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S25 Survey of the new driver and vehicle licensing authority (DVLA) guidance for obstructive sleep apnoea (OSA): uk sleep centres opinion
  1. EL Palmer,
  2. S West
  1. Freeman Hospital, Newcastle upon Tyne, UK

Abstract

Introduction and objectives The DVLA produced new guidelines ‘Assessing Fitness to Drive – a guide for medical professionals’ in March 2016. An online survey was designed to seek opinion about the guidance relating to patients with OSA, which was completed in May 2016.

Methods An anonymous online survey was designed and the survey link emailed to staff at UK sleep centres, identified from addresses held by the ARTP, BSS and SATA. It could be completed by any member of the sleep team, or more than one member. Responses were collated centrally.

Results There were 204 survey respondents, representing sleep centres of different sizes (<500 CPAP users to >10,000). They included physiologists, consultants and nurses. 77% were aware the DVLA had produced new guidelines. Only 2% stated they had received communication from the DVLA about the changes. 75% did not find the new guidance for OSA easy to follow.

62% of responders said the guidelines will cause confusion for patients and potentially stop them coming forward for treatment. 33% were unclear what advice to give to their patients.

The majority defined ‘excessive sleepiness’ based on symptoms (80%), including Epworth Sleepiness Score (ESS) >9 (28%) or >12 (56%). Only 19 people (10%) felt that apnoea-hypopnea index (AHI) >5 or oxygen desaturation index (ODI) >5 contributed to their assessment of patients’ sleepiness. 87% did not think AHI or ODI was a good way to assess a patient’s ability to drive.

72% of responders said the suggested frequency of follow-up appointments would increase their workload. 41% said their service did not have sufficient capacity to meet guidance for confirming adherence to treatment in group 2 drivers. 45% said their service could not meet the guidelines for reviewing symptoms and treatment compliance in patients with moderate/severe OSA with excessive sleepiness.

Conclusions The new DVLA guidelines for OSA are difficult to follow for the majority of sleep professionals. These guidelines may prevent patients coming forward for assessment and treatment and will stretch the capacity of many already overworked sleep services. The guidelines require urgent further review by the DVLA and discussion with sleep experts in the UK.

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