By Kerry Grens
NEW YORK (Reuters Health) - People with sleep apnea should not have their driving restricted just because of their diagnosis, says a leading medical group.
"You don't want to unfairly prejudice people with a diagnosis of sleep apnea, because many of them are not sleepy or are less sleepy than people in the general population" who might work night shifts or have restricted sleep, said Dr. Kingman Strohl, the lead author of the guidelines from the American Thoracic Society (ATS).
Patients who have recently had a car crash or near miss accident or who are excessively sleepy during the day, however, should be warned about the risks of drowsy driving and be treated for sleep apnea, says the ATS.
And the ATS guidelines, published in the American Journal of Respiratory and Critical Care Medicine, recommend against using stimulants to reduce the chances of crashing among high risk drivers with sleep apnea.
Such drugs are "like a Band-Aid," said Strohl, of Case Western Reserve University School of Medicine.
People who have sleep apnea - some 18 million Americans, according to the National Sleep Foundation - experience numerous pauses in breathing that can last from seconds to minutes.
The disrupted sleep can lead to daytime sleepiness, and people with the disorder are several times more likely to have a car crash than those without it, according to the ATS report.
There has been some concern, Strohl said, that imposing driving restrictions on people with the diagnosis could backfire.
"We don't want to have patients reluctant to bring up the fact that they might have sleep apnea or be reluctant to talk about sleepy driving because it's in their best interest that they be treated and restore their vigilance," said Strohl.
Studies have shown that people with untreated sleep apnea perform worse than healthy drivers on driving simulations (see Reuters Health report of October 6, 2009 here: http://reut.rs/jBfxwI).
Strohl said that research has found that treating sleep apnea will improve driving performance.
The ATS guidelines recommend that if doctors find that their patients are at a high risk of drowsy driving, they should be warned about the hazards of driving while sleepy and tested and treated as soon as possible.
"I think for those patients it would be reasonable to ask them to stop driving," said Dr. Najib Ayas, an associate professor at the University of British Columbia, who was not involved in drafting the guidelines.
"At this point it's hard to make clear recommendations just because the crash risk depends on so many other things, not only sleep apnea, but how much sleep people get, if they're on medications, or if there are other medical issues," he told Reuters Health.
SOURCE: http://bit.ly/10VUEE4 American Journal of Respiratory and Critical Care Medicine, June 1, 2013.