Sleep apnea drivers often mum to authorities

VIENNA (Reuters Health) - While UK drivers with sleep apnea are required to inform the Driver Vehicle and Licensing Agency (DVLA) of their diagnosis, they often fail to do so, according to research released at the 2009 European Respiratory Society annual congress.

In sleep apnea, a person wakes up repeatedly during the night due to a partial or complete airway collapse that obstructs breathing. The condition causes daytime sleepiness, and has been linked to impaired driving and greater accident risk.

In the UK, a patient diagnosed with sleep apnea is legally required to report their diagnosis to the DVLA. The DVLA has the authority to determine if the patient is fit to drive.

Moe Kyi, MRCP, registrar in Respiratory Medicine at the Sheffield Thoracic Institute (UK), and colleagues wanted to see how good their patients are at informing the DVLA about their diagnosis of sleep apnea.

Individuals who contact the DVLA in writing are evaluated by a DVLA doctor, who assesses the patient and then contacts the patient's doctor to discuss the patient's fitness to drive. Patients who contact the DVLA by telephone are evaluated by non-medically trained call center staff.

Kyi's team found that only 79 of 271 sleep apnea patients -- about 29 percent --had appropriately informed the DVLA of their sleep apnea.

The remaining 192 patients were sent a reminder letter reiterating instructions to contact the DVLA along with a DVLA information brochure entitled "Tiredness Can Kill."

Overall, 65 of 192 patients (34 percent) who were sent a reminder letter subsequently contacted the DVLA by telephone and were told they were fit to drive.

In the investigators' opinions, however, 24 of these 65 patients were unfit to drive, reflecting about a 37 percent discrepancy between doctor and call center assessments.

"About one-third of patients whom we had deemed unfit to drive were considered fit to drive by call center staff," Kyi said.

"We think there are big loopholes in the present system," Kyi told Reuters Health.

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