Abstract
Obstructive sleep apnoea (OSA) is highly prevalent and is a recognised risk factor for motor vehicle accidents (MVA). Effective treatment with continuous positive airway pressure (CPAP) has been associated with a normalisation of this increased accident risk. Thus, many jurisdictions have introduced regulations restricting the ability of OSA patients from driving until effectively treated. However, uncertainty prevails regarding the relative importance of OSA severity determined by the apnoea-hypopnoea frequency per hour and the degree of sleepiness in determining accident risk. Furthermore, the identification of subjects at risk for OSA and/or accident risk remains elusive. The introduction of official European regulations regarding fitness to drive prompted the European Respiratory Society to establish a Task Force to address the topic of sleep apnoea, sleepiness and driving with a view to providing an overview to clinicians involved in treating patients with the disorder. The present report evaluates the epidemiology of MVA in patients with OSA, the mechanisms involved in this association, the role of screening questionnaires, driving simulators and other techniques to evaluate sleepiness and/or impaired vigilance, the impact of treatment on MVA risk in affected drivers, and highlights the evidence gaps regarding the identification of OSA patients at risk for MVA.
Footnotes
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Conflict of interest: Dr. Bonsignore has nothing to disclose.
Conflict of interest: Dr. Randerath reports grants and personal fees from Philipps Respironics , grants and personal fees from Heinen & Löwenstein, grants and personal fees from Resmed, outside the submitted work;.
Conflict of interest: Dr. SCHIZA has nothing to disclose.
Conflict of interest: Dr. Verbraecken reports grants and personal fees from ResMed, personal fees from Philips, personal fees from Sanofi, personal fees from Agfa-Gevaert, grants and personal fees from Bioprojet, grants and personal fees from Jazz Pharmaceutics, grants from AirLiquide, personal fees from Springer, grants from Westfalen Medical, grants from SomnoMed, grants from Vivisol, grants from Total Care, grants from Medidis, grants from Fisher & Paykel, grants from Wave Medical, grants from OSG, grants from Mediq Tefa, grants from NightBalance, grants from Heinen & Löwenstein, grants from AstraZen, grants from Accuramed, grants from Bekaert Deslee Academy, grants from UCB Pharma, outside the submitted work;.
Conflict of interest: Dr. Elliott has nothing to disclose.
Conflict of interest: Dr. Riha has nothing to disclose.
Conflict of interest: Dr. Barbe has nothing to disclose.
Conflict of interest: Dr. BOULOUKAKI has nothing to disclose.
Conflict of interest: Dr. Castrogiovanni has nothing to disclose.
Conflict of interest: Dr. Deleanu has nothing to disclose.
Conflict of interest: Dr. Gonçalves has nothing to disclose.
Conflict of interest: Dr. LEGER reports grants from grants from Philips (Netherlands), grants from Vanda (USA), grants from Sanofi, grants from Vitalaire International, grants from Merck, grants from Jannsen, Jazz and RYTHM outside the submitted work;.
Conflict of interest: Dr. Marrone has nothing to disclose.
Conflict of interest: Dr. Penzel reports grants from Cidelec, grants from Philips, personal fees from Heel Pharmaceuticals, personal fees from Bayer, outside the submitted work; and I am a shareholder of Advanced Sleep Research, Somnico, Nukute, and The Siestagroup GmbH..
Conflict of interest: Dr. Ryan has nothing to disclose.
Conflict of interest: Dr. Smyth has nothing to disclose.
Conflict of interest: Dr. TURINO has nothing to disclose.
Conflict of interest: Dr. McNicholas has nothing to disclose.
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- Received April 27, 2020.
- Accepted August 24, 2020.
- Copyright ©ERS 2020
