nach oben

Sleep and Breathing

Erschienen in:

08.02.2019 | Neurology • Original Article

Assessing readiness to drive in adolescents with narcolepsy: what are providers doing?

verfasst von: David G. Ingram, Ann Marie Marciarille, Zarmina Ehsan, Gayln V. Perry, Teresa Schneider, Baha Al-Shawwa

Erschienen in: Sleep and Breathing | Ausgabe 2/2019

Einloggen, um Zugang zu erhalten

Abstract

Purpose

There are no universally accepted guidelines for assessing driving readiness in adolescents with narcolepsy. The purpose of the present study was to survey pediatric sleep medicine providers regarding their current practice patterns for assessing driving readiness in adolescents with narcolepsy, knowledge of their state laws regarding physician reporting of unsafe drivers, and opinions regarding what physician duty ought to be.

Methods

This was an anonymous web-based survey distributed via the PedSleep listserv, which serves as a hub of communication for pediatric sleep medicine providers.

Results

A total of 52 pediatric sleep providers from 25 different states completed the survey. Eighty-eight percent of providers routinely assess driving readiness in adolescents with narcolepsy. Factors rated as “absolutely essential” by at least 50% of respondents included the following: history of previous fall-asleep crash or near miss, sleepiness (reported by patient), sleepiness (reported by caregiver), and cataplexy (reported by patient). Providers included maintenance of wakefulness testing: never (34%), if patient reports no/mild sleepiness (10%), if patient reports moderate/severe sleepiness (25%), or always regardless of patient symptoms (30%), and the median minimally acceptable result was 30 min (25–75th: 20–40 min). There was substantial lack of knowledge regarding legal obligations for reporting.

Conclusions

These results demonstrate great variability in practice patterns among pediatric sleep medicine providers for assessing driving readiness in adolescents with narcolepsy. In addition, it shows limited knowledge of the providers about their respective states’ laws. Further studies are required to identify the best approach to assess residual sleepiness in this population.

Broughton R, Ghanem Q, Hishikawa Y, Sugita Y, Nevsimalova S, Roth B (1981) Life effects of narcolepsy in 180 patients from North America, Asia and Europe compared to matched controls. Can J Neurol Sci 8(4):299–304CrossRefPubMed

Aldrich MS (1989) Automobile accidents in patients with sleep disorders. Sleep 12(6):487–494CrossRefPubMed

Liu SY, Perez MA, Lau N (2018) The impact of sleep disorders on driving safety-findings from the Second Strategic Highway Research Program naturalistic driving study. Sleep 41(4). https://doi.org/10.1093/sleep/zsy023

Scammell TE (2018) In: Eichler AF (ed) Treatment of narcolepsy in adults. UpToDate, Waltham. (Accessed on September 7, 2018)

Philip P, Chaufton C, Taillard J, Sagaspe P, Leger D, Raimondi M et al (2013) Maintenance of Wakefulness Test scores and driving performance in sleep disorder patients and controls. Int J Psychophysiol 89(2):195–202. https://doi.org/10.1016/j.ijpsycho.2013.05.013 CrossRefPubMed

Littner MR, Kushida C, Wise M, Davila DG, Morgenthaler T, Lee-Chiong T, Hirshkowitz M, Daniel LL, Bailey D, Berry RB, Kapen S, Kramer M, Standards of Practice Committee of the American Academy of Sleep Medicine (2005) Practice parameters for clinical use of the multiple sleep latency test and the maintenance of wakefulness test. Sleep 28(1):113–121CrossRefPubMed

Pizza F, Jaussent I, Lopez R, Pesenti C, Plazzi G, Drouot X, Leu-Semenescu S, Beziat S, Arnulf I, Dauvilliers Y (2015) Car crashes and central disorders of hypersomnolence: a French study. PLoS One 10(6):e0129386. https://doi.org/10.1371/journal.pone.0129386 CrossRefPubMedPubMedCentral

Division of Sleep Medicine at Harvard Medical School. Living with Narcolepsy - Safety. 2018. http://healthysleep.med.harvard.edu/narcolepsy/living-with-narcolepsy/safety. Accessed 7 Sept 2018

Zandieh S, Ramgopal S, Khatwa U, Sangiuliano M, Gunnuscio M, Zarowski M et al (2013) The maintenance of wakefulness test in pediatric narcolepsy. Pediatr Neurol 48(6):443–446. https://doi.org/10.1016/j.pediatrneurol.2013.02.007 CrossRefPubMed

10.

Philip P, Chaufton C, Taillard J, Capelli A, Coste O, Leger D et al (2014) Modafinil improves real driving performance in patients with hypersomnia: a randomized double-blind placebo-controlled crossover clinical trial. Sleep 37(3):483–487. https://doi.org/10.5665/sleep.3480 CrossRefPubMedPubMedCentral

11.

Erman M, Emsellem H, Black J, Mori F, Mayer G (2017) Correlation between the Epworth Sleepiness Scale and the Maintenance of Wakefulness Test in patients with narcolepsy participating in two clinical trials of sodium oxybate. Sleep Med 38:92–95. https://doi.org/10.1016/j.sleep.2017.07.015 CrossRefPubMed

12.

Philip P, Sagaspe P, Taillard J, Chaumet G, Bayon V, Coste O, Bioulac B, Guilleminault C (2008) Maintenance of Wakefulness Test, obstructive sleep apnea syndrome, and driving risk. Ann Neurol 64(4):410–416. https://doi.org/10.1002/ana.21448 CrossRefPubMed

13.

Mansukhani MP, Kotagal S (2012) Sodium oxybate in the treatment of childhood narcolepsy-cataplexy: a retrospective study. Sleep Med 13(6):606–610. https://doi.org/10.1016/j.sleep.2011.10.032 CrossRefPubMed

Titel: Assessing readiness to drive in adolescents with narcolepsy: what are providers doing?
verfasst von: David G. Ingram
Ann Marie Marciarille
Zarmina Ehsan
Gayln V. Perry
Teresa Schneider
Baha Al-Shawwa
Publikationsdatum: 08.02.2019
Verlag: Springer International Publishing
Erschienen in: Sleep and Breathing / Ausgabe 2/2019
Print ISSN: 1520-9512
Elektronische ISSN: 1522-1709
DOI: https://doi.org/10.1007/s11325-019-01799-2

Leitlinien kompakt für die Innere Medizin

Mit medbee Pocketcards sicher entscheiden.

^{Seit 2022 gehört die medbee GmbH zum Springer Medizin Verlag}

Kostenlos registrieren

Neu im Fachgebiet Innere Medizin

Notfall-TEP der Hüfte ist auch bei 90-Jährigen machbar

26.04.2024 Hüft-TEP Nachrichten

Ob bei einer Notfalloperation nach Schenkelhalsfraktur eine Hemiarthroplastik oder eine totale Endoprothese (TEP) eingebaut wird, sollte nicht allein vom Alter der Patientinnen und Patienten abhängen. Auch über 90-Jährige können von der TEP profitieren.

Niedriger diastolischer Blutdruck erhöht Risiko für schwere kardiovaskuläre Komplikationen

25.04.2024 Hypotonie Nachrichten

Wenn unter einer medikamentösen Hochdrucktherapie der diastolische Blutdruck in den Keller geht, steigt das Risiko für schwere kardiovaskuläre Ereignisse: Darauf deutet eine Sekundäranalyse der SPRINT-Studie hin.

Bei schweren Reaktionen auf Insektenstiche empfiehlt sich eine spezifische Immuntherapie

25.04.2024 Allergien und Intoleranzreaktionen Nachrichten

Insektenstiche sind bei Erwachsenen die häufigsten Auslöser einer Anaphylaxie. Einen wirksamen Schutz vor schweren anaphylaktischen Reaktionen bietet die allergenspezifische Immuntherapie. Jedoch kommt sie noch viel zu selten zum Einsatz.

Therapiestart mit Blutdrucksenkern erhöht Frakturrisiko

25.04.2024 Hypertonie Nachrichten

Beginnen ältere Männer im Pflegeheim eine Antihypertensiva-Therapie, dann ist die Frakturrate in den folgenden 30 Tagen mehr als verdoppelt. Besonders häufig stürzen Demenzkranke und Männer, die erstmals Blutdrucksenker nehmen. Dafür spricht eine Analyse unter US-Veteranen.

Update Innere Medizin

Bestellen Sie unseren Fach-Newsletter und bleiben Sie gut informiert.

Newsletter bestellen

Springer Medizin

Abstract

Purpose

Methods

Results

Conclusions

Bitte loggen Sie sich ein, um Zugang zu diesem Inhalt zu erhalten

Weitere Artikel der Ausgabe 2/2019

Associations between objectively assessed physical fitness levels and sleep quality in community-dwelling elderly people in South China

Oxidative stress does not contribute to the release of proinflammatory cytokines through activating the Nod-like receptor protein 3 inflammasome in patients with obstructive sleep apnoea

Cognitive impairment and sleep disturbances after minor ischemic stroke

Toll-like receptor-4 deficiency alleviates chronic intermittent hypoxia-induced renal injury, inflammation, and fibrosis

REM obstructive sleep apnea: risk for adverse health outcomes and novel treatments

Nutrigenetic genotyping study in relation to Sleep Apnea Clinical Score