Safe Driving When You Have Sleep Apnea

Obstructive sleep apnea and driving risks discussed in new official guidelines

(RxWiki News) Obstructive sleep apnea is a sleeping disorder linked to various other health problems. It can also cause daytime sleepiness that makes driving risky.

A series of guidelines and recommendations were just released by the American Thoracic Society about sleep apnea and driving risks.

The committee said patients with sleep apnea should follow their treatment plan, which usually means sleeping with a continuous positive airway pressure (CPAP) machine.

The committee said stimulant medications were not recommended for patients with sleep apnea to reduce driving risks.

"Follow your sleep doctor's treatment plan."

The guidelines, written by a committee of American Thoracic Society doctors led by Kingman P. Strohl, MD, director of the Center for Sleep Disorders Research at Case Western Reserve University, updated the guidelines that had been published in 1994.

The primary recommendation of the committee was that patients diagnosed with obstructive sleep apnea be treated with CPAP to reduce driving risk.

CPAP involves wearing a mask to bed. The mask includes tubes that force air into the patient's lungs to ensure they always are receiving oxygenated air continuously.

"Treatment of obstructive sleep apnea improves performance on driving simulators and might reduce the risk of drowsy driving and drowsy driving crashes," the authors wrote.

The committee reviewed the most up-to-date research on sleep apnea and driving risk and then wrote a series of conclusions and recommendations.

They concluded that the risk of a car accident was two to three times higher for individuals with obstructive sleep apnea compared to those without sleep apnea.

However, this risk varies by the person, by the severity of their illness and by whether they are receiving treatment.

"Up to 20 percent of crashes that occur on monotonous roads can be attributed to sleepiness, and the most common medical cause of excessive daytime sleepiness is obstructive sleep apnea (OSA)," Dr. Strohl said in a prepared statement.

The committee regarded a "high-risk driver" as one who had "moderate to severe daytime sleepiness and a recent unintended motor vehicle crash or a near miss attributable to sleepiness, fatigue or inattention."

However, the researchers said there is not evidence to support restricting the driving privileges of patients who have sleep apnea if they have not had a car accident or near miss.

The committee also noted that patients who are evaluated, treated and educated about sleep apnea in a timely manner are less likely to become one of the statistics in car crashes related to sleepiness caused by obstructive sleep apnea.

The first recommendation made by the committee was that doctors who are screening patients suspected of having sleep apnea ask the patient about daytime sleepiness and drowsiness while driving.

Asking about drowsy driving or sleep-related car accidents allows doctors to warn potentially high-risk drivers about the dangers of driving with untreated sleep apnea.

If doctors suspect a patient has obstructive sleep apnea and is a high-risk driver, a sleep study should be done as soon as possible.

Doctors should also determine how severe the patient's sleep apnea is, if they have it, and assess how well the patient is following their treatment plan.

While CPAP is recommended for patients diagnosed with sleep apnea, the use of stimulant medications is not recommended for reducing driving risks.

Doctors should also regularly check in with their patients about driving risks, daytime sleepiness and their adherence to their treatment plan.

CPAP machines require a prescription and can cost anywhere from $150 to over $5,500, though most insurance plans will cover some or all of the expense. CPAP masks range from $30 to $200.

The guidelines were published June 1 in the American Journal of Respiratory and Critical Care Medicine.

No information was provided regarding funding for drafting the committee recommendations or potential disclosures about conflicts of interest.

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Review Date: 
May 31, 2013