Car Crashes and Central Disorders of Hypersomnolence: A French Study

Fabio Pizza (1, 2, 3) , Isabelle Jaussent (4) , Regis Lopez (3, 4, 5) , Carole Pesenti (3, 4, 5) , Giuseppe Plazzi (1, 2) , Xavier Drouot (6) , Smaranda Leu-Semenescu (7, 5) , Severine Beziat (4) , Isabelle Arnulf (5, 7) , Yves Dauvilliers (3, 4, 5)

1 UNIBO - Alma Mater Studiorum Università di Bologna = University of Bologna
2 IRCCS
3 Sleep disorders center
4 PSNREC - Neuropsychiatrie : recherche épidémiologique et clinique
5 National reference centre for orphan diseases, narcolepsy, idiopathic hypersomnia and Kleine-Levin syndrome
6 Clinical neurophysiology department
7 ICM - Institut du Cerveau et de la Moëlle Epinière = Brain and Spine Institute

Background Drowsiness compromises driving ability by reducing alertness and attentiveness, and delayed reaction times. Sleep-related car crashes account for a considerable proportion of accident at the wheel. Narcolepsy type 1 (NT1), narcolepsy type 2 (NT2) and idiopathic hypersomnia (IH) are rare central disorders of hypersomnolence, the most severe causes of sleepiness thus being potential dangerous conditions for both personal and public safety with increasing scientific, social, and political attention. Our main objective was to assess the frequency of recent car crashes in a large cohort of patients affected with well-defined central disorders of hypersomnolence versus subjects from the general population. Methods We performed a cross-sectional study in French reference centres for rare hypersomnia diseases and included 527 patients and 781 healthy subjects. All participants included needed to have a driving license, information available on potential accident events during the last 5 years, and on potential confounders; thus analyses were performed on 282 cases (71 IH, 82 NT2, 129 NT1) and 470 healthy subjects. Results Patients reported more frequently than healthy subjects the occurrence of recent car crashes (in the previous five years), a risk that was confirmed in both treated and untreated subjects at study inclusion (Untreated, OR = 2.21 95%CI = [1.30–3.76], Treated OR = 2.04 95%CI = [1.26–3.30]), as well as in all disease categories, and was modulated by subjective sleepiness level (Epworth scale and naps). Conversely, the risk of car accidents of patients treated for at least 5 years was not different to healthy subjects (OR = 1.23 95%CI = [0.56–2.69]). Main risk factors were analogous in patients and healthy subjects. Conclusion Patients affected with central disorders of hypersomnolence had increased risk of recent car crashes compared to subjects from the general population, a finding potentially reversed by long-term treatment.

Domaines: Médecine humaine et pathologie

Fabio Pizza, Isabelle Jaussent, Regis Lopez, Carole Pesenti, Giuseppe Plazzi, et al.. Car Crashes and Central Disorders of Hypersomnolence: A French Study. PLoS ONE, 2015, 10 (6), pp.e0129386. ⟨10.1371/journal.pone.0129386⟩. ⟨hal-01228014⟩