Luzzi Valeria, Mazur Marta, Guaragna Mariana, Di Carlo Gabriele, Cotticelli Luisa, Magliulo Giuseppe, Marasca Beatrice, Pirro Valentina, Di Giorgio Gianni, Ndokaj Artnora, Pasqualetti Patrizio, Simonelli Ilaria, Martini Agnese, Pietrafesa Emma, Polimeni Antonella
Department of Oral and Maxillofacial Sciences, Sapienza University of Rome, Via Caserta 6, 00161 Rome, Italy.
Department of Sensory Organs, Sapienza University of Rome, 00100 Rome, Italy.
J Clin Med. 2022 Jul 8;11(14):3971. doi: 10.3390/jcm11143971.
Obstructive sleep apnea syndrome (OSAS) is an under-recognized clinical condition and is correlated with sleepiness and impaired cognitive function. Objectives: The primary aim of this systematic review, developed within the Sleep@OSA project, was to determine the correlations of obstructive sleep apnea syndrome, daytime sleepiness and sleep-disordered breathing with the risk of car accidents in adult working populations; a secondary aim was to analyze the epidemiologic data with a gender-based approach to identify differences between women and men in the data and in associated risk factors. Methods: Clinical trials and studies reporting data on the frequency of car accidents involving adult working population with daytime sleepiness and/or OSAS compared with a control group of participants were included. Literature searches of free text and MeSH terms were performed using PubMed, Google Scholar, the Cochrane Library and Scopus from 1952 to 3 May 2021. Results and Conclusions: The search strategy identified 2138 potential articles. Of these, 49 papers were included in the qualitative synthesis, and 30 were included in the meta-analysis. Compared with controls, the odds of car accidents were found to be more than double in subjects with OSAS (OR = 2.36; 95% CI 1.92−2.91; p < 0.001), with a similar risk between commercial motor vehicle drivers (OR = 2.80; 95% CI 1.82−4.31) and noncommercial motor vehicle drivers (OR = 2.32; 95% CI 1.84−2.34). No significant correlation was found between sleepiness and car crashes, but subjects with sleep-disordered breathing were at increased risk of car accidents (OR = 1.81; 95% CI 1.42−2.31; p < 0.001). To our surprise, although epidemiological studies on the risk of road accidents in the adult population with OSAS and daytime sleepiness are currently very abundant, specific data on the female population are not available.
阻塞性睡眠呼吸暂停综合征（OSAS）是一种未被充分认识的临床病症，与嗜睡和认知功能受损相关。目的：本系统评价是在Sleep@OSA项目中开展的，其主要目的是确定阻塞性睡眠呼吸暂停综合征、日间嗜睡和睡眠呼吸紊乱与成年工作人群交通事故风险之间的相关性；次要目的是采用基于性别的方法分析流行病学数据，以确定女性和男性在数据及相关风险因素方面的差异。方法：纳入了与对照组参与者相比，报告涉及有日间嗜睡和/或OSAS的成年工作人群交通事故发生率数据的临床试验和研究。使用PubMed、谷歌学术、考克兰图书馆和Scopus对1952年至2021年5月3日的自由文本和医学主题词进行文献检索。结果与结论：检索策略共识别出2138篇潜在文章。其中，49篇论文纳入定性综合分析，30篇纳入荟萃分析。与对照组相比，发现OSAS患者发生交通事故的几率是对照组的两倍多（OR = 2.36；95% CI 1.92−2.91；p < 0.001），商业机动车驾驶员（OR = 2.80；95% CI 1.82−4.31）和非商业机动车驾驶员（OR = 2.32；95% CI 1.84−2.34）的风险相似。未发现嗜睡与车祸之间存在显著相关性，但睡眠呼吸紊乱的受试者发生交通事故的风险增加（OR = 1.81；95% CI 1.42−2.31；p < 0.001）。令我们惊讶的是，尽管目前关于患有OSAS和日间嗜睡的成年人群道路交通事故风险的流行病学研究非常丰富，但尚无关于女性人群的具体数据。
