Sleep Disorders as a Cause of Motor Vehicle Collisions

Studies have shown that a large proportion of traffic accidents aroundthe world are related to inadequate or disordered sleep. recent surveyshave linked driver fatigue to 16% to 20% of serious highway accidentsin the uk, australia, and brazil. fatigue as a result of sleep disorders(especially obstructive sleep apnea), excessive workload and lack ofphysical and mental rest, have been shown to be major contributingfactors in motor vehicle accidents. a number of behavioral,physiological, and psychometric tests are being used increasingly toevaluate the impact of fatigue on driver performance. these includethe oculography, polysomnography, actigraphy, the maintenance ofwakefulness test, and others. various strategies have been proposedfor preventing or reducing the impact of fatigue on motor vehicleaccidents. these have included: educational programs emphasizing theimportance of restorative sleep and the need for drivers to recognizethe presence of fatigue symptoms, and to determine when to stopto sleep; the use of exercise to increase alertness and to promoterestorative sleep; the use of substances or drugs to promote sleep oralertness (i.e. caffeine, modafinil, melatonin and others), as well asspecific sleep disorders treatment; the use of cpap therapy forreducing excessive sleepiness among drivers who have been diagnosedwith obstructive sleep apnea. the evidence cited in this review justifiesthe call for all efforts to be undertaken that may increase awarenessof inadequate sleep as a cause of traffic accidents. it is stronglyrecommended that, for the purpose of promoting highway safety andsaving lives, all disorders that cause excessive sleepiness should beinvestigated and monitored.