Sleep-related breathing disorders: unrecognized risk factors for road traffic accidents. A focus on the Italian situation

Sleep-related breathing disorders (SRBDs), and in particular obstructive sleep apnea (OSA), are of considerable epidemiological importance, which requires physicians to pay special attention to the detection of these often-unrecognized pathologies. In view of the known link between OSA and road accidents, often fatal, legislation has been in force in Europe and Italy for some years regarding the issue and renewal of driving licenses for people at risk of or affected by OSA. In addition, other pathological conditions often associated with OSA, such as excessive daytime sleepiness (EDS) and residual excessive daytime sleepiness (rEDS), which are treated with new specific drugs, have also received attention. The need for a proper evaluation of people affected by OSA, especially drivers, requires the collaboration of different specialists to optimize the clinical framework and to prevent the direct and indirect health costs associated with a lack of early diagnosis. Moreover, personalized sleep medicine is essential, with innovative technological tools and analysis methods, including artificial intelligence, to allow a better understanding of individual physiopathological mechanisms and to prepare therapeutic strategies tailored to the individual patient. In this narrative review, we focused on the relationship between OSA and road accidents in Italy.