Overweight lorry drivers “should be screened” for sleep disorder

May 14, 2009 at 4:34 pm Leave a comment

by Tony Grew

Labour MP Meg Munn had to wait until 1.30 on Wednesday morning to begin her adjournment debate on road deaths caused by a sleeping disorder, as the House discussed the Finance Bill into the night.

Ms Munn explained that sleep apnoea is a disorder in which the upper airway repeatedly closes, causing people to wake up briefly in order to breathe.

“People with sleep apnoea wake many times an hour; their pattern of sleep is disrupted, leading to tiredness and sleepiness during the day,” she said.

“Research has shown that someone deprived of sleep has the same impairment of reaction time and judgment as someone who is over the drink-drive limit.

“One study calculated that people with severe sleep apnoea are between six and 15 times more likely to be involved in a road traffic accident.

“Sleep apnoea is also highly correlated with being overweight. The lifestyle of lorry drivers means that many are significantly overweight—they lead a sedentary lifestyle, keep unsocial hours and have unhealthy diets.

“A study of lorry drivers showed that only 11 per cent. had a body mass index of less than 25, that just over 38 per cent. had body mass indexes of between 25 and 30, which is considered to be overweight, and that 50 per cent. had body mass indexes of more than 30, which is considered to be obese.”

Ms Munn said that sleep experts believe that nearly one in six lorry drivers may have sleep apnoea.

“That is nearly 80,000 of the nearly 500,000 LGV drivers. Sufferers from sleep apnoea tend to under-report difficulties when driving, perhaps for fear of losing their licence and livelihood.

“Identification of sleep apnoea is now relatively easy. Sufferers are provided with a continuous positive airway pressure machine, or CPAP. A mask that blows air into the airways is placed over the nose during sleep.

“Sufferers breathe normally, but the slightly higher pressure of air in the nose helps keep the upper airway open.

“Almost all drivers suffering from the condition can be back at work very soon after obtaining effective treatment. Successful treatment improves their quality of life as well as that of their families.”

Ms Munn said that despite calls from a coroner for action, including regular medical screening for all lorry drivers and an amendment of the DVLA medical examination report form to improve identification of undiagnosed sufferers from sleep apnoea, nothing had been done.

“The DVLA should look again at how these forms can identify that there may be a possible diagnosis of sleep apnoea,” she said.

“One option would be a requirement that the driver’s body mass index be calculated and for the doctor’s attention be directed to the higher incidence of sleep apnoea among obese people.

“While some major businesses in road and passenger transport take sleep apnoea seriously, I am not aware of any example of a company routinely testing its drivers.”

For the government, Jim Fitzpatrick, Parliamentary Under-Secretary of State for Transport, said “up to one fifth of crashes on motorways and other main roads may be caused by drivers falling asleep at the wheel.”

He said the department “is preparing to consult the haulage industry on the UK domestic drivers hours rules. That consultation will include discussion of driver fatigue and possible means to manage it.”

“I assure her that the DVLA is looking at making its guidance notes for doctors more explicit to highlight the importance of sleep apnoea,” he said.

“However, the DVLA must have reasonable grounds for believing that somebody is suffering from a relevant disability.

“It cannot initiate medical investigations of fitness to drive unless there are reasonable grounds for believing that there is a relevant disability. The DVLA cannot screen for undiagnosed conditions.

“Investigation of symptoms, diagnosis and treatment are matters for a doctor. As in the case that we are considering, there are, unfortunately, individuals whose symptoms have not been recognised, and have therefore not been treated.

“Some drivers also press on when they feel tired and unwell. We aim to manage the problem by improving the range of information to drivers, and especially to the medical profession.”

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