Introduction Tiredness while driving is potentially fatal and it is recommended that a driver who starts to feel tired should stop and have a rest, but some may use various strategies to try to stay alert. We devised a questionnaire that assessed various commonly used coping strategies and explored whether there is a difference between patients with OSAS and normal controls. We also hypothesised that patients might admit to utilising such strategies more readily than to sleepiness while driving and asked about sleepiness while driving in various situations.
Method 133 (52±10 yrs, ESS 12±6, ODI 31± 24) untreated OSAS patients and 49 healthy controls (45±17 yrs, ESS 3±2) were included in the study. The coping strategy section included ten questions about various strategies they adapt in order to stay awake. They were asked to rate on a 3-point scale, from “never” to “frequently”. The questionnaire was scored by adding up the ratings for the ten questions, and the highest possible score was 30. Comparisons were made using one way ANOVA.
Results There was a significant difference in the total coping strategy score between the patients of different severities (mild, moderate, severe, as per ODI) and the healthy controls. However there was no difference when different severities of OSAS were compared against each other (Table 1). There was strong correlation between the coping strategy score & ESS (Spearman r=0.53, p<0.0001). 81% (38/47) of patients and 77% (23/30) of controls who did not admit to feeling sleepy while driving admitted using coping strategies.
Conclusion OSAS patients report using significantly higher number of coping strategies compared to healthy individuals irrespective of the severity of disease. It also correlated strongly with marker of day time sleepiness (ESS). Asking about such coping strategies may be a better way identifying who are at risk of an accident than asking directly about problems with sleepiness while driving.