It is believed that about 20% of car accidents are sleep related and research has shown that it can impair driving more than drink. Indeed patients with OSA have a 7-12 fold chance of a road traffic accident (RTA) compared to those who do not, and treating the condition can reduce accident rates by 83%.
It has been reported that up to 1:6 Heavy Goods Vehicle (HGV) drivers may have OSA and some unions are calling for mandatory testing for all drivers. Falling asleep at the wheel results in far more serve injuries and likelihood of death as there is no attempt at braking and evasive manoeuvres.
The condition is not confined to commercial drivers and the results of a recent study of 1,000 drivers by the road safety charity Brake and Cambridge Weight Plan showed that one in eight drivers have nodded off at the wheel.
Prevalence of OSA
OSA is associated with obese patients in two-thirds of cases, but can affect anyone. With the obesity epidemic which is spreading across the world, and in particular in developed and wealthy countries, the impact on society of this chronic condition is becoming more apparent. Although about 20% of the population snore, OSA is thought to affect between 2 and 4% of the population and is at least twice as common in males as females.
In practice, overweight males in sedentary occupations (lorry drivers for example) in their 30s and 40s are the group most commonly present in the clinics, with a history of loud snoring and fatigue. They are often accompanied by their irate bed partner who is not getting any sleep due to severe snoring associated with breath-holding at night.
In the UK, only 20% of patients have been diagnosed and only half of these have been treated; and the British Thoracic Society(BTS) estimates that if you treated 59,400 you could reduce RTAs by 7,000 and over 400 lives would be saved as well as £400 million in RTA associated costs over 5 years.
The BTS also estimates that untreated OSA costs the NHS £432 million a year and a large proportion of these costs will be incurred in the treatment of the other conditions that are commonly associated with OSA; diabetes, hypertension, stroke and heart attacks.
Lincolnshire case study
In Lincolnshire, a multi-agency approach was adopted with significant success. Occupational road-related deaths in Lincolnshire averaged about 79 per year in 2006. I established the Sleeping Disorders Centre and worked in partnership with the Road Safety Partnership to promote awareness of sleep apnoea to the public. By December 2010, the number of fatal road traffic accidents had fallen from to 45. In this time the Sleeping Disorders Centre treated overd over 1,200 patients with sleep apnoea and these people are now able to drive more safely, being far less likely to fall asleep at the wheel.
The Corporate Manslaughter Act
There is good evidence to demonstrate that a third of fatalities occur while driving for work and this has serious implications for employers in the UK under the corporate manslaughter act of April 2009. Under this legislation an employer has a duty of care to an employee and there could be a strong legal argument for a claim if the employer failed to make sure that they were fit to drive.
About The Sleeping Disorders Centre
The Sleeping Disorders Centre, a new and innovative service led by consultant surgeon Mr Michael Oko, provides an accurate and prompt diagnosis of various sleep problems including sleep apnoea and snoring and helps to identify the most appropriate treatment for both NHS and private patients.