Odds for motor vehicle accidents fall with sleep surgery vs. CPAP in OSA

Key takeaways:

• This study evaluated motor vehicle accident incidence rates based on CPAP, sleep surgery or no treatment.
• Of the three sets of patients, researchers found the lowest rates among those who had sleep surgery.

Among patients with obstructive sleep apnea, those treated with sleep surgery vs. CPAP had decreased odds for motor vehicle accident incidence, according to results published in Otolaryngology-Head and Neck Surgery.

“These findings emphasize the importance of considering sleep surgery for appropriate OSA patients, as it offers a substantial reduction in [motor vehicle accident (MVA)] risk compared to CPAP or no treatment, addressing adherence challenges with CPAP,” Elliott M. Sina, BA, MD candidate at Sidney Kimmel Medical College at Thomas Jefferson University, told Healio.

In this retrospective cohort study, Sina and colleagues evaluated 2,834,163 patients with OSA from the TriNetX database to determine if there are differences in MVA incidence rates based on treatment with CPAP, sleep surgery (uvulopalatopharyngoplasty or hypoglossal nerve stimulation) or no treatment.

Researchers used propensity scores to match the groups with each other based on age, sex and race. The analysis of no sleep apnea treatment vs. CPAP included 702,189 patients in each group, the analysis of no treatment vs. sleep surgery included 11,578 patients in each group and the analysis of CPAP vs. sleep surgery included 11,578 patients in each group.

Of the three sets of patients, researchers found the lowest MVA incidence rates among those who had sleep surgery (3.403% vs. 4.103% among those who did not receive treatment; 3.403% vs. 6.072% among those who had CPAP treatment).

Between the patients who did not receive treatment and the patients who had sleep surgery, the study noted significantly elevated odds for MVA incidence with no receipt of treatment (OR = 1.214; 95% CI, 1.06-1.391).

Additionally, patients treated with sleep surgery vs. CPAP had significantly decreased odds for MVA incidence (OR = 0.545; 95% CI, 0.48-0.618), according to researchers.

When assessing different comorbidities between those in MVAs and those not in MVAs, researchers reported that patients in these accidents more often had:

• hypertension (58.8% vs. 45.4%);
• obesity (42.3% vs. 34.7%);
• diabetes (33.8% vs. 24.2%);
• heart failure (19.5% vs. 11.7%);
• atrial fibrillation (10.1% vs. 6.2%);
• pulmonary hypertension (5.8% vs. 3.4%); and
• myocardial infarction (5.9% vs. 3.4%).

“Future studies should focus on controlling for OSA severity, directly measuring CPAP adherence and evaluating a broader range of surgical interventions to comprehensively assess their impact on MVA risk reduction,” Sina told Healio.

Reference:

• Does sleep apnea treatment influence patients’ risk of getting into car accidents? https://newsroom.wiley.com/press-releases/press-release-details/2025/Does-sleep-apnea-treatment-influence-patients-risk-of-getting-into-car-accidents/default.aspx. Published Jan. 22, 2025. Accessed Jan. 22, 2025.