Sleep Apnea, Sleepiness, and Driving Risk in Noncommercial Drivers

Publication Date: June 3, 2013

Conclusions

Conclusions

Automobile crashes are the fifth leading cause of death and injury in the United States.

The number of crashes and severity of injury by distance driven are highest in young drivers (15-25 yr) and in those >65 yr.

Crashes due to sleepiness typically involve running off the road or into the back of another vehicle.

Sleepiness is most commonly caused by insufficient sleep, which is associated with prolonged wakefulness or chronic sleep restriction due to long hours of work or play, shift work (comprising 7.4% of all those employed), or a variety of medical and neurological disorders.

Fatality reduction currently targets increasing seat belt use and reducing speeding and alcohol. However, inattentiveness, fatigue, and sleepiness are increasingly recognized as contributing, and possibly primary, factors.

Obstructive sleep apnea (OSA) is the most common medical disorder that causes excessive daytime sleepiness, increasing the risk for motor vehicle crashes two to three times.

Sleepiness may account for up to 20% of crashes on monotonous roads, especially highways.

A high-risk driver is defined as one who has moderate to severe daytime sleepiness and a recent unintended motor vehicle crash or a near-miss attributable to sleepiness, fatigue, or inattention.

There is no compelling evidence to restrict driving privileges in patients with sleep apnea if there has not been a motor vehicle crash or an equivalent event.

Treatment of OSA improves performance on driving simulators and might reduce the risk of drowsy driving and drowsy driving crashes.

Timely diagnostic evaluation and treatment and education of the patient and family are likely to decrease the prevalence of sleepiness-related crashes in patients with OSA who are high-risk drivers.

Management

...anagemen...

...ng initially evaluated for suspected or con...


...rmation that should be elicited du...


...ts that polysomnography be performed and, if indi...

...ggests NOT using empiric continuous...


...ith confirmed OSA who have been deemed...


...patients with suspected or confirmed OSA w...


...o improve clinical practice include the following...