@article{ref1,
title="Medico-legal implications of sleep apnoea syndrome: Driving license regulations in Europe",
journal="Sleep Medicine",
year="2007",
author="Alonderis, A. and Barbé, Ferran and Bonsignore, M. and Calverley, P. and De Backer, W. and Diefenbach, K. and Donic, V. and Fanfulla, F. and Fietze, I. and Franklin, Keita and Grote, L. and Hedner, J. and Jennum, P. and Krieger, J. and Levy, P. and McNicholas, W. and Montserrat, J. and Parati, Gianfranco and Pascu, M. and Penzel, T. and Riha, R. and Rodenstein, Daniel and Sanna, A. and Schulz, Ronald and Sforza, E. and Sliwinski, P. and Tomori, Z. and Tonnesen, P. and Varoneckas, G. and Zielinski, J. and Kostelidou, K.",
volume="9",
number="4",
pages="362-375",
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.<p /> <p>Language: en</p>",
language="en",
issn="1389-9457",
doi="10.1016/j.sleep.2007.05.008",
url="http://dx.doi.org/10.1016/j.sleep.2007.05.008"
}