Medico-legal implications of sleep apnoea syndrome: Driving license regulations in Europe

A. Alonderis; F. Barbee; M. Bonsignore; P. Calverley; W. De Backer; K. Diefenbach; V. Donic; F. Fanfulla; I. Fietze; K. Franklin; L. Grote; J. Hedner; P. Jennum; J. Krieger; P. Levy; W. McNicholas; J. Montserrat; G. Parati; M. Pascu; T. Penzel; R. Riha; D. Rodenstein; A. Sanna; R. Schulz; E. Sforza; P. Sliwinski; Z. Tomori; P. Tonnesen; G. Varoneckas; J. Zielinski; K. Kostelidou

Medico-legal implications of sleep apnoea syndrome: Driving license regulations in Europe

A. Alonderis, F. Barbee, M. Bonsignore, P. Calverley, W. De Backer, K. Diefenbach, V. Donic, F. Fanfulla, I. Fietze, K. Franklin, L. Grote, J. Hedner, P. Jennum, J. Krieger, P. Levy, W. McNicholas, J. Montserrat, G. Parati, M. Pascu, T. PenzelR. Riha, D. Rodenstein, A. Sanna, R. Schulz, E. Sforza, P. Sliwinski, Z. Tomori, P. Tonnesen, G. Varoneckas, J. Zielinski, K. Kostelidou

Faculty of Law

53 Citations (Scopus)

Abstract

Background: Sleep apnoea syndrome (SAS), one of the main medical causes of excessive daytime sleepiness, has been shown to be a risk factor for traffic accidents. Treating SAS results in a normalized rate of traffic accidents. As part of the COST Action B-26, we looked at driving license regulations, and especially at its medical aspects in the European region. Methods: We obtained data from Transport Authorities in 25 countries (Austria, AT; Belgium, BE; Czech Republic, CZ; Denmark, DK; Estonia, EE; Finland, FI; France, FR; Germany, DE; Greece, GR; Hungary, HU; Ireland, IE; Italy, IT; Lithuania, LT; Luxembourg, LU; Malta, MT; Netherlands, NL; Norway, EC; Poland, PL; Portugal, PT; Slovakia, SK; Slovenia, SI; Spain, ES; Sweden, SE; Switzerland, CH; United Kingdom, UK). Results: Driving license regulations date from 1997 onwards. Excessive daytime sleepiness is mentioned in nine, whereas sleep apnoea syndrome is mentioned in 10 countries. A patient with untreated sleep apnoea is always considered unfit to drive. To recover the driving capacity, seven countries rely on a physician's medical certificate based on symptom control and compliance with therapy, whereas in two countries it is up to the patient to decide (on his doctor's advice) to drive again. Only FR requires a normalized electroencephalography (EEG)-based Maintenance of Wakefulness Test for professional drivers. Rare conditions (e.g., narcolepsy) are considered a driving safety risk more frequently than sleep apnoea syndrome. Conclusion: Despite the available scientific evidence, most countries in Europe do not include sleep apnoea syndrome or excessive daytime sleepiness among the specific medical conditions to be considered when judging whether or not a person is fit to drive. A unified European Directive seems desirable. (C) 2007 Elsevier B.V. All rights reserved
Udgivelsesdato: 2008/5

Original language	English
Journal	Sleep Medicine
Volume	9
Issue number	4
Pages (from-to)	362-375
Number of pages	13
ISSN	1389-9457
Publication status	Published - 2008

Cite this

Alonderis, A., Barbee, F., Bonsignore, M., Calverley, P., Backer, W. D., Diefenbach, K., Donic, V., Fanfulla, F., Fietze, I., Franklin, K., Grote, L., Hedner, J., Jennum, P., Krieger, J., Levy, P., McNicholas, W., Montserrat, J., Parati, G., Pascu, M., ... Kostelidou, K. (2008). Medico-legal implications of sleep apnoea syndrome: Driving license regulations in Europe. Sleep Medicine, 9(4), 362-375.

Alonderis, A, Barbee, F, Bonsignore, M, Calverley, P, Backer, WD, Diefenbach, K, Donic, V, Fanfulla, F, Fietze, I, Franklin, K, Grote, L, Hedner, J, Jennum, P, Krieger, J, Levy, P, McNicholas, W, Montserrat, J, Parati, G, Pascu, M, Penzel, T, Riha, R, Rodenstein, D, Sanna, A, Schulz, R, Sforza, E, Sliwinski, P, Tomori, Z, Tonnesen, P, Varoneckas, G, Zielinski, J & Kostelidou, K 2008, 'Medico-legal implications of sleep apnoea syndrome: Driving license regulations in Europe', Sleep Medicine, vol. 9, no. 4, pp. 362-375.

@article{436019d08b1111de8bc9000ea68e967b,

title = "Medico-legal implications of sleep apnoea syndrome: Driving license regulations in Europe",

abstract = "Background: Sleep apnoea syndrome (SAS), one of the main medical causes of excessive daytime sleepiness, has been shown to be a risk factor for traffic accidents. Treating SAS results in a normalized rate of traffic accidents. As part of the COST Action B-26, we looked at driving license regulations, and especially at its medical aspects in the European region. Methods: We obtained data from Transport Authorities in 25 countries (Austria, AT; Belgium, BE; Czech Republic, CZ; Denmark, DK; Estonia, EE; Finland, FI; France, FR; Germany, DE; Greece, GR; Hungary, HU; Ireland, IE; Italy, IT; Lithuania, LT; Luxembourg, LU; Malta, MT; Netherlands, NL; Norway, EC; Poland, PL; Portugal, PT; Slovakia, SK; Slovenia, SI; Spain, ES; Sweden, SE; Switzerland, CH; United Kingdom, UK). Results: Driving license regulations date from 1997 onwards. Excessive daytime sleepiness is mentioned in nine, whereas sleep apnoea syndrome is mentioned in 10 countries. A patient with untreated sleep apnoea is always considered unfit to drive. To recover the driving capacity, seven countries rely on a physician's medical certificate based on symptom control and compliance with therapy, whereas in two countries it is up to the patient to decide (on his doctor's advice) to drive again. Only FR requires a normalized electroencephalography (EEG)-based Maintenance of Wakefulness Test for professional drivers. Rare conditions (e.g., narcolepsy) are considered a driving safety risk more frequently than sleep apnoea syndrome. Conclusion: Despite the available scientific evidence, most countries in Europe do not include sleep apnoea syndrome or excessive daytime sleepiness among the specific medical conditions to be considered when judging whether or not a person is fit to drive. A unified European Directive seems desirable. (C) 2007 Elsevier B.V. All rights reserved Udgivelsesdato: 2008/5",

author = "A. Alonderis and F. Barbee and M. Bonsignore and P. Calverley and Backer, {W. De} and K. Diefenbach and V. Donic and F. Fanfulla and I. Fietze and K. Franklin and L. Grote and J. Hedner and P. Jennum and J. Krieger and P. Levy and W. McNicholas and J. Montserrat and G. Parati and M. Pascu and T. Penzel and R. Riha and D. Rodenstein and A. Sanna and R. Schulz and E. Sforza and P. Sliwinski and Z. Tomori and P. Tonnesen and G. Varoneckas and J. Zielinski and K. Kostelidou",

note = "Times Cited: 0ArticleEnglishRodenstein, DUniv Catholique Louvain, Clin Univ St Luc, Serv Pneumol, Av Hippocrate 10, B-1200 Brussels, BelgiumCited References Count: 17322DNELSEVIER SCIENCE BVPO BOX 211, 1000 AE AMSTERDAM, NETHERLANDSAMSTERDAM",

year = "2008",

language = "English",

volume = "9",

pages = "362--375",

journal = "Sleep Medicine",

issn = "1389-9457",

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TY - JOUR

T1 - Medico-legal implications of sleep apnoea syndrome: Driving license regulations in Europe

AU - Alonderis, A.

AU - Barbee, F.

AU - Bonsignore, M.

AU - Calverley, P.

AU - Backer, W. De

AU - Diefenbach, K.

AU - Donic, V.

AU - Fanfulla, F.

AU - Fietze, I.

AU - Franklin, K.

AU - Grote, L.

AU - Hedner, J.

AU - Jennum, P.

AU - Krieger, J.

AU - Levy, P.

AU - McNicholas, W.

AU - Montserrat, J.

AU - Parati, G.

AU - Pascu, M.

AU - Penzel, T.

AU - Riha, R.

AU - Rodenstein, D.

AU - Sanna, A.

AU - Schulz, R.

AU - Sforza, E.

AU - Sliwinski, P.

AU - Tomori, Z.

AU - Tonnesen, P.

AU - Varoneckas, G.

AU - Zielinski, J.

AU - Kostelidou, K.

N1 - Times Cited: 0ArticleEnglishRodenstein, DUniv Catholique Louvain, Clin Univ St Luc, Serv Pneumol, Av Hippocrate 10, B-1200 Brussels, BelgiumCited References Count: 17322DNELSEVIER SCIENCE BVPO BOX 211, 1000 AE AMSTERDAM, NETHERLANDSAMSTERDAM

PY - 2008

Y1 - 2008

N2 - Background: Sleep apnoea syndrome (SAS), one of the main medical causes of excessive daytime sleepiness, has been shown to be a risk factor for traffic accidents. Treating SAS results in a normalized rate of traffic accidents. As part of the COST Action B-26, we looked at driving license regulations, and especially at its medical aspects in the European region. Methods: We obtained data from Transport Authorities in 25 countries (Austria, AT; Belgium, BE; Czech Republic, CZ; Denmark, DK; Estonia, EE; Finland, FI; France, FR; Germany, DE; Greece, GR; Hungary, HU; Ireland, IE; Italy, IT; Lithuania, LT; Luxembourg, LU; Malta, MT; Netherlands, NL; Norway, EC; Poland, PL; Portugal, PT; Slovakia, SK; Slovenia, SI; Spain, ES; Sweden, SE; Switzerland, CH; United Kingdom, UK). Results: Driving license regulations date from 1997 onwards. Excessive daytime sleepiness is mentioned in nine, whereas sleep apnoea syndrome is mentioned in 10 countries. A patient with untreated sleep apnoea is always considered unfit to drive. To recover the driving capacity, seven countries rely on a physician's medical certificate based on symptom control and compliance with therapy, whereas in two countries it is up to the patient to decide (on his doctor's advice) to drive again. Only FR requires a normalized electroencephalography (EEG)-based Maintenance of Wakefulness Test for professional drivers. Rare conditions (e.g., narcolepsy) are considered a driving safety risk more frequently than sleep apnoea syndrome. Conclusion: Despite the available scientific evidence, most countries in Europe do not include sleep apnoea syndrome or excessive daytime sleepiness among the specific medical conditions to be considered when judging whether or not a person is fit to drive. A unified European Directive seems desirable. (C) 2007 Elsevier B.V. All rights reserved Udgivelsesdato: 2008/5

AB - Background: Sleep apnoea syndrome (SAS), one of the main medical causes of excessive daytime sleepiness, has been shown to be a risk factor for traffic accidents. Treating SAS results in a normalized rate of traffic accidents. As part of the COST Action B-26, we looked at driving license regulations, and especially at its medical aspects in the European region. Methods: We obtained data from Transport Authorities in 25 countries (Austria, AT; Belgium, BE; Czech Republic, CZ; Denmark, DK; Estonia, EE; Finland, FI; France, FR; Germany, DE; Greece, GR; Hungary, HU; Ireland, IE; Italy, IT; Lithuania, LT; Luxembourg, LU; Malta, MT; Netherlands, NL; Norway, EC; Poland, PL; Portugal, PT; Slovakia, SK; Slovenia, SI; Spain, ES; Sweden, SE; Switzerland, CH; United Kingdom, UK). Results: Driving license regulations date from 1997 onwards. Excessive daytime sleepiness is mentioned in nine, whereas sleep apnoea syndrome is mentioned in 10 countries. A patient with untreated sleep apnoea is always considered unfit to drive. To recover the driving capacity, seven countries rely on a physician's medical certificate based on symptom control and compliance with therapy, whereas in two countries it is up to the patient to decide (on his doctor's advice) to drive again. Only FR requires a normalized electroencephalography (EEG)-based Maintenance of Wakefulness Test for professional drivers. Rare conditions (e.g., narcolepsy) are considered a driving safety risk more frequently than sleep apnoea syndrome. Conclusion: Despite the available scientific evidence, most countries in Europe do not include sleep apnoea syndrome or excessive daytime sleepiness among the specific medical conditions to be considered when judging whether or not a person is fit to drive. A unified European Directive seems desirable. (C) 2007 Elsevier B.V. All rights reserved Udgivelsesdato: 2008/5

M3 - Journal article

SN - 1389-9457

VL - 9

SP - 362

EP - 375

JO - Sleep Medicine

JF - Sleep Medicine

IS - 4

ER -