Driving Impairment and Accident Risk in Sleep Apnea: We Need Better Assessment Tools

Obstructive sleep apnea (OSA) is strongly associated with neurobehavioral impairment and increased motor vehicle accident (MVA) risk resulting in an estimated 1400 road fatalities and a cost of $15.9 billion annually in the United States alone. Despite these alarming figures, the elevated MVA risk might only relate to a subset of the OSA patient population, while a large proportion of patients show minimal or no driving impairment and present no relative risk on the road. At present, assessing an OSA patient’s MVA risk, and their eligibility to hold an unrestricted driver’s licence, is challenging. Current clinical metrics of OSA severity and daytime sleepiness are limited in their ability to identify at-risk patients. There is a need for novel assessment tools that may better reflect the risk of neurobehavioral impairment and MVA in individuals, allowing for targeted prioritisation of clinical resources and ultimately, improving traffic safety.