Excessive daytime sleepiness and associations with sleep-related motor vehicle accidents: results from a nationwide survey.

OBJECTIVE/BACKGROUND: Insufficient sleep can have fatal consequences, and up to 30% of motor vehicle accidents (MVAs) are related to driving when drowsy. The objective of this study was to investigate how sleep quality and excessive daytime sleepiness (EDS) affect falling asleep while driving and sleep-related MVAs/near-misses.

PARTICIPANTS/METHODS: A population-wide sample of Saudi adults was surveyed. The questionnaire gathered data on sleep quality, EDS (Epworth Sleepiness Scale), and episodes of falling asleep while driving and sleep-related MVAs/near-misses in the previous year. Univariable and multivariable analyses were used to assess associations.

RESULTS

A total of 19% (902/3802) and 10% (474/4229) of respondents had fallen asleep while driving or had a sleep-related MVA/near-miss in the preceding year, respectively. Being male, married, having a shorter sleep duration, being an office worker, having poor subjective sleep quality, and having moderate or severe EDS were associated with an increased risk of having fallen asleep while driving in the previous year. Younger age, male gender, having worse subjective sleep quality [OR 2.11 (95% CI 1.36-3.29); p < 0.0001 for "very bad" sleep quality], and having moderate or severe EDS [ESS ≥ 13; OR 1.90 (95% CI 1.38-2.60); p < 0.0001 and OR 2.39 (95% CI 1.56-3.67); p < 0.0001, respectively] were associated with having had/nearly had an accident due to being tired or falling asleep while driving in the previous year.

CONCLUSIONS

Sleepy driving and sleep-related accidents/near-misses are common in Saudi Arabia, and sleep quality and EDS contribute to the burden of MVAs. Further efforts are required to quantify the contribution of sleepiness to MVAs to develop and prioritize interventions to prevent MVA-related injuries and death.