Study: Sleep surgery reduces motor vehicle accident risk in OSA patients

Editor's Note

Sleep surgery outperforms continuous positive airway pressure (CPAP) therapy in reducing of motor vehicle accidents (MVA) risk among patients with obstructive sleep apnea (OSA), particularly those with poor CPAP adherence or severe disease, according to research published January 21 by the American Academy of Otolaryngology-Head and Neck Surgery.

The retrospective cohort study used data from over 2.8 million OSA patients in the TriNetX national database. Patients were grouped based on treatment type: CPAP therapy, sleep surgery (including uvulopalatopharyngoplasty and hypoglossal nerve stimulation), or no treatment. Propensity score matching (PSM) ensured comparability between cohorts by controlling for age, sex, and race. MVA incidence was analyzed along with OSA-related comorbidities. Key findings include:

• Sleep surgery patients had a significantly lower MVA incidence (3.403%) compared to CPAP users (6.072%) and untreated patients (4.662%).
• Odds ratios for MVA incidence favored sleep surgery over CPAP (OR: 0.545, 95% CI: 0.480–0.618, P < .0001) and no treatment (OR: 1.214, 95% CI: 1.060–1.391, P = .0051).
• Patients with OSA who experienced MVAs were more likely to have comorbidities such as hypertension (58.8% vs. 45.4%), diabetes (33.8% vs. 24.2%), and heart failure (19.5% vs. 11.7%).

While CPAP is the gold standard for OSA treatment, its efficacy is undermined by poor adherence, researchers write, noting that up to 83% of patients report challenges such as mask discomfort and device inconvenience. In contrast, sleep surgery offers a permanent anatomical solution, bypassing adherence issues and delivering consistent therapeutic benefits. This may explain the significantly lower MVA risk in the surgical cohort.

Future research should explore broader surgical options and post-MVA survival, researchers write, cautioning that reliance on retrospective data and diagnostic codes limited granular insights and that geographic and socioeconomic factors could have influenced outcomes.