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Philip P, Micoulaud-Franchi JA, Taillard J, Coelho J, Tisserand C, Dauvilliers Y, Sagaspe P. The Bordeaux Sleepiness Scale (BOSS): a new questionnaire to measure sleep-related driving risk. J Clin Sleep Med 2023; 19:957-965. [PMID: 36727504 PMCID: PMC10152350 DOI: 10.5664/jcsm.10470] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/29/2022] [Revised: 01/10/2023] [Accepted: 01/10/2023] [Indexed: 02/03/2023]
Abstract
STUDY OBJECTIVES Sleepiness is a well-known risk factor for traffic accidents. Our study presents a new questionnaire, the Bordeaux Sleepiness Scale (BOSS), specifically designed to evaluate sleep-related driving risk in patients with sleep disorders. METHODS The BOSS was designed by gathering data on sociodemographics, sleepiness, driving items, and traffic accident exposure (kilometers driven) in the past year of 293 patients followed for sleep disorders at a French sleep clinic. It was then validated on data from a large population-based cohort of 7,296 highway drivers. Its performance was compared to the Epworth sleepiness scale and to self-reported episodes of severe sleepiness at the wheel. Receiver operating characteristic curves were computed. RESULTS The sensitivity and specificity of the BOSS (cutoff = 3) to predict sleep-related near-misses or accidents was, respectively, 82% and 74%, with an area under the receiver operating characteristic curve of 0.83. In a cohort of patients and a large population-based cohort, the area under the curve of the BOSS was significantly larger than that of the Epworth sleepiness scale (P < .001). Although the areas under the curve were equivalent between the BOSS and sleepiness at the wheel, the specificity of the BOSS was higher. CONCLUSIONS The BOSS scale combining exposure (kilometers driven) and self-perception of situational sleepiness provides a simple and reliable evaluation of sleep-related driving risk. This short, specific questionnaire should be promoted as a first-line tool to evaluate the risk of traffic accidents in sleepy patients. CITATION Philip P, Micoulaud-Franchi J-A, Taillard J, et al. The Bordeaux Sleepiness Scale (BOSS): a new questionnaire to measure sleep-related driving risk. J Clin Sleep Med. 2023;19(5):957-965.
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Affiliation(s)
- Pierre Philip
- Sleep, Addiction and Neuropsychiatry, University of Bordeaux, Bordeaux, France
- CNRS, SANPSY, UMR 6033, Bordeaux, France
- CHU de Bordeaux, Centre Hypersomnies Rares, Bordeaux, France
- INSERM CIC1401, Université de Bordeaux, CHU de Bordeaux, Bordeaux, France
| | - Jean-Arthur Micoulaud-Franchi
- Sleep, Addiction and Neuropsychiatry, University of Bordeaux, Bordeaux, France
- CNRS, SANPSY, UMR 6033, Bordeaux, France
- CHU de Bordeaux, Centre Hypersomnies Rares, Bordeaux, France
| | - Jacques Taillard
- Sleep, Addiction and Neuropsychiatry, University of Bordeaux, Bordeaux, France
- CNRS, SANPSY, UMR 6033, Bordeaux, France
- CHU de Bordeaux, Centre Hypersomnies Rares, Bordeaux, France
| | - Julien Coelho
- Sleep, Addiction and Neuropsychiatry, University of Bordeaux, Bordeaux, France
- CNRS, SANPSY, UMR 6033, Bordeaux, France
- CHU de Bordeaux, Centre Hypersomnies Rares, Bordeaux, France
| | | | - Yves Dauvilliers
- Reference National Center for Narcolepsy, Sleep Unit, CHU Montpellier, Montpellier, France
- PSNREC, University of Montpellier, INSERM, Montpellier, France
| | - Patricia Sagaspe
- Sleep, Addiction and Neuropsychiatry, University of Bordeaux, Bordeaux, France
- CNRS, SANPSY, UMR 6033, Bordeaux, France
- CHU de Bordeaux, Centre Hypersomnies Rares, Bordeaux, France
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Sagaspe P, Micoulaud-Franchi JA, Bioulac S, Taillard J, Guichard K, Bonhomme E, Dauvilliers Y, Bastien CH, Philip P. Self-perceived sleep during the Maintenance of Wakefulness Test: how does it predict accidental risk in patients with sleep disorders? Sleep 2021; 44:6309942. [PMID: 34173829 DOI: 10.1093/sleep/zsab159] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/08/2020] [Revised: 05/17/2021] [Indexed: 11/13/2022] Open
Abstract
STUDY OBJECTIVES To determine whether the feeling of having slept or not during the Maintenance of Wakefulness Test (MWT) is associated with the occurrence of self-reported sleep-related traffic near misses and accidents in patients with sleep disorders. METHODS This study was conducted in patients hospitalized in a French sleep center to perform a 4*40 min MWT. Relationship between mean sleep latency on the MWT, feeling of having slept or not during MWT trials and sleep-related near misses and accidents reported during the past year was analyzed. RESULTS 192 patients suffering from OSAS, idiopathic hypersomnia, narcolepsy, restless leg syndrome or insufficient sleep syndrome were included. 165 patients presented no or one misjudgment of feeling of having slept during MWT trials while 27 presented more than two misjudgments. Almost half of the latter (48.1%) reported a sleepiness-related traffic near miss or accident in the past year versus only one third (27.9%) for the former (P<.05). Multivariate logistic regression showed that patients with more than two misjudgments had a 2.52-fold (95% CI, 1.07-5.95, P<.05) increase in the risk of reporting a sleepiness-related near miss/accident. CONCLUSIONS Misjudgment in self-perceived sleep during the MWT is associated with the occurrence of self-reported sleepiness-related traffic near misses and accidents in the past year in patients suffering from sleep disorders. Asking about the perception of the occurrence of sleep during the MWT could be used to improve driving risk assessment in addition to sleep latencies.
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Affiliation(s)
- Patricia Sagaspe
- University of Bordeaux, Sleep, Addiction and Neuropsychiatry, USR, Bordeaux, France.,CNRS, SANPSY, USR, Bordeaux, France.,CHU Bordeaux, Centre Hypersomnies Rares, Bordeaux, France
| | - Jean-Arthur Micoulaud-Franchi
- University of Bordeaux, Sleep, Addiction and Neuropsychiatry, USR, Bordeaux, France.,CNRS, SANPSY, USR, Bordeaux, France.,CHU Bordeaux, Centre Hypersomnies Rares, Bordeaux, France
| | - Stéphanie Bioulac
- University of Bordeaux, Sleep, Addiction and Neuropsychiatry, USR, Bordeaux, France.,CNRS, SANPSY, USR, Bordeaux, France.,CHU Bordeaux, Centre Hypersomnies Rares, Bordeaux, France
| | - Jacques Taillard
- University of Bordeaux, Sleep, Addiction and Neuropsychiatry, USR, Bordeaux, France.,CNRS, SANPSY, USR, Bordeaux, France.,CHU Bordeaux, Centre Hypersomnies Rares, Bordeaux, France
| | - Kelly Guichard
- University of Bordeaux, Sleep, Addiction and Neuropsychiatry, USR, Bordeaux, France.,CNRS, SANPSY, USR, Bordeaux, France.,CHU Bordeaux, Centre Hypersomnies Rares, Bordeaux, France
| | - Emilien Bonhomme
- University of Bordeaux, Sleep, Addiction and Neuropsychiatry, USR, Bordeaux, France.,CNRS, SANPSY, USR, Bordeaux, France
| | - Yves Dauvilliers
- Reference National Center for Narcolepsy, Sleep Unit, CHU Montpellier, Montpellier, France.,PSNREC, University of Montpellier, INSERM, Montpellier, France
| | - Célyne H Bastien
- School of Psychology, Laval University, Quebec, Canada.,CERVO Research Centre, Beauport, Quebec, Canada
| | - Pierre Philip
- University of Bordeaux, Sleep, Addiction and Neuropsychiatry, USR, Bordeaux, France.,CNRS, SANPSY, USR, Bordeaux, France.,CHU Bordeaux, Centre Hypersomnies Rares, Bordeaux, France
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