Driving When You Have Sleep Apnea

What is Obstructive Sleep Apnoea Syndrome (OSAS)?

OSAS, is believed to affect at least 100,000 people in Ireland. Those affected stop breathing briefly on repeated occasions while they are asleep.

Sleepiness and driving

Driving is a complex task that can be impaired by a driver’s physical, mental and emotional health, including fatigue (tiredness). There is good evidence that sleepiness and fatigue account for 15 – 20% of all road traffic crashes. Many of these sleep-related crashes are as a result of lifestyle issues – such as driving without adequate sleep. However, some are due to medical conditions.

Why is health important for drivers?

Your health is important, as driving any motor vehicle requires:

• constant attention;
• good judgement;
• appropriate responsiveness;
• reasonable perception and physical capability; and
• good senses – for example, sight and hearing.

Why is it important I am fully fit to drive?

The Road Safety Authority (RSA) and the National Driver Licence Service (NDLS) aim to minimise the risk caused by any medical condition you might have both to you and to the community. Indeed, for many conditions, treatment and rehabilitation may improve your safety when driving.

We also want to give consideration to your social, lifestyle and employment-related mobility and independence. Our aim is to help you be as independently mobile as possible for as long as possible. However, it is important to strike the right balance between mobility and safety for drivers, their families and other road users.

If you drive against advice, and evidence is found of this, the NDLS and the Gardaí will take action to revoke your licence. If you are involved in a crash or stopped by a member of An Garda Síochána, you may be asked to prove you are in full control of your vehicle. A charge can be brought against you even if you don’t have a crash. If you cause harm to a person or property, the charge will be more serious. In these circumstances, driving becomes a statutory offence that may lead to a prison sentence. Finally, driving against medical advice will affect your car insurance.

The NDLS aims to maximise drivers’ mobility and to encourage patients with OSAS to seek diagnosis and effective treatment. Treated patients no longer pose an increased crash risk.

However, it is important to ensure that an appropriate balance is found between mobility and safety.

Why does OSAS affect driving?

Although you may not realise it, OSAS interrupts your sleep and may result in daytime sleepiness, which could cause you to fall asleep at the wheel. Signs of sleep apnoea include loud snoring, disturbed sleep, fighting for breath during sleep and falling asleep in the daytime. Drivers with OSAS are three times more likely to have a road traffic crash than the general population, but this increased risk is avoided with effective treatment.

What are the actual rules about OSAS, and do I need to stop driving?

Drivers with moderate or severe OSAS which causes excessive daytime (awake-time) sleepiness, and who do not follow the rules below (while driving), are driving while unsafe to do so and are breaking the law.

Group 1 drivers – driving a car, motor cycle or tractor n You must not drive until your symptoms are under control and can be kept under control with ongoing treatment. This must be confirmed by a medical professional. Also, you will need to have regular medical reviews. n You must also notify the NDLS.

After that, a 1-3 year licence may be granted.

 Group 2 drivers – driving a bus or truck n You must not drive until your symptoms are under control and can be kept under control with ongoing treatment. This must be confirmed by a medical professional. n You must also notify the NDLS. n You will have your licence reviewed regularly – usually every year.

How is OSAS diagnosed?

OSAS is diagnosed by combining the results of a sleep study and an assessment of how sleepy the patient is.

Be aware of these warning signs:

Trouble keeping your eyes open or focused

Continual yawning

Not being able to remember driving parts of your journey.

Should I keep a Sleep Diary?

 It may be helpful to keep a record of:

how many hours you sleep each night,

how often you awaken during the night and for how long,

how long it takes you to fall asleep,

how well rested you feel upon awakening, and

how sleepy you feel during the day. As you may not be aware of some symptoms, ask your sleeping partner if you snore loudly, snort or gasp for breath, or have jerking movements. You may also perspire at night or have morning headaches.

If you have the above symptoms, your doctor may refer you to a sleep specialist for further investigation and help. Ultimately, the onus is on you – the driver – and your sense of social responsibility not to drive if you are sleepy.

OSAS is included in the Irish driving licence regulations (as required by Directive 2014/85/EU) and the regulations are set out in Sláinte agus Tiomáint: Medical Fitness to Drive Guidelines available on www.ndls.ie.

 Do OSAS and sleep-related crashes have any particular distinguishing features?

Yes. Usually, OSAS and sleep-related crashes have the following features in common:

• They are single-vehicle collisions.
• The driver is alone in the vehicle and does not attempt to avoid the crash.
• The crash is likely to be serious and occur on a high-speed road.
• The crash occurs either late at night, early in the morning, or mid-afternoon.

What if I disagree that my sleep patterns are a problem?

You can get a second opinion. You must not drive until this opinion agrees that your sleep problems are not problematic.

What will happen if I continue to drive?

It is important to strike a balance between mobility and safety. If you continue to drive against medical advice or ignore early warning symptoms, and evidence is found of this, it will affect your insurance, and the NDLS and the Gardaí will take action to revoke (cancel) your licence.

Be a responsible driver

It is your responsibility as a driver to:

• follow your doctor’s advice
• take your prescribed medication correctly and consistently 
• monitor and manage your medical condition(s)
• tell the NDLS and your insurance provider if you have a long-term or permanent injury or illness that may affect your ability to drive safely
• meet the requirements of your licence, including going for regular medical check-ups to make sure that your symptoms are managed well for safe driving
• get professional medical advice on your medical fitness to drive, which might include training with an On-Road Driving Assessor (ORDA) or Occupational Therapist (OT)
• You should get further professional medical advice if you develop a new medical condition or if your medical condition changes.

If I need to, how do I inform the NDLS?

If following a consultation with your doctor, your medical condition is one that must be notified to the NDLS you will need to have a medical report form completed and make an application for a change of personal (medical) details.

This can be done by 

– applying in person at an NDLS centre, which is by appointment only.

Please see www.ndls.ie/how-to-apply/applying-in-person

– applying online*, provided you have a Public Services Card and a verified MyGovID account.

 *If you have a code 101 on your existing licence and you are not renewing and you wish to update your medical details you will need to attend an NDLS centre to have this done.

Source: NDLS

What is the treatment for OSAS?

Further information:

Your doctor will advise you on your condition and where and how to seek help.

Web Irish Sleep Apnoea Trust: http://www.isat.ie/

Tel: (086) 605 3891

 Sláinte agus Tiomáint: Medical Fitness to Drive Guidelines is available on www.ndls.ie

Every heavy snorer does not need treatment however any snorer is a potential obstructive sleep apnea patient. So, if you have loud snoring which disrupts your sleep, causing excessive daytime sleepiness/tiredness that is having an effect on your driving, you need to see a sleep specialist.

People often do not know where to start. The first step is to get in touch info@beacondentalsleep.ie or call 01 213 5644 to discuss your specific concerns and let us help you solve the problem and regain control of your night-time sleep.

About the Beacon Dental Sleep Medicine Clinic

Located in the Beacon Consultants Clinic in Sandyford, our facility collaborates with major hospital sleep disorder clinics and other specialists and have been active in the development and use of oral sleep appliances in the area of Dental Sleep Medicine in Ireland over many years.

We utilise a range of new technologies and treatment approaches. These include the use of customised digitally fabricated oral devices with specific sensor technology use to enable monitoring for ongoing evaluation.

As a result, the clinic has been successful in assisting many patients, and oftentimes also importantly, their sleep disrupted partners, in achieving more optimal and healthy sleep experiences.

To book an appointment with the Beacon Dental Clinic, click here 

Click here to download the Beacon Dental Sleep Patient Brochure

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