Medico-legal implications of respiratory disorders during sleep
D. Boisteanu, A. Mita-Baciu, R. Vasiluta
Abstract: Sleep-related breathing disorders are the most frequent medical cause of daytime sleepiness.
Obstructive sleep apnea syndrome (OSAS) has been demonstrated to significantly increase safety and health risks and has
been associated with a high risk for motor vehicle accidents, probably the highest of all risks due to medical conditions.
Treatment of patients with obstructive sleep apnoea with continuous positive airway pressure (CPAP) is effective as it
reduces both apnoeas during the night and sleepiness during the day and improve quality of life. The primary task of the
physician is proper diagnosis, therapy and counseling. All professional drivers with excessive daytime sleepiness as well as
uncooperative or therapy resistant drivers should be referred to a sleep disorder centre for objective measurements of
excessive daytime sleepiness and assessment of driving capability. Given the high prevalence of breathing disorders during
sleep in the general population, and the evidence that treatment decreases the risk of accidents, it seems legitimate to try
and reduce the occurrence of sleepiness-related accidents in affected patients by regulating the access to a driving license
in those patients.
Keywords: sleep apnea, driving legislation