Section 11: Respiratory Diseases

1. Asthma

2. Chronic obstructive pulmonary disease (COPD)

3. Sleep apnea

Section 11: Respiratory Diseases

Asthma No restrictions.

Patients should be counseled not to drive during acute asthma attacks or while suffering transient side effects (if any) from their asthma medications.

Chronic obstructive pulmonary disease (COPD) No restrictions if symptoms are well-controlled and the patient does not experience any significant side effects from the condition or medications.

The patient should not drive if he/she suffers dyspnea at rest or at the wheel (even with the use of supplemental oxygen), excessive fatigue, or significant cognitive impairment. If the patient requires supplemental oxygen to maintain a hemoglobin saturation of 90% or greater, he/she should be counseled to use the oxygen at all times while driving. Due to the often tenuous oxygenation status of these patients, they should also be counseled to avoid driving when they have other respiratory symptoms that may indicate concomitant illness or exacerbation of COPD (eg, new cough, increased sputum production, change in sputum color, or fever).

Because COPD is often progressive, periodic reevaluation for symptoms and oxygenation status is recommended.

If the physician is concerned that the patient’s symptoms compromise his/her driving safety, referral to a driver rehabilitation specialist for a driver evaluation (including on-road assessment) is recommended. The patient’s oxygen saturation may be measured during the course of the on-road assessment to provide additional information for patient management.

Sleep apnea The patient may resume driving when he/she no longer suffers excessive daytime drowsiness. Physicians may consider using scoring tools such as the Epworth Sleepiness Scale19 to assess the patient’s level of daytime drowsiness, or brief cognitive tests to assess the patient’s level of attention.

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