Be careful of sleepy drivers

Patients who may be impaired by their medications or sleep disorders have a higher risk of fatal motor vehicle accidents.

People impaired by medications or sleep disorders have a higher risk of fatal car accidents.
People impaired by medications or sleep disorders have a higher risk of fatal car accidents.

 I have practiced both pain medicine and sleep medicine in my career. After reading a recent study, it occurred to me that there are a lot of people driving who are impaired due to their medication or sleep disorders. I did some research, and I found a few alarming statistics. These do not account for other drivers who are out there with alcohol or illegal substances in their systems.

Between 1993 and 2010, the CDC reports that the number of fatal crashes related to drivers having three or more prescription drugs in their system increased from 11.5 to 21.5%. This figure is three times the rate of crashes involving marijuana. It also shows that the accidents involving medication have almost doubled in frequency.

My patients with untreated sleep apnea have confessed at times that they have been sleepy while driving. No one wants to admit to the severity because they are afraid of losing their license. These patients often tell me that they pull over to rest stops to take a nap because they are sleepy.  You better believe that I counsel these people: I warn them that not only are they jeopardizing their own lives but those of other people as well.

Statistics show that patients with sleep apnea are 5 to 7 times more likely to have a motor vehicle accident that those without apnea.

The latest sleep disorder to increase the risk for fatal motor vehicle accidents is insomnia. Insomnia is defined as patients who have trouble falling asleep, maintaining sleep, waking early, or have feelings of non-restorative sleep. It is a prevalent disorder with as many as 33% of the general population experiencing at least one of these symptoms.

The HUNT study, a Norwegian population-based prospective study with a mean follow-up of 14 years, included 54,399 participants, both men and women. The researchers found a correlation between insomnia and increased fatal injuries. Of those that had a fatal motor vehicle injury, 34% of them had complained of difficulty initiating sleep, 11% complained of difficulty maintaining sleep, and 10% of those had feelings of non-restorative sleep.

Please be sure to talk to your patients about their sleepiness and driving, whether it's related to medications or a sleep disorder. Looking at these statistics is scary. Don't be afraid to suggest to a patient that they need to have someone else do the driving for them or take public transportation. If you have grave concerns that a patient is being unsafe, take the next step and report your concerns to the Department of Motor Vehicles or Department of Transportation.

Safe driving!

Sharon M. O'Brien, MPAS, PA-C, is a practicing clinician with an interest in helping patients understand the importance of sleep hygiene and the impact of sleep on health.

References

  1. Mercola, J. “Common medications and multiple drug combinations increasingly linked to fatal car crashes.” 22 Oct 2014. Retrieved from http://articles.mercola.com/sites/articles/archive/2014/10/22/car-accident-multiple-drug-combinations.aspx
  2. WebMD. “Sleep Apnea and Related Health Conditions.” 24 June 2013. Retrieved from http://www.webmd.com/sleep-disorders/sleep-apnea/sleep-apnea-conditions
  3. Strohl, KP et al. Am J Respir Crit Care Med; DOI: 10.1164/rccm.201304-0726ST.
  4. Ward, KL et al. J Clin Sleep Med; 2013;9(10):1013-1021.
  5. Laugsand, LE et al. ; 2014;37(11):1777-1786.
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