Management of Obstructive Sleep Apnea in Commercial Motor Vehicle Operators: Recommendations of the AASM Sleep and Transportation Safety Awareness Task Force

Gurubhagavatula, Indira; Sullivan, Shannon; Meoli, Amy; Patil, Susheel P.; Olson, Ryan; Berneking, Michael; Watson, Nathaniel F.

doi:10.5664/jcsm.6598

Cited by 53 publications

(42 citation statements)

References 69 publications

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“…Therefore, identifying professional drivers with OSA and treating them effectively should decrease crashrelated injuries and fatalities and improve drivers' health. Professional drivers show a higher prevalence of OSA, between 28% and 78%, compared with the general population [10], probably because they tend to be obese, male and middle-aged, the three most common risk factors for OSA [11]. Despite this risk, OSA is often undiagnosed and undertreated in this population, mainly due to lack of appropriate screening and sleep study referrals [12][13][14].…”

Section: Screening For Obstructive Sleep Apnoea In Professional Driversmentioning

confidence: 99%

“…Furthermore, a joint Task Force of the European Respiratory Society and the European Sleep Research Society is currently on production to develop practical recommendations to cope with the problems raised by the new EU directive on issuing driving licences and to suggest a research agenda to improve safety on the road in Europe [16]. Additionally, the American Academy of Sleep Medicine has issued a comprehensive and detailed document on screening, and diagnostic and therapeutic approaches for commercial drivers [10]. However, still there is no consensus in the OSA screening approach and there is a lack of a clear standardised model applicable in different countries.…”

Section: Screening For Obstructive Sleep Apnoea In Professional Driversmentioning

confidence: 99%

“…Furthermore, Ghosh et al [39] suggested that driving regulatory authorities should take into account specific parameters to assess the risk of road traffic accidents in patients suspected of having OSA, as outlined below. [10,40]. The American Academy of Sleep Medicine recommends that commercial drivers be referred to a sleep medicine specialist for clinical sleep evaluation and diagnostic testing if they meet any of the following criteria [10].…”

Section: • •mentioning

confidence: 99%

“…[10,40]. The American Academy of Sleep Medicine recommends that commercial drivers be referred to a sleep medicine specialist for clinical sleep evaluation and diagnostic testing if they meet any of the following criteria [10]. Although these criteria intend to classify drivers as high risk for OSA, individuals with lower BMI will likely be missed.…”

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confidence: 99%

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Screening for obstructive sleep apnoea in professional drivers

Schiza

Bouloukaki

2020

Breathe

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Professional drivers show a higher prevalence of obstructive sleep apnoea (OSA) compared with the general population. Furthermore, there is concern about the association between OSA and car crash risk given that drivers with OSA show an increased risk for car accidents. Despite this risk, OSA is often underdiagnosed and undertreated in this population, mainly due to lack of appropriate screening and sleep study referrals. Polysomnography (PSG), the gold standard test, is inappropriate for systematic screening because of its high expense, complexity and relative inaccessibility in this population. Therefore, there is a strong demand for good screening tools, including both subjective and objective data that may assist in early identification of possible OSA among professional drivers and, thus, aid in PSG examination referral and OSA management in an accredited sleep centre. However, there is considerable disagreement over screening methods and criteria for triggering a sleep study referral in different countries. There is also a strong need for further research in the area of OSA screening of commercial drivers in order to improve the diagnostic accuracy of screening tools and ensure that patients with OSA are accurately identified.Key pointsObstructive sleep apnoea (OSA) is often undiagnosed and undertreated in professional drivers.Professional drivers often under-report and are reluctant to report OSA symptoms.Barriers to OSA diagnosis include appropriate screening and sleep study referrals.Screening tools including both subjective and objective data may assist in early identification of possible OSA among professional drivers.Educational aimsTo evaluate screening instruments currently used to identify OSA risk in professional drivers.To provide guidance for developing an assessment strategy for OSA by professional driver medical examiners.

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Section: Screening For Obstructive Sleep Apnoea In Professional Driversmentioning

confidence: 99%

Section: Screening For Obstructive Sleep Apnoea In Professional Driversmentioning

confidence: 99%

Section: • •mentioning

confidence: 99%

Section: • •mentioning

confidence: 99%

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Screening for obstructive sleep apnoea in professional drivers

Schiza

Bouloukaki

2020

Breathe

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“…Of course, other factors such as sleep deficiency must also be addressed as an important contributing factor to the risk of a driving accident (Garbarino et al., ; Gottlieb, Ellenbogen, Bianchi, & Czeisler, ). Furthermore, screening programmes and related policies should ensure that appropriate measures of driving risk are identified, especially the level of sleepiness, and these should not be simply based on syndrome severity determined by AHI (Gurubhagavatula et al., ; Rizzo et al., ). A recent report (Pien et al., ) demonstrates that the beneficial impact of CPAP therapy on driving risk in a cluster analysis of OSA is largely restricted to the excessive sleepiness phenotype.…”

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confidence: 99%