Sleepiness, driving, and motor vehicle accidents: A questionnaire-based survey

• Published in: Journal of forensic and legal medicine Vol. 44; pp. 183 - 187
• Main Authors: Zwahlen, Daniel, Jackowski, Christian, Pfäffli, Matthias
• Format: Journal Article
• Language: English
• Published: England Elsevier Ltd 01.11.2016
• Subjects: Accidents, Traffic - prevention & control; Accidents, Traffic - statistics & numerical data; Adult; Aged; Aged, 80 and over; Automobile Driving; Body Mass Index; Driving capacity; Excessive daytime sleepiness; Fatigue - epidemiology; Female; Humans; Hypertension - epidemiology; Male; Middle Aged; Obstructive sleep apnea syndrome; Pathology; Sleep Apnea, Obstructive - epidemiology; Sleep disorder; Surveys and Questionnaires; Switzerland - epidemiology; Traffic accident; Young Adult; Sleep disorder; Driving capacity; Obstructive sleep apnea syndrome; Excessive daytime sleepiness; Traffic accident
• ISSN: 1752-928X; 1878-7487
• DOI: 10.1016/j.jflm.2016.10.014

In Switzerland, the prevalence of an excessive daytime sleepiness (EDS) in drivers undergoing a driving capacity assessment is currently not known. In this study, private and professional drivers were evaluated by means of a paper-based questionnaire, including Epworth Sleepiness Scale, Berlin Questionnaire, and additional questions to sleepiness-related accidents, near-miss accidents, health issues, and demographic data. Of the 435 distributed questionnaires, 128 completed were returned. The response rate was 29%. The mean age of the investigated drivers was 42.5 years (20–85 years). According to the Epworth Sleepiness Scale, 9% of the participants are likely to suffer from excessive daytime sleepiness. An equal percentage has a high risk for obstructive sleep apnea syndrome based on the Berlin Questionnaire. 16% admitted an involuntary nodding off while driving a motor vehicle. This subset of the participants scored statistically significant higher on the Epworth Sleepiness Scale (p = 0.036). 8% of the participants already suffered an accident because of being sleepy while driving. An equal number experienced a sleepiness-related near-miss accident on the road. The study shows that a medical workup of excessive daytime sleepiness is highly recommended in each driver undergoing a driving capacity assessment. Routine application of easily available and time-saving assessment tools such as the Epworth Sleepiness Scale questionnaire could prevent accidents in a simple way. The applicability of the Berlin Questionnaire to screen suspected fatal sleepiness-related motor vehicle accidents is discussed. •Approximately one out of ten drivers suffers from excessive daytime sleepiness (EDS).•Medical workup of sleepiness at the wheel is mandatory in every driving aptitude assessment.•Routine application of the Epworth Sleepiness Scale could prevent accidents.•Reasonable suspicion of a sleep apnea and thus a higher risk for nodding-of at the wheel can be expressed post mortem.