FRINK Linked Data Fragments server

Matches in SemOpenAlex for { <https://semopenalex.org/work/W2229436456> ?p ?o ?g. }

• W2229436456 endingPage "4" @default.
• W2229436456 startingPage "3" @default.
• W2229436456 abstract "While the recognition of OSA and its potential consequences on driving represents a major step towards increased safety on the road, European pulmonologists and sleep specialists have to face several problems. First, practical application of the Directive is demanded from governments of Member States. Because rules for medical assessment before obtaining a driving licence differ among European States (Alonderis et al., 2008), a standardized approach to implementation of the EU Directive would be highly desirable. Secondly, patients with diagnosed OSA represent the tip of the iceberg of a large population with unrecognized and untreated sleep-disordered breathing, and the new requirements established by the EU Directive can considerably increase the requests for specialist evaluation and lengthen waiting-lists. Affordable medical evaluation, and an acceptable time-frame to obtain the new or renewed driving licence, appear to be reasonable targets, but screening for OSA on a large scale will strain the Health Systems considerably throughout Europe. Thirdly, episodes of sleepiness at the wheel in the previous 2 years were reported by 17% of European drivers in a recent survey, underlining that it is a common problem (Gonçalves et al., 2015). Sleepiness at the wheel was associated with poor sleep, younger age, male gender, driving exposure, daytime sleepiness and high risk of OSA (Gonçalves et al., 2015). Although OSA increases the risk of traffic accidents (Strohl et al., 2013), the disorder is associated with excessive daytime sleepiness (EDS) in only approximately 50% of patients. While reports differ, the majority of evidence supports the view that driving risk in OSA is related more closely to the degree of daytime sleepiness than the objective severity of sleep-disordered breathing as measured by the frequency of apneas and hypopneas per hour of sleep [Apnea–Hypopnea Index (AHI)] (McNicholas and Rodenstein, 2015). However, other factors can contribute to sleepiness in patients with OSA, which include inadequate sleep time, time of day (early morning and afternoon), shiftwork, sedative medications, poor sleep hygiene, other sleep disorders and alcohol intake (Di Milia et al., 2011), and these additional factors may be particularly important in commercial drivers. Furthermore, these factors, which are not related directly to OSA severity, may contribute to some of the variability in reported sleepiness in patients with differing levels of disease severity based on the AHI and, of course, may also be present in patients without OSA, thus contributing to accident risk. Effective OSA treatment, usually with CPAP, resolves both apnea and EDS rapidly in the large majority of affected patients (Sassani et al., 2004; Tregear et al., 2010). A possible way to deal with the problem of driving in OSA patients was proposed by the British Thoracic Society (BTS) in 2014. The BTS statement on driving licence regulation focused pragmatically on the evaluation and treatment of sleepy patients only. However, UK subjects requesting a driving licence receive detailed information about OSA symptoms, and have to report symptoms of sleepiness to their general practitioner (GP). Moreover, the Driver and Vehicle Licensing Agency manages the assessment directly, if necessary together with the GP or a specialist (BTS Statement, 2014). Such an approach would be hardly applicable in most EU Member States, where the GP or a specialist have to issue a medical certificate. Subjective EDS in OSA patients is usually assessed by questionnaires, which are subjective and thus susceptible to reporting bias by a driver who seeks to underestimate severity, whereas objective evaluation is expensive, time-consuming and not well suited to being performed on a large scale. It is likely that the EU Directive will foster research to develop new tools to assess fitness to drive. Such tools are currently lacking, and this is a major problem to face in the near future. This lack is particularly evident in the context of the assessment of sleepiness. The need for practical guidelines for clinicians is particularly evident in a recent report demonstrating a lack of consensus in clinicians’ judgement of fitness to drive in both untreated and CPAP-treated patients with OSA (Dwarakanath et al., 2015). Because of the major impact the Directive might have on sleep and pulmonary specialists, the European Respiratory Society and the European Sleep Research Society will jointly appoint a group of experts to develop practical recommendations to cope with the problems raised by the new EU Directive on issuing driving licences in Europe. The European Lung Foundation will also be involved, by providing the important points of view of patients with OSA. Patient involvement is particularly important in order to minimize the risk of encouraging OSA patients to avoid seeking medical attention and treatment because of the understandable concern that such a diagnosis would compromise the ability to continue driving. This risk is particularly concerning for commercial drivers, who depend upon retention of a valid driving licence for their livelihood, and also represent the group where failure to diagnose and treat OSA carries the greatest risk to public safety. In this context, a ‘carrot-and-stick’ approach is required, with the principal emphasis being on the carrot, and a detailed campaign to educate patients, employers and other relevant stakeholders is required on this topic. As well as this document, planned for early 2016, further initiatives will be set to obtain additional information over time, and update/adjust recommendations." @default.
• W2229436456 created "2016-06-24" @default.
• W2229436456 creator A5013533005 @default.
• W2229436456 creator A5030566289 @default.
• W2229436456 creator A5065594704 @default.
• W2229436456 creator A5073782024 @default.
• W2229436456 creator A5084271839 @default.
• W2229436456 creator A5087334301 @default.
• W2229436456 creator A5088679503 @default.
• W2229436456 date "2015-12-31" @default.
• W2229436456 modified "2023-10-13" @default.
• W2229436456 title "New rules on driver licensing for patients with obstructive sleep apnea: European Union Directive 2014/85/EU" @default.
• W2229436456 cites W1984092710 @default.
• W2229436456 cites W2019688520 @default.
• W2229436456 cites W2030392165 @default.
• W2229436456 cites W2119033075 @default.
• W2229436456 cites W2128389162 @default.
• W2229436456 cites W2161750470 @default.
• W2229436456 cites W2183429569 @default.
• W2229436456 cites W55607816 @default.
• W2229436456 doi "https://doi.org/10.1111/jsr.12379" @default.
• W2229436456 hasPubMedId "https://pubmed.ncbi.nlm.nih.gov/26906643" @default.
• W2229436456 hasPublicationYear "2015" @default.
• W2229436456 type Work @default.
• W2229436456 sameAs 2229436456 @default.
• W2229436456 citedByCount "24" @default.
• W2229436456 countsByYear W22294364562016 @default.
• W2229436456 countsByYear W22294364562017 @default.
• W2229436456 countsByYear W22294364562018 @default.
• W2229436456 countsByYear W22294364562019 @default.
• W2229436456 countsByYear W22294364562020 @default.
• W2229436456 countsByYear W22294364562021 @default.
• W2229436456 countsByYear W22294364562022 @default.
• W2229436456 countsByYear W22294364562023 @default.
• W2229436456 crossrefType "journal-article" @default.
• W2229436456 hasAuthorship W2229436456A5013533005 @default.
• W2229436456 hasAuthorship W2229436456A5030566289 @default.
• W2229436456 hasAuthorship W2229436456A5065594704 @default.
• W2229436456 hasAuthorship W2229436456A5073782024 @default.
• W2229436456 hasAuthorship W2229436456A5084271839 @default.
• W2229436456 hasAuthorship W2229436456A5087334301 @default.
• W2229436456 hasAuthorship W2229436456A5088679503 @default.
• W2229436456 hasBestOaLocation W22294364561 @default.
• W2229436456 hasConcept C105639569 @default.
• W2229436456 hasConcept C126322002 @default.
• W2229436456 hasConcept C144133560 @default.
• W2229436456 hasConcept C162853370 @default.
• W2229436456 hasConcept C17744445 @default.
• W2229436456 hasConcept C177713679 @default.
• W2229436456 hasConcept C199360897 @default.
• W2229436456 hasConcept C199539241 @default.
• W2229436456 hasConcept C2776003135 @default.
• W2229436456 hasConcept C2776006263 @default.
• W2229436456 hasConcept C2777363581 @default.
• W2229436456 hasConcept C2779547435 @default.
• W2229436456 hasConcept C2908647359 @default.
• W2229436456 hasConcept C2908861384 @default.
• W2229436456 hasConcept C2910001868 @default.
• W2229436456 hasConcept C41008148 @default.
• W2229436456 hasConcept C545542383 @default.
• W2229436456 hasConcept C71924100 @default.
• W2229436456 hasConcept C99454951 @default.
• W2229436456 hasConceptScore W2229436456C105639569 @default.
• W2229436456 hasConceptScore W2229436456C126322002 @default.
• W2229436456 hasConceptScore W2229436456C144133560 @default.
• W2229436456 hasConceptScore W2229436456C162853370 @default.
• W2229436456 hasConceptScore W2229436456C17744445 @default.
• W2229436456 hasConceptScore W2229436456C177713679 @default.
• W2229436456 hasConceptScore W2229436456C199360897 @default.
• W2229436456 hasConceptScore W2229436456C199539241 @default.
• W2229436456 hasConceptScore W2229436456C2776003135 @default.
• W2229436456 hasConceptScore W2229436456C2776006263 @default.
• W2229436456 hasConceptScore W2229436456C2777363581 @default.
• W2229436456 hasConceptScore W2229436456C2779547435 @default.
• W2229436456 hasConceptScore W2229436456C2908647359 @default.
• W2229436456 hasConceptScore W2229436456C2908861384 @default.
• W2229436456 hasConceptScore W2229436456C2910001868 @default.
• W2229436456 hasConceptScore W2229436456C41008148 @default.
• W2229436456 hasConceptScore W2229436456C545542383 @default.
• W2229436456 hasConceptScore W2229436456C71924100 @default.
• W2229436456 hasConceptScore W2229436456C99454951 @default.
• W2229436456 hasIssue "1" @default.
• W2229436456 hasLocation W22294364561 @default.
• W2229436456 hasLocation W22294364562 @default.
• W2229436456 hasOpenAccess W2229436456 @default.
• W2229436456 hasPrimaryLocation W22294364561 @default.
• W2229436456 hasRelatedWork W2359160503 @default.
• W2229436456 hasRelatedWork W2365237607 @default.
• W2229436456 hasRelatedWork W2370536927 @default.
• W2229436456 hasRelatedWork W2386772716 @default.
• W2229436456 hasRelatedWork W2387992839 @default.
• W2229436456 hasRelatedWork W2394083072 @default.
• W2229436456 hasRelatedWork W2884651741 @default.
• W2229436456 hasRelatedWork W2962682847 @default.
• W2229436456 hasRelatedWork W3092939585 @default.
• W2229436456 hasRelatedWork W4235511908 @default.
• W2229436456 hasVolume "25" @default.
• W2229436456 isParatext "false" @default.

• next