Sindrome delle apnee ostruttive del sonno e rischio di incidenti stradali: doveri del medico e possibili responsabilità del paziente

[Obstructive Sleep Apnea Syndrome and road accident risk: physician’s duties and patient’s potential liability] Obstructive Sleep Apnea Syndrome (OSAS) is the most common sleep disorder associated with excessive daytime sleepiness (EDS), and it is estimated to affect 1,600,000 people in Italy. Untreated OSAS is significantly associated with an increased risk of driving accidents. This article reviews the main professional duties of physicians dealing with patients with OSAS, and the patient’s potential liability in case of sleep-related road accidents. Physician’s duties were divided into the following: 1. duties related to certification according to the law 120/2010 and the Decree 22 December 2015; and 2. duties related to patient education about the risks related to EDS and about his/her potential liability in case of driving accidents. The latter issue was reviewed in light of several Italian Supreme Court decisions about the criminal and civil liability in case of motor vehicle crashes due to sudden “sleep attack”. Finally, since in Italy there is not a specific law requiring physicians to report the drivers affected by OSAS associated with EDS, circumstances in which physicians may (or have to) inform driving licence authorities are discussed. Indiscriminate reporting of patients is not recommended, but it should be limited to selected and actually dangerous patients.