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It is suspected that about 20% of car accidents are sleep related and research has show that sleepiness can impair driving more than drink! Indeed patients with Obstructive Sleep Apnoea (OSA) have a 7-12 fold chance of a road traffic accident (RTA) compared to those who do not and treating the condition can reduce the accident rate by 83%.
It has been reported that up to 1:6 Heavy Goods Vehicle (HGV) drivers are thought to have OSA and some Unions are calling for mandatory testing for all drivers. Falling asleep at the wheel results in far more serve injuries and likelihood of death as there is no attempt at breaking and evasive manoeuvres. In Lincolnshire we adopted a multi agency approach to this issue with significant success (see graph).
In the UK only 20% of patients have been diagnosed and only half of these have been treated and the British Thoracic Society
(BTS) estimates that if you treated 59,400 you could reduce RTA’s by 7000 and over 400 lives would be saved and £400 million in RTA costs over 5 years.
The UK Driver Vehicle Licensing Agency (DVLA) has regulations for people who have been diagnosed with sleep apnoea, because these drivers are much more likely to be involved in crashes by falling asleep at the wheel. However, the clinical advice can be variable; from do not drive until on therapy to it is ok if you are not sleepy at the wheel. This seems to be something of a grey area and needs clarification.
The DVLA requires:
Group 1 licence holders (car/ motorcycle) diagnosed with sleep apnoea must stop driving until the symptoms have been controlled and confirmed by medical opinion.
Group 2 licence holders (LGV) diagnosed with sleep apnoea must stop driving until the symptoms have been controlled, and must have ongoing treatment. Licensing reviews will be carried out regularly, usually annually.
A new leaflet ‘Think! Tiredness Can Kill’ has been published by the DVLA, offering advice for drivers on the risks of sleepiness while driving.