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Drivers With Untreated Sleep Apnea: A Cause of Death and Serious Injury

Drivers With Untreated Sleep Apnea: A Cause of Death and Serious Injury Abstract Three patients with untreated sleep apnea fell asleep while driving and caused serious automobile accidents. One person died, another became permanently paraplegic, and the three patients with sleep apnea were seriously injured in these crashes. This sequela of sleep apnea is not surprising, since subjects with sleep apnea may be poor drivers with a high accident rate and a high incidence of "near-miss" vehicular incidents. Because drivers with untreated sleep apnea may cause a large number of preventable automobile accidents, physicians have specific duties involving these drivers. First, physicians must try to identify impaired drivers with sleep apnea before they have an accident; routinely asking patients about loud snoring and hypersomnolence may help identify these impaired drivers. Second, physicians must consider the diagnosis of sleep apnea when examining patients who fall asleep while driving. Next, physicians must warn their patients with sleep apnea about the risks of driving with untreated sleep apnea. Finally, physicians must treat any seriously impaired driver with sleep apnea and keep these patients from driving until they can receive successful treatment. (Arch Intern Med. 1991;151:1451-1452) References 1. Findley L, Unverzadt M, Suratt P. Automobile accidents in patients with obstructive sleep apnea . Am Rev Respir Dis. 1988;138:337-340.Crossref 2. George C, Nickerson P, Hanly P, Millar T, Kryger M. Sleep apnoea patients have more automobile accidents . Lancet. 1987;8556:447.Crossref 3. Findley L, Fabrizio M, Knight H, Norcross B, LaForte A, Suratt P. Driving simulator performance in patients with sleep apnea . Am Rev Respir Dis. 1989;140:529-530.Crossref 4. Gonzalez-Rothi R, Foresman G, Block A. Do patients with sleep apnea die in their sleep? Chest. 1988;94:531-538.Crossref 5. Aldrich M. Automobile accidents in patients with sleep disorders . Sleep. 1989;12:487-494. 6. Parsons M. Fits and other causes of loss of consciousness while driving . Q J Med. 1986;227:295-303. 7. Lavie P. Incidence of sleep apnea in a presumably healthy working population: a significant relationship with excessive daytime sleepiness . Sleep. 1983;6:312-318. 8. Lavie P. Sleep apnea in industrial workers . In: Guillimenault C, Lugaresi E, eds. Sleep/Awake Disorders: Natural History, Epidemiology, and Long-term Evolution . New York, NY: Raven Press; 1983:127-135. 9. Findley L, Bonnie R. Auto crashes and sleep apnea: what is the doctor to do? Chest. 1988;94:225-226.Crossref 10. Doege T, Engelberg A. Medical Conditions Affecting Drivers . Chicago, Ill: American Medical Association; 1986:30. 11. Wittig R, Zorick F, Conway W, et al. Normalization of the MSLT after 6 weeks of CPAP for sleep apnea syndrome . Sleep Res. 1986;15:185. 12. Rajagopal K, Bennett L, Dillard T, Tellis C, Tenholder M. Overnight nasal CPAP improves hypersomnolence in sleep apnea . Chest. 1986;90:172-176.Crossref http://www.deepdyve.com/assets/images/DeepDyve-Logo-lg.png Archives of Internal Medicine American Medical Association

Drivers With Untreated Sleep Apnea: A Cause of Death and Serious Injury

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Publisher
American Medical Association
Copyright
Copyright © 1991 American Medical Association. All Rights Reserved.
ISSN
0003-9926
eISSN
1538-3679
DOI
10.1001/archinte.1991.00400070193028
Publisher site
See Article on Publisher Site

Abstract

Abstract Three patients with untreated sleep apnea fell asleep while driving and caused serious automobile accidents. One person died, another became permanently paraplegic, and the three patients with sleep apnea were seriously injured in these crashes. This sequela of sleep apnea is not surprising, since subjects with sleep apnea may be poor drivers with a high accident rate and a high incidence of "near-miss" vehicular incidents. Because drivers with untreated sleep apnea may cause a large number of preventable automobile accidents, physicians have specific duties involving these drivers. First, physicians must try to identify impaired drivers with sleep apnea before they have an accident; routinely asking patients about loud snoring and hypersomnolence may help identify these impaired drivers. Second, physicians must consider the diagnosis of sleep apnea when examining patients who fall asleep while driving. Next, physicians must warn their patients with sleep apnea about the risks of driving with untreated sleep apnea. Finally, physicians must treat any seriously impaired driver with sleep apnea and keep these patients from driving until they can receive successful treatment. (Arch Intern Med. 1991;151:1451-1452) References 1. Findley L, Unverzadt M, Suratt P. Automobile accidents in patients with obstructive sleep apnea . Am Rev Respir Dis. 1988;138:337-340.Crossref 2. George C, Nickerson P, Hanly P, Millar T, Kryger M. Sleep apnoea patients have more automobile accidents . Lancet. 1987;8556:447.Crossref 3. Findley L, Fabrizio M, Knight H, Norcross B, LaForte A, Suratt P. Driving simulator performance in patients with sleep apnea . Am Rev Respir Dis. 1989;140:529-530.Crossref 4. Gonzalez-Rothi R, Foresman G, Block A. Do patients with sleep apnea die in their sleep? Chest. 1988;94:531-538.Crossref 5. Aldrich M. Automobile accidents in patients with sleep disorders . Sleep. 1989;12:487-494. 6. Parsons M. Fits and other causes of loss of consciousness while driving . Q J Med. 1986;227:295-303. 7. Lavie P. Incidence of sleep apnea in a presumably healthy working population: a significant relationship with excessive daytime sleepiness . Sleep. 1983;6:312-318. 8. Lavie P. Sleep apnea in industrial workers . In: Guillimenault C, Lugaresi E, eds. Sleep/Awake Disorders: Natural History, Epidemiology, and Long-term Evolution . New York, NY: Raven Press; 1983:127-135. 9. Findley L, Bonnie R. Auto crashes and sleep apnea: what is the doctor to do? Chest. 1988;94:225-226.Crossref 10. Doege T, Engelberg A. Medical Conditions Affecting Drivers . Chicago, Ill: American Medical Association; 1986:30. 11. Wittig R, Zorick F, Conway W, et al. Normalization of the MSLT after 6 weeks of CPAP for sleep apnea syndrome . Sleep Res. 1986;15:185. 12. Rajagopal K, Bennett L, Dillard T, Tellis C, Tenholder M. Overnight nasal CPAP improves hypersomnolence in sleep apnea . Chest. 1986;90:172-176.Crossref

Journal

Archives of Internal MedicineAmerican Medical Association

Published: Jul 1, 1991

References