Turan ACICAN, Ayşe BAÇÇIOĞLU, Eriş Banu GÜLBAY, Ruşina DOĞAN, Emine GÜLLÜ, Gülseren KARADAĞ

Taksi sürücülerinde gündüz aşırı uyku hali ile trafik kazaları arasındaki ilişki

Özellikle profesyonel sürücüler için önemli bir problem oluşturan gündüz aşırı uyku hali (GAUH); sık görülmesine karşın tanınmayan ve trafik kazalarının önlenebilir bir nedenidir. Bu çalışmada, taksi sürücülerinde GAUH'yi saptamak ve bu durumun sürüş performansı üzerindeki etkilerini saptamak için, 118 profesyonel taksi sürücüsüne Epworth uykululuk skalası (ESS) ve yaptıkları trafik kazalarına ilişkin anket uygulandı. Sürücü grubunda horlayan 58 (%49.2), obstrüktif uyku apne sendromu (OUAS)'na ait kardinal semptomları bulunan 8 (%5.9), ESS$geq$ 10 olan 28 (%23.7) olgu bulunuyordu. Kaza yapan toplam 80 (%67.8) olgu vardı. Yapılan kaza sayısı ile sürücülerin GAUH, tanıklı apne varlığı, OUAS'ye ait kardinal semptom varlığı arasında istatistiksel olarak anlamlı bir ilişki gösterilirken, aynı ilişki horlama ile gösterilemedi. Bu sonuçlar, GAUH'nin sürücülerde yaygın bir semptom olarak bulunduğunu ve trafik kazaları ile ilişkili olabileceğini göstermektedir.

The evaluation of excessive daytime sleepiness in taxi drivers

Excessive daytime sleepiness (EDS) is a common but underrecognized and preventable cause of traffic accidents. It creates a problem of particular importance for professional drivers. We performed the Epworth Sleepiness Scale (ESS) and questionnaire related to their history of traffic accidents to 118 professional taxi drivers to determine the EDS and its effects on driving performance in taxi drivers. There were 58 (49.2%) subjects with loud snoring, 8 (5.9%) subjects with cardinal symptoms due to obstructiue sleep apnea syndrome (OSAS) and 28 (23.7%) subjects with ESS $geq$ 10 in the group of taxi drivers. Eighty (67.8%) drivers had been involved in a traffic accident We found a significant relation between the number of traffic accident and EDS, witnessed apnea, cardinal symptom related to OSAS but not with snoring. The present data that sleepiness is a common symptom in taxi driuers and may be related to traffic accident.

PDF

___

1. ATS Statement Sleep apnea, sleepiness, and driving risk. Am J Respir Crit Care Med 1994; 150:1463-73.
2. Laube I, Bloch KE. Falling asleep at the steering wheel-a dangerous sequel of sleep apnea. Ther Umsch 2000; 57: 435-8.
3. Lioberes P, Levy G, Descals C, et al. Self-reported sleepiness while driving as a risk factor for traffic accidents in patients with obstructive sleep apnea syndrome and in non-apnoeic snorers. Respir Med 2000; 94:971-6.
4. Hui DS, Chan JK, Ho AS, et at. Prevalence of snoring and sleep-disordered breathing in a student population. Chest 1999; 116: 1530-6.
5. Suratt PM, Findley LJ. Driving With sleep apnea. N Engl J Med 1999;340: 881-3.
6. Johns MW. A new method for measuring daytime sleepiness: The Epworth sleepiness scale. Sleep 1991; 14:540-5.
7. Idem. Daytime sleepiness, snoring, and obstructive sleep apnea: The Epworth sleepiness scale. Chest 1993; 103: 30-6.
8. Ardıç S, Uyku hastalıktan ve trafik kazaları. Toraks Dergisi 2001; 2: 91-8.
9. McNicholas WT. Editorial: Sleep apnea and driving risk. Eur Respir J 1999; 13:1225-7.
10. Turkington PM, Sircar M, Allgar V, Elliott MW. Relationship between obstructive sleep apnea, driving simulator performance, and risk of road traffic accidents. Thorax 2001; 56: 800-5.
11. Findley LJ, Unuerzagt ME, Suratt PM. Automobile accidents Involving patients with obstructive sleep apnea. Am Rev Respir Dis 1988; 138:337-40.
12. Findley LJ,Bonnie RJ. Sleep apnea and auto crashes, what is the doctor to do? Chest 1988; 94:225-6.
13. George CF, Nickerson PW, Hanly PJ, et al. Sleep apnea patients have more automobile accidents. Lancet 1987; 447 (letter).
14. Stradling JR. Obstructive sleep apnoea and driving. BMJ 1989; 298: 904-5.
15. Aldrich MS. Automobile accidents in patients with sleep disorders. Sleep 1989; 12: 487-94.
16. Dement WC, Mitler MM. It's time to wake up to the importance of sleep disorders. JAMA 1993; 269: 1548-50.
17. Findley LJ, Weiss W, Jabour R. Drivers with untreated sleep apnea. A cause of death and serious injury. Arch Intern Med 1991; 151: 1451-2.
18. Findley LJ, Levinson MP, Bonnie RJ. Driving performance and automobile accidents in patients with sleep apnea. Clin Chest Med 1992; 13: 427-35.
19. Bernal C, Gil FC, Benhamou BG, et al. Assessment of excessive day-time sleepiness in professional drivers with suspected obstructiue sleep apnea syndrome. Arch Bronconeumol 2000; 36:436-40 (Medline).
20. Armengol SA, Gomez CS, Gil CF, et al. The detection of the sleep apnea syndrome in a population of professional drivers, An Med Interna 1997; 14: 547-53 (Medline).
21. George CF, Smiley A. Sleep apnea £ automobile crashes. Sleep 1999; 15; 22: 790-5.
22. Maycock G. Sleepiness and driving: The experience of UK car drivers, Accid Anal Prev 1997; 29:453-62 (Medline).