Debate Over Inclusion Of Sleep Apnea In The Standards For Driving

(Europeans consider Sleep Apnea standards for driver's licenses)

Nov 2007

Obstructive Sleep Apnea (OSA) is a disease that not many people know about although they may even suffer from it. Patients are unable to sleep and breathe at the same time: during sleep (and during sleep only) the throat collapses and air can no longer reach the lungs. Breathing stops despite frantic efforts and oxygen drops… until sleep is interrupted, the throat pops open with a loud snoring, breathing resumes and sleep proceeds until the next apnea. The average patient experiences 250 to 400 apneas per night, and is completely unaware that this is happening…

OSA leads to snoring and daytime sleepiness, high blood pressure as well as cerebral and cardiac accidents; it also increases the risk of traffic accidents by seven times. Data from Germany, Spain, Switzerland, Australia, Canada and the USA are concordant: OSA has been estimated to be responsible for 5 to 10 % of all motor vehicle accidents.

Despite clear evidence of this dangerous effect, and of its possible correction with an adequate treatment, only nine European Countries include sleep apnea among the diseases to be considered at the time of delivering a driving license. Moreover, there is no unique attitude among different countries on how to assess the severity of the disease, or the effects of treatment, or who is to decide on the fate of the potentially dangerous driver.

Every effort should be made to put Sleepiness and Obstructive Sleep Apnea on the agenda of European Transport Authorities. The Comitology procedure appears as a pragmatic and feasible approach. OSA could be included in the next amendment to Annex III while sleepiness could be addressed with information and education campaigns.

On 12 and 13 October 2007, COST Action B26 hosted a working meeting with international experts to discuss the best way to include OSA within the health disorders representing a serious risk for traffic accidents in the entire European Union. The meeting was organised by the Centre for Sleep Medicine, Cliniques universitaires Saint-Luc, Université catholique de Louvain in Brussels.

Further to this initiative, a meeting with the High Commission on transport was held, where COST Action B26 had the chance to present their suggestions for the future inclusion of OSA under the Annex III for European Driving Regulations.

Obstructive Sleep Apnea is not important only in itself; if introduced in the driving license regulations in all European Countries it may also serve as a marker for the whole domain of fatigue and sleepiness while driving. We are convinced that this domain needs to be brought to the attention of all drivers, private and professionals alike.


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http://www.medicalnewstoday.com/articles/89581.php

I see your point, but wanted to add that there are many things that cause a driver to be sleepy or less than able to drive. If apnea sufferers must be noted on driving licences, what about those people who are diabetic? Or what about those on medicines that cause sleepiness? And what about people being treated for things like depression or other mental health issues that could possibly interfere with their driving abilities? And I have to mention how important it is to address dui's and the need to better 'police' people who do this dangerous sort of thing. I think more than anything it is important for us to keep this in mind as apnea sufferers. I personally don't drive long distances alone if at all possible (have not done so since I moved three years ago and drove two hours alone). I decided this course of action because I am diabetic, way before the sleep apnea was diagnosed. It is really about being responsible.

It all boils down to personal responsibility. If you are excessively tired due to a bad bout of sleep apnea. Take a short nap. Regain your strength and commence onward. As someone who drives cross country frequently (as much as 850 miles in a day), it is absurd to think that we need any type of law or registration pertaining to sleep apnea/fatigue.

There is no dounbt that driver fatigue (no matter what the source) is very dangerous. There have been many studies that indicate that excessive fatigue can actually impair a driver worse than being intoxicated.

However "fatigue" can be caused by all sorts of factors such as: overwork, a cold, a virus, stress, physical exhaustion, etc, etc........

If you unfortunately have ever fallen asleep while driving (ever) due to the severity of your apnea, then you personally need to take responsibility for your dangerous behavior of driving under gross fatigue. But as someone who is clinically diagnosed with "severe" apnea, and drives daily, I have never experienced this (Do I get fatigued mid-afternoon...everyday....and to counteract I usually take a 10 minute nap, good to go after that...)

Fatigue is controllable. A nanny state is not needed.

My final word: registration of apnea on driver's licenses is absurd. Practice responsibility instead.

Thanks for the forum !

Totally agree. We don't need more "Nanny State" laws. Personal responsibility should be the key here for certain. Of course, that's not the way the trend is moving, unfortunately. The government is becoming more and more intrusive - into everything from parental rights, to what we eat, to gun laws, and now some want to legislate our health. Sad, really.

:(