Cassel W, Ploch T, Becker C, Dugnus D, Peter J H, von Wichert P
Klinikum der Philipps-Universität, Abteilung Poliklinik, Marburg, Germany.
Eur Respir J. 1996 Dec;9(12):2606-11. doi: 10.1183/09031936.96.09122606.
Sleepiness whilst driving constitutes a road safety risk. Sleep-related breathing disorders are the most frequent medical cause of daytime sleepiness, and untreated patients with this condition have been shown to be at a higher risk of having accidents while driving. This study addressed the question of the extent to which treatment of sleep-disordered breathing by nasal continuous positive airway pressure (nCPAP) is related to changes in patient's accident risk. Seventy eight male patients requiring treatment of sleep-related breathing disorders with nCPAP were enrolled in the study. The protocol included a questionnaire dealing with alertness-related problems while driving, an 80 min vigilance test, and the Multiple Sleep Latency Test. These baseline evaluations were repeated after 1 year of treatment with nCPAP. Fifty nine patients completed the study. The accident rate was significantly decreased from 0.8 per 100,000 km (untreated) to 0.15 per 100,000 km with nCPAP treatment. Variables that were considered to be likely to increase accident risk (sleeping spells, fatigue, vigilance test reaction time, daytime sleep latency) also improved with treatment. We conclude that treatment of sleep-disordered breathing by nasal continuous positive airway pressure is related to reduction in patient motor vehicle accident rates, probably due to the reversal of excessive daytime sleepiness.
驾车时困倦会构成道路安全风险。与睡眠相关的呼吸障碍是导致日间困倦最常见的医学原因，已有研究表明，患有这种疾病且未接受治疗的患者在驾车时发生事故的风险更高。本研究探讨了通过鼻持续气道正压通气（nCPAP）治疗睡眠呼吸障碍与患者事故风险变化之间的关联程度。78名需要使用nCPAP治疗睡眠相关呼吸障碍的男性患者参与了该研究。研究方案包括一份关于驾车时与警觉性相关问题的问卷、一项80分钟的警觉性测试以及多次睡眠潜伏期测试。在使用nCPAP治疗1年后，重复进行这些基线评估。59名患者完成了研究。事故率从每100,000公里0.8次（未治疗时）显著降至使用nCPAP治疗后的每100,000公里0.15次。那些被认为可能增加事故风险的变量（睡眠发作、疲劳、警觉性测试反应时间、日间睡眠潜伏期）在治疗后也有所改善。我们得出结论，通过鼻持续气道正压通气治疗睡眠呼吸障碍与降低患者机动车事故率相关，这可能是由于日间过度嗜睡的逆转。
