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The Bordeaux Sleepiness Scale (BOSS): a new questionnaire to measure sleep-related driving risk

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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 the sleep-related driving risk in patients with sleep disorders.


The BOSS was designed by gathering data on the socio-demographics, sleepiness, driving items and traffic accidental 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 (ESS) and to self-reported episodes of severe sleepiness at the wheel (SAW). Receiver Operating Characteristic (ROC) curves were computed.


The sensitivity and specificity of the BOSS (cut-off = 3) to predict sleep-related near-misses or accidents was respectively 82% and 74%, with an area under the ROC curve of 0.83. In a patients cohort and in a large population-based cohort, the area under the curve of the BOSS was significantly larger than that of the ESS (P<.001). Although the areas under the curve were equivalent between the BOSS and SAW, the specificity of the BOSS was higher.


The BOSS scale combining exposure (kilometers driven) and self-perception of situational sleepiness provides a simple and reliable evaluation of the sleep-related driving risk. This short specific questionnaire should be promoted as first line to evaluate the risk of traffic accidents in sleepy patients.

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