The Swedish National Road and Transport Research Institute (VTI), Linköping, Sweden.
Department of Psychology, Stress Research Institute, Stockholm University, Stockholm, Sweden.
Traffic Inj Prev. 2021;22(4):272-277. doi: 10.1080/15389588.2021.1894639. Epub 2021 Mar 26.
The objective of this study was to understand the relationship between some of the most common diseases that are known to contribute to excessive daytime sleepiness (EDS) and traffic injury crashes. Specific focus was on the relationship between disease and crash type (single-vehicle or multiple-vehicle crash) and between disease and injury severity.
This registry-based study considered all passenger car drivers involved in a crash in Sweden between 2011 and 2016 who were 40 years or older at the time of the crash ( = 54,090). For each crash-involved driver, selected medical diagnoses registered from 1997 until the day before the crash were extracted from the National Patient Register. The drivers were assigned to 1 of 4 groups, depending on prior diseases: sleep apnea (SA; group 1, = 2,165), sleep disorders (group 2, = 724), Parkinson's or epilepsy (group 3, = 645) and a reference group (group 4, = 50,556). Logistic regression analysis compared single-vehicle crashes with multiple-vehicle crashes and moderately/severely injured drivers with slightly/uninjured drivers.
Drivers with EDS-related diseases (groups 1-3) had higher probability of a single-vehicle crash than a multiple-vehicle crash compared to the reference group. The most sizeable effect was found for Parkinson's/epilepsy with an odds ratio (OR) of 2.5 (confidence interval [CI], 2.1-3.0). For multiple-vehicle crashes, the probability of a moderate/severe injury was higher for drivers with other sleep disorders (OR = 1.5; CI, 1.0-2.2) and Parkinson's/epilepsy (OR = 1.6; CI, 1.1-2.3) compared to the reference group.
This study has made first steps toward understanding the relationship between some of the most common diseases that are known to contribute to EDS and crashes. Having Parkinson's/epilepsy, in particular, elevated the probability of a single-vehicle crash compared to a multiple-vehicle crash. A single-vehicle crash was seen as indicative of causing a crash; thus, having Parkinson's/epilepsy could be interpreted as a risk factor for crash involvement. Having Parkinson's/epilepsy, as well as other sleep disorders, was also related to more severe outcomes in multiple-vehicle crashes, given that a crash occurred. This was not identified in single-vehicle crashes.
本研究旨在了解已知与日间嗜睡（EDS）相关的一些最常见疾病与交通伤害事故之间的关系。研究特别关注疾病与事故类型（单车事故或多车事故）之间的关系，以及疾病与伤害严重程度之间的关系。
本基于登记的研究考虑了 2011 年至 2016 年间在瑞典发生事故的所有 40 岁及以上的乘用车驾驶员（n=54090）。对于每一位涉及事故的驾驶员，从国家患者登记处提取了从 1997 年到事故发生前一天记录的选定医疗诊断。根据既往疾病，驾驶员被分为 4 组之一：睡眠呼吸暂停（SA；组 1，n=2165）、睡眠障碍（组 2，n=724）、帕金森病或癫痫（组 3，n=645）和参考组（组 4，n=50556）。逻辑回归分析比较了单车事故和多车事故，以及中度/重度受伤驾驶员和轻度/未受伤驾驶员。
与参考组相比，患有 EDS 相关疾病的驾驶员（组 1-3）发生单车事故的可能性更高。帕金森病/癫痫的影响最大，比值比（OR）为 2.5（95%置信区间[CI]，2.1-3.0）。对于多车事故，与参考组相比，其他睡眠障碍（OR=1.5；95%CI，1.0-2.2）和帕金森病/癫痫（OR=1.6；95%CI，1.1-2.3）的驾驶员发生中度/重度损伤的可能性更高。
本研究初步探讨了已知与 EDS 相关的一些最常见疾病与事故之间的关系。与参考组相比，患有帕金森病/癫痫的驾驶员发生单车事故的可能性更高，而发生多车事故的可能性更低。单车事故被视为导致事故的原因；因此，患有帕金森病/癫痫可能被视为事故发生的危险因素。发生多车事故时，患有帕金森病/癫痫以及其他睡眠障碍与更严重的后果有关，因为发生了事故。这在单车事故中没有发现。
