How European countries are applying driving laws for people with sleep apnoea

Background

Obstructive sleep apnoea (OSA) is a common sleep disorder that causes repeated pauses in breathing during sleep. It can lead to excessive daytime sleepiness, which can increase the risk of car accidents. In response to this risk, the European Union (EU) introduced a legal directive in 2014 to restrict driving for people with moderate-to-severe OSA who are also sleepy, unless they are receiving effective treatment.

A “directive” is a legal step that sets out a goal that EU countries must achieve. However, it is up to the individual countries to make their own laws on how to reach these goals.

What did the study look at?

This research explored how countries across Europe have put these EU driving rules into practice. Experts in sleep medicine from 25 EU countries and 8 nearby non-EU countries were asked about their national regulations. They reported on how the rules are applied, what level of OSA is used as criteria for restricting driving, what treatment is needed to resume driving and how long driving licences are valid for.

What did the results show?

All EU countries surveyed had introduced the EU rules into their national laws, although some made them stricter. For example, a few countries apply the rules even to mild cases of OSA or require a set amount of time on treatment before allowing driving again. Most countries use both OSA severity and sleepiness to decide whether someone is fit to drive.

However, the study also identified several challenges:

• the lack of resources to diagnose and treat OSA 

• rules may be too strict or not well matched to the actual risk of accidents 

• people may under-report their sleepiness due to fear of losing their driving licence, especially professional drivers.

Why is this important?

The findings show that while the EU has a shared standard for driving with OSA, the way countries apply the rules can vary. In some cases, the rules may be too strict or not strict enough based on the latest and most reliable research about how OSA affects driving and what actually helps reduce the risk of accidents. There is also concern that relying only on standard sleep tests may not reflect a person’s real risk of having an accident.

The study recommends further research to find better ways of measuring sleepiness and understanding how driving laws affect road safety. It also highlights the need to balance safety with fair treatment for people with OSA, so they can get a diagnosis and effective care without fear of losing their right to drive.

Read the paper: Implementation of European National Driving Regulations for Obstructive Sleep Apnoea: challenges and recommendations