- © 2007 Canadian Medical Association or its licensors
Norman Wolkove and colleagues recently presented an excellent review of sleep disorders in older people.1,2 However, they did not mention that one of the main symptoms of sleep disorders, excessive daytime sleepiness, increases the risk of automobile accidents.3 Primary caregivers should be aware that sleepy drivers (including those with untreated sleep apnea) must be reported to the relevant motor vehicle licensing authority in some provinces. Such reports have the potential to limit an older person's independence because, as pointed out by Wolkove and colleagues,2 there is marked variability within Canada in the coverage for continuous positive airway pressure devices, the treatment of choice for obstructive sleep apnea. Astonishingly, some provinces do not cover this therapy at all.
Another problem facing Canadian patients with sleep disorders is the variability between provinces in the time patients have to wait for sleep testing. In several provinces patients must wait much longer for testing than recommended by the Canadian Thoracic Society Sleep Disordered Breathing Committee.4,5 This places these patients at increased medical risk; the increased risk that they will be involved in an automobile accident may also endanger the public.
Footnotes
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Competing interests: None declared for Dr. Kryger. Dr. George is on the Medical Advisory Board for Sleeptech LLC.