Can the MSLT be a Useful Tool to Assess Motor Vehicle Crash Risk in Sleepy Drivers?

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OVER THE LAST 15 YEARS, EPIDEMIOLOGICAL STUDIES HAVE HIGHLIGHTED THE PREVALENCE OF SLEEPINESS AND SLEEP DISORDERS AMONG THE GENERAL population.^1–3 Sleepiness at the wheel^2,4 has been identified as one of the major reasons for highway accidents and fatal crashes and patients suffering from excessive daytime sleepiness have a higher chance of traffic accidents than non sleepy drivers.^5–9 These findings have raised questions for clinicians who treat patients that rely on driving on a daily basis. Is a simple questionnaire suffcient to estimate the risk of accidents in sleepy patients, or could an objective test provide a better estimate regarding accident risk?

Intuitively, questionnaires may not be the optimal tools when evaluating the actual level of sleepiness at the wheel, especially in professional drivers. Indeed, workers may under report their level of sleepiness at the wheel particularly if they can loose their jobs because of this symptom. In that case an objective measure of sleepiness, if not falsifable, should be more reliable.