CPAP Blog

We discussed Sleep Apnoea in drivers before when we dug up some frightening statistics regarding the prevalence of sleep disorders amongst drivers in Britain. As this is such an important topic and often asked about in the various forums, we decided to dedicate another post to the matter of Sleep Apnoea and driving cars or trucks.

There are many good sources on the web benefiting drivers with sleep disorders. A good starting point is the road safety charity aptly named Brake. They list a staggering amount of scary statistics, pointing out the large groups of people endangering our roads on a day to day basis. They estimate that one in ten road accidents are down to driver sleepiness; that statistic alone warrants utmost caution among those who know they aren’t sleeping well. Brake quotes:

Sleep scientist Melanie Marshall says, “Untreated, undiagnosed sleep apnoea individuals are more lethal on our roads than individuals who have been drink driving.”

Brake has great further information on Driver Tiredness, Driver Stress & Emotions, Risks for Older Drivers and Laws regarding Death by Dangerous Driving. They also have PDF documents for fleet managers containing information about how they can assist their drivers in road safety. Those relevant to sleep disorders include Stress & Distractions and Driver Assessment & Monitoring.

If you are unsure whether you are just not sleeping well temporarily or a sleep disorder might cause your sleepiness symptoms, take this free online screening test and discuss the results with your doctor. If a clinical diagnosis confirms you have a sleep disorder like Obstructive Sleep Apnoea (OSA) you are obliged to inform the DVLA.

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.

The Driver & Vehicle Licensing Agency (DVLA) has many pages on their website dedicated to tired driving and Sleep Apnoea in drivers. This PDF leaflet called “Think! Tiredness can kill!” explains the implications of Sleep Apnoea for drivers. Their D9 form tells us:

If you have ever had or presently suffer from any of the following
conditions you must write to the Drivers Medical Group, DVLA,
Swansea SA99 1TU or telephone on 0870 600 0301 with the nature
of your condition, as it may affect your fitness to drive.
FAILURE TO DO SO IS A CRIMINAL OFFENCE PUNISHABLE
BY A FINE OF UP TO £1,000.

• …
• Narcolepsy or sleep apnoea syndrome
• …

The DVLA’s medical section has all the information you need including how tell them about your sleep disorder and what happens next. Your licence can be accordingly issued, revoked or refused. In some cases they may contact your doctor, arrange to be examined or ask you to undergo a driving assessment or test. They aim to resolve most medical enquiries within 15 working days. CPAP users tend to get their licence re-issued after they confirm with the patient’s doctor that the CPAP therapy is having the desired effect.

Some people may feel opposed to risking their licence by telling the DVLA or even by seeing their doctor. After all, some rely on driving to pay their bills and food. It is important to realize the full extent of the risks you expose yourself and other road users to if you keep on driving whilst sleepy, fatigued or lethargic. It’s not just yourself who can be harmed or killed. Think about your children in the back seat or the car behind you.

UPDATE: There is a scheme called “Access to Work” run by the Employment Service (ES) which can help people with disabilities and those who’s licence has been revoked for medical reasons to regain access to work. A good write-up can be found here and an evaluation here.

The Government has produced various leaflets and posters to hit home the risks you pose. You can see some of them here and here.

Some of the slogans designed to make you take direct action:

• [Disabled Parking Sign] Every Hour A Driver With OSA Makes Someone Else Eligible To Park Here
• Daddy Used To Drive A Big Lorry, Then He Fell Asleep
• Bet You Wish You’d Crashed At A Mate’s
• You Drive For A Living But You’d Kill For Some Sleep?
• Think You Can Do The Job With Your Eyes Closed?

You can watch a video or listen to audio by the THINK! Road Safety initiative here. Also read their publication called “Wake up to the signs of tiredness” here.

If you are worried about nodding off whilst at the wheel, we urge you to do the following:

1. Take this online test today.
2. Consult your doctor and if need be, get referred to a Sleep Clinic to get diagnosed.
3. Based on the outcome of the sleep lab test, consider your sleep disorder treatment options. This can range from surgery or dental splints to CPAP or lifestyle changes and weight loss.
4. Don’t forget to tell the DVLA about your test results.
5. For some forms of treatment you may have to join the queue on the NHS waiting lists though most are available privately as well.
6. Once receiving treatment, arrange a follow-up with your doctor or sleep clinic to confirm the symptoms have sufficiently reduced.
7. Now re-apply for your drivers license, if applicable.
8. Don’t drive when feeling tired!

If you have any questions about OSA, CPAP and driving please leave them in the comments below or discuss them with fellow drivers in our forums.

CPAP in the news again. This time, we’re at the WorldSleep07 in Cairns, where Dr Monica Anderson spoke about how chronic sleep deprivation, as experienced by sleep apnoea sufferers, causes erectile dysfunction and lower libido. I guess one of those things we all know about but not hear about from the experts very often.

Dr. Anderson is a sexual health expert from Brazil and has done research proving that sleep deprivation and extreme or persistent body clock disruption has a negative impact on our sex life. In the press article, she goes on to say that some men may get so deprived of sexual activity they may develop a rare and disturbing condition called sexomnia, when their libido is heightened and initiate sex while asleep.

The article continues to say…

Studies have proven that those who are sleep deprived, particularly those with disrupted body clocks, have a much poorer libido in general.

The same complaints come from men with the night-time breathing problem, sleep apnoea, who need treatment with continuous positive airway pressure (CPAP) to help restore their erectile function.

“This is a sad product of the busy 24-hour life that we’re living now,” Prof Andersen said.

So there you have it. Not only does CPAP help OSA patients with sleep, it also aids in other areas concerning bedroom activities. I wonder how long before spammers send me e-mails pitching the latest REMStar as oppose to the infamous “V” pills that solve similar issues

I read an article in the Times Online today about “The £400 mask that promises to silence snorers - on the NHS”. The journalist, David Rose, did an OK job in reporting that the government will recommend CPAP to those with moderate or severe symptoms starting next year, but I got the impression he didn’t quite understand the topic at all.

Article: http://www.timesonline.co.uk/tol/news/uk/health/article2351411.ece

Let’s start with the title. A CPAP mask on its own does absolutely nothing. It seems like David Rose hasn’t grasped the fact that there’s an air pump of sorts at the end of it. A mask certainly doesn’t cost £400. More like £100 with another £300 or so for the machine.

He also seems to think CPAP is a cure for snoring, but fails to understand - or at least to put in proper perspective - it’s a therapy for Obstructive Sleep Apnoea (OSA) which is something else entirely. There are plenty of people who snore without any consequences other than annoying their bed partners, or neighbours. There are no OSA patients who don’t feel the consequences of their issues.

The following sentence again illustrates he has not done his homework properly, as he seems to think there is no pump involved. “The continuous positive airways pressure (CPAP) devices, worn as masks covering the nose or face, […]”.

Then comes the only exciting bit of the article:

[…] provisional details issued by the watchdog to medical experts last month indicate that the masks could be recommended for patients with moderate or severe symptoms from next year.

I’m not sure how severe the symptoms had to be for the NHS to recommend CPAP prior to this publication by the NICE, but if they now decided to increase the accessibility to CPAP therapy by lowering the symptoms threshold, that can only be a good thing for those who don’t necessarily choke every night but do experience apnoea events.

Mr Rose also fails to mention CPAP equipment can be bought privately. He reckons “[…] the treatment is currently available only through selected NHS trusts and sleep clinics, as some local primary care trusts refuse to fund it.” Of course it’s more sensational to find another way to slam the NHS but if he cares about informing his readers, he could have mentioned the fact there is an alternative to the NHS when it comes to CPAP.

In the comments we find some Times readers recognize the short-comings of this article:

Misleading - people with OSA snore but that’s not why they need CPAP. Untreated, the underlying breathing difficulty can lead to more serious health problems and expense for the NHS. I seriously doubt that NICE has sanctioned the use of CPAP for snoring in general.

One commenter summarizes his or her CPAP experience as follows:

I cannot praise CPAP therapy enough. It has given me a complete new life. I used to be exhausted even after 7 hours’ “sleep” and after 11 a.m. was useless, with my body screaming silently for sleep. Now I am fit until 22h and wake up ready to take on anything.

It’s a shame this journalist didn’t grasp the problem at hand in its entirety. OSA and CPAP can certainly do with mainstream media coverage to help awareness of both the problem as well as the solution. But this article leaves room for improvement. But then again, it does come from the paper whose journalists “have no qualms at all about the hounding, marginalisation, stigmatisation and social exclusion of public snorers“.