PMID- 31342234
OWN - NLM
STAT- MEDLINE
DCOM- 20210322
LR  - 20210322
IS  - 1522-1709 (Electronic)
IS  - 1520-9512 (Linking)
VI  - 24
IP  - 1
DP  - 2020 Mar
TI  - Excessive daytime sleepiness in obstructive sleep apnea: implications for driving 
      licenses.
PG  - 37-47
LID - 10.1007/s11325-019-01903-6 [doi]
AB  - PURPOSE: Excessive daytime sleepiness (EDS) while driving is a major 
      international public health issue resulting in a more than doubled risk of motor 
      vehicle accidents (MVAs). Obstructive sleep apnea (OSA) is the most frequent 
      medical cause of EDS. Therefore, the European Union Directive 2014/85/EU 
      determined that "untreated moderate to severe OSA coincident with EDS constitutes 
      a medical disorder leading to unfitness to drive." The paper aims are to provide 
      a brief review of sleepiness and its implications for driving safety, as well as 
      to describe the subjective and objective methods to accurately evaluate EDS in 
      order to assess fitness to drive in patients with OSA. METHODS: We examined 
      databases including PubMed, Medline, and EMBASE using the search terms 
      "sleepiness at the wheel, excessive daytime sleepiness, sleepiness measure, 
      sleep-wake cycle, obstructive sleep apnea, driving license, fitness to drive." 
      RESULTS: Significant interindividual variability in EDS exists in patients with 
      comparable severity of OSA. Objective methods of measuring EDS are too expensive 
      and time consuming to be suitable for the certification of driving licenses. The 
      reliability of subjective methods depends upon the clinical setting and 
      subjective tools assess only limited aspects of EDS. Objective measures, such as 
      biochemical biomarkers, must, therefore, support subjective methods. CONCLUSIONS: 
      Extensive data have supported different subjective and objective methods for the 
      appraisal of EDS in patients with OSA depending upon the clinical and 
      experimental setting. Challenges remain to determine an appropriate tool for the 
      evaluation of fitness to drive.
FAU - Garbarino, Sergio
AU  - Garbarino S
AUID- ORCID: 0000-0002-8508-552X
AD  - Department of Neuroscience, Rehabilitation, Ophthalmology, Genetics and 
      Maternal/Child Sciences (DINOGMI), Polyclinic Hospital San Martino IRCCS, 
      University of Genoa, Genoa, Italy. sgarbarino.neuro@gmail.com.
LA  - eng
PT  - Journal Article
PT  - Review
DEP - 20190724
PL  - Germany
TA  - Sleep Breath
JT  - Sleep & breathing = Schlaf & Atmung
JID - 9804161
SB  - IM
MH  - Accidents, Traffic/legislation & jurisprudence/prevention & control
MH  - Automobile Driver Examination/*legislation & jurisprudence
MH  - Disorders of Excessive Somnolence/complications/*diagnosis
MH  - Europe
MH  - Licensure/*legislation & jurisprudence
MH  - Physical Examination
MH  - Risk Factors
MH  - Safety/legislation & jurisprudence
MH  - Sleep Apnea, Obstructive/complications/*diagnosis
MH  - Sleep Deprivation/complications/diagnosis
MH  - Sleep Disorders, Circadian Rhythm/complications/diagnosis
MH  - Surveys and Questionnaires
OTO - NOTNLM
OT  - Driving license
OT  - Excessive daytime sleepiness
OT  - Fitness to drive
OT  - Medical assessment
OT  - Obstructive sleep apnea
EDAT- 2019/07/26 06:00
MHDA- 2021/03/23 06:00
CRDT- 2019/07/26 06:00
PHST- 2019/02/04 00:00 [received]
PHST- 2019/07/16 00:00 [accepted]
PHST- 2019/07/14 00:00 [revised]
PHST- 2019/07/26 06:00 [pubmed]
PHST- 2021/03/23 06:00 [medline]
PHST- 2019/07/26 06:00 [entrez]
AID - 10.1007/s11325-019-01903-6 [pii]
AID - 10.1007/s11325-019-01903-6 [doi]
PST - ppublish
SO  - Sleep Breath. 2020 Mar;24(1):37-47. doi: 10.1007/s11325-019-01903-6. Epub 2019 
      Jul 24.