Risk factors associated with sleep-disordered breathing in professional truck drivers whose collisions were attributed to microsleep-related behaviors while driving

Abstract

Abstract This retrospective study assessed the association between overnight pulse oximetry parameters, including subjective daytime sleepiness on the Epworth Sleepiness Scale (ESS), and dashcam footages of confirmed truck collisions attributed to microsleep-related behaviors at the wheel (TC-MRBs) among professional truck drivers. The study included 108 matched professional truck drivers with and without TC-MRBs (TC-MRBs: N = 54; non-TC-MRBs: N = 54). ESS and overnight pulse oximetry parameters were considered associated factors. In the TC-MRBs group, microsleep-related behaviors were confirmed by dashcam video footage in all collisions. The mean age and body mass index of participants were 41.9 ± 11.3 years and 23.0 ± 3.7 kg/m2, respectively (males: 100.0%, night-time drivers: 30.6%). Night-time driving, 4% oxygen desaturation index (ODI), and nadir oxygen saturation (SpO2) were associated with TC-MRBs (odds ratio (OR) [95% confidence interval (CI)]: 25.63 [5.88–111.77], p < 0.0001; OR [95%CI]: 1.25 [1.01–1.56], p = 0.045; OR [95%CI]: 1.15 [1.00–1.31], p = 0.04, respectively). The area under the curve of TC-MRBs for 4%ODI and nadir SpO2 were 0.50 and 0.57, respectively (4%ODI: sensitivity = 0.30, specificity = 0.85; nadir SpO2: sensitivity = 0.36, specificity = 0.85). The mean SpO2, 3%ODI, or ESS were not associated with TC-MRBs. In contrast, although the sensitivity of TC-MRBs using 4%ODI or nadir SpO2 was poor, 4%ODI and nadir SpO2 were associated with TC-MRBs.