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BTS issues new guidance on driving and sleep apnoea

The British Thoracic Society (BTS) has published an updated position statement on driving and obstructive sleep apnoea (OSA). The latest guidance follows recent legislative changes in this area.

The new position statement has been designed to meet the updated ‘Excessive Sleepiness including OSA’ section of the Driver and Vehicle Licensing Agency (DVLA) assessing fitness to drive guide, issued in October 2017. The BTS says it is crucial that patients are not deterred from seeking advice and treatment for OSA because of concerns about driving and potential loss of licence and livelihood. Generic statements to “stop driving and notify the DVLA”, in the absence of any informed assessment of sleepiness or OSA, have caused some patients to lose their livelihoods when they were not sleepy and did not have OSA on subsequent assessment, it reports.

The organisation strongly supports a fast-track pathway for professional drivers, where OSA can be diagnosed and treatment initiated within 4 weeks of referral. It states that such a system would give drivers the confidence to present with symptoms suggestive of OSA.

The new position statement advises that the Epworth Sleepiness Scale (ESS) alone is unlikely to adequately determine when sleepiness is likely to adversely affect driving. It points to the American Thoracic Society guidelines which suggest a high-risk driver is one who has moderate to severe daytime sleepiness (ESS of >17/24) plus a recent motor vehicle collision (MVC) or a near‐miss attributable to sleepiness, fatigue or inattention. The American Thoracic Society found no compelling evidence to restrict driving privileges in patients with OSA without an MVC or equivalent event.


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