The American Thoracic Society (ATS) has released new clinical practice guidelines on sleep apnea, sleepiness, and driving risk for noncommercial drivers. The report, “Sleep Apnea, Sleepiness, and Driving Risk in Noncommercial Drivers,” was published in American Journal of Respiratory and Critical Care Medicine and is an update to a 1994 ATS statement on the same topics.

Recommendations include asking all patients undergoing initial evaluation for suspected or confirmed OSA about daytime sleepiness and recent unintended motor vehicle crashes or near-misses attributable to sleepiness, fatigue, or inattention. The ATS believes it is important to warn these high-risk drivers about the potential risk of driving until effective therapy is initiated.

“Up to 20 percent of crashes that occur on monotonous roads can be attributed to sleepiness, and the most common medical cause of excessive daytime sleepiness is obstructive sleep apnea (OSA),” said Kingman P. Strohl, MD, director of the Center for Sleep Disorders Research at Case Western Reserve University and chair of the committee that drafted the guidelines. “Addressing the issue of drowsy driving requires the combined effort of physicians, patients, and policy makers. The assessment for sleepiness before and with treatment of OSA, as outlined in these new guidelines, is an essential part of these joint efforts.”

The ATS recommends that clinicians develop a practice-based plan to inform patients and their families about drowsy driving and other risks of excessive sleepiness, as well as behavioral methods that may reduce those risks. Providers should also familiarize themselves with local and state statutes or regulations regarding the compulsory reporting of high-risk drivers with OSA.