Obstructive Sleep Apnoea Syndrome
FISA Safety Bulletin
If you drive any type of vehicle for your living, or have responsibility for others that drive, you should ensure you are aware of the condition known as Obstructive Sleep Apnoea Syndrome (OSAS).
More associated with HGV drivers who are driving long distances, the condition can also affect others who drive for long stints during the day too, such as harvester and forwarder drivers.
The following provides an overview of the syndrome, its symptoms, treatment, and the legalities of driving should you receive a positive diagnosis.
OSAS – the condition.
Obstructive Sleep Apnoea Syndrome is a treatable condition that is particularly prevalent among haulage drivers.
Without treatment, driving with OSAS can make the chance of having a road traffic accident between three and nine times more likely and increase the severity of the accident. It can also greatly reduce quality of life, lead to other health problems and even impact on life expectancy.
It is essential that drivers are aware of the symptoms of sleep apnoea. It is a condition that can be very easily diagnosed and treated, and following this, patients are able to lead normal lives. It is especially significant for HGV drivers as successful treatment will enable them to drive as safely as anyone without OSAS.
Symptoms of Obstructive Sleep Apnoea Syndrome
Symptoms of sleep apnoea mainly occur during sleep. When you’re asleep, the muscles in your mouth, nose and throat (upper airways) relax. If you have Obstructive Sleep Apnoea (OSA), this can cause your airways to narrow or completely close, which stops you from breathing for a short time (10 or more seconds). You may temporarily wake up and might feel like you’re choking or gasping for breath. Usually, you fall asleep again very quickly so you may not even remember it in the morning.
This cycle can happen many times (sometimes hundreds of times) during the night, and affect how well you sleep. The disturbed sleep pattern can impact significantly on your ability to perform your driving duties safely.
Symptoms include:
- Breathing stopping and starting
- Making gasping, snorting or choking noises
- Waking up several times a night
- Loud snoring.
During the day, you may also:
- Feel very tired
- Find it hard to concentrate
- Have mood swings
- Have a headache when you wake up.
Source: Logistics (FTA)
Help to Become Symptom Aware
Following a collaboration between the Freight Transport Association (FTA) and the OSA Partnership Group, a partial Certificate of Professional Competence (CPC) module has been developed free of charge to both FTA and non-FTA members. The training module has been specifically designed to help make more HGV drivers aware of the symptoms of sleep apnoea and the consequences of not seeking treatment.
The DVLA and Obstructive Sleep Apnoea Syndrome
The DVLA provides detailed guidance on the legalities of driving when you suffer from OSAS.
DVLA Rules
Group 2, Bus and Lorry (and Taxi) Drivers
Mild, moderate or severe Obstructive Sleep Apnoea (OSA) without excessive sleepiness:
- You may continue to drive as normal and you do not need to notify the DVLA.
Mild Obstructive Sleep Apnoea Syndrome (OSAS), i.e. Obstructive Sleep Apnoea with the symptom of excessive sleepiness:
- You must not drive until your excessive sleepiness symptom has been satisfactorily controlled. If your excessive sleepiness symptom cannot be controlled within three months you must notify the DVLA.
- Moderate or severe Obstructive Sleep Apnoea Syndrome (OSAS) i.e. Obstructive Sleep Apnoea with the symptom of excessive sleepiness:
- You must not drive until your Sleep Clinic has confirmed to you that your OSAS is under control, your sleepiness is no longer excessive, and you are complying with CPAP treatment. You must notify the DVLA. The DVLA will require medical confirmation that your symptoms are under control. If your driving license has already been revoked, you then can apply for it to be restored.
Excessive sleepiness where Obstructive Sleep Apnoea Syndrome (OSAS) is suspected:
- You must not drive until OSAS has been diagnosed and your Sleep Clinic has confirmed that your excessive sleepiness is being satisfactorily controlled by treatment. If moderate or severe OSAS is diagnosed the notification requirements in the previous paragraph will apply. If mild OSAS is diagnosed you only need to notify the DVLA if your excessive sleepiness cannot be controlled within three months.
Note: Whenever the term “excessive sleepiness” is used it means “excessive sleepiness having, or likely to have, an adverse effect on driving”, as defined by the DVLA. Where DVLA guidance refers to “drowsiness” it should be interpreted as excessive sleepiness.
Review of Treatment.
The DVLA guidelines require you, as the driver, to confirm that a review of your condition has been undertaken at least annually if you are a Group 2 driver. It will be your responsibility to contact your Sleep Clinic to arrange for this review in good time before the end of each annual period. How this review will be undertaken will be a matter for your Sleep Clinic, and options may range from a simple telephone conversation to a visit to the Sleep Clinic.
What Should I do?
There is a common element in these revised DVLA Guidelines. This is that where excessive sleepiness is present and OSAS is suspected you must not drive until a diagnosis is confirmed, and the excessive sleepiness symptoms are controlled.
If you have some of the symptoms described above, particularly excessive sleepiness, do not drive, seek an appointment with your GP, and ask the GP for a referral to a Sleep Clinic. Before seeing your GP, download and complete the Epworth Sleepiness Scale Score Form from this website Epworth Sleepiness Scale for SATA.
If you are a professional driver who relies on your driving licence for your livelihood, or you are disabled, or have little access to public transport and others depend on you for transport etc, you should mention this to your GP and ask that on your referral letter the GP clearly requests the Sleep Clinic to provide fast tracked treatment within four weeks, as recommended by NICE.
If your Sleep Clinic diagnoses Sleep Apnoea, their diagnosis needs to be clear and precise so that you can make a decision on whether or not you have to inform the DVLA. If they have diagnosed Obstructive Sleep Apnoea without excessive sleepiness, no notification is necessary. If their diagnosis is Obstructive Sleep Apnoea with excessive sleepiness, in other words, Obstructive Sleep Apnoea Syndrome (OSAS), notification will be required. If necessary, you need to ask the Sleep Clinic to clarify this.
Do not notify the DVLA until you have been diagnosed and then only if the rules state that you have to.
If this guidance suggests that you do need to notify the DVLA, SATA recommends that you do so in writing rather than telephoning their helpline number or sending them an e-mail.
You must of course continue not to drive until you have started your prescribed treatment (probably by means of CPAP) and your Sleep Clinic is satisfied that the treatment is controlling your excessive sleepiness.