Mayer G
Hephata-Klinik Schwalmstadt-Treysa, Deutschland.
Wien Med Wochenschr. 1996;146(13-14):391-5.
Knowledge gained in sleep medicine over the past 10 years has not yet been incorporated into laws for the severely handicapped and pension law. The impact of increased accident incidence of patients with hypersomnia has not yet been recognized in the guidelines for medical diseases in automobile traffic in governmental driving regulations. In preparation for implementation of sleep-wake disorders into medico-legal jurisdiction they must be introduced to the guidelines as a separate medical entity according to the International Classification of Sleep Disorders. Due to different prognoses sleep-wake disorders should be separated into reversible and irreversible disorders. To decide on driving ability, degree of disablement and permanent and total disability therapeutic efficiency should be documented by methods acknowledged in sleep medicine. Professional and nonprofessional drivers and personnel in charge of responsible monitoring should be submitted to regular therapy controls. Degree of disablement or permanent and total disability can only be recommended for patients with symptoms partially or completely refractory to therapy. Accompanying diseases posing a high health risk or those causing sleepiness themselves have to be included in the overall judgement. Sleep specialists have to be nominated as expert witnesses and should furthermore contribute to multiplication of knowledge on sleep medicine for public health officers.
过去十年间在睡眠医学领域所获得的知识尚未纳入针对重度残疾人士的法律以及养老金法中。在政府驾驶法规中有关汽车交通中医疗疾病的指导方针里，尚未认识到发作性睡病患者事故发生率增加所带来的影响。为了将睡眠-觉醒障碍纳入法医学管辖范围做准备，必须根据《国际睡眠障碍分类》将其作为一个单独的医学实体引入指导方针。由于预后不同，睡眠-觉醒障碍应分为可逆性和不可逆性障碍。为了确定驾驶能力、残疾程度以及永久性完全残疾，治疗效果应由睡眠医学认可的方法记录。职业和非职业驾驶员以及负责监督的人员应接受定期治疗检查。对于症状部分或完全难以治疗的患者，只能建议其残疾程度或永久性完全残疾情况。构成高健康风险的伴随疾病或本身导致嗜睡的疾病必须纳入整体判断。必须指定睡眠专家作为专家证人，此外，睡眠专家还应为向公共卫生官员传播睡眠医学知识做出贡献。
