"It is estimated that as many as 40 million Americans have undiagnosed sleep apnea," said the paper's senior author, Terence Davidson, M.D., professor of surgery, UCSD Division of Otolaryngology-Head and Neck Surgery. "Dr Sassani's study clearly demonstrates that these people are falling asleep while driving, killing themselves and innocent bystanders. It is time for American Medicine and the American people to wake up to sleep."

The UCSD investigators noted the prevalence of obstructed sleep apnea in drivers is estimated at 3 percent, or 4.7 million drivers. A recent study of 1,391 commercial truck drivers found that 28 percent had obstructive sleep apnea, with more than one-third characterized as moderate to severe. Sassani indicated that in one year alone - the year 2000 - more than 800,000 drivers with the condition were involved in motor-vehicle accidents.

The researchers estimate that 980 of the 1,400 fatalities each year will be avoided with treatment, based on a 70 percent CPAP success rate. While the annual cost of treating sleep apnea patients is approximately $3.18 billion, including screening costs, the researchers noted that collision costs for accidents caused by sleep apnea patients were $15.9 billion annually. These collision costs would be reduced annually by $11.1 billion, using a 70 percent effectiveness rate.

Furthermore, the study investigators added that the savings from CPAP treatment "do not take into account the other economic, medical and social benefits of treating obstructive sleep apnea syndrome, including decreased accidents at work, decreased hospitalization costs, and the improved quality of life."

The authors also noted that their results pertain only to CPAP treatment and not to non-CPAP treatments whose efficacy in preventing collisions has not been fully established. These include weight loss (surgical and nonsurgical), maxillomandibular advancement (surgery involving facial changes), laser correction, uvulopalatopharyngoplasty (minor surgery to lessen excessive soft-palate tissue), and oral appliances.

According to Davidson, "It is noteworthy that this study was made possible by a $2,000 educational grant from a local sleep company, ResMed, to Dr. Sassani when he was a UCSD medical student. This is an exemplary example of how the business community and the university can partner to make good things happen."

Additional authors of the paper included Larry J. Findley, M.D., Sleep Disorders Center of Northern Colorado; Meir Kryger, M.D., University of Manitoba and Sleep Disorders Centre, St. Boniface General Hospital, Winnepeg, Canada; Eric Goldlust, Ph.D., UCSD Department of Family and Preventive Medicine; and Charles George, M.D., University of Western Ontario.

Source: University of California, San Diego, news release, May 1, 2004.