Moderate-to-severe OSA and objective drowsiness are associated with driving-related accidents, but not subjective sleepiness: a simulator study

Abstract

Obstructive sleep apnea (OSA) is associated with an increased risk of motor vehicle accidents, traditionally attributed to excessive daytime sleepiness (EDS). However, subjective sleepiness may be underreported and does not consistently reflect functional impairment. We aimed to examine the association between objectively measured drowsiness during simulated driving and traffic accidents in OSA, and to compare the predictive roles of objective drowsiness, subjective sleepiness, and OSA severity. Methods: Fifty-one male drivers underwent overnight polysomnography followed by a 50-min driving simulation. OSA severity was categorized as moderate-to-severe (AHI ≥ 15 events/h) or no/mild (AHI