Sleep apnea and excessive daytime sleepiness may increase the risk of road accidents, particularly among drivers on long or overnight journeys. Indian studies have linked sleep disturbance and OSA-related risk factors with higher accident odds, while road-specific data highlights the role of drowsiness and drivers falling asleep. Experts recommend adequate rest, screening for sleep disorders, timely treatment and safer driving practices to reduce sleep-related crash risks.
India recorded 4,87,707 road accidents and 1,77,175 deaths in 2024, according to the Ministry of Road Transport and Highways' Road Accidents in India 2024 report. While drowsiness and drivers falling asleep have been identified as contributors to crashes on specific Indian roads, there is no national dataset that directly attributes road accidents to diagnosed sleep apnea. Research instead examines related factors such as sleep disturbance, obstructive sleep apnea (OSA) and excessive daytime sleepiness to assess their connection with crash risk.
What Is Sleep Apnea and Why Can It Affect Driving?
Obstructive sleep apnea (OSA) is a condition in which the upper airway repeatedly narrows or closes during sleep, stopping or reducing airflow for a few seconds at a time. Each interruption can cause a brief arousal that helps restore breathing, often without the person fully waking up. This can happen dozens or even hundreds of times in one night, leaving sleep less restorative even when the person spends enough hours in bed.
Fragmented sleep:
Waking up unrefreshed:
Daytime sleepiness:
Microsleeps:
Slower reaction time:
Repeated brief awakenings interrupt the normal sleep cycle and reduce the amount of deep, restorative sleep.
A person may spend eight hours in bed but still wake up tired because their sleep has been repeatedly interrupted.
Poor-quality sleep can lead to daytime fatigue, difficulty concentrating and excessive sleepiness.
These are brief, involuntary episodes of sleep that can last for a few seconds. At 80 km/h, a vehicle can travel more than 100 metres while the driver is asleep.
Sleep deprivation can affect attention, judgement and reaction time, reducing a driver's ability to respond to hazards on the road.
Long highway stretches can increase the risk of drowsiness. Monotonous scenery, night-time driving and several hours of continuous driving, including on expressways such as the Agra-Lucknow and Mumbai-Pune roadways, can make it harder to maintain alertness.
Sleep Apnea and Road Accidents: What Does the Evidence Say?
The most direct Indian evidence comes from two very different studies: one drawing on a national ageing survey, the other on a focused sample of professional drivers.
The 2025 LASI-based national study
A study published in Sleep Science and Practice in October 2025 analysed data from the Longitudinal Ageing Study in India (LASI), a nationally representative survey of adults aged 45 and above.[2]
| Metric | Finding |
|---|---|
| Sample size | 66,383 participants aged 45+ |
| RTA prevalence (overall) | 1.85% |
| RTA prevalence, ages 45-59 | 2.20% |
| RTA prevalence, ages 60+ | 1.46% |
| Sleep disturbance and RTA link | Adjusted Odds Ratio (AOR) 1.84 (95% CI 1.58-2.14) |
| Men with sleep disturbance | AOR 2.17, versus AOR 1.32 for women |
| Highest-risk age group | 45-59 years (AOR 1.93) |
RTA: Road Traffic Accident
AOR: Adjusted Odds Ratio
Sleep disturbance here was measured with a validated four-item scale covering trouble falling asleep, night-time waking, early waking, and unrefreshing sleep, not a formal OSA diagnosis. The association held after adjusting for education, income, occupation, physical activity, and alcohol and tobacco use. Punjab, Uttar Pradesh, West Bengal, Kerala, Madhya Pradesh and Uttarakhand showed high prevalence of both road accidents and sleep disturbance together.
The Delhi public-transport driver study
A separate study screened 4,094 public transport drivers refuelling at CNG stations across Delhi.[3] The findings were sharper:
Prior accident history: 299 drivers (7%) reported a motor vehicle accident in the preceding three years.
STOP-BANG risk score: Drivers scoring 3 or higher on this OSA screening tool had significantly higher accident odds (OR 1.59).
Epworth Sleepiness Scale: A score of 10 or above carried the strongest association measured: OR 26.95.
Alcohol use: A secondary but still significant risk factor (OR 1.37).
Daytime sleepiness, more than any other factor measured, was the dominant contributor to accidents among Delhi's public transport drivers.
What Does Global Research Say About Sleep Apnea and Car Accidents?
A 2022 systematic review and meta-analysis in the Journal of Clinical Medicine, pooling 49 studies, found that adults with diagnosed OSA had more than double the odds of a car crash compared with those without it (pooled OR 2.36).[4] The risk was almost identical for commercial drivers (OR 2.80) and non-commercial drivers (OR 2.32), which undercuts the idea that this is mainly a truck-driver problem. Sleep-disordered breathing on its own, short of a full OSA diagnosis, still carried significant crash risk (OR 1.81).
That same review found no significant link between a high Epworth Sleepiness Scale score alone and crash risk once other variables were controlled for. OSA and self-reported sleepiness don't always move together.
Danish nationwide cohort study:
Undiagnosed OSA in crash-involved drivers:
Found a significant association between diagnosed OSA and road traffic accidents at population scale.
A 2020 U.S. study of drivers who had just been in a crash found a strikingly high prevalence of undiagnosed OSA risk in that group.
Recent India Road Accident Statistics Put the Issue in Perspective
| Location / Corridor | Period | Headline Figure | Sleep/Fatigue-Attributed Share |
|---|---|---|---|
| India (national) | 2024 | 4,87,707 accidents, 1,77,175 deaths | Over-speeding: 70.3% of deaths[1] |
| Hyderabad Outer Ring Road | Jan-Apr 2026 | 5-6 accidents/day | 33% attributed to drowsiness/sleep deprivation[5] |
| Delhi | 2025 | 5,689 accidents, 1,617 deaths | Highest annual death toll since 2019[6] |
| Tamil Nadu | 2024 | 67,526 accidents, 18,449 deaths | Highest accident count nationally, 5th year running[7] |
| Agra-Lucknow Expressway | Jan 2021-Sep 2025 | 7,024 crashes over 57 months | 54.71% attributed to driver sleep or nap[8] |
Hyderabad's Outer Ring Road:
In May 2026, Hyderabad's Police Commissioner told a road-safety coordination meeting that drowsiness and sleep deprivation accounted for 33% of accidents on the ORR over the preceding four months, ahead of reckless driving (25%), overspeeding (15%), and tyre bursts (14%).[5] With roughly 2.8 lakh vehicles using the corridor daily, this reframed drowsy driving as the leading identified cause on one of south India's busiest expressways.
The Agra-Lucknow Expressway:
Data presented to the Supreme Court's Road Safety Committee in October 2025 showed that of 7,024 accidents on the 302 km expressway between January 2021 and September 2025, 3,843 (54.71%) were caused specifically by the driver falling asleep at the wheel.[8] It's the starkest sleep-attributed figure in Indian road-safety data available today, on a corridor built for exactly the conditions that invite microsleeps: long, monotonous, high-speed, and heavily used for overnight travel.
Delhi's rising toll:
Delhi recorded 1,617 road deaths in 1,578 fatal crashes in 2025, its highest fatality figure since 2019.[6] The toll kept climbing into 2026: Delhi Traffic Police recorded 782 deaths in the first half of 2026, up from 778 in the same period of 2025, even as the raw number of fatal crashes edged down slightly.[9]
Sleep Apnea vs Ordinary Driver Fatigue: What's the Difference?
Not every drowsy-driving crash traces back to sleep apnea, and treating the two as interchangeable overstates what the evidence shows.
| Factor | Ordinary Fatigue | Sleep Apnea-Related Sleepiness |
|---|---|---|
| Cause | One bad night, long shift, jet lag | Chronic, nightly airway obstruction |
| Duration | Temporary, resolves with rest | Persistent even after a full night in bed |
| Warning signs | Yawning, heavy eyelids after a known trigger | Loud snoring, witnessed breathing pauses, morning headaches |
| Fix | Sleep, rest breaks | Medical diagnosis and treatment (CPAP or surgery) |
| Risk pattern | Situational, worse after long trips | Constant background risk regardless of hours in bed |
Common triggers behind ordinary fatigue, distinct from an underlying sleep disorder:
Sleep deprivation: A late night before an early departure, common before festival or wedding travel.
Shift work: Commercial drivers and delivery riders on irregular or overnight schedules.
Long-distance driving: Extended hours behind the wheel regardless of underlying sleep health.
Alcohol or sedating medicines: Antihistamines and certain cold, cough or anti-anxiety medications impair alertness.
Chronic daytime sleepiness that persists despite what looks like adequate sleep, especially alongside loud snoring, points toward an underlying disorder that rest alone won't fix.
Could Screening Drivers for Sleep Apnea Reduce Road Accidents?
The Delhi driver study offers a template. Two low-cost, non-invasive tools, the STOP-BANG questionnaire and the Epworth Sleepiness Scale, flagged high-risk drivers without a single sleep-lab test.
Licence-renewal screening: Add a brief validated sleepiness/OSA-risk questionnaire to periodic commercial licence renewal.
Fleet-level screening: Bus and truck operators screening drivers at onboarding and at intervals, especially on night or long-haul routes.
Referral pathways: A positive screen leading to a sleep study, not an automatic licence denial, since most OSA is treatable.
Treatment follow-up: Verifying CPAP compliance or surgical outcomes before high-risk drivers return to long-haul duty.
Rest infrastructure: Better-lit, secure rest areas on high-fatigue corridors like Agra-Lucknow and Mumbai-Pune.
Regulated driving hours: Formal caps on continuous driving time for commercial operators, enforced through logbooks or telematics.
What Can Drivers Do to Reduce Sleep-Related Crash Risk?
Sleep before long trips - A full night's rest matters more than an extra coffee once on the road.
Take real breaks - Stop every two hours on long drives, and actually walk around.
Don't push through heavy sleepiness - Heavy eyelids are a signal to pull over, not a challenge to overcome.
Treat microsleeps as a hard stop - Even one instance of "losing" a few seconds behind the wheel means the drive needs to end for the day.
Skip alcohol before driving - It compounds any existing sleep debt.
Check medication labels - Many common cold, allergy and anxiety medicines carry drowsiness warnings.
Take snoring seriously - Loud, habitual snoring combined with daytime sleepiness is worth raising with a doctor.
Follow through on treatment - For drivers diagnosed with OSA, sticking with CPAP isn't optional if driving is part of the job.
Commercial drivers, watch your hours - Fatigue accumulates predictably; ignoring rest schedules doesn't make the risk go away.
Why Sleep Apnea Matters for Road Safety and Insurance?
A sleep-related crash carries the same consequences as any other accident: vehicle damage, third-party liability, medical costs, and an insurance claim. Having sleep apnea does not automatically raise a person's premium or invalidate a claim. That depends on individual policy terms, and drivers should check their specific insurer's conditions rather than assume either outcome.
At the International Surgical Sleep Society's 2026 conference, sleep-surgery specialists estimated the macroeconomic cost of untreated sleep apnea in India at over 2-3 lakh crore rupees annually, built on an estimate of 104 million working-age Indians living with OSA.[10] That figure lines up with a peer-reviewed 2023 meta-analysis putting pooled OSA prevalence at 11% among Indian adults, translating to roughly 104 million working-age Indians affected.[11] The conference's claim that 40% of India's road accidents tie back to poor sleep is an industry estimate, not a peer-reviewed population finding, and should be read as directional. The underlying prevalence numbers it draws on are well supported.
For insurers, fleet operators and policymakers, preventing a crash is cheaper than paying for one. Diagnosing and treating OSA, often with a CPAP machine or a low-cost surgical procedure, sits far below the cost of a single serious accident claim.
Conclusion
Sleep apnea deserves more attention in India's road-safety conversation. A national Indian study links sleep disturbance to 84% higher odds of a road accident, and a global meta-analysis puts OSA-related crash risk at more than double the general population's. Screening high-risk drivers and improving highway rest infrastructure are levers India hasn't pulled hard yet.
Frequently Asked Questions
How many road accidents in India are caused by sleep apnea?
There's no official national figure for diagnosed sleep apnea specifically. What exists is corridor-level data: 54.71% of accidents on the Agra-Lucknow Expressway between 2021-2025 were attributed to the driver falling asleep, and 33% of Hyderabad ORR accidents in early 2026 were linked to drowsiness or sleep deprivation.[5] [8]
How many accidents in India are linked to drivers falling asleep?
On specific corridors studied, the share is substantial: over half on the Agra-Lucknow Expressway and a third on Hyderabad's ORR. National, India-wide figures broken down this precisely aren't yet published by MoRTH.
Can sleep apnea be detected in drivers?
Yes. Low-cost tools like the STOP-BANG questionnaire and Epworth Sleepiness Scale can flag high-risk individuals for further evaluation without requiring a full sleep-lab study upfront.[3]
Can treating sleep apnea reduce driving risk?
Research on CPAP treatment and driving-risk reduction internationally supports this, and Indian sleep-surgery specialists argue treatment is broadly accessible and effective. Large-scale Indian outcome data specific to crash reduction is still limited.[10]
How common is sleep apnea in India?
A 2023 systematic review and meta-analysis found pooled OSA prevalence of 11% among Indian adults (13% in men, 5% in women), translating to an estimated 104 million working-age Indians affected.[11]
Sources
Ministry of Road Transport and Highways, Government of India: Road Accidents in India 2024
Drowsiness behind one-third of ORR accidents in Hyderabad, Telangana Today (May 2026)
Delhi records highest road accident deaths in 7 years, The Hans India (January 2026)
This is India's Most Dangerous State To Drive/Ride In, Cartoq (2026)
UP mulls major speed limit cut on Agra-Lucknow Expressway at night, India TV News (November 2025)
Road riddle: fatal accidents drop, body count rises in Delhi, The Patriot (July 2026)
