Posted by idaho on March 23, 2003 at 14:47:28:

In Reply to: Assessing Roadworthiness posted by Krishna on March 23, 2003 at 12:41:59:

Initial eval:
Problem; EDS w/ MVA from-
1. untreated/diagnosed osahs
2. alpha intrusion secondary to chronic pain w/ frequent arousals

Current eval:
Problem; treated OSAHS w/ short SOL in face of weight gain in anxious driver-
1. undertreated OSAHS from weight gain
2. major depression from MVA w/ death
3. alpha intrusion from chronic pain
4. insufficinet sleep sym (6.5 hrs)
5. w/ available info doubt: post-traumatic hypersomnolence, narcolepsy
6. cannot exclude PLMD causing EMA/SMI

Plan:
1. no driving 'til certain sleep addressed & pt not sleepy
2. trial of auto-CPAP to make certain 8 cm H2O OK
3. trial increased sleep period (> 6.5 hrs)
4. consider formal eval for ,or empiric tx of, depression
5. consider rx of nocturnal pain..elavil or other TCA
6. once above done, PSG w/ CPAP followed by MWT... if neg ie SOL > 10 min, OK to drive w/ close follow-up

Follow Ups:

• Re: Assessing Roadworthiness NewHampshire 11:22 3/24/03 (0)

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