The prevalence of obstructive sleep apnea (OSA) has been steadily increasing in recent decades. Correspondingly, the legal implications of this chronic disease are also being recognized and addressed. The insurance coverage for diagnosis and management of OSA and the medico-legal implications of undiagnosed OSA is clearly defined in some western countries. Health insurance coverage in India is predominantly for hospitalization and chronic disorders, such as OSA, are often not covered. In this review, we describe and compare the current status of medical and legal aspects in different countries, including issues related to health insurance, driving license, disability status, professional indemnity, and perioperative liabilities. We call to attention the need for more robust legislation in India relating to sleep disorders.
Franklin KA, Lindberg E. Obstructive sleep apnea is a common disorder in the population—a review on the epidemiology of sleep apnea. J Thorac Dis 2015;7(8):1311–1322. DOI: 10.3978/j.issn.2072-1439.2015.06.11.
Udwadia ZF, Doshi AV, Lonkar SG, et al. Prevalence of sleep-disordered breathing and sleep apnea in middle-aged urban Indian men. Am J Respir Crit Care Med 2004;169(2):168–173. DOI: 10.1164/rccm.200302-265OC.
Sharma SK, Kumpawat S, Banga A, et al. Prevalence and risk factors of obstructive sleep apnea syndrome in a population of Delhi, India. Chest 2006;130(1):149–156. DOI: 10.1378/chest.130.1.149.
Venkateshiah SB, Hoque R, Collop N. Legal aspects of sleep medicine in the 21st century. Chest 2018;154(3):691–698. DOI: 10.1016/j.chest.2018.04.033.
Ghosh D, Mackay TW, Riha RL. European Union directive 2014/85/EU on driver licensing in obstructive sleep apnoea: early experiences with its application in the UK. Breathe (Sheffield, England) 2016;12(3):e59–e63. Available from: http://www.ncbi.nlm.nih.gov/pubmed/28194236.
The Sleep Apnoea Trust Association. Detailed DVLA Guidance for UK Drivers with Sleep Apnoea—Updated 23rd Jan 2019—Sleep Apnoea Trust. Updated 23rd Jan. 2019 [cited 2019 Oct 11]. Available from: http://www.sleep-apnoea-trust.org/driving-and-sleep-apnoea/detailed-guidance-to-uk-drivers-with-sleep-apnoea/.
Does sleep apnea affect car insurance? [cited 2019 Oct 11]. Available from: https://www.autoinsurance.org/does-having-sleep-apnea-affect-your-car-insurance/.
Gopalakrishnan S. A public health perspective of road traffic accidents. J Fam Med Prim Care 2012;1(2):144. DOI: 10.4103/2249-4863.104987. Available from: http://www.ncbi.nlm.nih.gov/pubmed/24479025.
Dubey A, Bajaj DK, Mishra A, et al. Obstructive sleep apnea risk for driving license applicants in india—a community based study. Int J Occup Med Env Health 2018;31(1):25–36.
Tan SY. Medicolegal aspects of sleep apnea CHEST Physician. 2015 [cited 2019 Oct 11]. Available from: https://www.mdedge.com/chestphysician/article/102942/sleep-medicine/medicolegal-aspects-sleep-apnea.
Singh A. Current Situation of Health Care Coverage in India. ISPOR, News Across Asia. 2016;5(Number 1 April–July). Available from: https://www.ispor.org/consortiums/asia/NewsAcrossAsia_Spring2016.pdf.
Kumar Jain Narender, vs United India Insu. Co. Ltd. & Ors. on 12 December, 2013. [cited 2019 Oct 11]. Available from: https://indiankanoon.org/doc/184463617/.
Rajendra Kapoor vs New India Assurance Co. Ltd. & Anr. on 12 May, 2016. [cited 2019 Oct 11]. Available from: https://indiankanoon.org/doc/51932122/.
Viswanathan V, Ramalingam IP, Ramakrishnan N. High prevalence of obstructive sleep apnea among people with type 2 diabetes mellitus in a tertiary care center. J Assoc Physicians India 2017;65(11):38–42.
The Rights of Persons with Disabilities Act, 2016, Gazette of India (Extra-Ordinary). 2016 [cited 2019 Oct 11]. Available from: http://disabilityaffairs.gov.in/upload/uploadfiles/files/RPWDACT2016.pdf.
Failure to Diagnose Sleep Apnea - Miller & Wagner. [cited 2019 Oct 11]. Available from: https://www.miller-wagner.com/malpractice/diagnosis-errors/failure-to-diagnose-and-treat-sleep-apnea/.
Tolisano AM, Bager JM. Sleep surgery and medical malpractice. Laryngoscope 2014;124(6):E250–E254. DOI: 10.1002/lary.24559.
Fouladpour N, Jesudoss R, Bolden N, et al. Perioperative complications in obstructive sleep apnea patients undergoing surgery. Anesth Analg 2016;122(1):145–151. DOI: 10.1213/ANE.0000000000000841.
How snoring could harm your marriage or relationship. [cited 2019 Oct 11]; available from: https://www.ibtimes.co.in/how-snoring-could-harm-your-marriage-relationship-764099.
Nofzinger EA, Wettstein RM. Homicidal behavior and sleep apnea: a case report and medicolegal discussion. Sleep. 1995;18(9):776–782. DOI: 10.1093/sleep/18.9.776.
Summaries of Current Drowsy Driving Laws. [cited 2019 Oct 11]. Available from: http://www.ncsl.org/research/transportation/summaries-of-current-drowsy-driving-laws.aspx.