How a respiratory problem can cause road deaths
Sleep Apnoea Obstructive sleep apnoea leads to road accidents. It's time to tackle the issues that stop workers and professional drivers from coming forward to be tested.
Snoring is often treated as a joke, but it can be the sign of a condition that results in many accidents due to excessive daytime sleepiness.
"This is a potential health and safety issue for everyone, but particularly to lorry and coach drivers.”
“Snoring is a major indicator of obstructive sleep apnoea (OSA), which causes disturbed sleep and, in some cases, daytime sleepiness. This is a potential issue for everyone, but particularly when it happens to lorry and coach drivers,” says John Stradling, Emeritus Professor of Respiratory Medicine at Oxford University.
“Many lorry drivers – and others – have died because OSA often goes unrecognised or untreated and the current system actively discourages drivers who may have OSA from coming forward,” he says.
OSA is not taken seriously
People consulting their GP about daytime sleepiness are often not taken seriously or are tested for other conditions that present with tiredness or fatigue. If they are referred to a sleep clinic – the essential first step in diagnosing and treating OSA – it can take months to get an appointment. Meanwhile they are likely to be forbidden to drive.
“For a professional driver, this can mean losing their job,” says Stradling. “As a result, professional drivers are reluctant to request testing, especially if they are self-employed.”
"People are often not taken seriously, or just diagnosed as tired: it's costing them their jobs."
Stradling is part of a group battling to change the situation. “Through the OSA Partnership Group, which includes physicians, haulage contractors and motorists' associations, we are pushing to raise awareness of the OSA problem and institute a nationwide 'fast track' system for professional drivers, which takes them from initial GP consultation through to a sleep clinic test and, if necessary, to treatment within four weeks – a period that the road haulage groups have said would be acceptable to most haulage companies.'
“This can be done,” says Stradling. “Some clinics, such as in Newcastle and Oxford already offer this, but many cannot. It requires no extra money, just a bit of reorganisation.”
Dispelling the OSA myths
Getting action on the OSA health and safety issue also requires dispelling myths about OSA. “OSA does not just affect overweight people – a third of OSA patients would not be classified as obese – though it can be exacerbated by extra weight. It is not an issue confined to overweight individuals, though with an average BMI of 32, lorry drivers are at greater risk,” he says.
While not all people who snore have OSA, almost all people with OSA snore.
"The typical OSA patient is male, 55 and with a long history of snoring and recent daytime sleepiness."
There are no exact figures for the number of road accidents caused by OSA-linked daytime sleepiness but, Stradling says: “Typical accidents caused by sleepiness include running off the road and ploughing into slowing or stationary vehicles in front. When lorries jack-knife, it is often because the driver has braked and over-corrected his steering after nodding off.”
Stradling adds: “GPs also need to be aware of OSA, and should ask specifically about daytime sleepiness, not just general tiredness. All these things can be done and we must do them to encourage professional drivers to come forward so they – and the public – are safer on the roads.”