Obstructive sleep apnea and road traffic accidents: a Danish nationwide cohort study

Udholm, Nichlas; Rex, Christian Emil; Fuglsang, Milos; Lundbye‐Christensen, Søren; Bille, Jesper; Udholm, Sebastian

doi:10.1016/j.sleep.2022.04.003

Cited by 21 publications

(14 citation statements)

References 35 publications

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“…Patients with severe OSAHS have recurrent apnea or reduced breathing range during sleep. The basic pathophysiology is repeated intermittent hypoxia during sleep, sleep fragmentation, and frequent microawakenings, resulting in daytime sleepiness, fatigue, inattention, and cognitive decline, thus significantly reducing work efficiency and quality of life [12][13][14][15][16]. Clinical treatment for moderate to severe OSAHS patients is mainly CPAP therapy.…”

Section: Discussionmentioning

confidence: 99%

Effect of Simultaneous Multiplane Surgery on Cardiopulmonary Function in Patients with Moderate to Severe Obstructive Sleep Apnea-Hypopnea Syndrome and Its Curative Effect

Gong

Shao

2022

BioMed Research International

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Objective. To investigate the changes in cardiopulmonary function in patients with obstructive sleep apnea-hypopnea syndrome (OSAHS) by one-stage multiplane surgery. Methods. 70 patients with moderate and severe OSAHS underwent nasal in our hospital from July 2017 to February 2021, palatopharyngeal, and/or tongue operations simultaneously and were followed up for 6 months. The Epworth Sleeping Scale (ESS) scores of patients before and after surgery were compared to observe the surgical efficacy, and the changes in the cardiopulmonary function of patients before and after surgery were detected. The static and dynamic indexes of cardiopulmonary function, respiratory disturbance index (AHI), and blood oxygen saturation (SaO2) were compared before and after the operation. Results. After surgery, all patients’ indexes of static lung function were improved compared with that before surgery. After surgery, the percentage of maximal oxygen uptake peak to the predicted value, percentage of oxygen pulse to the predicted value, the ratio of oxygen uptake power, anaerobic threshold, and maximum ventilatory capacity per minute/maximum exercise volume were increased compared with that before surgery, and AHI and SaO2 were improved compared with that before surgery. Conclusion. This study suggests that it is feasible for patients with OSAHS who are unable to tolerate or unwilling to undergo noninvasive assisted ventilation to undergo simultaneous surgery for multiplane stenosis. It can reduce clinical symptoms and improve cardiopulmonary function.

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Section: Discussionmentioning

confidence: 99%

Effect of Simultaneous Multiplane Surgery on Cardiopulmonary Function in Patients with Moderate to Severe Obstructive Sleep Apnea-Hypopnea Syndrome and Its Curative Effect

Gong

Shao

2022

BioMed Research International

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“…It has been demonstrated that sleep fragmentation and intermittent hypoxemia, characterizing sleep apnea episodes, leads to excessive daytime sleepiness, cognitive processing, and reaction time delays. The most recent and most extensive study on this subject, conducted in Denmark, including all citizens diagnosed with OSA from 1995 to 2015, concluded that sleep apnea patients are not only at an increased risk for road traffic accidents, but also tend to be involved in more severe accidents [ 1 ].…”

Section: Discussionmentioning

confidence: 99%

“…Through micro awakenings and oxygen desaturation characterizing the pathology, it leads to daytime sleepiness, cognitive impairment, psychological problems, and a significant reduction in quality of life. Secondary to the patients’ delayed reaction time, especially in those suffering from frequent desaturations during sleep, OSA can result in tragic traffic road accidents [ 1 ]. Inverted papilloma is a rare benign sinonasal tumor characterized by a strong potential for local destruction, a high rate of recurrence, and a risk of malignant transformation.…”

Section: Introductionmentioning

confidence: 99%

The Role of Inverted Papilloma Surgical Removal for Sleep Apnea Treatment Success—A Case Report

et al. 2023

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In recent years, increased attention has been directed to sleep apnea syndrome due to its high prevalence and preventable severe health consequences. Besides enhancing the risk of cardiovascular, cerebrovascular, and metabolic disorders, it determines increased daytime somnolence, cognitive impairment, and delayed reaction time. These symptoms, determined by sleep fragmentation and chronic hypoxemia, can result in a decrease in professional performance and, moreover, could have tragic implications, especially in patients with high-risk professions. We present the case of a 58-year-old male-truck driver, known to suffer from uncontrolled OSA and chronic obstructive pulmonary disease, who presented to our ENT department for incapacitating daytime somnolence and severe nasal obstruction. These symptoms were caused by a voluminous sinonasal inverted papilloma, occupying the entire left cavity with extension in the nasopharynx. Following nose permeabilization, the patients’ APAP compliance grew substantially, with a dramatic decrease in daytime sleepiness and improvement in polysomnographic parameters. Due to the overlap syndrome of OSA and COPD, an oxygen supplementation was added to PAP therapy by a pulmonologist, improving pulse-oximetry parameters and resulting in the best outcome for the patient. Through this case report, we aim to emphasize the importance of multimodal, personalized treatment of sleep apnea with a focus on nasal surgical permeabilization. At the same time, we sustain a multidisciplinary approach, especially in patients with sleep apnea and associated pathologies, to obtain therapeutic success. We propose increased attention to the early recognition and proper treatment of sleep apnea in patients with high-risk professions as it prevents catastrophes.

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“…The hazard ratio for MVA in patients with OSA was 1.29 (IC 1.18-1.39), while the incidence rate ratio was 1.3 (1.2-1.42). Interestingly, CPAP therapy determined a statistically significant risk reduction for MVA in comparison to OSA patients that were not treated, with a hazard ratio of 0.82 (0.67-1.02) and an incidence rate ratio of 0.75 (0.6-0.91) [30]. Another recent study was performed in older subjects to assess the effect of sleep apnea on driving behavior.…”

Section: Epidemiology Of Driving Accidents In the General Population ...mentioning

confidence: 99%

Epidemiology, Physiology and Clinical Approach to Sleepiness at the Wheel in OSA Patients: A Narrative Review

Bonsignore

Lombardi

Lombardo

et al. 2022

JCM

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Sleepiness at the wheel (SW) is recognized as an important factor contributing to road traffic accidents, since up to 30 percent of fatal accidents have been attributed to SW. Sleepiness-related motor vehicle accidents may occur both from falling asleep while driving and from behavior impairment attributable to sleepiness. SW can be caused by various sleep disorders but also by behavioral factors such as sleep deprivation, shift work and non-restorative sleep, as well as chronic disease or the treatment with drugs that negatively affect the level of vigilance. An association between obstructive sleep apnea (OSA) and motor vehicle accidents has been found, with an increasing risk in OSA patients up to sevenfold in comparison to the general population. Regular treatment with continuous positive airway pressure (CPAP) relieves excessive daytime sleepiness and reduces the crash risk. Open questions still remain about the physiological and clinical determinants of SW in OSA patients: the severity of OSA in terms of the frequency of respiratory events (apnea hypopnea index, AHI) or hypoxic load, the severity of daytime sleepiness, concomitant chronic sleep deprivation, comorbidities, the presence of depressive symptoms or chronic fatigue. Herein, we provide a review addressing the epidemiological, physiological and clinical aspects of SW, with a particular focus on the methods to recognize those patients at risk of SW.

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Obstructive sleep apnea and road traffic accidents: a Danish nationwide cohort study

Cited by 21 publications

References 35 publications

Effect of Simultaneous Multiplane Surgery on Cardiopulmonary Function in Patients with Moderate to Severe Obstructive Sleep Apnea-Hypopnea Syndrome and Its Curative Effect

Effect of Simultaneous Multiplane Surgery on Cardiopulmonary Function in Patients with Moderate to Severe Obstructive Sleep Apnea-Hypopnea Syndrome and Its Curative Effect

The Role of Inverted Papilloma Surgical Removal for Sleep Apnea Treatment Success—A Case Report

Epidemiology, Physiology and Clinical Approach to Sleepiness at the Wheel in OSA Patients: A Narrative Review

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