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Abstract
Introduction In 2013 a BTS survey showed substantial variability in the advice that patients with obstructive sleep apnoea syndrome (OSAS) would be likely to receive from clinicians with regard to whether they were fit to drive or not. Since then the BTS has issued guidance and the DVLA changed its emphasis to sleepiness “likely to impair safe driving”, rather than sleepiness in general. The survey was divided into two parts, the first focusing on patients at presentation and the second after treatment, with the wording of the questions reflecting that used in the DVLA forms. We repeated this study in 2016 to assess whether these changes had resulted in greater consistency. Additional questions about BTS and DVLA guidance were included.
Methods Web based survey of members of BTS, BSS and ARTP.
Results 304 respondents. The vignettes at diagnosis are directly comparable between the surveys and the results are very similar (p = NS). In the most contentious case there remains an approximately 50:50 chance of a patient receiving opposing advice.
Significant variation in the assessments of control of patient’s condition, improvement in sleepiness and compliance after treatment remains (Figure 1). 2 36% were not aware that the BTS have issued a statement 63% felt the change in emphasis from excessive sleepiness to sleepiness likely to impair safe driving helpful. 64% of respondents were not aware that DVLA had changed its guidance in January 2016. 18% of respondents advise patients to inform the DVLA when diagnosis felt to be likely based on symptoms. 57% when diagnosis confirmed following investigation, 13% when CPAP first trialled and 12% when CPAP issued to the patient.
Conclusions The results of the 2016 survey confirm the results of the 2013 survey. Disappointingly the guidance from the BTS appears to have had little impact. The change in emphasis from excessively sleepy to sleepiness likely to impair safe driving was felt to be helpful by a small majority. There is a clear need for tools which are felt to be robust by clinicians and patients to help make decisions about fitness to drive and for these to be disseminated to clinicians.
