Many major maladies have been linked to disturbed slumber caused by sleep apnea, high blood pressure, heart problems and diabetes.

Add car wrecks to that list, a study published Jan. 21 in the journal Otolaryngology–Head and Neck Surgery, says.

People with untreated sleep apnea are more likely to wind up in a vehicle crash, researchers reported.

“Our findings underscore the profound impact that inadequately managed obstructive sleep apnea can have on individual health and public safety,” lead researcher Elliott Sina, a student at the Sidney Kimmel Medical College at Thomas Jefferson University in Philadelphia, said in a news release.

Sleep apnea occurs when a person’s breathing repeatedly stops and starts during the night, causing them to wake again and again. It’s most commonly caused by throat muscles relaxing during sleep and blocking the flow of air into the lungs.

This form of sleep apnea can be treated using a continuous positive airway pressure (CPAP) machine, which maintains enough air pressure to keep upper airway passages open.

Surgery to remove or shrink the tissue that’s sagging into the airways, or to reposition the jaw, can also effectively treat sleep apnea. Another surgical method involves inserting an implant to stimulate the hypoglossal nerve, which controls tongue movement.

For the new study, researchers analyzed data on more than 2.8 million people with sleep apnea, including more than 700,000 who used a CPAP machine and nearly 12,000 who underwent surgery for their condition.

About 5% of people not receiving any treatment for their sleep apnea wound up in a car wreck, compared with 6% of those using a CPAP machine and 3% of those who had surgery, results show.

Overall, patients who got no treatment had 21% higher odds of a crash compared to those who got surgery.

Surgery also outperformed CPAP, with those patients having 45% lower odds of a wreck, the study found.

“This work adds to the growing body of evidence supporting surgical interventions such as hypoglossal nerve stimulation as an effective alternative treatment for select patients with obstructive sleep apnea,” Sina said.

Folks with poor sleep are more likely to be drowsy and have poorer reflexes behind the wheel, researchers said.

They noted that other studies have shown that CPAP use can reduce the risk of crashes for sleep apnea patients. The untreated patients in this study might have had milder sleep apnea, potentially explaining why they had fewer crashes than CPAP users.

The findings suggest that sleep surgery matches and may even surpass the reduction in risk of motor vehicle accidents, particularly for select patients with a greater disease burden of obstructive sleep apnea, the researchers concluded.

Car accidents aren’t just dangerous in the moment, either. Sleep apnea patients in a wreck were more likely to develop health problems following their accident, results show.