European Respiratory Society Statement on Sleep Apnoea, Sleepiness and Driving Risk

Obstructive sleep apnoea (OSA) is highly prevalent and is a recognised risk factor for motorvehicle accidents (MVA). Effective treatment with continuous positive airway pressure (CPAP)has been associated with a normalization of this increased accident risk. Thus, manyjurisdictions have introduced regulations restricting the ability of OSA patients from drivinguntil effectively treated. However, uncertainty prevails regarding the relative importance ofOSA severity determined by the apnoea-hypopnoea frequency per hour and the degree ofsleepiness in determining accident risk. Furthermore, the identification of subjects at risk forOSA and/or accident risk remains elusive. The introduction of official European regulationsregarding fitness to drive prompted the European Respiratory Society to establish a Task Forceto address the topic of sleep apnoea, sleepiness and driving with a view to providing anoverview to clinicians involved in treating patients with the disorder. The present reportevaluates the epidemiology of MVA in patients with OSA, the mechanisms involved in thisassociation, the role of screening questionnaires, driving simulators and other techniques toevaluate sleepiness and/or impaired vigilance, the impact of treatment on MVA risk in affecteddrivers, and highlights the evidence gaps regarding the identification of OSA patients at risk forMVA.