Drivers headed towards sleep disorder checks

Photo: Corbis/Scanpix

Lots of drivers will never admit an accident resulted from nodding off at the wheel, searching for other explanations.

Estonian Road Administration thinks that before issuing health certificates, drivers should be tested regarding excessive drowsiness of sleep apnea.

«At the moment, a simple questionnaire is in the making for family doctors or physicians at traffic committees could interview drivers and find out whether or not they are inclined to go to sleep while driving,» said Vitali Nester, chief traffic education specialist at Road Administration.

To compile the questionnaire, Road Administration addressed Estonian Sleep Medicine Association and research company Res-Medica. By doctor Erve Sõõru of Res-Medica, a research on Obstructive Sleep Apnea: Risk Factor Assessment, Diagnosis Model Creation, and Impact Assessment of the Disease on Social Activity.

The thesis reveals close to 35 percent of traffic accidents are related to fatigue of drivers, leading to slowness of reaction, nodding off or falling asleep at the wheel.

According to Mr Nester, drivers will not often admit to a nap while driving. The knee-jerk reaction is coming up with other excuses: a beast leaped out the forest, a car cut me off etc. Still, Mr Nester says that if a car has driven into the ditch, in normal road and weather conditions, sleepiness may be assumed.

Res-Medica research says that drivers will often explain sleepiness with long working hours. In reality, sleepiness during the day may be a chronic problem. Even so, drivers used to being tired will never suspect that.

A driver with sleep apnea not cured will have up to seven times the risk of having an accident, says the research.

Currently, doctors are not looking into nor asking questions regarding drowsiness or sleep apnea when issuing health certificates. Therefore, Erve Sõõru advises change to how health certificates are issued.

How exactly, is only being found out. Ms Sõõru was unwilling to give Postimees in-depth comments as the project is in baby shoes. Mr Nester noted the topic will be up soon at traffic committee of economy and communication ministry. According to Road Administration knowledge, the European Commission is also dealing with the issue.

Diagnosing sleep apnea

In the research thesis by Erve Sõõru, two models are suggested to diagnose sleep apnea.

• Variant one:

Include the internationally recognised questionnaire STOP-Bang Scoring Model to the health data declaration submitted by a driver.

1. Do you snore loudly (louder than usual speech; or: is you snoring heard in next room while the bedroom door is closed?

2. Do you often feel not rested, tired, or sleepy during the day?

3. Have people detected pauses in your breathing during night sleep?

4. Dou you have high blood pressure or have you used high blood pressure medicines?

5. Does your body mass index exceed 35 kg/m²?

6. Are you over 50 years of age?

7. Is your neck over 40 centimetres in diameter? 

8. Are you male?

Whoever answers «yes» to three of more questions fall into risk group. In that case, a driver needs further examination. Still, the danger is a driver may deliberately submit false data, fearing he will lose his job die to possible health issues, or just to avoid extra trouble.

• Variant two:

Add three questions to the current health declaration filled by drivers.

1. Dou you have high blood pressure or have you used high blood pressure medicines?

2. If female, is your neck over 40 cm in diameter? If male, is it over 43 cm?

3. Is your body mass index over 35 kg/m²?

With at least  one yes, the driver will need additional examination and treatment regarding sleep apnea. Honesty of answers can be directly checked. Additional examination and treatment must be advisory in nature, as sleep apnea is not yet reflected in Traffic Act additional limitations list.