Neurológia pre prax 5/2019
Obstructive sleep apnoea with excessive daytime sleepiness as a risk factor for falling asleep while driving with respect to medical fitness to drive motor vehicles
Drivers with untreated obstructive sleep apnoea (OSA) report more frequent excessive daytime sleepiness (EDS) while driving. They have a two- to five-fold higher risk of traffic accidents, with one in six accidents having serious consequences, including fatal ones. Treatment with positive airway pressure (PAP) reduces the risk of traffic accidents while improving EDS. OSA and EDS are important determining factors in road accidents associated with sleep. OSA with EDS is thus among diseases which, unless properly controlled, compromise road safety. A major challenge in the decision-making process is the estimation of EDS severity which has not been defined precisely. In these cases, the decision to issue a driving licence requires careful clinical consideration using subjective scales (the Epworth sleepiness scale – ESS) as well as objective tests (the maintenance of wakefulness test – MWT). Timely screening of patients-drivers (OSA screening questionnaires and/or device-based screening for OSA) is also of importance.
Keywords: obstructive sleep apnoea (OSA), excessive daytime sleepiness (EDS), falling asleep while driving, risk of traffic accidents, positive airway pressure (PAP), Epworth sleepiness scale (ESS)
