Sleep, sleep disorders and motor vehicle crashes.

There is wide consensus that drowsiness and sleep during driving put the driver and others at high risk for motor vehicle crashes. A large percentage of both private automobile and commercial vehicle crashes and crash fatalities are associated with the sleepy driver each year. Sleepiness in persons without sleep disorders may occur from potentially preventable causes such as sleep deprivation, drinking alcohol or taking sedative medications. Sleepiness also occurs uncontrollably in persons with certain sleep disorders. It is important, therefore, for persons to have a diagnosis of a sleep disorder, objectively confirmed with an MSLT, to be considered for restriction of driving privileges. The MSLT serves as a marker for the sleep disorder and also as evidence of effective treatment. While sleepiness is widespread, this regulation addresses only the highest risk group for attention. Proposed guidelines for sleep related disorders and driving in Wisconsin are presented with this background in mind.