Narcolepsy and Highway Accidents

To the Editor:—  Waller's recent report "Medical Impairment and Highway Crashes" (208:2293, 1969) stresses the importance of alcoholism but completely fails to mention another medical impairment—narcolepsy—which undoubtedly contributes to the total highway death and accident rate. In 1965 Bartels and Kushacioglu¹ called attention to the possible role of narcolepsy in automobile accidents. Based on 105 patient questionnaires, they reported that "77% of the patients with narcolepsy admitted driving while drowsy, as compared to 14% of the controls" and "40% of the patients with narcolepsy actually fell asleep while driving as compared with 7% of the controls."Roberts, who has made studies on narcolepsy among Negroes, also noted that patients with the disease were potential highway hazards. Some of his narcoleptic patients were even penalized for purported intoxication by misinterpretation of their symptoms.^2,3It is difficult to estimate how much narcolepsy contributes to highway accidents for lack of