ABSTRACT
Sleep disorders may affect driving ability by the downstream consequences of fatigue and sleepiness. Such disorders may be behavioural because of poor sleep hygiene and inadequate time in bed, or a result of medical disorders such as sleep apnoea and narcolepsy. Insomnia may also contribute to impaired driving ability, principally because of daytime fatigue. The most common medical disorder associated with excessive daytime sleepiness is obstructive sleep apnoea (OSA), which affects up to one billion people worldwide. The collision risk associated with the disorder has resulted in many jurisdictions, most notably the European Union, introducing regulations that provide criteria under which drivers affected by this disorder may hold a driving licence. This chapter reviews the potential impact on driving of behavioural sleep disturbance, medical disorders associated with excessive daytime sleepiness, and insomnia. The most extensive discussion is devoted to OSA because of its high prevalence and the existence of driving regulations for the disorder. The discussion covers the manifestations of the relevant disorder, the impact on driving safety, and management considerations.
