Sleep and Breathing, vol.29, no.1, 2025 (SCI-Expanded)
Background: Sleepiness significantly contributes to traffic accidents, with obstructive sleep apnea syndrome (OSA) being the leading medical cause. Effective treatment of OSA has been shown to reduce accident-related deaths and injuries. Turkish legislation has been updated to address driver’s license issues for individuals with OSA, but implementation challenges and debates persist. Methods: Data from 159 patients who applied to obtain or renew their driver’s licenses and underwent polysomnography between January 2020 and January 2024 were evaluated retrospectively. Results: The body mass index of 126 patients (79.24%) exceeded 33 kg per meter of height squared. OSA (apnea hypopnea index greater than 5) was detected in 85.5% of our patients, and the rate of severe OSA was 31.4%. We evaluated the presence of severe OSA using logistic regression analysis. Among the variables, the most important factor was neck circumference Receiver operating characteristic curve analysis identified severe OSA risk thresholds as neck circumference of 42.5 cm or greater and waist circumference of 122 cm or greater. Conclusions: Considering neck and waist circumference rather than body mass index may facilitate informed decisions based on empirical measurements to identify OSA in driver’s license applicants who require overnight polysomnography assessment.