Sleep Apnea, Sleepiness, and Driving Risk in Noncommercial Drivers
Publication Date: June 3, 2013
Last Updated: September 2, 2022
Management
All patients being initially evaluated for suspected or confirmed OSA should be asked about daytime sleepiness, especially falling asleep unintentionally and inappropriately during daily activities, as well as recent unintended motor vehicle crashes or near-misses attributable to sleepiness, fatigue, or inattention. Patients with these characteristics are deemed high-risk drivers and should be immediately warned about the potential risk of driving until effective therapy is instituted. (C, VL)
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Additional information that should be elicited during an initial visit for suspected or confirmed OSA includes the clinical severity of the OSA and therapies that the patient has received, including behavioral interventions. Adherence and response to therapy should be assessed at subsequent visits. The drowsy driving risk should be reassessed at subsequent visits if it was initially increased. (, )
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For patients in whom there is a high clinical suspicion of OSA and who have been deemed high-risk drivers:
The ATS suggests that polysomnography be performed and, if indicated, treatment initiated as soon as possible, rather than delayed until convenient. (, VL)
The ATS recognizes that the duration that constitutes “as soon as possible” will vary according to the resources available, but ATS favors the goal of less than 1 month. For appropriately selected patients (e.g., no comorbidities, high clinical suspicion for OSA), at-home portable monitoring is a reasonable alternative to polysomnography.
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The ATS suggests NOT using empiric continuous positive airway pressure (CPAP) for the sole purpose of reducing driving risk. (, VL)
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For patients with confirmed OSA who have been deemed high-risk drivers, the ATS recommends CPAP therapy to reduce driving risk, rather than no treatment (S, M)
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For patients with suspected or confirmed OSA who have been deemed high-risk drivers, the ATS suggests NOT using stimulant medications for the sole purpose of reducing driving risk (, VL)
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Title
Sleep Apnea, Sleepiness, and Driving Risk in Noncommercial Drivers
Authoring Organization
American Thoracic Society
Publication Month/Year
June 3, 2013
Last Updated Month/Year
June 26, 2023
External Publication Status
Published
Country of Publication
US
Inclusion Criteria
Female, Male, Adult, Older adult
Health Care Settings
Ambulatory
Intended Users
Nurse, nurse practitioner, physician, physician assistant
Scope
Assessment and screening, Prevention, Management
Diseases/Conditions (MeSH)
D012890 - Sleep, D000077260 - Sleepiness
Keywords
sleepiness, driving risk, sleep apnea