Sleep Apnoea DVLA Guidance for Drivers

This article provides essential information for Group 1 and Group 2 drivers regarding Obstructive Sleep Apnoea DVLA guidance, focusing on the DVLA’s approach to diagnosis, notification, and driving with the condition.

Introduction to Obstructive Sleep Apnoea (OSA)

Obstructive Sleep Apnoea (OSA) is a widespread yet often under-diagnosed condition that affects both breathing and sleep. It is characterised by intermittent breathing disruptions caused by the narrowing or blockage of the upper airways during sleep.

Key characteristics of OSA include:

Loud snoring
Breath cessation or shallow breathing (apnoea or hypopnoea)
Excessive daytime sleepiness

In the UK, it is estimated that around 1.5 million individuals are affected by OSA, although many remain undiagnosed.¹

OSA is strongly associated with various health risks, including:

Cardiovascular diseases, such as hypertension and ischaemic heart disease.²
Stroke.³
Increased risk of motor accidents, which is a key concern for drivers.⁴

2. DVLA Classification of Drivers and Vehicles

The DVLA classifies drivers into two main groups:

Group 1: Drivers of small cars and motorbikes.
Group 2: Drivers of vehicles weighing over 3.5 tonnes or carrying more than 8 passengers (including the driver). This includes HGVs, LGVs, buses, minibuses, and other large vehicles such as ambulances, fire engines, and police vans.

The DVLA’s approach to OSA applies similarly to both Group 1 and Group 2 drivers, with the key focus being whether the condition is associated with excessive daytime sleepiness, which can impair driving ability.

3. What do you mean by excessive sleepiness

The DVLA’s primary concern is whether the condition causes excessive sleepiness, which can significantly increase the risk of accidents.

Symptoms of excessive sleepiness that may impair driving include:

Nodding off while driving
Hitting the side of the curb or vibration strips on highways
Frequently using alertness strategies such as drinking caffeinated beverages or listening to loud music to stay awake ⁵

If you experience any of these symptoms, it is crucial to stop driving and seek medical advice promptly.

4. DVLA’s Approach to Sleep Apnoea

The DVLA classifies OSA into two primary groups:

With Excessive Sleepiness
Without Excessive Sleepiness

For those with excessive sleepiness, OSA is further categorised by severity:

Category 1: Mild OSA
Category 2: Moderate to severe OSA

5. Steps to Take If You experience daytime drowsiness or tiredness

If you experience some or all of the symptoms above, then follow these steps:

Consult your GP: If your GP suspects you may have OSA and that your symptoms of tiredness could affect your driving safety, you must stop driving and your GP will refer you to a Sleep Clinic.
Referral Process: The wait time for a referral depends on the clinic’s availability. However, if driving is essential to your livelihood, or if you transport someone who depends on you, your GP can fast-track your referral as per NICE guidelines.⁵

6. What Happens at the Sleep Clinic?

At the Sleep Clinic, the healthcare team will assess your symptoms using a combination of:

Health questionnaires
Sleep study (polysomnography), which is a non-invasive test that monitors your sleep overnight to help identify the cause of your symptoms.

This will determine whether OSA is contributing to your excessive sleepiness.

7. What Happens if I’m Diagnosed with Sleep Apnoea with Excessive Sleepiness?

If you are diagnosed with OSA with excessive sleepiness, you must clarify the severity of your condition with your specialist. The severity determines your next steps with the DVLA:

Mild OSA with Excessive Sleepiness: You do not have to inform the DVLA immediately. You have 3 months to get the condition under control. If not, then you must notify the DVLA. In the meantime, you must not driver your vehicle.
Moderate to Severe OSA with Excessive Sleepiness: You must notify the DVLA immediately and stop driving until the condition is managed.

This applies to both Group 1 and Group 2 drivers.

8. Can I Drive an HGV with OSA?

Yes, Group 2 drivers (HGV, bus, etc.) diagnosed with OSA may still be permitted to drive, provided they meet the following criteria:

OSA is under control.
No excessive sleepiness.
Compliance with treatment, such as using CPAP therapy.

9. How Will the DVLA Know If My Condition is Under Control?

To confirm that your OSA is under control, the DVLA will require confirmation from your treating specialist. It is recommended that you contact the DVLA in writing to inform them of your condition and provide the details of your specialist. The DVLA will then communicate with your healthcare provider to ensure your condition no longer impacts your ability to drive safely.

For more guidance on how and when to notify the DVLA, refer to the Sleep Apnoea Trust’s information page which you can access from here

Conclusion

If you are diagnosed with Obstructive Sleep Apnoea, it’s essential to understand the DVLA’s guidelines on when to notify them and whether you are fit to drive. If you experience excessive daytime sleepiness, you must stop driving and seek medical advice. Taking the necessary steps to manage your condition not only ensures your safety but also the safety of others on the road.

Disclaimer

The information provided in this article is for informational purposes only and should not be considered a substitute for professional medical advice, diagnosis, or treatment. Always seek the guidance of your healthcare provider with any questions you may have regarding a medical condition. Do not disregard professional medical advice or delay seeking it because of something you have read in this article.

Refrences:

1- Toolkit for commissioning and planning local NHS services in the UK Obstructive Sleep Apnoea (OSA). (2015). Available at: https://www.asthmaandlung.org.uk/sites/default/files/OSA_Toolkit_2015_BLF_0.pdf.

2- Nishida, Y., et al. (2013). “Obstructive sleep apnea and cardiovascular disease.” Journal of the American College of Cardiology, 62(6), 481–489.

3- Obstructive Sleep Apnea and Risk of Stroke: A Systematic Review and Meta-Analysis.” Journal of Clinical Sleep Medicine, 10(2), 77-83.Obstructive Sleep Apnea and Risk of Stroke: A Systematic Review and Meta-Analysis.” Journal of Clinical Sleep Medicine, 10(2), 77-83.

4-Findley, L. J., et al. (2011). “Sleep apnea, driving, and motor vehicle accidents.” Sleep Medicine Reviews, 15(2), 77-85.

5- British Thoracic Society. (2018). POSITION STATEMENT DRIVING AND OBSTRUCTIVE SLEEP APNOEA (OSA) 2018. [online] Available at: Position%20Statement%20on%20Driving%20and%20Obstructive%20Sleep%20Apnoea%20(5).pdf [Accessed 19 Nov. 2024].

‌6- SATA Patient Information Sheet Detailed DVLA Guidance for UK Drivers with Sleep Apnoea Revised -August 2021. (n.d.). Available at: https://sleep-apnoea-trust.org/wp-content/uploads/2022/03/SATA-Detailed-DVLA-Guidance-for-UK-Drivers-with-Sleep-Apnoea-Aug-2021.pdf.

7- Mayo Clinic (2018). Polysomnography (sleep study) – Mayo Clinic. [online] Mayoclinic.org. Available at: https://www.mayoclinic.org/tests-procedures/polysomnography/about/pac-20394877.