British Snoring & Sleep Apnoea Association

Much as I'd like to give you a clear-cut answer, I can't, except to say that there may be a bit of a difference in the rules governing driving when one has OSA and when one has MS.

Some time has gone by since you posted, and I think, if I recall correctly, that you have now had a diagnosis confirmed. If you have been issued with a xPAP machine, you will need to be compliant (using it for 4 hours every night as a minimum) to be ok on the road. I hope other posters who live in the UK (I don't) will tell you the exact rules, or pm Nuneatonman37 or Mac as they know a lot more than I do.

I have an unusual (though probably far from unique) problem in this respect; the London Borough of Lambeth have decided to withdraw concessionary Disabled Freedom Passes at short notice, which is a severe problem for me due to my many hospital appointments and such, so I'm trying to apply for a full Disabled Freedom Pass. To this end I'm going to apply to the DVLA for a provisional driving licence, in the hope that my application will be rejected on medical grounds other than drug abuse (Criterion F of the national Disabled Freedom Pass criteria); if it is, Lambeth will be legally unable to refuse me a pass.

My situation is that as well as being on CPAP for four years now, I am also type 2 diabetic and have been insulin dependent for just over a year. I think that either of these might not be enough to get my application rejected, but will both of them together swing it? (One long-term problem I have is that I find it quite easy to doze off on motor vehicles; perhaps I should mention that.)

As far as I am aware having sleep apnoea (especially controlled by CPAP) and type 2 diabetic (even if on insulin) is not enough criteria to be considered disabled and eligible for a Disabled Freedom Pass, unless of course you have other physical disabilities. I also don't think that the DVLA will necessarily see Sleep Apnoea and Type 2 Diabetes as a reason for refusing you a provisional driving license because as long as they are both under control (and you do use CPAP and have regular diabetes checks) I don't see that there is a reason to.

You say that you fall asleep when you are in a car, lots of people do when they are passengers. When I was learning to drive I never felt drowsy at the wheel, I was too busy concentrating but if I was a passenger I could drop off quite quickly. I would also say that if you are still falling asleep in a car even as a passenger and are on CPAP that you should mention this to your CPAP clinic as they may need to adjust your pressure. As soon as I got my CPAP machine my falling asleep in a car was significantly reduced and now it only happens if I'm really tired, have to say though that I gave up driving after failing my test for the 4th time at 54. Also, when I told the DVLA that I had to use a CPAP machine they said it was fine for me to continue learning to drive.

I think if you apply for a provisional licence that they will more than likely let you have one even with sleep apnoea and T2 diabetes.

This topic is quite old and maybe things have changed a little but I'm sure people will be asking the same questions. So here are the categorical answers - I know because I have just been through the system.

Yes it is the law that you MUST tell the DVLA. No exceptions.

You MUST NOT drive if you have been diagnosed with OSA. This is effective immediately and remains so until your doctor/consultant tells the DVLA that your OSA is being successfully treated.

Do not believe those reassuring web sites which say that the DVLA will not stop you driving until they have investigated your case. That is not true. They suspend your licence the moment you tell them.

Your licence will be invalid - and your insurance probably also invalid - even if you don't tell them, once you have been diagnosed.

I went to my doctor because I reckoned I was more tired in the day than I should be. I did the Epworth test and scored 13 which is borderline. I have never fallen asleep driving and am not aware of any lapses of concentration which are attributable to tiredness. My only concern was dozing off unintentionally while working at the computer. Niothing to do with driving.

My doctor did not mention the possible repercussions with driving but booked an appointment with the respiratory department, which did not come through for about six months. Presumably I was driving around with the "7 to 12 times" higher risk of an accident than all the shouting screaming thugs and drunks who infest the roads.

But then I was offered an overnight oximetry test. Thanks to a certain amount of managing my sleep, my Epworth score by then was 8 which is normal. But the test showed severe OSA (I must have had it for years) and being a law abiding person I asked the DVLA what to do. And was suspended there and then. They were not interested in my Epworth score nor even my AHI. Just the magic words "sleep apnoea". I'm glad I'd had the forethought to get my car home before I phoned them.

I am now in a queue of 22 people, waiting for CPAP machines. Presumably we're waiting for 22 existing users to die. So I expect to be grounded for at least a couple of months. The one good bit of news is that people who drive for a living are fast-tracked. But the rest of us are treated like criminals.

Hope this is useful to someone. I have one more thing to say.

Grrr!

I was diagnosed a few years ago now and was learning to drive at the time. I rang the DVLA and told them I'd been diagnosed and had been given a CPAP machine (I was very lucky to do the test at home one weekend, take it to the clinic on the Monday and come home with a CPAP machine!). I gave them my details and the hospital contacts and they said that as I was on CPAP they wouldn't suspend my provisional licence.

At no time did I feel like I was being treated like a criminal, the fact is though that I would've been negligent if I'd driven without telling them and being on CPAP would've made me a criminal. I was lucky as from the time I saw my GP till the time I got my machine was around 3 months but I don't think you being no. 22 on a waiting list means you've got to wait for someone to die! That's ridiculous, you don't die from sleep apnoea unless you've got damage to your internal organs through not using your CPAP machine or you drive without being on CPAP.

Its unfortunate that you have to wait but this can also be down to funding in your area, I hope that your wait isn't too long and that you have everything under control soon.

Oh-oh! I have been using CPAP for a few weeks now, but haven't notified the DVLA. Before you all start jumping at me, I have the following reasons:

1: According to my Embletta test result, I DON'T have OSA, but am very "symptomatic" due to a high Epworth score. This is making me feel like some kind of guinea pig.
2: Although my husband has a car, I cannot drive due to it having a MANUAL gearbox as my driving licence entitles me to drive "AUTOMATIC" cars!!!
3: I'm waiting to attend my check up at the end of the month. I want to find out exactly what data gets picked up by the CPAP data card (if anything). Will I be "compliant"?
4: However, I feel quite nervous getting behind the wheel due to the attitude of other roads users in my local area.
5: Due to reason 3, I haven't GOT a car.......

Any answer to my problem would be appreciated.....

I still haven't informed the DVLA yet, still no car! But I had received a copy of a letter sent to my GP after I asked him if he heard from the sleep clinic regarding my check up...

Anyway here goes:

"Dear DR N,

Tiredtracey- D.O.B: sometime in the 1970s
Lives in Basildon, Essex

Thank you for your letter date 1st August regarding Tiredtracey.

She was referred to us with a history of tiredness and snoring. She had an Epworth score of 16/24 in my clinic and 18/24 in our sleep laboratory, suggesting she was significantly sleepy. (YES, dear doc, I'm shattered!!) Indeed, her EMBLETTA test was in the normal range (Didn't feel normal, going home on the bus with that gear on!!!); however, in patients who are significantly hypersomnolent there are two options open to us:

(1) Place them on a trial of CPAP therapy, to see if their symptoms improve: you may be aware that there is a condition called upper airway resistance syndrome where the actual apnoeas and hypopnoea and desaturations may not be at significant levels; however even mild obstruction can cause a poor sleep and consequent hypersomnolent.

(2) To repeat the sleep test: (Not the EMBLETTA palaver -AGAIN! ) In view of the upper airway resistance syndrome, which can only be diagnosed by oesophageal manometry, (EH? ) we provisionally provide a trial of treatment which is occured in Tiredtracey's case. It is our experience that a number of these patients do benefit from CPAP therapy, with significant improvement in symptoms (funnily enough, I do notice the difference when I forget to wear to the face hugger!). In fact, we are in the process of writing a paper on this. (I knew it! I am a snoring guinea pig!!!! )

Coming back to your query; you are absolutely right there is no objective evidence of objective (think he meant "obstructive") sleep apnoea on the single test ( I had two tests! The oximeter wrist watch thingy and Embletta get up! Best of three tests anyone???); perhaps a repeat test or a more extensive polysomnogram may reveal more insight. In any case; as she is sleepy, I have opted to call her condition 'upper airway resistance syndrome' (Hmmm, sounds like it could be a "pre- condition" to OSA. Wonder if the DVLA know about it???) and place her no (must mean "on") a CPAP; however, if CPAP does not benefit her, the plan of action would be to investigate further with a full polysomnogram if required. (Does this mean I could sleep and snore as much as I like in the name of medical science!!!!)

As far as driving in concerned; the DVLA regulations state that hypersomnolence, of any cause should be follwed by cessation of driving (I haven't driven since passing my test in November 2011!!!) until treatment has been started that particular condition.

Iwould suggest that Tiredtracey does not drive until she feels better. ( I do feel better, even more so if I had a flaming car!)

We also inform our patients that is their obligation to inform the DVLA of their condition (right, I will do now, since a name has been given to it!!) and we strongly advise that they do so. after treatmenty has been started and found to be effective; in Tiredtracey's case this would be if CPAP is beneficial for her ( you don't speak to your sleep team??), then there should be no implications to driving; however whilst the intial trial has been carried out we advise all of our patients not to drive, as per DVLA regulations.

I hope this clarifies your questions. I have copied this letter to Tiredtracey for her information. (Thank you very much, dear Sir! )

She is due to be seen again in our Pulmonary Physiology and Sleep Laboratory in July 2013 but she is aware that she can contact them if she has any problems with her equipment. (I hope he means CPAP..... )

If you (or Tiredtracey) have any further questions then please do not hesitate to contact me again.

Your Sincerely


Dr J.S
Consultant Physiscian
Respiratory Medicine"

So, that clears it up then!

at the commentary !!

Oh hell!!!! I can't find the counterpart to my licence. Where did I put it?????

Dan, do I still qualify to be a member of this lovely forum after reading this little snippet of information??????


Link: http://www.en.wikipedia.org/wiki/Upper_ ... e_Syndrome

Just some points:
1) I snore EVEN when sleeping on my side
2) I have the very occasional glass of wine
3) If I go for further tests, where does "the probe" as mentioned in the article go?
OOO-Er missus!!!

Just a thought: If "Upper Airway Resistance Syndrome" was abreievated to it's initials: U.....A.....R....S.....Well, is it just me or does it sound like an insult!!!
("You Ass!" or another similar word...)

Hi,

I'm new to this forum and I've had a look through the various answers but I couldn't see an answer to a couple of questions so apologies if you've discussed these before :

- Do you have to notify DVLA if the diagnosis has not yet been confirmed ie you've not seen a consultant yet or had any tests (apart from Epworth)?

- I score only 6 on Epworth unless the temperature gets above about 19 Degrees centigrade then the score goes up to about 16. Is this normal or does it indicate that there's some other problem?

CG3

Hi ,
To answer your above questions,

How can you notify when you have not been diagnosed with anything yet ??? so answer is NO

Epworth score of 6 is very low would not be a indicator of osa
score of 16 would be more likely be osa related ???

Regards,

Im taking driving lessons atm and I know its bad, but until they ask if I have sleep apnoea face to face, Im not telling them

If you have been diagnosed with sleep apnoea it is your legal duty to advise the DVLA - I had to when I was learning and I was first diagnosed. If you have an accident whilst driving you will not be covered by any insurance if you haven't informed them, and you will be fined at least £1000 and possibly lose your license. It is not worth taking the risk, you must tell your driving instructor and inform the DVLA, if you don't your GP or clinic might do it and you will risk losing your license until you can prove that you have it all under control.

It is really irresponsible not to tell the authorities and at least your driving instructor. Tell them asap.