Continuous positive airway pressure reduces risk of motor vehicle crash among drivers with obstructive sleep apnoea: systematic review and meta-analysis

  • Published: Sleep. 2010 October 1; 33(10): 1373–1380.
  • Authors: Tregear S, Reston J, Schoelles K, Phillips B.
  • Date Added: 29 Dec 2013
  • Last Update: 29 Dec 2013
  • Format: html


Determine whether CPAP use could reduce the risk of motor vehicle accidents among drivers with OSA. A secondary objective involved determining the time on treatment required for CPAP to improve driver safety.


Literature review searching MEDLINE, PubMed (PreMEDLINE), EMBASE, PsycINFO, CINAHL, TRIS, and the Cochrane library.

Key Findings:

  • A meta-analysis of 9 observational studies examining accident risk of drivers with OSA pre- vs. post-CPAP found a significant risk reduction following treatment (risk ratio = 0.278, 95% CI: 0.22 to 0.35; P < 0.001).

  • Although accident data are not available to assess the time course of change, daytime sleepiness improves significantly following a single night of treatment, and simulated driving performance improves significantly within 2 to 7 days of CPAP treatment.

  • Observational studies indicate that CPAP reduces motor vehicle accident risk among drivers with OSA.


Sleep apnoea, crash, motor vehicle, CPAP, public health


This review demonstrates the benefits of CPAP in reducing daytime sleepiness and the increased risk associated with sleepiness when driving.