After 6 years, AustRoads have issued the latest Medical standards for licensing and clinical management guidelines. You can find a copy of AustRoads “Assessing Fitness to Drive, 2022 Edition” here: AustRoads, “Assessing Fitness to Drive” clinical management guidelines
Below is a brief summary of relevant changes to Section 8: Sleep Disorders as compiled by our review.
1. Assessing for sleep apnoea now includes clinical features of significant concern
- BMI of >40kg/m2
- BMI of >35kg/m2 ( with Hypertension requiring >2 medications for control OR Type 2 diabetes)
- Sleepiness-related crash or accident including off-road deviation, rear-ending another vehicle
- Excessive sleepiness during the major wake period
2. Evaluation of sleep apnoea includes clinical assessment followed by overnight monitoring to identify sleep apnoea.
3. The STOPBANG, OSA50 and Berlin Questionnaire are listed as valid clinical screening tools that assist in the decision to refer for an overnight sleep study.
4. Health professionals are advised to consider non-driving or restricted driving periods for their patients while assessing efficacy of sleep apnoea treatment. For commercial drivers this decision is made by a sleep physician. For example, limiting driving to 30 minutes or restricting night-time driving (ie. 11pm – 7am)
5. Subjective measurement of sleepiness should be based on clinical assessment, using the Epworth Sleepiness Scale as a validated tool for subjective sleepiness, recognising it’s limited use in screening for OSA (it is neither sensitive nor specific in determining likelihood of OSA)
6. Treatment recommendations for cataplexy have been made non-specific