1233 participants, of whom 30 experienced an MVA. Participants with MVA were younger than those without MVA (39.43 vs. 45.53 years; p = 0.019). In the age-, sex-, and ESS-adjusted model, each 10-year increase in age was associated with lower MVA odds (OR 0.718, 95% CI 0.533–0.946; p = 0.0199), whereas ESS showed an inverse but nonsignificant association (OR 0.933 per point, 95% CI 0.858–1.009; p = 0.0839). In the age-, sex-, and AHI-adjusted model, AHI did not show a positive association with 1-year MVA (OR 0.859 per 10 events/h, 95% CI 0.711–1.006; p = 0.0754). In the 2-year cohort (n = 926; 56 MVA events), ESS showed a statistically significant inverse association (OR 0.921, 95% CI 0.865–0.978; p = 0.0078), whereas AHI was not associated with MVA (OR 1.003, 95% CI 0.899–1.110; p = 0.9488). Conclusions: Age, subjective sleepiness, and AHI showed different relationships with subsequent police-recorded MVA in this clinical OSA population. These measures did not demonstrate a simple positive gradient with real-world crash risk in this selected cohort; these exploratory findings should not be interpreted as evidence that greater sleepiness is protective or that AHI lacks clinical relevance for driving safety.
Source: Medicina
Authors: Yu-Ching Hsu, Yu-Wen Chien, Cheng-Yu Lin
Language: English
Subfield: Physiology (medical)
Field: Medicine
Domain: Health Sciences
Open Access status: gold
Estimated APC paid: $2,654
OpenAlex ID: W7225750892
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